The Committee on Emerging Surgical Technologies has previously
published "Guidelines for Evaluation of Credentials of Individuals
for the Purpose of Awarding Surgical Privileges in New Technologies."
In that statement, which was approved by the American College
of Surgeons' Board of Regents and published in 1994, the completion
of a defined educational program in the technology, including
didactic and practical elements, was recommended. The following
statement, which was approved by the Board of Regents in October
1997, defines standards for courses in new technology that are
designed to prepare the practicing surgeon to apply the technology
to the care of patients.
Most new surgical techniques are learned informally, through
courses given commercially by experts or by the manufacturers
of the new equipment, through mini-preceptorships, or simply
by observing and/or assisting surgeons who have begun to use
the techniques. Informal learning is irregular in quality, often
expensive, and tends to be largely technique oriented without
a solid theoretical and evidence-based cognitive component. Acquisition
of knowledge and skills is rarely documented. Surgeons seek high-quality
courses, and health care institutions need to know if the course
taken by an applicant for privileges is of high quality and if
the surgeon has acquired the knowledge and skills needed to safely
apply the new technology to patients.
Beginning with a course in flexible colonoscopy/sigmoidoscopy
approximately 20 years ago, the American College of Surgeons
has responded on occasion to the need to educate practicing surgeons
in technology that has become available following completion
of a residency. The College is now offering the following courses
with didactic and practical components: “Advanced Trauma
Life Support,” "Image-Guided Breast Biopsy," "Ultrasound
for General Surgeons," and a variety of trauma and critical
care techniques and skills. Courses in new techniques and skills,
offered by organizations or individuals not associated with the
College, are widely available.
The establishment of standards for courses in new technology
that will include the testing of acquisition of knowledge and
skills will provide a mechanism for surgeons to choose courses
that will meet their educational needs and a method for institutions
to use determining if a surgeon applying for privileges in a
new technology has obtained the expected level of knowledge and
Standards for Advanced Courses in New Technology
1. A Program Goal(s) is announced.
Detailed course learning objectives are listed, including
concepts and principles, indications and contraindications for
the procedure, anticipated complications and outcomes and subsequent
The procedural skills that are needed to apply the
technique safely and effectively are listed.
2. Content of the course addresses each of the listed
course objectives and the method to be used to teach the listed
3. Acquisition of the cognitive materials is assessed
by a method described in advance by the course developers. Such
assessment will frequently involve pre-and post-course testing;
other validated methods may be used when appropriate.
4. Acquisition of the listed skills is assessed by
the individual student based on comparison of his/her performance
relative to established standards available at each skill station
(time, accuracy, successful completion of task, correct interpretation
of data displayed, and so on).
Acquisition of the listed skills is assessed by the instructor
who observes and assesses the global and individual level of
skill demonstrated by the student. The method of assessing skills
should be validated (for example, by repeated measurements or
independent assessors) at the outset of the course.
5. A syllabus is provided containing representative
references to the pertinent literature on the technique, indications
and contraindications for the procedure, complications, outcome,
and subsequent management, as well as a written outline or text
addressing the course goal and objectives.
Documentation to be Provided by the Course Director for
Courses Sponsored by the American College of Surgeons
Level 1. Verification of Attendance:
The surgeon has attended and completed a course.
Level 2. Verification of Satisfactory Completion of Course
The surgeon has satisfactorily met the specified learning objectives.
Level 3. Instructor Level:
The surgeon has had monitored practice experience with the technology
and has documented satisfactory patient outcomes; the surgeon
has participated in development of goals and objectives for educational
programs in the technology and is experienced in teaching these
skills to others.
Reprinted from Bulletin of the American College
Vol.83, No. 03, March 1998