{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"Show Me The Evidence","title":"The Crisis in Surgical Training & Proficiency-Based Progression (PBP)","html":"","width":"100%","height":180,"duration":3876,"description":"Guest: Professor Anthony G Gallagher\nTopic: The Crisis in Surgical Training & Proficiency-Based Progression (PBP)\nEpisode Summary\nIn this inaugural episode, Patrick Kiely sits down with Professor Tony Gallagher — founder of Proficiency-Based Progression and one of the world's leading researchers in surgical skills assessment and simulation-based training — to examine a deeply uncomfortable truth: that professional credentialing in medicine tells us almost nothing about actual clinical competence. Tony shares 30 years of evidence challenging the assumptions underpinning surgical and procedural training worldwide, and makes the case for Proficiency-Based Progression (PBP) as the superior — and inevitable — alternative.\nKey Topics Covered\n1. The Competence Problem in Surgery — 0:00\nWhy credentials don't equal competence\nThe Halsted training paradigm — developed in the late 19th/early 20th century — and why it's still in use\nHow to actually find out if your surgeon is good (hint: ask the theater sister)\n2. Why Current Training Metrics Are Failing — 5:08\nProcedure volume and hours logged as proxies for competence — and why they're wrong\nThe misuse of Likert-type scales in surgical assessment\nReduced work hours legislation (Europe/US) and its impact on trainee experience\nThe Libby Zion case (New York) and how it changed US residency hours\n3. The Yale Study That Changed Everything — 9:53\nThe landmark 2002 Yale study showing simulator-trained residents made 60% fewer errors\nWhy it became a citation classic — and why change was still slow\nPublication:  Gallagher & Seymour (2002). Virtual reality training for laparoscopic surgery. Annals of Surgery, October 2002. (Presented at American Surgical Association, April 2002) https://journals.lww.com/annalsofsurgery/abstract/2002/10000/virtual_reality_training_improves_operating_room.8.aspx\n\n4. The American College of Surgeons Response — 12:29\nGerry Healy's pivotal leadership shift at the Boston meeting\nThe establishment of...","thumbnail_url":"https://img.transistorcdn.com/JPxx16guuIWtjNqUkS-VeCJVeP1R-gkQQ7xD4SsyqqM/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS9lZGMy/MjkyM2UxYTkzZmM5/ZjVkMmI4MzAzOTM0/YTIzYi5wbmc.webp","thumbnail_width":300,"thumbnail_height":300}