C1 - 13: TEACHING MULTIDISCIPLINARY ONCOLOGIC SURGERY USING CADAVERIC-BASED SIMULATION
Sara Nofal, MD, MEd, Jose Karam, MD, Stella Anderson, Jennifer Deneen, George J Chang, MD, MS, Matthew Katz, MD, John Davis, MD, Surena Matin, MD, Pamela Soliman, MD, Brian Bednarski, MD; University of Texas MD Anderson Cancer Center
Introduction: Cadaver-based simulation has been utilized in surgical training to prepare for and augment learning in the operating room. Advanced oncologic surgery training programs are challenged to prepare trainees to execute complex procedures requiring multidisciplinary surgical teams. Clinically these cases are technically challenging, but also require good inter-team communication to safely and efficiently conduct the operation. To enhance the clinical education in multidisciplinary surgical procedures, we sought to implement cadaver simulation as a multidisciplinary educational tool for trainees in advanced oncologic surgery fellowships.
Methods: A multidisciplinary, case-based cadaveric simulation curriculum was developed at a tertiary cancer center for fellows training in Complex General Surgical Oncology (CGSO), Urologic Oncology (UO) and Gynecologic Oncology (GynOnc). The 4-hour course was conducted for the 2016 and 2017 academic years and included two multidisciplinary surgical simulations: pelvic exenteration and left upper quadrant exenteration. Faculty facilitated the cases performed by multidisciplinary surgical teams consisting of participants from each fellowship. Handouts were provided with case scenarios, radiographic images and discussion prompts. Fellows were surveyed regarding the course structure and learning experience using 5-point Likert scales.
Results: Thirty-eight fellows participated in the courses: 11 GynOnc fellows, 14 UO fellows, and 13 CGSO fellows. Twenty-six fellows (68%) completed the post course survey. Overall, 77% (20/26) of the respondents rated the cadaveric multidisciplinary procedures as highly valuable. When evaluated individually, the pelvic exenteration simulation and left upper quadrant exenteration simulation were rated similarly with highly valuable scores of 77% and 65%, respectively. The majority of respondents (81%) strongly agreed that the use of multidisciplinary teams improved the learning experience. Finally, 69% of the respondents strongly agreed that the multidisciplinary case-based dissections created learning opportunities from fellows in other disciplines regarding technique and operative approach.
Conclusions: Advanced surgical trainees in oncologic disciplines (CGSO, UO, and GynOnc) perceived high educational value from participation in multidisciplinary case-based cadaveric simulation. Further, the interaction with fellows across disciplines positively impacted the learning environment and created unique learning opportunities. For advanced surgical trainees, utilization of multidisciplinary case-based cadaveric simulation may enhance the traditional specialty-specific educational curricula.