The nature of our research interests fosters interdisciplinary collaboration with economists, epidemiologists, measurement specialists, as well as other health professionals, including nursing, physiotherapists, nutritionists, pain specialists, and pharmacists.
Our research program focusses on 1. Patients outcomes stream and 2. Surgical education stream
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Patients outcomes stream
What matters to patients and what surgeons need to know.
The driving force behind surgical innovation – including MIS, enhanced recovery pathways, and new technologies to strengthen trainees’ surgical skills – is to improve patient outcomes while performing safe and effective surgery. Yet measuring the impact and effectiveness of these interventions is a complex and somewhat elusive task. It involves assessment of traditional clinical endpoints, patient-reported outcomes, costs, as well as surgical performance.
The focus of our research is to define and measure the relevant domains of surgical recovery and to investigate strategies that may enhance this process. We use both traditional clinical and audit data as well as patient-reported measures to determine the effect of introducing prehabilitation programs and Enhanced Recovery Perioperative Care Pathways (ERPs), as well as the cost (economic and societal) of these. These programs and pathways have been developed by a multidisciplinary team based on the best available evidence and on the needs and possibilities of our institution. Patient-level prospectively collected data is also being used to validate HRQL instruments commonly used to measure surgical outcomes and to study the properties of these instruments when applied to a surgical population. A dedicated research assistant and a statistician maintain databases for ongoing randomized trials and cohort studies.
Surgical education stream
We have developed a manual skills training system in a physical simulator, called MISTELS. This training system requires the completion of a series of tasks in a physical simulator with a system to measure performance that has been shown to be reliable and valid. This system has been widely used across North America and has been adopted by the Society of American Gastrointestinal and Endoscopic Surgeons as a component of their Fundamentals of Laparoscopic Surgery education and certification program. It is has been endorsed and co-sponsored by the AmericanCollege of Surgeons.
Educational research projects include training and evaluation of manual skills, the development of a system of metrics that has been shown to be reliable and valid and the definition of competence using the manual skills system as an objective measuring tool.
Our group has also led a multi-institution effort to develop a training and assessment tool – the Global Operative Assessment of Laparoscopic Skills – to evaluate proficiency in essential laparoscopic skills.10 This was then adapted specifically for inguinal and incisional hernia (GOALS-GH, GOALS-IH) and for flexible endoscopy (GAGES). We continue to be actively involved in identifying valid ways of translating skills and abilities in a simulated environment to the operating room.
