Spinal surgery fellowship education in Canada: evaluation of trainee and supervisor perspectives on cognitive and procedural competencies.
METHODS
A cross-sectional survey of spine surgery fellowship educators and trainees.


OBJECTIVE
To determine educator and trainee perspectives on the relative importance of core cognitive and procedural competencies in fellowship training. To determine perceptions of confidence in competencies by trainees near the end of their fellowship. Finally, to determine potential differences comparing surgeons by background specialty training (neurosurgical or orthopedic) of their views on competencies.


BACKGROUND
Spine surgery is a growing subspecialty with increasing collaboration among specialists of varied specialty backgrounds involved in education. With the recent implementation of competency-based curricula during specialty training, opportunities may exist in enhancing fellowship education.


METHODS
A questionnaire on cognitive and procedural competencies was administered (online and paper) to fellowship educators and trainees across Canada. A follow-up questionnaire was administered to nonresponders 3 months later. Survey results were summarized using qualitative and descriptive statistics with comparative analyses performed.


RESULTS
Of the identified respondents, the response rate was 91%, (15/17 fellow trainees; 47/51 educators). Twelve of the 13 core cognitive skill categories were rated as being important to acquire by the end of fellowship. Trainees were not comfortable performing, and requested additional training in 8 of the 29 less common and technically demanding procedural skills. There were different perceptions on the relative importance of competencies comparing trainees by specialty background as well as different perceptions on the types of competencies where additional training was desired to achieve competency (P < 0.05). Fellowship educators and trainees possessed similar perceptions on the relative importance of core cognitive and procedural competencies required for successful training.


CONCLUSIONS
Background specialty influenced the perceptions of both fellowship educators and trainees. This study identified potential gaps or perceived deficiencies in the competency of current fellows. Improvements in spine fellowship education should target these areas through developing evidence-based curriculum changes.
Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, Holland Musculoskeletal Program, University of Toronto, Toronto, Ontario, Canada.
Harsha
H
Malempati
Veronica M R
VM
Wadey
Scott
S
Paquette
Hans J
HJ
Kreder
Eric M
EM
Massicotte
Raja
R
Rampersaud
Charles
C
Fisher
Marcel F
MF
Dvorak
Michael G
MG
Fehlings
David
D
Backstein
Albert
A
Yee
D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003071:Cognition; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D019637:Orthopedic Procedures / Q000193:education / Q000592:standards*; D013038:Specialization / Q000592:standards*; D013122:Spinal Diseases / Q000601:surgery