ORIGINAL ARTICLE
The American Society of Maxillofacial Surgery Preceptorship Program: A Product of the 2013 American Society of Maxillofacial Surgery Executive Board Strategy Session and Survey Francis Papay, MD, Peter J. Taub, MD,y Gaby Doumit, MD, MSc, Roberto L. Flores, MD,z Anna A. Kuang, MD,§ Karolina Mlynek, MD, Kashyap K. Tadisina, BS, and Bahar Bassiri Gharb, MD, PhD Abstract: One of the main goals of the American Society of Maxillofacial Surgery (ASMS) is to develop educational programs that increase expertise in maxillofacial surgery. We describe the outline of the new ASMS Preceptorship Program, a collective effort by ASMS members to increase access to all areas of maxillofacial surgery. Furthermore, we discuss the original survey pertinent to the development of this program, the results of the survey, and specifics regarding the structure of the program. We hope for the preceptorship program to be an excellent resource for members to mentor one another, develop intellectual and academic curiosity, provide avenues for collaboration, and further the ASMS’s role in shaping maxillofacial surgery into the future. Key Words: Preceptorship program, American Society of Maxillofacial Surgery, maxillofacial surgeons, education (J Craniofac Surg 2015;26: 1156–1158)
O
ne of the main goals of the 2013 American Society of Maxillofacial Surgery (ASMS) executive committee meeting was to identify strategies for developing educational programs that could increase expertise in maxillofacial surgery. Toward this end, a survey study was designed by the leadership to examine the areas of expertise in which ASMS members wished to gain experience and to implement educational programs that could increase proficiency in these areas.1 The survey aimed to evaluate the expertise of current ASMS members and identify the topics in which members wished to From the Department of Plastic Surgery, Institute of Dermatology and Plastic Surgery, Cleveland Clinic, Cleveland, OH; yDivision of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai Medical Center and Kravis Children’s Hospital, New York, NY; zDivision of Plastic Surgery, Riley Hospital for Children, Indiana University Medical Center, Indianapolis, IN; and §Division of Pediatric Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR. Received August 24, 2014. Accepted for publication January 21, 2015. Address correspondence and reprint requests to Francis Papay, MD, Department of Plastic Surgery, Institute of Dermatology and Plastic Surgery, Cleveland Clinic, 9500 Euclid Ave, Desk A60, Cleveland, OH 44195; E-mail: [email protected] The authors report no conflict of interest. Copyright # 2015 by Mutaz B. Habal, MD ISSN: 1049-2275 DOI: 10.1097/SCS.0000000000001606
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increase knowledge. The ASMS also gauged the willingness of members to participate in the education of their fellow members as ‘‘no cost’’ preceptors. We describe the outline of the new ASMS Preceptorship Program, a collective effort by all members to increase access to all areas of maxillofacial surgery and discuss the original survey pertinent to the development of this program, the results of the survey, and specifics regarding the structure of the program. Continuing in a great tradition of innovation, educational progress, and facilitation of educational endeavors,2,3 the preceptorship program is the first of its kind, as it is the first such program that is available on a national level, exclusively for maxillofacial surgeons.
METHODS A customized survey software was written for the ASMS by the Professional Relations and Research Institute using Perl/CHI language connecting to the SQL Server database. As part of a 7-section survey, members of the ASMS were asked if they were willing to act as preceptors for other ASMS members. The survey was sent to 799 members, including 335 active members, 4 associate members, 38 candidates, and 31 international and 391 resident/affiliate members. The e-mail sent to participants contained a link to the survey Web site, and nonresponders received an additional follow up e-mail reminder.
RESULTS A total of 67 members completed this survey, resulting in an overall response rate of 17%. Respondents reported average years of maxillofacial surgery experience as 14.5 9.9 years. Responses
FIGURE 1. ASMS survey results for preceptorship willingness among members.
The Journal of Craniofacial Surgery
Volume 26, Number 4, June 2015
Copyright © 2015 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.
