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Medical education and training
Original research
Retrospective qualitative study evaluating the application of IG4 curriculum: an adaptable concept for holistic surgical education
  1. Iakovos Theodoulou1,
  2. Michail Sideris2,
  3. Kola Lawal1,
  4. Marios Nicolaides3,
  5. Aikaterini Dedeilia4,
  6. Elif Iliria Emin1,
  7. Georgios Tsoulfas5,
  8. Vassilios Papalois6,7,
  9. George Velmahos8,
  10. Apostolos Papalois9,10
  1. 1 King's College London - Strand Campus, London, UK
  2. 2 Women's Health Research Unit, Queen Mary University of London, London, UK
  3. 3 Barts and The London School of Medicine and Dentistry, London, UK
  4. 4 National and Kapodistrian University of Athens, Athinon, Greece
  5. 5 Aristotle University of Thessaloniki, Thessaloniki, Greece
  6. 6 Renal Transplant Directorate, Imperial College Healthcare NHS Trust, London, UK
  7. 7 Department of Surgery and Cancer, Imperial College London, London, UK
  8. 8 Harvard Medical School GHSM, Boston, Massachusetts, USA
  9. 9 European University Cyprus, Nicosia, Nicosia, Cyprus
  10. 10 Experimental Educational and Research Centre ELPEN, Athens, Greece
  1. Correspondence to Dr Michail Sideris; msideris{at}nhs.net

Abstract

Objectives Faced with a costly and demanding learning curve of surgical skills acquisition, the growing necessity for improved surgical curricula has now become irrefutable. We took this opportunity to formulate a teaching framework with the capacity to provide holistic surgical education at the undergraduate level.

Setting Data collection was conducted in all the relevant healthcare centres the participants worked in. Where this was not possible, interviews were held in quiet public places.

Participants We performed an in-depth retrospective evaluation of a proposed curriculum, through semi-structured interviews with 10 participants. A targeted sampling technique was employed in order to identify senior academics with specialist knowledge in surgical education. Recruitment was ceased on reaching data saturation after which thematic data analysis was performed using NVivo 11.

Results Thematic analysis yielded a total of 4 main themes and 29 daughter nodes. Majority of study participants agreed that the current landscape of basic surgical education is deficient at multiple levels. While simulation cannot replace surgical skills acquisition taking place in operating rooms, it can be catalytic in the transition of students to postgraduate training. Our study concluded that a standardised format of surgical teaching is essential, and that the Integrated Generation 4 (IG4) framework provides an excellent starting point.

Conclusions Through expert opinion, IG4 has been validated for its capacity to effectively accommodate learning in a safer and more efficacious environment. Moreover, we support that through dissemination of IG4, we can instil a sense of motivation to students as well as develop robust data sets, which will be amenable to data analysis through the application of more sophisticated methodologies.

  • medical education & training
  • surgery
  • adult surgery
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-033181

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    Footnotes

    • IT and MS are joint first authors.

    • IT and MS contributed equally.

    • Contributors MS is responsible for the conception of the Integrated Generation 4 ESMSC curriculum. MS and AP are the primary leads of the ESMSC marathon course and share ownership of the course concept. IT designed the validation methods of the IG4 curriculum and drafted parts of the manuscript. MS co-designed and approved research methodology (validation). MS and IT are equal contributors for this manuscript. KL, MN, AD and EIE contributed in performing study and collecting the data. GT, VP and GCV are senior authors providing constructive feedback in the IG4 and the manuscript. All authors have approved final idea.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement statement This study did not include any patients. However, all the included subjects were qualified senior clinicians and academics, experts in the field of surgical education. The conclusions are addressed at the medical community, reflecting a future direction of medical education.

    • Patient consent for publication Not required.

    • Ethics approval The ESMSC course is compatible with the current 3R principles for animal-model simulation (refinement, replacement and reduction). Ethical approval was granted by the Hellenic Republic - Attica Region (Perifereia Attikis - PATT), Department of Animal Studies and Relevant Affairs and met directive 63/2010, PD 56/April 2013. The license reference number is 4857/15-09-2017, MS, AP et al. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All applicable international, national and/or institutional guidelines for the care and use of animals were followed.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. Interview transcripts and thematic analysis can be made available upon reasonable request from the authors. Due to participant confidentiality, all data will be provided after removal of identifiable details.