Date: Sunday, June 2, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Living kidney donation is unique, as healthy patients are placed at risks inherent with major surgery without physical benefit. The procedure receives intense scrutiny to adhere to the principle of nonmaleficence. It is prudent for fellowships and the ASTS to optimize training with the goal of graduating fellows who can safely and efficiently perform a laparoscopic donor nephrectomy (LDN). There is significant variability in fellowship training and confidence level regarding LDN. The ASTS Laparoscopic Donor Nephrectomy workshop is a resource that can provide intense instruction to help bridge the training deficit. Despite its popularity, the success of this course has yet to be empirically examined.
*Methods: From 2016-2018, 36 abdominal transplant surgery fellows and junior faculty participated in a two-day workshop consisting of live surgery observation, cadaver lab, and didactic sessions. Surveys were completed pre-course, post-course and at three-month follow-up.
*Results: Prior to the workshop, 61% of participants reported less than 50% confidence in independent performance of LDN. Following workshop completion, 95% reported improved confidence. At three-month follow up, there was an average 30% (p<0.05) increase in confidence level. Immediately following the course, 67% reported improved ability to analyze kidneys prior to donation, 74% changed the way donor candidates were evaluated, and 67% reported enhanced ability to risk stratify donors. 85% felt it strengthened operative techniques with 70% implementing new diagnostic treatments and surgical strategies. 70% of participants felt it improved their communication with colleagues and 67% had enhanced communication with patients. These trends were maintained at three-month follow-up. Despite these improvements, 41% expressed need for further training, specifically with an assigned mentor to fully implement skills obtained during the ASTS course.
*Conclusions: These results indicated that the LDN workshop improves confidence and increases fellows’ skillset in a high stakes procedure. The ASTS workshop is a useful adjunct to fellowship training to optimize successful, efficient and safe performance of a demanding procedure in a uniquely healthy donor population. ASTS is now developing other hands on courses in areas where fellowship training is frequently insufficient.
To cite this abstract in AMA style:Rice T, Lewis H, Cuffy M, Ratner L, Diwan T. Changing Education Paradigms: Training Fellows for High Stake Procedures [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/changing-education-paradigms-training-fellows-for-high-stake-procedures/. Accessed March 7, 2021.
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