The Journal of Craniofacial Surgery
Volume 26, Number 4, June 2015
TABLE 1. Areas of Specialty for Preceptorship
The ASMS Preceptorship Program
TABLE 3. Responsibilities of the Preceptor and Preceptee Within the ASMS Preceptorship Program
Areas of Specialty 1 2 3 4 5 6 7
Cranial surgery Orbital surgery Orthognathic surgery Craniomaxillofacial trauma primary reconstruction Craniomaxillofacial trauma secondary reconstruction Cleft lip and palate Primary maxillofacial trauma
pertaining to question 4 and willingness to be a ‘‘no charge’’ preceptor indicated that 25 (37%) of responders were keen to be observational preceptors, 1 to 4 times per year for 1 to 5 working days. An additional 29 (43%) of responders expressed willingness to consider being preceptors, yielding a grand total of 80% of responders willing to be preceptors of their colleagues (Fig. 1).
Preceptor List and Program Structure The members willing to serve as preceptors or to consider preceptorship are listed in the members’ corner of the ASMS Web site (http://maxface.org/membersOnly.cgi), along with details regarding institution and expertise offerings for each. Areas of expertise and further subspecialty categories are outlined in Tables 1 and 2. As a step further, to facilitate the establishment of the program, the ASMS has created a series of guidelines. These include the following: (1) standardized responsibilities for both preceptors and preceptees (Table 3), (2) prepreceptorship expectation and postpreceptorship evaluation forms to be completed by preceptor and preceptee (Figs. 2–3), and (3) a Likert scale–based evaluation to be completed and signed by both preceptor and preceptee. The goals of TABLE 2. Subspecialty Areas to Improve Proficiency Subspecialty Proficiency 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
#
Orthognathic surgery Cephalometric analysis Craniofacial osseous integrated implants Dental osseous integrated implants Biomodeling Craniosynostosis Maxillary/mandibular distraction Cranial distraction Skull base tumor ablation Microvascular craniomaxillofacial reconstruction Cleft lip and palate Secondary craniomaxillary reconstruction Facial implants Auricular reconstruction Cleft lip nasal rhinoplasty Primary and secondary rhinoplasty Nasal valve and turbinate surgery Osseous genioplasty Obstructive sleep apnea Endoscopic sinus surgery Orbital surgery Dental extraction (third molar) Facial nerve reanimation Vascular malformation of the head and neck Headache—facial pain Facial aesthetic surgery
2015 Mutaz B. Habal, MD
Role
Responsibilities
Preceptor
(1) Assign and identify an individual (secretary, coordinator, fellow, or yourself) to act as the chief organizer and contact person for the preceptee. A phone number and e-mail address should be provided to the preceptee. (2) Make appropriate efforts to schedule the preceptee’s visit to expose them to the case(s) of interest. (3) Schedule the visit at a time when you will be there. (4) Provide all necessary paperwork for hospital and operating room access to the preceptee prior to the visit. (5) The preceptor cannot charge a professional fee to the preceptee. (6) Complete the ASMS evaluation form at the end of the preceptee’s visit. (7) Serve as a representative of the ASMS. (1) Provide a curriculum vitae and background of yourself when you are scheduling your visit to the preceptor. (2) Be flexible with the preceptor’s visit schedule. (3) Respect the professional and social norms of the hospital and practice you are visiting. (4) Be responsible for all financial aspects of the visit. (5) Complete the ASMS evaluation form at the end of your visit. (6) Serve as a representative of the ASMS.
Preceptee
establishing these guidelines are to ensure (a) adherence to a standardized level of dedication and excellence from both preceptors and preceptee, (b) ample opportunity for self-evaluation and improvement, and (c) an objective measure that the ASMS could use to gauge the success of the preceptorship program.
DISCUSSION The term preceptor is defined ‘‘a specialist in a profession. . . who gives practical training to a student.’’4 In this case, both the specialist and student are ASMS members, with one being an expert in an area in which the other is seeking to gain expertise. In a recent American College of Surgeons Bulletin regarding teaching robotic surgery, observer preceptorships were found to be an effective method particularly when designed as a group
FIGURE 2. A, Preceptee prepreceptorship evaluation form. B, Preceptee postpreceptorship evaluation form.
