Teaching and learning metabolic bariatric surgery

The research in this thesis of Mirjam Kaijser focuses on training in metabolic bariatric surgery (MBS), particularly in the context of Dutch surgical education system. It highlights the shift from traditional master-apprentice learning to a competency-based system driven by high healthcare standards and work-hour regulations. The curriculum is structured around "Entrustable Professional Activities" (EPAs), one of which focusses on MBS.

The thesis is divided into three parts:

1. Current Training Practices: It reviews the existing international literature and the training practices in the Netherlands, emphasizing the need for structured laparoscopic training, simulation, and stepwise learning for procedures like the Roux-en-Y gastric bypass (LRYGB) and sleeve gastrectomy (LSG).
2. Training and Assessment: The second part introduces a Delphi-consensus on key steps in MBS procedures. A specific assessment tool is developed, to evaluate surgical trainees' independence in the steps of the LRYGB, contributing to a more standardized training approach.
3. Technical Training: The final part focusses on technical skills, such as estimating bowel length during surgery. Training experiments show that focused training reduces errors in surgical tasks.

The thesis concludes by proposing a three-part MBS curriculum, offering a framework for comprehensive training in metabolic bariatric surgery, enabling future surgeons to master MBS procedures and manage related complications effectively.