The survey was sent to 1,453 recipients and a total of 390 (27%) anonymous responses were received including 180 (15%) consultants (153) and trainees (27), 196 (75%) NAHPs and 14 (74%) chapter-leads
After consultation with its members, the Association of Coloproctology of Great Britain and Ireland (ACPGBI) has published a paper outlining the perceived educational needs, knowledge and skill gaps, and current barriers of the UK and Ireland colorectal community. The paper, ‘Developing a national colorectal educational agenda: a survey of the Association of Coloproctology of Great Britain and Ireland’, was published in Colorectal Disease.
“The aims of the study were to canvass multidisciplinary needs and explore the perceived gaps and barriers to meeting them. This is in line with the ACPGBI's mission statement that improving training will lead to the development of excellence in the prevention and care of bowel disease for the benefit of patients and the public,” the authors write. “…A series of training needs across the coloproctology disciplines have been identified. These will underpin the development of the educational agenda for the ACPGBI.”
The Association sought the opinion of its members and focused on colorectal consultant and nurses (including 261 non-ACPGBI colorectal nurse specialists and nursing and allied health professionals (NAHPs)).
In July, the ACPGBI emailed its entire membership and asked them to report on:
- details of attended courses over the past two years including funding source(s)
- the type of simulations and course accreditation
- access to education (accessibility of education events and the barriers to attending courses)
- ways of learning (how they learn new skills and plans for achieving current needs)
- gaps in education and learning needs (for knowledge and technical and non-technical skills) and;
- how the ACPGBI can assist them to meet these challenges in the future.
The survey was sent to 1,453 recipients and a total of 390 (27%) anonymous responses were received including 180 (15%) consultants (153) and trainees (27), 196 (75%) NAHPs and 14 (74%) chapter-leads.
A majority (84%) of responders attended two to three courses over the last two years, 78% of these courses were held in the UK, although 24% were not continuing professional development (CPD) accredited. Interestingly, 45% attended a course purely to meet CPD requirements. Consultant responders said that a lack of funding and difficulties obtaining study leave were the main restrictions to attending educational courses and meetings.
Training in transanal total mesorectal excision (TaTME) was the top educational need among consultants (52%) with laparoscopic fellowships for colorectal surgery forming the top need for trainees and formal management and leadership training was the highest stated priority for non-technical skills.
In all, 196 NAHPs responded to the survey with 95% identifying themselves as colorectal nurse specialists. Interestingly, 50% were not previously aware of the ACPGBI NAHP group. Similar to consultants, 82% reporting that they had insufficient funding to attend desired educational activities.
79% of NAHPs highlighted self-perceived knowledge gaps in their coloproctology education including non-clinical (management and leadership, legal issues, research and audit) and clinical (stoma care, enhanced recovery, tissue viability and general surgery) topics. Developing and supporting the advanced nurse practitioner role in coloproctology was one of the top requirements of NAHPs.
Top 10 key educational needs in coloproctology were
1. Improve access to relevant courses and education events across all disciplines, including information and funding support
2. Support practical skills training for consultants in TaTME
3. Improve access to laparoscopic colorectal fellowships for senior trainees
4. Support lower gastrointestinal endoscopy training for colorectal trainees
5. Provide regular coloproctology updates encompassing latest research
6. Provide best evidence guidelines with benchmarking and audit
7. Develop specific NAHP focused colorectal knowledge courses
8. Develop and support the coloproctology advanced nurse practitioner role
9. Support bespoke general surgery and non-clinical training for management, leadership and medicolegal issues across all disciplines
10. Support the delivery of regional educational activities across the chapters
The proposed educational curriculum based on survey findings are:
1. Develop a coordinated information hub that can serve multiple purposes
(a) Contain all upcoming courses, conferences and chapter activities with regular e-mail dissemination of upcoming events
(b) Provide a platform for education and educational materials
(c) Promote networking among members across the chapters to support professional issues and career development
2. Facilitate access and affordability of training and educational activities in coloproctology including
(a) Increase provision of ACPGBI knowledge courses through the motorway coloproctology courses
(b) Support fellowships and advanced nurse practitioner roles through partnership with other educational stakeholders in coloproctology
3. Support training initiatives to colorectal consultant for novel procedures to ensure safe introduction of novel techniques such as TaTME
4. Structure and enhance the quality of chapter educational activities, including defining an active and clear role for trainees and nurses
5. Ensure optimum delivery of educational activities through promoting the use of course accreditation and CPD approval system
The ACPGBI has already taken steps to develop the educational framework of the ACPGBI, including a redesign of the ACPGBI website improving the accessibility to members of educational and training activities, and the relaunch of the ‘ACPGBI motorway coloproctology course’ making the meeting more affordable for all members – in part – by rotating the location of the meeting and increasing its capacity which should reduce costs.
“Following this survey, a structured training programme for TaTME based on an agreed framework of training curriculum has been proposed and agreed by the ACPGBI with a national TaTME pilot training programme set to run in the UK in the near future,” the paper concludes. “Additionally, the ACPGBI has been in discussion with the Royal College of Surgeons of England to explore collaborative approaches to addressing the issue of laparoscopic colorectal fellowships for the benefit of members of both organisations.”
To access this paper, please click here