1157
Copyright © 2015 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.
Papay et al
The Journal of Craniofacial Surgery
FIGURE 3. A, Preceptor prepreceptorship evaluation form. B, Preceptor postpreceptorship evaluation form.
learning model for safe implementation of surgical modalities and procedures.5 The success of short preceptorship programs has been documented in the surgical literature. Kolla et al6 reported the success of a 5-day mini fellowship in laparoscopic techniques provided to urology trainee surgeons. At 1- and 3-year follow-up, the study found that the 5-day experience with a mentor, preceptor, and potential proctor helped surgeons increase the scope of their practice by introducing them to new techniques with which they were previously unfamiliar. The 5-day session included tutorial sessions, hands-on skills training, and case observation.6 These findings are corroborated by Garneau et al,7 who studied a 2-part training program, the first of which was observation-based preceptorship of laparoscopic sleeve gastrectomy, and the second part was a proctorship, where a consulting surgeon and accompanying support staff came on site to the trainee surgeon’s hospital to teach. Both aspects of training were found to be an effective way of teaching the new technique, and subsequent surgeries resulted in a low complication rate and sufficient weight loss at 6 months’ follow-up.7 Much like the previously described studies, appropriate followup for the ASMS Preceptorship Program with both preceptors and preceptees is expected. The ASMS must assess the viability of the program, the impact of observation-based preceptorships on clinical practice and research endeavors, and finally members’ opinions of
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proficiency in areas of weakness identified by the 2013 ASMS survey. Since the inception of the ASMS, a culture of innovation, education, and collaboration has been successfully pursued for over 65 years through teaching courses, productive research, national meetings, social gatherings, and education for fellows/residents (S. R. Cohen).2 Although no endeavor similar to the preceptorship has been undertaken on a national scale for maxillofacial surgeons, the obvious willingness of members to foster relationships and collaboration allows us to believe in the potential success of this program. Despite the less than ideal 2013 survey response rate of 17%, we believe that the large percentage of responders willing to help fellow members is deeply encouraging, and expect more members to be willing to add themselves to the list of preceptors once the program is implemented. The willingness of ASMS members to allow fellow members to learn from one another speaks to the long history and culture of camaraderie and friendship that has resulted in productive collaboration and educational endeavors in the society. We hope that by identifying and strengthening areas of perceived weakness along with the development of a powerful academic tool, the ASMS Preceptorship Program, the ASMS can continue to make strides in influencing maxillofacial surgery on a large scale. We expect the preceptorship program to be an excellent resource for members to continue mentoring one another, developing intellectual and academic curiosity, providing avenues for collaboration, and further contributing to the ASMS’s role in shaping maxillofacial surgery into the future.
REFERENCES 1. Papay FA, Bassiri B, Taub PJ, et al. Priorities for the education of members of the American Society of Maxillofacial Surgery. J Craniofac Surg 2014;25:735–737 2. Cohen SR, Juhala CA, Manson PN, et al. History of the American Society of Maxillofacial Surgeons: 1947–1997. Plast Reconstr Surg 1997;100:766–801 3. Cohen MN, Evans GR, Wexler A, et al. American Society of Maxillofacial Surgeons, 1997 to 2006: another decade of excellence in education and research. Plast Reconstr Surg 2006;118(5 Suppl):32S–42S 4. Soukhavov A, ed. Encarta World English Dictionary. New York, NY: St. Martin’s Press; 1999. 5. Landry CS, Grubbs EG, Lee JE, et al. From scalpel to console: a suggested model for surgical skill acquisition. Bull Am Coll Surg 2010;95:20–24 6. Kolla SB, Gamboa AJ, Li R, et al. Impact of a laparoscopic renal surgery mini-fellowship program on postgraduate urologist practice patterns at 3year followup. J Urol 2010;184:2089–2093 7. Garneau P, Ahmad K, Carignan S, et al. Preceptorship and proctorship as an effective way to learn laparoscopic sleeve gastrectomy. Obes Surg 2014;24:2021–2024
#
2015 Mutaz B. Habal, MD
Copyright © 2015 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.
