title: Innovative training for new surgical roles--the place of evaluation.
abstract: BACKGROUND
  This paper describes the central role of 'external' evaluation, provided by an independent researcher, in developing an innovative curriculum for new professional roles with surgery. Workforce changes affecting the National Health Service provided an opportunity to develop 2 new roles and design training programmes to support them. The perioperative specialist practitioner (PSP) role was designed from scratch, while surgical care practitioner (SCP) training built on existing practice. Training programmes combined formal modules at Imperial College London (approximately 48 days over 10 months) with supervised clinical practice in each participant's base hospital. Programmes balanced factual knowledge, clinical and communication skills, professional issues and personal development and used a range of innovative techniques.
  
  
  METHODS
  A qualitative approach based on a utilisation-focused model monitored the development and implementation of 4 pilot PSP and SCP training programmes. A total of 124 individual and 48 group interviews were conducted at intervals over 3 years, sampling course participants, the project team clinical supervisors and administrators. An independent researcher collected, analysed and presented data at key stages, feeding back findings to the project team as the programmes evolved.
  
  
  CONCLUSIONS
  Effective training programmes for new roles can be developed, but the process is time-consuming and requires sensitivity. An independent evaluator offers great benefits, modulating the collaborative partnership between participants and project team. Positive responses (relating to content and teaching methods) from our study enabled us to refine a learner-centred programme. Negative responses often demanded immediate action to address important concerns, and evaluation provided early warning. External evaluation provides a vital perspective in the development of curricula supporting new roles.
authors.affiliation: Department of Biosurgery and Technology, Imperial College London, St Mary's Campus, London W2 1NY, UK. r.kneebone@imperial.ac.uk
authors.forename: R L
authors.initials: RL
authors.lastname: Kneebone
authors.forename: D
authors.initials: D
authors.lastname: Nestel
authors.forename: J
authors.initials: J
authors.lastname: Chrzanowska
authors.forename: A E
authors.initials: AE
authors.lastname: Barnet
authors.forename: A
authors.initials: A
authors.lastname: Darzi
mesh_terms: D003479:Curriculum; D004502:Education, Medical, Continuing / Q000379:methods*; D013502:General Surgery / Q000193:education*; D007318:Inservice Training / Q000379:methods*; D008131:London; D013222:State Medicine; D006113:United Kingdom