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Training the gynecologic oncologists of the future – challenges and opportunities
  1. Ben-Lawrence Kemah1,2,
  2. Nanak Bhagat3,
  3. Aayushi Pandya4,
  4. Richard Sullivan5 and
  5. Sudha S Sundar6,7
  1. 1Department of Obstetrics and Gynaecology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
  2. 2Department of Health Research, Health Education and Research Organisation (HERO), Buea, Cameroon
  3. 3Department of Gynaecological Oncology, Aberdeen Royal Infirmary, Aberdeen, UK
  4. 4Department of Obstetrics and Gynaecology, Barts Health NHS Trust, London, UK
  5. 5Department of Cancer and Global Health, King's College London, London, UK
  6. 6Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
  7. 7Pan Birmingham Gynaecological Cancer Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
  1. Correspondence to Professor Sudha S Sundar, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; S.S.Sundar{at}bham.ac.uk

Abstract

Several recent advances in gynecologic cancer care have improved patient outcomes. These include national screening and vaccination programs for cervical cancer as well as neoadjuvant chemotherapy for ovarian cancer. Conversely, these advances have cumulatively reduced surgical opportunities for training creating a need to supplement existing training strategies with evidence-based adjuncts. Technologies such as virtual reality and augmented reality, if properly evaluated and validated, have transformative potential to support training. Given the changing landscape of surgical training in gynecologic oncology, we were keen to summarize the evidence underpinning current training in gynecologic oncology.

In this review, we undertook a literature search of Medline, Google, Google Scholar, Embase and Scopus to gather evidence on the current state of training in gynecologic oncology and to highlight existing evidence on the best methods to teach surgical skills. Drawing from the experiences of other surgical specialties we examined the use of training adjuncts such as cadaveric dissection, animation and 3D models as well as simulation training in surgical skills acquisition. Specifically, we looked at the use of training adjuncts in gynecologic oncology training as well as the evidence behind simulation training modalities such as low fidelity box trainers, virtual and augmented reality simulation in laparoscopic training. Finally, we provided context by looking at how training curriculums varied internationally.

Whereas some evidence to the reliability and validity of simulation training exists in other surgical specialties, our literature review did not find such evidence in gynecologic oncology. It is important that well conducted trials are used to ascertain the utility of simulation training modalities before integrating them into training curricula.

  • Gynecologic Surgical Procedures
  • Miscellaneous

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Footnotes

  • B-LK and NB are joint first authors.

  • Twitter @ben_kemah, @sundar_sudha

  • Contributors SS conceptualised the paper, selected search terms, supervised the searches, reviewed drafts and edited the manuscript. B-LK, NB and AP performed searches, extracted information and wrote the paper. RS reviewed the manuscript.

  • 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.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.