The American Society of Maxillofacial Surgery Preceptorship Program: A Product of the 2013 American Society of Maxillofacial Surgery Executive Board Strategy Session and Survey Francis Papay, MD, Peter J. Taub, MD,y Gaby Doumit, MD, MSc, Roberto L. Flores, MD,z Anna A. Kuang, MD,§ Karolina Mlynek, MD, Kashyap K. Tadisina, BS, and Bahar Bassiri Gharb, MD, PhD Abstract: One of the main goals of the American Society of Maxillofacial Surgery (ASMS) is to develop educational programs that increase expertise in maxillofacial surgery. We describe the outline of the new ASMS Preceptorship Program, a collective effort by ASMS members to increase access to all areas of maxillofacial surgery. Furthermore, we discuss the original survey pertinent to the development of this program, the results of the survey, and specifics regarding the structure of the program. We hope for the preceptorship program to be an excellent resource for members to mentor one another, develop intellectual and academic curiosity, provide avenues for collaboration, and further the ASMS’s role in shaping maxillofacial surgery into the future. Key Words: Preceptorship program, American Society of Maxillofacial Surgery, maxillofacial surgeons, education (J Craniofac Surg 2015;26: 1156–1158)
O
ne of the main goals of the 2013 American Society of Maxillofacial Surgery (ASMS) executive committee meeting was to identify strategies for developing educational programs that could increase expertise in maxillofacial surgery. Toward this end, a survey study was designed by the leadership to examine the areas of expertise in which ASMS members wished to gain experience and to implement educational programs that could increase proficiency in these areas.1 The survey aimed to evaluate the expertise of current ASMS members and identify the topics in which members wished to From the Department of Plastic Surgery, Institute of Dermatology and Plastic Surgery, Cleveland Clinic, Cleveland, OH; yDivision of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai Medical Center and Kravis Children’s Hospital, New York, NY; zDivision of Plastic Surgery, Riley Hospital for Children, Indiana University Medical Center, Indianapolis, IN; and §Division of Pediatric Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR. Received August 24, 2014. Accepted for publication January 21, 2015. Address correspondence and reprint requests to Francis Papay, MD, Department of Plastic Surgery, Institute of Dermatology and Plastic Surgery, Cleveland Clinic, 9500 Euclid Ave, Desk A60, Cleveland, OH 44195; E-mail: [email protected] The authors report no conflict of interest. Copyright # 2015 by Mutaz B. Habal, MD ISSN: 1049-2275 DOI: 10.1097/SCS.0000000000001606
1156
increase knowledge. The ASMS also gauged the willingness of members to participate in the education of their fellow members as ‘‘no cost’’ preceptors. We describe the outline of the new ASMS Preceptorship Program, a collective effort by all members to increase access to all areas of maxillofacial surgery and discuss the original survey pertinent to the development of this program, the results of the survey, and specifics regarding the structure of the program. Continuing in a great tradition of innovation, educational progress, and facilitation of educational endeavors,2,3 the preceptorship program is the first of its kind, as it is the first such program that is available on a national level, exclusively for maxillofacial surgeons.
METHODS A customized survey software was written for the ASMS by the Professional Relations and Research Institute using Perl/CHI language connecting to the SQL Server database. As part of a 7-section survey, members of the ASMS were asked if they were willing to act as preceptors for other ASMS members. The survey was sent to 799 members, including 335 active members, 4 associate members, 38 candidates, and 31 international and 391 resident/affiliate members. The e-mail sent to participants contained a link to the survey Web site, and nonresponders received an additional follow up e-mail reminder.
RESULTS A total of 67 members completed this survey, resulting in an overall response rate of 17%. Respondents reported average years of maxillofacial surgery experience as 14.5 9.9 years. Responses
FIGURE 1. ASMS survey results for preceptorship willingness among members.
The Journal of Craniofacial Surgery
Volume 26, Number 4, June 2015
Copyright © 2015 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.
