The Definitions Document: A Reference for Use of SAGES Guidelines
Miscellaneous published on: 01/2009
by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)
The Definitions Document: A Reference for Use of SAGES Guidelines
CLINICAL PRIVILEGES
Authorization by a health care organization allowing a health care practitioner to provide a defined class of patient care services.
COLLABORATIVE PRACTICE
A medical or surgical procedure performed by two or more competent health care
practitioners within the same or different specialties. These practitioners will have
expertise in various portions of the procedure, so that all aspects of the procedure are
safely and proficiently performed. Common examples of collaborative practice are
1) A surgeon(s) would provides anatomical access to allow the other(s) to perform a
specific task. 2) Two surgeons in the same specialty with complimentary technical skills
and knowledge.
COMPLETE PROCEDURAL CONDUCT
Competency of the applicant and/or institution regarding patient selection, peri-procedural care, conduct of the operation, technical skill and equipment necessary to safely complete the procedure using laparoscopic and/or thoracoscopic techniques, and the ability to proceed immediately with the traditional open procedure
COMPETENCE
A health care practitioner’s capability to utilize their skill and knowledge, derived through training and experience, to safely and proficiently perform a task or procedure. - OR – The ability of a health care practitioner to perform up to defined expectations.
CO-SURGEON
A co-surgeon is one of two or more surgeons of the same or different specialties working together to perform a specific procedure. Each co-surgeon assumes primary responsibility for that portion of the patient care and operative procedure that falls within his/her area of expertise.
COURSE
This is a limited period of instruction that should offer category I Continuing Medical Education (CME) credits that meet American Medical Association (AMA) standards. The course should be taught by instructors with appropriate clinical experience. The curriculum should include didactic instruction, hands on experience utilizing inanimate and/or animate educational tools, and the opportunity to observe performance of the task by an instructor. Documentation must verify the level of the attendee’s participation, i.e. attendance, mastery of course objectives, etc. A formal course alone is generally not appropriate training to begin performing a procedure independently.
CREDENTIALS
Documented evidence of licensure, education, training, experience, or other qualifications.
DOCUMENTED TRAINING AND EXPERIENCE
- Case list that must specify the applicant’s role (primary surgeon/operator, co-surgeon, first assistant, chief resident, junior resident or observer). Complications, outcomes, and conversion to traditional techniques should be included if known. The applicant must specify if these details are not known.
- Summary letter from preceptor and/or program director and/or chief of surgery (should state if applicant can independently and competently perform the procedure in question).
LAPAROSCOPY AND THORACOSCOPY
Specialized areas within the field of surgery, which require unique knowledge and skills related to equipment, physiology, and operative technique, whether the procedure is performed inside or outside of the traditional operating room.
MAY OR COULD
Optional recommendation; many alternatives may be appropriate
MUST OR SHALL
Mandatory or indispensable recommendation
PERI-PROCEDURAL CARE
Competency and participation in the necessary pre-treatment preparation process, treatment course, and post-treatment period by both the responsible physician and the facility where the patient will be cared for.
PRECEPTEE
A surgeon with appropriate basic knowledge and experience seeking individual training in skills and/or procedures not learned in prior formal training. The trainee must have appropriate background knowledge, demonstrated basic skills, and clinical experience relevant to the proposed curriculum.
PRECEPTOR
An expert surgeon who undertakes to impart his/her clinical knowledge and skills in a defined setting to a preceptee. The preceptor must be appropriately privileged, board certified, skilled, and experienced in the procedure(s) and or technique(s) in question. In order to serve as a preceptor in a specific procedure or technique, the surgeon (preceptor) must be a recognized authority (e.g. publications, presentations, extensive clinical experience) in the particular field of expertise.
PRECEPTORSHIP
An individual educational program in which a health care practitioner acquires additional skills, judgment, and/or knowledge to improve his/her performance of specific medical or surgical techniques and/or procedures. The preceptorship should define eligibility for participation, have a defined curriculum, and provide documentation of attendance, successful/unsuccessful completion of the program, and whether or not the health care practitioner can independently perform the intended procedure.
PRE-TEST
A quantifiable examination of a trainee’s level of clinical knowledge, manual skills or technical proficiency prior to commencing a training course.
PRIVILEGE
The process whereby a specific scope and content of patient care services (that is, clinical privileges) are authorized for a health care practitioner by a health care organization based on evaluation of the individual’s credentials and performance.
POST-TEST
A quantifiable examination of a trainee’s level of clinical knowledge, manual skills or technical proficiency after completion of a training course.
PROCTOR
A proctor differs from a consultant or a preceptor in that he/she functions as an observer and evaluator, does not directly participate in patient care, does not serve simultaneously as a preceptor, and receives no fees from the patient. Proctoring may be an element of the privileging process. The proctor should be responsible to the privileging committee, and not to the patient or to the individual being proctored. The proctor must have qualifications allowing him/her to make a determination of competency based on the observations. These qualifications should be defined by the appropriate staff of the health care facility. In rare cases, a proctor may intervene during a procedure on an emergency basis, and assume responsibility for patient care in order to preserve the welfare of the patient.
SHOULD
Highly desirable recommendation; a limited number of alternatives may be appropriate
SKILLS
The ability to use one’s knowledge effectively and readily for the performance of a task or procedure.
SKILLS LABORATORIES
A specialized, dedicated location (separate from the patient care area) in which a health care practitioner or student acquires, refines, and/or improves his/her ability to perform specific medical/surgical tasks or procedures utilizing animate and/or inanimate educational tools.
