A new chapter began at the University of the Free State (UFS) as the institution welcomed cardiothoracic surgeons who gathered in Bloemfontein for an Assessing Assessment symposium to evaluate SA specialist training requirements and international trends.
Certifying cardiothoracic surgeons and perfusionists (technologists who manage the heart-lung machines during open-heart surgery) for independent clinical practice remains an international challenge. Often examinations and assessment outcomes by statutory bodies do not relate to actual workplace performance. Assessing assessment is therefore a constant and continuous process to evaluate present structures and systems and benchmark South African training outcomes against international board requirements with a view to retaining our international recognition.
The Robert WM Frater Cardiovascular Research Centre, which is based in the Department of Cardiothoracic Surgery at the UFS, presented the Hannes Meyer Registrar Symposium in the Faculty of Health Sciences from 1 to 3 November. This symposium was supported by the College of Cardiothoracic Surgeons of South Africa and the Society of Cardiothoracic Surgery of South Africa (SCTSSA). We were privileged to host a delegation from the European Association for Cardiothoracic Surgery (EACTS), which included the Secretary General, Dr Patrick Myers, the vice-chairperson of the European Board of Cardiothoracic Surgery examinations, Dr Eduard Quintana, and Dr Alicja Zientara, member of the Education Committee of EACTS. Prof Francis Smit (UFS) is also a member of the EACTS Education Committee and is the current President of the College of Cardiothoracic Surgeons of South Africa.
The symposium was attended by all heads of training departments in SA or their delegates, and two registrars and two perfusionists from each training unit. The college council and the SCTCS were also represented, as well as a delegation from the ESCTS and the industry. A total of 65 delegates attended. The symposium programme included mock examinations in the current Colleges of Medicine of SA (CMSA) format, containing written assessments as well as imaging and objective structured clinical examinations (OSCE).
The use of simulation-based training and simulation-based assessment was evaluated in the UFS simulation laboratory. The simulation programme evaluated bench models for basic surgical techniques, and the use of our high-fidelity Califia system (functioning like a real open-heart procedure with the whole team in action). The simulation exercise also included a course in ECMO and VAD devices (devices supporting lung and heart function, for example in COVID-19 patients) and transcatheter vascular surgery for catheter base replacement of the thoracic aorta.
Comments from participants:
Dr Patrick Myers: “This has been a wonderful experience. The use of simulation in Bloemfontein is remarkable and provides a viable training alternative for surgeons in training.”
Dr Alicja Zientara: “This is my second visit to Bloemfontein. Registrar training using Califia simulation is a great training alternative and EACTS is interested in evaluating the implementation of similar or adapted programmes.”
Dr Eduard Qjuijtana: “The CMSA examination should be upgraded to an integrated MCQ-based examination where written and OSCE formats of the present SA assessment should be integrated.”
Prof Smit: “This was a fantastic weekend where valuable information was obtained through an interactive process. It will certainly form the basis of the development of an upgraded CMSA assessment structure.”
Prof Tim Pennel: Head of Department at UCT, College Council, and Vice-President of SCTSSA:
“This Hannes Meyer symposium was a milestone in the discussion about assessment of SA training and structures. The information gained will be invaluable in our efforts to develop new and internationally relevant assessment and training programmes for SA.”