The Journal of Craniofacial Surgery
Volume 26, Number 4, June 2015
TABLE 1. Areas of Specialty for Preceptorship
The ASMS Preceptorship Program
TABLE 3. Responsibilities of the Preceptor and Preceptee Within the ASMS Preceptorship Program
Areas of Specialty 1 2 3 4 5 6 7
Cranial surgery Orbital surgery Orthognathic surgery Craniomaxillofacial trauma primary reconstruction Craniomaxillofacial trauma secondary reconstruction Cleft lip and palate Primary maxillofacial trauma
pertaining to question 4 and willingness to be a ‘‘no charge’’ preceptor indicated that 25 (37%) of responders were keen to be observational preceptors, 1 to 4 times per year for 1 to 5 working days. An additional 29 (43%) of responders expressed willingness to consider being preceptors, yielding a grand total of 80% of responders willing to be preceptors of their colleagues (Fig. 1).
Preceptor List and Program Structure The members willing to serve as preceptors or to consider preceptorship are listed in the members’ corner of the ASMS Web site (http://maxface.org/membersOnly.cgi), along with details regarding institution and expertise offerings for each. Areas of expertise and further subspecialty categories are outlined in Tables 1 and 2. As a step further, to facilitate the establishment of the program, the ASMS has created a series of guidelines. These include the following: (1) standardized responsibilities for both preceptors and preceptees (Table 3), (2) prepreceptorship expectation and postpreceptorship evaluation forms to be completed by preceptor and preceptee (Figs. 2–3), and (3) a Likert scale–based evaluation to be completed and signed by both preceptor and preceptee. The goals of TABLE 2. Subspecialty Areas to Improve Proficiency Subspecialty Proficiency 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
#
Orthognathic surgery Cephalometric analysis Craniofacial osseous integrated implants Dental osseous integrated implants Biomodeling Craniosynostosis Maxillary/mandibular distraction Cranial distraction Skull base tumor ablation Microvascular craniomaxillofacial reconstruction Cleft lip and palate Secondary craniomaxillary reconstruction Facial implants Auricular reconstruction Cleft lip nasal rhinoplasty Primary and secondary rhinoplasty Nasal valve and turbinate surgery Osseous genioplasty Obstructive sleep apnea Endoscopic sinus surgery Orbital surgery Dental extraction (third molar) Facial nerve reanimation Vascular malformation of the head and neck Headache—facial pain Facial aesthetic surgery
2015 Mutaz B. Habal, MD
Role
Responsibilities
Preceptor
(1) Assign and identify an individual (secretary, coordinator, fellow, or yourself) to act as the chief organizer and contact person for the preceptee. A phone number and e-mail address should be provided to the preceptee. (2) Make appropriate efforts to schedule the preceptee’s visit to expose them to the case(s) of interest. (3) Schedule the visit at a time when you will be there. (4) Provide all necessary paperwork for hospital and operating room access to the preceptee prior to the visit. (5) The preceptor cannot charge a professional fee to the preceptee. (6) Complete the ASMS evaluation form at the end of the preceptee’s visit. (7) Serve as a representative of the ASMS. (1) Provide a curriculum vitae and background of yourself when you are scheduling your visit to the preceptor. (2) Be flexible with the preceptor’s visit schedule. (3) Respect the professional and social norms of the hospital and practice you are visiting. (4) Be responsible for all financial aspects of the visit. (5) Complete the ASMS evaluation form at the end of your visit. (6) Serve as a representative of the ASMS.
Preceptee
establishing these guidelines are to ensure (a) adherence to a standardized level of dedication and excellence from both preceptors and preceptee, (b) ample opportunity for self-evaluation and improvement, and (c) an objective measure that the ASMS could use to gauge the success of the preceptorship program.
DISCUSSION The term preceptor is defined ‘‘a specialist in a profession. . . who gives practical training to a student.’’4 In this case, both the specialist and student are ASMS members, with one being an expert in an area in which the other is seeking to gain expertise. In a recent American College of Surgeons Bulletin regarding teaching robotic surgery, observer preceptorships were found to be an effective method particularly when designed as a group
FIGURE 2. A, Preceptee prepreceptorship evaluation form. B, Preceptee postpreceptorship evaluation form.
1157
Copyright © 2015 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.
