March 3rd: Join SIMPL in Improving Trainee Competence

In our shared work, we have highlighted competency gaps for graduating residents across many surgical specialties.1–7 These gaps are a call to action.
 
The Society for Improving Medical Professional Learning (SIMPL, formerly the PLSC) invites you to a live informational webinar on Wednesday, March 3rd at 10am Pacific/11am Mountain/12pm Central/1pm Eastern to discuss a new initiative to improve trainee competence for key procedures across all levels of trainees.
 
In launching this multi-institutional, multi-specialty project, we will build on the existing assessment infrastructure of SIMPL to collectively develop and test small, practical teaching and learning practices. Those practices will target trainees’ competence as measured by SIMPL OR app evaluations.   
 
For this pilot, our collective goal is that every trainee achieve practice-readiness on one specialty-defined index procedure within each PGY. Index procedures will be collectively chosen by project participants and informed by existing SIMPL data. For example, in general surgery it might be chest tube placement for PGY-1 trainees and partial colectomy for PGY-5 trainees.
 
To achieve this goal we will apply a formal collaborative quality improvement approach based on the Institute for Healthcare Improvement’s Breakthrough Series8 and the Carnegie Foundation for the Advancement of Teaching9 models. As far as we are aware, this will be the first time a collaborative QI approach has been used to improve medical education outcomes at a national level.
 
We welcome programs participating from all specialties. Furthermore, individuals need not be from a current SIMPL member program to attend this informational event.

To register for this exciting webinar and receive a calendar invite, please fill out this google form: https://forms.gle/Yt41VJ3PP23S7B138 or email This email address is being protected from spambots. You need JavaScript enabled to view it..
 
Register Now!
References
 
1. George BC, Bohnen JD, Williams RG, et al. Readiness of US General Surgery Residents for Independent Practice. Ann Surg. 2017;266(4):582-594.
2. Chen JX, Kozin E, Bohnen J, et al. Assessments of Otolaryngology Resident Operative Experiences Using Mobile Technology: A Pilot Study. Otolaryngol Neck Surg. 2019;161(6):939-945. doi:10.1177/0194599819868165
3. Koduri S, Altshuler DB, Khalsa SSS, et al. Using a Mobile Application for Evaluation of Procedural Learning in Neurosurgery. World Neurosurg. 2020;138:e124-e150. doi:https://doi.org/10.1016/j.wneu.2020.02.049
4. Zendejas B, Lillehei CW, George BC, Modi BP. Assessment of Operative Autonomy and Readiness for Independent Practice Among Pediatric Surgery Fellows. J Pediatr Surg. 2020;55(1):117-121. doi:https://doi.org/10.1016/j.jpedsurg.2019.09.061
5. Shekar R, George BC, Bohnen JD, Villa A. Assessing Clinical Competence and Autonomy of Oral Medicine Residents:  It Is Simple. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017;124(3):e194. doi:10.1016/j.oooo.2017.05.488
6. Kobraei EM, Bohnen JD, George BC, et al. Uniting Evidence-Based Evaluation with the ACGME Plastic Surgery Milestones: A Simple and Reliable Assessment of Resident Operative Performance. Plast Reconstr Surg. 2016;138(2):349e-357e. doi:10.1097/PRS.0000000000002411
7. Kaban LB, Cappetta A, George BC, Lahey ET, Bohnen JD, Troulis MJ. Evaluation of Oral and Maxillofacial Surgery Residents’ Operative Skills: Feasibility and Engagement Study Using SIMPL Software for a Mobile Phone. J Oral Maxillofac Surg. 2017;75(10):2041-2047. doi:10.1016/j.joms.2017.05.036
8. The breakthrough series: IHI’s collaborative model for achieving breakthrough improvement. Published online 2003.
9. Bryk AS, Gomez LM, Grunow A, LeMahieu PG. Learning to Improve: How America’s Schools Can Get Better at Getting Better. Harvard Education Press; 2015.
09 Oct

AHRQ Patient Safety Network

in Press Releases

10/9/2017

Readiness of US general surgery residents for independent practice.

Insufficient trainee supervision may lead to adverse events, but lack of autonomy may leave trainee physicians unprepared for independent practice. In this direct observation surgical education study, attending physicians rated readiness for independent practice and level of supervision for surgical trainees performing specific core procedures throughout the course of their training. At the end of training, 90% of trainees performed competently on average complexity patients, but this proportion dropped to less than 80% for the most complex cases. For about two-thirds of core procedures, surgical residents still had significant supervision in their last 6 months of training. The authors raise concerns about whether graduating residents have sufficient experience practicing independently to enter clinical practice. A previous PSNet perspective advocated for continued appropriate supervision to augment patient safety.

