title: Training Assistants Improves the Process of Adoption of Video-Assisted Thoracic Surgery Lobectomy.
abstract: BACKGROUND
  Despite overwhelming evidence of decreased pain, fewer complications, and shorter length of stay with equivalent oncologic outcomes, video-assisted thoracic surgery (VATS) lobectomy has been slow to be adopted in the community. This study evaluates the role of training surgical assistants to ease the transition to VATS lobectomy.
  
  
  METHODS
  A half-day training course for physician assistants in the specific skills needed to assist with VATS lobectomy was developed to be offered annually in conjunction with a national meeting. Each participant completed a needs assessment before the course and a course assessment afterward. One-year follow-up data were obtained from the first cohort to determine the effects of the course on their practice.
  
  
  RESULTS
  Forty-four physician assistants participated in the course in either 2013 or 2014. Participant-identified educational needs included enhanced camera navigation skills, use of specialized instruments, and knowledge of the steps of the operation to provide proactive assistance. After completing the course, 90% (n = 39) felt more confident in their ability to provide optimal visualization for the operating surgeon, and 93% (n = 40) felt more confident in their ability to recognize and anticipate the steps of a VATS lobectomy. These changes persisted at 1 year.
  
  
  CONCLUSIONS
  Specific training directed at surgical assistants may improve the adoption of new technology by mechanisms including improved visualization and better understanding of methods to facilitate the operation and avoid frustration. This type of training should be made available to assistants of surgeons learning new operations.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address: smeyerso@nm.org.
authors.forename: Shari L
authors.initials: SL
authors.lastname: Meyerson
authors.affiliation: Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Stafford S
authors.initials: SS
authors.lastname: Balderson
authors.affiliation: Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: D'Amico
mesh_terms: D006801:Humans; D010823:Physician Assistants / Q000193:education*; D011013:Pneumonectomy / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted / Q000592:standards* / Q000706:statistics & numerical data*