title: A structured preceptorship programme for laparoscopic colorectal surgery in Wales: An early experience.
abstract: BACKGROUND
  A single experienced laparoscopic colorectal surgeon introduced an outreach preceptorship programme (OPP) for laparoscopic colorectal surgery (LCS) in Wales with the aim of supporting consultants in the early stages of their learning curve, as well as to help avoid some of the problems faced by self-taught laparoscopic surgeons. The structured programme consisted of a minimum 1 day master class at the preceptor's operating theatre, followed by multiple outreach visits by the preceptor. The aim of this study was to evaluate the effectiveness and early experience of this programme.
  
  
  METHODS
  Clinical end-points (conversions, morbidity/mortality and length of hospital stay) were analysed from a prospectively maintained database. Evaluation of the programme was based on interviews with the preceptee surgeons performed by a neutral observer.
  
  
  RESULTS
  Between May 2008 and July 2010, 11 Consultants (six hospitals) were preceptored (two still in programme). 66 cases (20 in the master class, 46 as an outreach service) were performed as a part of this programme.
  
  
  RESULTS
  Conversion rate and 30-day mortality was 1.5%. Morbidity was reported at 12% (8/66) and median length of stay was 6 days. Programme evaluation: All interviewed respondents found the master class and outreach service to be well-organised and would recommend it to their colleagues. The median number of outreach visits per hospital was 5. All the preceptees have performed independent cases since the programme.
  
  
  CONCLUSIONS
  This OPP delivers one-to-one coaching at the point of service delivery and has been shown to be effective in achieving safe transference of skills to those wishing to develop a service for LCS.
authors.affiliation: Department of Surgery, Prince Charles Hospital, Merthyr Tydfil, Wales, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Rees
authors.affiliation: Department of Surgery, Princess of Wales Hospital, Bridgend, UK.
authors.forename: Avanish
authors.initials: A
authors.lastname: Saklani
authors.affiliation: Department of Surgery, Prince Charles Hospital, Merthyr Tydfil, Wales, UK.
authors.forename: Parin
authors.initials: P
authors.lastname: Shah
authors.affiliation: Department of Surgery, Prince Charles Hospital, Merthyr Tydfil, Wales, UK ; Department of Coloproctology, University of Glamorgan, Pontypridd, UK.
authors.forename: Puthucode
authors.initials: P
authors.lastname: Haray
keywords: Colorectal; laparoscopic; preceptorship; training