Link to original article: https://psnet.ahrq.gov/resources/resource/31440

 

7/20/2017
 
Tool Could Enhance Education ; Are Residents Less Competent or Just More Closely Scrutinized?
Read More

5/4/2017

 

AT THE ASA ANNUAL MEETING

PHILADELPHIA – The question of how prepared general surgery residents are to operate independently after their training is longstanding, but clear definitions of competency and readiness have been elusive.

Read More

7/24/2017 

Research from the Procedural Learning and Safety Collaborative's national trial has been published in the Annals of Surgery.

Read More
07 Dec

SIMPL Android app is launched!

in Press Releases

The SIMPL app has officially been launched for Android!  It is available in the Google Play store for download and can now be used by all study participants.

01 Jul

SIMPL iOS app is now available!

in Press Releases

The SIMPL app has officially been launched for iOS!  It is available in the Apple app store for download and can now be used by all study participants.

This week at the Association for Surgical Education meeting in Seattle, WA, researchers from PLSC held a kick-off meeting for the upcoming multi-institutional trial of the SIMPL system.  This trial will investigate national patterns of resident supervision in the operating room and is being supported by the American Board of Surgery.  Multiple surgical training programs from across the country have already agreed to participate, with the planned start date for the trial this summer.

January 14th, 2015

Procedural Learning and Safety Collaborative, Inc (PLSC) researchers were this week awarded a grant by the American Board of Surgery (ABS) to fund a multi-institutional trial using the SIMPL (System for Improving and Measuring Performance Evaluation) system.  This trial, the first of its kind, represents the next step in a larger national effort to define performance standards for the next generate of surgeons.  This effort is both timely and critical as there is significant concern among surgical educators that general surgery training programs are not adequately preparing residents for independent surgical practice.

The planned trial will examine whether SIMPL is an effective instrument to:

    1. Generate national data to define norms and set standards pertaining to levels of autonomy achieved by residents with specific procedures.
    2. Statistically define the number of procedures residents need to participate in to achieve operative autonomy.
    3. Facilitate acquisition of reliable and valid performance assessments for procedures performed by surgical trainees.
    4. Facilitate timely assessment of the vast majority of residents’ operative performances.
    5. Enhance focus on intra-operative teaching and resident progression to operative autonomy.

Surgeon educators are challenged with balancing their responsibility to patients in ensuring optimal operative outcomes with their responsibility to residents in preparing them for independent practice. Overseeing quality of care and supervising residents is further complicated by shortened work hours for residents and an emphasis on operating room cost efficiency, both of which diminish time critical to teaching and honing residents’ operative judgment and skills. These and other recent changes in the health care environment, the economic climate, and accreditation requirements dictate the need for enhanced educational models for preparing tomorrow’s surgeons. Researchers at PLSC have developed the SIMPL system to monitor surgical residents’ progression towards operative autonomy by documenting the guidance and supervision provided by surgical faculty in the operating room.

SIMPL is a smart phone based assessment system that utilizes the four-level Zwisch scale to assess the level of autonomy achieved by a resident in performing a surgical procedure.  The SIMPL system, which is connected to the OR scheduling system, facilitates the assessment process by delivering text prompts to the supervising faculty surgeons reminding them to complete an evaluation for the procedure they just performed. Completion of the entire assessment requires only a few seconds and therefore does not disrupt busy surgical workflow.

All evaluation data in centrally stored in a secure database and can be used for further analysis.  Longitudinal assessment of resident autonomy progression can be determed by case, rotation, and overall. This can be used for both individual resident assessments and residency program evaluations.  It can also be used to evaluate faculty based on the level of guidance and supervision they provide in the operating room.

The pilot version of SIMPL was evaluated in the general surgery residency training program at Northwestern University where we demonstrated that SIMPL is feasible, reliable, and valid method of evaluating resident operative performance.  Using the Zwisch scale and SIMPL, PLSC researchers have also compared faculty and resident expectations of what level of autonomy residents should be achieving by the end of their residency training to the level of autonomy they are actually achieving.  In partnership with the American Board of Surgery PLSC will be extending this work over the next several years.

 

Want to participate?  Contact us!