1. Joseph A. Sclafani MD1, Choll W Kim MD,PhD1
The Skin-to-Skin Program: A New Paradigm in MIS Training. Initial Results on Adoption Rates
Joseph A. Sclafani MD1, Choll W Kim MD,PhD1
1Spine Institute of San Diego, Minimally Invasive Spine Surgery Center of Excellence
INTRODUCTION
Traditional MIS cadaver courses have crowded lab stations and limited individual hands-on experience.
Such MIS training programs may be insufficient to overcome learning curve issues, leading to a poor adoption rate
The Skin-to-Skin (S2S) cadaver course is an intensive program designed to overcome learning curve barriers and increase the adoption rate of MIS techniques
RESULTS
Data was obtained for 43/45 (96%) of S2S trained surgeons within the first year after training
The average impact factor after S2S training was 2.7 (n=43)
The major adoption rate (Impact Factor >5) was 12/43 (28%)
MATERIALS AND METHODS
All S2S trained surgeons completed an based survey one year after training to assess the S2S curriculum and surgeon adoption rate of MIS after course completion
Participants were assigned an impact score based on the number of MIS procedures they performed during the initial one year period after S2S training
An S2S trained surgeon with an impact score ≥ 5 was considered a major adopter of MIS techniques
CONCLUSIONS
The S2S curriculum contains several unique features (1 preceptor:1 trainee ratio, detailed technique guide) that generate a high post-training MIS adoption rate
Continued surveillance is necessary to determine the sustainability of MIS practice patterns after the initial adoption period
Figure 1. An overview of Skin to Skin training program itinerary. The visiting surgeon directly observes the preceptor perform live surgery and is able to discuss the case in detail on day 1 (left). The following morning is dedicated to rounding with the preceptor followed by a cadaver lab in which the visiting surgeon performs the entire MIS procedure from start to finish (right). The entire course is conducted on a 1 visiting surgeon:1 preceptor ratio.
Figure 2. Unique, important features of the S2S course were: a single surgeon to each cadaver (92%), observation of live surgery as a component of the cadaver course (100%), availability of the S2S host surgeon after the course to discuss upcoming cases (83%), and provision of a detailed technique guide (92%).
Figure 3. An impact score was assigned to each participating surgeon within the first year after training.