Key components of a hepatobiliary surgery curriculum for general surgery residents: results of the FULCRUM International Delphi consensus

Nikdokht Rashidian; Wouter Willaert; Isabelle Van Herzeele; Zenichi Morise; Adnan Alseidi; Roberto I Troisi; FULCRUM Research Group

doi:10.1016/j.hpb.2020.01.011

Key components of a hepatobiliary surgery curriculum for general surgery residents: results of the FULCRUM International Delphi consensus

HPB (Oxford). 2020 Oct;22(10):1429-1441. doi: 10.1016/j.hpb.2020.01.011. Epub 2020 Feb 12.

Authors

Nikdokht Rashidian¹, Wouter Willaert¹, Isabelle Van Herzeele², Zenichi Morise³, Adnan Alseidi⁴, Roberto I Troisi⁵; FULCRUM Research Group

Collaborators

FULCRUM Research Group:
Saleh Alabbad⁶, Maria B Doyle⁷, Javier Briceño-Delgado⁸, Fulvio Calise⁹, Eugene P Ceppa¹⁰, Kuo-Hsin Chen¹¹, Daniel Cherqui¹², Tan T Cheung¹³, Charles C-W Lin¹⁴, Sean Cleary¹⁵, Choon H David Kwon¹⁶, Ismael Dominguez-Rosado¹⁷, Alessandro Ferrero¹⁸, Susanne G Warner¹⁹, Gian L Grazi²⁰, Chet Hammill⁷, Ho-Seong Han²¹, Paul Hansen²², Scott Helton²³, Osamu Itano²⁴, Ali Jafarian²⁵, Rohan Jeyarajah²⁶, Hironori Kaneko²⁷, Yutaro Kato²⁸, Shoji Kubo²⁹, Jun Li³⁰, Valerio Lucidi³¹, Pietro Majno³², Erin Maynard³³, Roberto Montalti³⁴, Silvio Nadalin³⁵, Hiroyuki Nitta³⁶, Yuichiro Otsuka³⁷, Fernando Rotellar³⁸, Benjamin Samstein³⁹, Olivier Soubrane⁴⁰, Atsushi Sugioka²⁸, Minoru Tanabe⁴¹, Guido Torzilli⁴², Aude Vanlander⁴³, Go Wakabayashi⁴⁴

Affiliations

¹ Department of Human Structure and Repair, Ghent University Faculty of Medicine, Belgium; Department of Gastrointestinal Surgery, Ghent University Hospital, Belgium.
² Department of Human Structure and Repair, Ghent University Faculty of Medicine, Belgium; Department of Thoracic and Vascular Surgery, Ghent University Hospital, Belgium.
³ Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan.
⁴ Division of Pancreas, Liver and Biliary Surgery, Virginia Mason Medical Center, Seattle, USA.
⁵ Department of Human Structure and Repair, Ghent University Faculty of Medicine, Belgium; Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy; Organ Transplant Center, King Faisal Specialist Hospital and Research Center and Al Faisal University, Riyadh, Saudi Arabia. Electronic address: [email protected].
⁶ King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
⁷ Washington University School of Medicine, St. Louis, USA.
⁸ Reina Sofia University Hospital, Cordoba, Spain.
⁹ Pineta Grande Hospital, Castel Volturno, Italy.
¹⁰ Indiana University School of Medicine, Indianapolis, USA.
¹¹ Far-Eastern Memorial Hospital, Taipei, Taiwan.
¹² Paul Brousse Hospital, Paris, France.
¹³ The University of Hong Kong, Hong Kong, China.
¹⁴ Too Foundation Sun Yet-Sen Cancer Center, Taipei, Taiwan.
¹⁵ Mayo Clinic, Rochester, USA.
¹⁶ Cleveland Clinic, Cleveland, USA.
¹⁷ Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
¹⁸ Ospedale Mauriziano Umberto I, Turin, Italy.
¹⁹ City of Hope National Medical Center, CA, USA.
²⁰ IRCCS - Regina Elena National Cancer Institute, Rome, Italy.
²¹ Seoul National University, Seoul, South Korea.
²² Portland Providence Cancer Institute, Portland, USA.
²³ Virginia Mason Medical Center, Seattle, USA.
²⁴ International University of Health and Welfare, Chiba, Japan.
²⁵ Tehran University of Medical Sciences, Tehran, Iran.
²⁶ Methodist Richardson Medical Center, TX, USA.
²⁷ Toho University School of Medicine, Tokyo, Japan.
²⁸ Fujita Health University, Toyoake, Japan.
²⁹ Osaka City University Graduate School of Medicine, Osaka, Japan.
³⁰ University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
³¹ Erasme University Hospital, Brussels, Belgium.
³² Ente Ospedaliero Cantonale, Lugano, Switzerland.
³³ Oregon Health Science University, Portland, USA.
³⁴ Federico II University, Naples, Italy.
³⁵ University Hospital Tübingen, Tübingen, Germany.
³⁶ Iwate Medical University, Morioka, Japan.
³⁷ Toho University Faculty of Medicine, Tokyo, Japan.
³⁸ Clínica Universidad de Navarra, Pamplona, Spain.
³⁹ Weill Cornell Medical College, New York, USA.
⁴⁰ Beaujon Hospital, Paris, France.
⁴¹ Tokyo Medical and Dental University, Tokyo, Japan.
⁴² Humanitas University, Milan, Italy.
⁴³ Ghent University Hospital, Ghent, Belgium.
⁴⁴ Ageo Central General Hospital, Tokyo, Japan.

PMID: 32060009
DOI: 10.1016/j.hpb.2020.01.011

Abstract

Background: In general surgery residency, hepatobiliary training varies significantly across the world. The aim of this study was to establish an international consensus among hepatobiliary surgeons on components of a hepatobiliary curriculum for general surgery residents.

Methods: A three-round modified Delphi technique was employed. Fifty-two hepatobiliary surgeons involved in general surgery training programs were invited. An initial questionnaire was developed by a group of experts in hepatobiliary and educational research after a systematic literature review. It comprised 90 statements about knowledge, technical skills, attitudes, and postoperative care. Panelists could add or alter items. The survey was delivered electronically and the panel was instructed to score the items based on 5-point Likert scale. Consensus was reached when at least 80% of panelists agreed on a statement with Cronbach's alpha value >0.8.

Results: Forty-one (79%) experts have participated. Sixteen panelists are based in Asia, 14 in Europe, and 11 in the Americas. Eighty percent of all proposed skills (81/101) were considered fundamental including knowledge (39/43), technical skills (16/32), attitude (15/15), and postoperative care (11/11).

Conclusion: An international consensus was achieved on components of a hepatobiliary curriculum. Acquiring broad knowledge is fundamental during residency. Advanced liver resection techniques require specialized hepatobiliary training.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Clinical Competence*
Consensus
Curriculum
Delphi Technique
Humans
Internship and Residency*