Mentorship for Participants in a Laparoscopic Colectomy Course

INTRODUCTION: Despite data suggesting improved outcomes with laparoscopic colectomy (LC), less than 10% of colectomies in the USA are currently performed laparoscopically . One mechanism of incorporating LC into practice is to attend a LC Course (LCC). Post-course mentorship is recommended by SAGES and the ASCRS, in addition to course participation, to encourage adoption of the new techniques. As the use of LC will likely increase, access to mentorship is an important consideration for LCC participants. We sought to evaluate mentorship access and related factors for participants in an ongoing LCC.

METHODS: Participants in 6 consecutive single center LCCs were anonymously surveyed regarding age, specialty, surgical experience, practice, and mentorship availability. Contingency and regression analyses were performed.

RESULTS: 84 participants were surveyed; 70 (85%) were male, and 47 (56%) were general surgeons. Detailed information is provided in Table 1. Of the 64 participants surveyed about mentorship, 60% (40) had access to a mentor. 58 (69%) performed ≤1 advanced laparoscopic case monthly at the time of participation. Factors associated with access to a mentor on univariate analysis included age (OR=0.40, 95% CI [0.04-0.44], p=0.001), level of training (OR=0.54, 95% CI [0.3, 0.96], p=0.041), and being a general surgeon (OR=0.32, 95% CI [0.11, 0.92], p=0.034). 26% (12/46) of younger surgeons (<47 years of age) did not have access to a mentor, as compared with 71% (15/21) of surgeons ≥47 years old. Older surgeons consistently had less access to mentorship in multivariate analysis (OR=0.12, 95% CI [0.025, 0.578], p=0.008).

CONCLUSIONS: A significant number (40%) of surgeons participating in LCC have limited access to mentors. In particular, older surgeons have the least access to mentorship. Further study is needed to see if lack of mentorship is a hurdle for surgeons incorporating these techniques into practice. In order to encourage adoption of LC, training methods should be adopted which accommodate surgeons without access to mentors. Possible strategies include longer or multi-session courses, simulator training, and remote mentoring.

Table 1

Parameter

N=84

#(%)

OR

[95% CI]

p-value*

Participants with access to a colleague who:1
Performs advanced laparoscopic surgery 51(76.1%)
Performs laparoscopic colectomies 47(70.2%)
Is able to be a “preceptor” 48(71.6%)
Participants with a mentor2 40(59.7%) —– —–
Age Group

0.14 [0.04,0.44]

0.001*
Less than 47 years 46(68.7%)
47 years and older 21(31.3%)
Sex

0.45 [0.08,2.44]

0.356
Male 70(85.4%)
Female 12(14.6%)
Training Level

0.54 [0.30,0.96]

0.041*
Resident/Fellow 29(34.5%)
Junior Attending (<5 years experience) 19(22.6%)
Senior Attending (>5 years experience) 36(42.9%)
Surgical Specialty

0.32 [0.11,0.92]

0.034*
General Surgery 47(56.0%)
Other3 37(44.0%)
Monthly Advanced Laparoscopic Cases

0.99 [0.49,1.98]

0.970
<1 Case 58(69.1%)
1-5 Cases 18(21.4%)
>5 Cases 8(9.5%)

*Significant p-value < 0.05, univariate logistic regression
1Mentorship evaluated in 64 surveys
2Dependent variable in the logistic regression. Participants had a "mentor" if they had access to the 3 parameters above
3Other included Colorectal, Surgical Oncology, Minimally Invasive, and other
4Advanced cases included cases other than appendectomy, cholecystectomy, and hernia repair


Session: Poster

Program Number: P197

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