title: What surgical skills rural surgeons need to master.
abstract: BACKGROUND
  As new technology is developed and scientific evidence demonstrates strategies to improve the quality of care, it is essential that surgeons keep current with their skills. Rural surgeons need efficient and targeted continuing medical education that matches their broader scope of practice. Developing such a program begins with an assessment of the learning needs of the rural surgeon. The aim of this study was to assess the learning needs considered most important to surgeons practicing in rural areas.
  
  
  METHODS
  A needs assessment questionnaire was administered to surgeons practicing in rural areas. An additional gap analysis questionnaire was administered to registrants of a skills course for rural surgeons.
  
  
  RESULTS
  Seventy-one needs assessment questionnaires were completed. The self-reported procedures most commonly performed included laparoscopic cholecystectomy (n = 44), hernia repair (n = 42), endoscopy (n = 43), breast surgery (n = 23), appendectomy (n = 20), and colon resection (n = 18). Respondents indicated that they would most like to learn more skills related to laparoscopic colon resection (n = 16), laparoscopic antireflux procedures (n = 6), laparoscopic common bile duct exploration/ERCP (n = 5), colonoscopy/advanced techniques and esophagogastroscopy (n = 4), and breast surgery (n = 4). Ultrasound, hand surgery, and leadership and communication were additional topics rated as useful by the respondents. Skills course participants indicated varying levels of experience and confidence with breast ultrasound, ultrasound for central line insertion, hand injury, and facial soft tissue injury.
  
  
  CONCLUSIONS
  Our results demonstrated that surgeons practicing in rural areas have a strong interest in acquiring additional skills in a variety of general and subspecialty surgical procedures. The information obtained in this study may be used to guide curriculum development of further postgraduate skills courses targeted to rural surgeons.
authors.affiliation: Nora Institute for Surgical Patient Safety of the American College of Surgeons, Chicago, IL; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address: ahalverson@nmff.org.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Halverson
authors.forename: Tyler G
authors.initials: TG
authors.lastname: Hughes
authors.forename: David C
authors.initials: DC
authors.lastname: Borgstrom
authors.forename: Ajit K
authors.initials: AK
authors.lastname: Sachdeva
authors.forename: Debra A
authors.initials: DA
authors.lastname: DaRosa
authors.forename: David B
authors.initials: DB
authors.lastname: Hoyt
mesh_terms: D002983:Clinical Competence; D006801:Humans; D020380:Needs Assessment; D019035:Rural Health Services / Q000592:standards*; D012424:Rural Population; D013043:Specialties, Surgical / Q000592:standards*; D011795:Surveys and Questionnaires; D014481:United States