Unifying the Hepatopancreatobiliary Surgery Fellowship Curriculum via Delphi Consensus

Background

HPB Fellowship training in the Americas consists of three distinctive routes with variable curricula: Surgical Oncology Fellowship via the Society of Surgical Oncology (SSO), Abdominal Transplant Surgery Fellowship via the American Society of Transplant Surgeons (ASTS), and HPB Fellowship via the Americas Hepato-Pancreato-Biliary Association (AHPBA). Our objective was to establish a pan-American consensus among hepatopancreatobiliary (HPB) surgeons, surgical oncologists, abdominal transplant surgeons, and general surgery residency program directors (GSPDs) on a core knowledge curriculum for HPB fellowship and to identify topics appropriate for general surgery residency and subspecialty beyond HPB fellowship.

Study Design

A three-round modified Delphi process was used. The baseline statements were developed by the Education and Training Committee of the AHPBA in collaboration with representatives of the SSO, ASTS, and GSPDs. The expert panel, consisting of members of the three societies together with GSPDs, rated the statements on a 5-point Likert scale and suggested editing or adding new statements. A statement was included in the final curriculum when Cronbach’s alpha value was ≥ 0.8 and ≥ 80% of the panel agreed on inclusion.

Results

The response rate was 100% for the first, and 98% for the second and third rounds. Eighty-nine of 138 proposed statements were included in the final HPB fellowship curriculum. Curricula for general surgery residency and subspecialty beyond HPB fellowship included 50 and 29 statements, respectively.

Conclusions

A multi-national consensus on core knowledge for an HPB fellowship curriculum was achieved via the modified Delphi method. This core curriculum may be used to standardize HPB fellowship training across different pathways in the Americas.

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