Clin Colon Rectal Surg 2021; 34(03): 186-193
DOI: 10.1055/s-0040-1722765
Review Article

Proctorship in Minimally Invasive Colorectal Surgery

Assad Zahid
1   St Mark's Hospital, London, United Kingdom
2   University of Sydney, Australia
,
Danilo Miskovic
1   St Mark's Hospital, London, United Kingdom
› Author Affiliations

Abstract

Teaching an established surgeon in a novel technique by a colleague who has acquired a level of expertise is often referred to as “proctoring” or “precepting.” Surgical preceptorships can be defined as supervised teaching programs, whereby individual or groups of surgeons (proctors) experienced in a certain technique support a colleague who wants to adopt this technique (sometimes referred to as “delegates” or “preceptees”). Preceptorship programs really focus on a specific technique, technology, or skill which is required to broaden, complement, or transform an established surgeon's practice.

Within colorectal surgery, in the past 30 years, there is been an evolution of interventional options including open, laparoscopic, robotic, and endoscopic procedures. With each new emerging technology and technique, safe and effective uptake by established surgeons is best been attained by a period of proctorship by an experienced colleague. Formalizing this has been facilitated largely through industry support. There, however, remains a considerable chasm when it comes to standardization, quality control, and jurisprudence.

This article aims to describe the requirements for a contemporary proctorship program, to examine instruments of quality control, and how to improve effectiveness.



Publication History

Article published online:
29 March 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Zorn KC, Gautam G, Shalhav AL. et al; Members of the Society of Urologic Robotic Surgeons. Training, credentialing, proctoring and medicolegal risks of robotic urological surgery: recommendations of the society of urologic robotic surgeons. J Urol 2009; 182 (03) 1126-1132
  • 2 Prinsloo T, Van Deventer JP. Using the Gartner Hype Cycle to Evaluate the Adoption of Emerging Technology Trends in Higher Education – 2013 to 2016. In: Emerging Technologies for Education. Cham: Springer International Publishing; 2017: 49-57 (Lecture Notes in Computer Science; vol. 10676)
  • 3 Soot SJ, Eshraghi N, Farahmand M, Sheppard BC, Deveney CW. Transition from open to laparoscopic fundoplication: the learning curve. Arch Surg 1999; 134 (03) 278-281 , discussion 282
  • 4 Miskovic D, Wyles SM, Carter F, Coleman MG, Hanna GB. Development, validation and implementation of a monitoring tool for training in laparoscopic colorectal surgery in the English National Training Program. Surg Endosc 2011; 25 (04) 1136-1142
  • 5 Moran MR. The learning curve for laparoscopic colorectal surgery. Arch Surg 1997; 132 (08) 931-931 , author reply 931–932
  • 6 Mackenzie H, Dixon AR. Proficiency gain curve and predictors of outcome for laparoscopic ventral mesh rectopexy. Surgery 2014; 156 (01) 158-167
  • 7 Zahid A, Hong J, Young CJ. Coaching experts: applications to surgeons and continuing professional development. Surg Innov 2018; 25 (01) 77-80
  • 8 Greenberg CC, Klingensmith ME. The continuum of coaching: opportunities for surgical improvement at all levels. Ann Surg 2015; 262 (02) 217-219
  • 9 Schwellnus H, Carnahan H. Peer-coaching with health care professionals: what is the current status of the literature and what are the key components necessary in peer-coaching? A scoping review. Med Teach 2014; 36 (01) 38-46
  • 10 Ericsson KA. Acquisition and maintenance of medical expertise. Academic medicine. Royal Australasian Coll Surg 2015; 90 (11) 1471-1486
  • 11 Ericsson KA, Smith J. (Eds.). Toward a general theory of expertise: Prospects and limits. Cambridge University Press; 1991
  • 12 Zahid A, Hong J, Young CJ. Surgical supervisor feedback affects performance: a blinded randomized study. Cureus 2017; 9 (05) e1276
  • 13 Münster T, Stosch C, Hindrichs N, Franklin J, Matthes J. Peyton's 4-Steps-Approach in comparison: medium-term effects on learning external chest compression - a pilot study. GMS J Med Educ 2016; 33 (04) Doc60
  • 14 Coleman M. Lapco: national training programme for laparoscopic colorectal surgery. The Bulletin of the Royal College of Surgeons of England. Royal Coll Surg Engl 2015; 91 (08) 274-275
  • 15 Coleman MG, Hanna GB, Colorectal RK. The National Training Programme for laparoscopic colorectal surgery in England: a new training paradigm. Wiley Online Library; 2011
  • 16 Coleman M, Francis N. Training the trainer in laparoscopic surgery. In: Training in Minimal Access Surgery. London: Springer, London; 2015: 183-195
  • 17 Abboudi M, Ahmed K, Kirby R, Khan MS, Dasgupta P, Challacombe B. Mentorship programmes for laparoscopic and robotic urology. BJU Int 2011; 107 (12) 1869-1871
  • 18 Di Domenico SI, Ryan RM. The emerging neuroscience of intrinsic motivation: a new frontier in self-determination research. Front Hum Neurosci 2017; 11: 145
  • 19 Adayener C, Okutucu T, Uygur C. Does prior laparoscopic and open surgery experience have any impact on learning curve in transition to robotic surgery?. J Urol Surg 2016; 3 (04) 110-113
  • 20 Martin JA, Regehr G, Reznick R, MacRae H, Murnaghan J, Hutchison C, Brown M. Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 1997; 84 (02) 273-278
  • 21 Vassiliou MC, Feldman LS, Andrew CG. et al. A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg 2005; 190 (01) 107-113
  • 22 Collins JW, Dell'Oglio P, Hung AJ, Brook NR. The importance of technical and non-technical skills in robotic surgery training. Eur Urol Focus 2018; 4 (05) 674-676
  • 23 Satava RM, Reed WP. Proctors, preceptors, and laparoscopic surgery. The role of “proctor” in the surgical credentialing process. Surg Endosc 1993; 7 (04) 283-284
  • 24 Livingston EH, Harwell JD. The medicolegal aspects of proctoring. Am J Surg 2002; 184 (01) 26-30
  • 25 Rivard PE, Rosen AK, Carroll JS. Enhancing patient safety through organizational learning: are patient safety indicators a step in the right direction?. Health Serv Res 2006; 41 (4 Pt 2): 1633-1653
  • 26 Choy I, Fecso A, Kwong J, Jackson T, Okrainec A. Remote evaluation of laparoscopic performance using the global operative assessment of laparoscopic skills. Surg Endosc 2013; 27 (02) 378-383
  • 27 Lenihan Jr J, Brower M. Web-connected surgery: using the internet for teaching and proctoring of live robotic surgeries. J Robot Surg 2012; 6 (01) 47-52