Skill Decay Refresher Training

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The potential barriers to the implementation of this program could be numerous. First, in a world of emphasis on production, there could be a lack of time commitment to further education. This commitment could be from physicians, administrators, or leaders. Next, there is the potential of a lack of compliance from a physician standpoint to acknowledge the skill has actually degraded. Finally, the costs associated with the program, task trainer, and staff would be significant. This is despite what Woods quotes the costs associated with biliary tract complication of $3,000 to $300,000.

To augment the associated costs, this program should not be mandatory for all returning general surgeons. For example, those who specialize in trauma, breast, plastic, or vascular surgery. In contrast, it should be mandatory for those who are actively participating in laparoscopy.

It is difficult to change a mentation from learn by doing, to one of utilization of simulation to achieve a common endpoint. Deployments are a necessary portion of an active duty general surgeon’s career. Unfortunately, the physician’s technical skills may weaken either in theory or actuality during this deployment. Skill degradation is an evolving topic that will be further evaluated through the use of simulation.

References

Aggarwal, R., Crochet, P., Dias, A., Misra, A., Ziprin, P., & Darzi, A. (2009). Development of a virtual reality training curriculum for laparoscopic cholecystectomy. British Journal of Surgery, 96(9), 1086-1093.

Deering, S. H., Rush, R. M., Lesperance, R. N., & Roth, B. J. (2011). Perceived effects of deployments on surgeon and physician skills in the US army medical department. The American Journal of Surgery, 201(5), 666-672.

Woods, M. (1996). Estimated costs of biliary tract complications in laparoscopic cholecystectomy based upon medicare cost/charge ratios. Surgical Endoscopy, 10(10), 1004-1007.