Papay et al
The Journal of Craniofacial Surgery
FIGURE 3. A, Preceptor prepreceptorship evaluation form. B, Preceptor postpreceptorship evaluation form.
learning model for safe implementation of surgical modalities and procedures.5 The success of short preceptorship programs has been documented in the surgical literature. Kolla et al6 reported the success of a 5-day mini fellowship in laparoscopic techniques provided to urology trainee surgeons. At 1- and 3-year follow-up, the study found that the 5-day experience with a mentor, preceptor, and potential proctor helped surgeons increase the scope of their practice by introducing them to new techniques with which they were previously unfamiliar. The 5-day session included tutorial sessions, hands-on skills training, and case observation.6 These findings are corroborated by Garneau et al,7 who studied a 2-part training program, the first of which was observation-based preceptorship of laparoscopic sleeve gastrectomy, and the second part was a proctorship, where a consulting surgeon and accompanying support staff came on site to the trainee surgeon’s hospital to teach. Both aspects of training were found to be an effective way of teaching the new technique, and subsequent surgeries resulted in a low complication rate and sufficient weight loss at 6 months’ follow-up.7 Much like the previously described studies, appropriate followup for the ASMS Preceptorship Program with both preceptors and preceptees is expected. The ASMS must assess the viability of the program, the impact of observation-based preceptorships on clinical practice and research endeavors, and finally members’ opinions of
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Volume 26, Number 4, June 2015
proficiency in areas of weakness identified by the 2013 ASMS survey. Since the inception of the ASMS, a culture of innovation, education, and collaboration has been successfully pursued for over 65 years through teaching courses, productive research, national meetings, social gatherings, and education for fellows/residents (S. R. Cohen).2 Although no endeavor similar to the preceptorship has been undertaken on a national scale for maxillofacial surgeons, the obvious willingness of members to foster relationships and collaboration allows us to believe in the potential success of this program. Despite the less than ideal 2013 survey response rate of 17%, we believe that the large percentage of responders willing to help fellow members is deeply encouraging, and expect more members to be willing to add themselves to the list of preceptors once the program is implemented. The willingness of ASMS members to allow fellow members to learn from one another speaks to the long history and culture of camaraderie and friendship that has resulted in productive collaboration and educational endeavors in the society. We hope that by identifying and strengthening areas of perceived weakness along with the development of a powerful academic tool, the ASMS Preceptorship Program, the ASMS can continue to make strides in influencing maxillofacial surgery on a large scale. We expect the preceptorship program to be an excellent resource for members to continue mentoring one another, developing intellectual and academic curiosity, providing avenues for collaboration, and further contributing to the ASMS’s role in shaping maxillofacial surgery into the future.
REFERENCES 1. Papay FA, Bassiri B, Taub PJ, et al. Priorities for the education of members of the American Society of Maxillofacial Surgery. J Craniofac Surg 2014;25:735–737 2. Cohen SR, Juhala CA, Manson PN, et al. History of the American Society of Maxillofacial Surgeons: 1947–1997. Plast Reconstr Surg 1997;100:766–801 3. Cohen MN, Evans GR, Wexler A, et al. American Society of Maxillofacial Surgeons, 1997 to 2006: another decade of excellence in education and research. Plast Reconstr Surg 2006;118(5 Suppl):32S–42S 4. Soukhavov A, ed. Encarta World English Dictionary. New York, NY: St. Martin’s Press; 1999. 5. Landry CS, Grubbs EG, Lee JE, et al. From scalpel to console: a suggested model for surgical skill acquisition. Bull Am Coll Surg 2010;95:20–24 6. Kolla SB, Gamboa AJ, Li R, et al. Impact of a laparoscopic renal surgery mini-fellowship program on postgraduate urologist practice patterns at 3year followup. J Urol 2010;184:2089–2093 7. Garneau P, Ahmad K, Carignan S, et al. Preceptorship and proctorship as an effective way to learn laparoscopic sleeve gastrectomy. Obes Surg 2014;24:2021–2024
#
2015 Mutaz B. Habal, MD
Copyright © 2015 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.
