{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"Show Me The Evidence","title":"Dr Ruben DeGroote, From Proficiency to Wisdom in Surgical Training","html":"<iframe width=\"100%\" height=\"180\" frameborder=\"no\" scrolling=\"no\" seamless src=\"https://share.transistor.fm/e/7aa03d61\"></iframe>","width":"100%","height":180,"duration":3605,"description":"Show Me the Evidence\nGuest: Dr Ruben De Groote\nTopic: From Time to Competence: Proficiency-Based Progression and the Reinvention of Robotic Surgical Training\nEpisode Summary\n\nIn this episode, Professor Tony Gallagher sits down with Dr Ruben De Groote, consultant urologist at OLV in Aalst, Belgium, CEO of 4Health and its digital learning platform Surgquest, and the researcher behind a recently completed PhD on Proficiency-Based Progression (PBP) robotic surgical training across three surgical disciplines. Ruben and Tony first met in 2019 while developing and validating the metrics for the robot-assisted radical prostatectomy.\nTogether they examine an uncomfortable reality: the century-old Halstedian apprenticeship model can no longer produce surgeons who are ready to operate independently. Reduced theatre exposure, rising bureaucracy, and working-hours legislation have hollowed out the \"see one, do one, teach one\" paradigm, leaving as many as one in three residents unready for independent practice. Ruben makes the evidence-based case for PBP: a standardised, metric-driven approach that measures what a surgeon actually does, gives explicit formative feedback, and trains to a benchmark rather than to a clock. The conversation moves from the failings of subjective assessment through a multi-specialty randomised controlled trial, and on to the harder question of how surgeons progress from proficiency to genuine wisdom.\nKey Topics Covered\n\n1. Why the apprenticeship model is breaking down (0:50) The Halstedian \"see one, do one, teach one\" model relied entirely on graded theatre exposure. Over the last 15 to 20 years, bureaucracy and a legal cap on working hours (departments are penalised for exceeding roughly 60 hours a week on average) have eroded that exposure. The result is a vicious circle in which trainees get less time in the operating room, and fellowships originally meant for super-specialisation are being repurposed simply to reach independence.\n2. Where the...","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}