The Essentials of Bariatric and Metabolic Surgery: A New Course for Every Provider Caring for Patients with Obesity
An Interview with: Daniel B. Jones, MD, MS, FASMBS Daniel B. Jones, MD, MS, FASMBS, Professor of Surgery, Harvard Medical School; Vice Chair, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Dr. Jones, thank you for taking the time to discuss the Essentials of Bariatric & Metabolic Surgery App. Please provide a history of what is now the Essentials of Bariatric & Metabolic Surgery App. How were you involved in its creation and evolution?
Dr. Jones: Ten years ago we were doing laparoscopic gastric bypass and adjustable band operations at Beth Israel Deaconess Medical Center (BIDMC), Boston, Massachusetts. Anesthesiologists, covering surgeons, and nurses would frequently confuse these two operations. Providers had lots of questions about preoperative assessment and postoperative follow up.
CRICO-RMF, which is the malpractice carrier for the Harvard hospitals, approached my wife Stephanie Jones (Associate Professor, Harvard Medical School; Vice Chair for Education and Residency Program; Director, Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts) and I to create an online module to teach about the perioperative care of the patient of size. Three years later we had a robust educational curriculum that covered the preoperative, intraoperative, and postoperative care of the bariatric surgery patient.
Over the next five years, almost every post-anesthesia care unit (PACU) nurse, operating room nurse, floor nurse, bariatric team member, anesthesiologist, and cross covering general surgeon completed the educational module. It was a huge success.
However, the module started to become outdated as new procedures like the laparoscopic sleeve gastrectomy became popular. CRICO-RMF took the module offline. BIDMC nurse educators and program directors asked if we could update and bring it back We approached the American Society for Metabolic and Bariatric Surgery Foundation to update the module at a national level. Under the leadership of Dr. Raul Rosenthal, the Foundation awarded a $30,000 grant. Dr. John Morton established a multidisciplinary task force during his term as ASMBS president.
Please provide an overview of the App’s sections and how they were built.
Dr. Jones: The program is available at http://essentials.asmbs.org/. When you first log on, the user must register as one of the following: surgeon, integrated health, anesthesiologist, anesthetist, nurse practitioner/physician assistant, or other physician. Once registered, the user is directed to take a pre-assessment, allowing them to test their knowledge before completing the course. The pre- and post-assessment tests are catered to the different learner groups. Afterwards there are a series of modules that you can work through. The module topics are as follows: Preoperative Evaluation, Metabolic Procedures, Intraoperative Considerations, Postoperative Management, Complications, Outcomes, and finally the post-test and continuing education section. The program allows users to repeat the test if they answer any questions incorrectly.
Audio clips and hyperlinks allow the learner to drill down and learn more. Color illustrations make it easy to learn about different operations and complications. Legal case reports emphasize the consequences of patient care decisions.
How do the case studies/patient examples help illustrate the learning objectives throughout the course?
Dr. Jones: The malpractice carriers analyze cases after settlements. We have included several of the cases to highlight best practices. These are one of the most popular aspects of the curriculum.
How did you keep up with changes in the field while working on the course? Did you have to re-visit sections/information in order to add/update according to the most recent findings (e.g., intragastric balloon approval)?
Dr. Jones: The ASMBS Essentials Task Force was crucial to the updates. The Task Force also had to make decisions on what not to include as there was a strong tendency to add more and more content until, frankly, it was too comprehensive. As editors, we had to keep going back to the fact that the curriculum was being built for all providers who care for patients of size. We had to remind ourselves that it’s the fundamentals. We also would remind ourselves that the course wasn’t being solely created for the bariatric surgeon, certified bariatric nurses, and others on the bariatric multidisciplary team who already had this working knowledge.
What do you hope the Essentials App achieves?
Dr. Jones: The goal is to get everyone on the same page. Whether an ED doc or floor nurse, we wanted a fun educational module that would teach the essentials of bariatric surgery. Through the program we hope to stimulate users to think about and learn answers to the following questios: Who is the ideal candidate for weight loss sugery? What are the different treatment options? What are the risks and potential benefits? What are complications and how to you identify early and treat? What other options are coming in the future?
What else do readers need to know about accessing and using this resource?
Dr. Jones: The app is available online at http://essentials.asmbs.org/ and also for free download in the Apple App Store. While registration is free, fees will apply should you elect to redeem continuing education credits. A lot of work and dedication has gone into this project and we encourage everyone to share the app with everyone in practice.
Funding: No funding was provided in the preparation of this interview.
Financial disclosures: The author reports no conflicts of interest relevant to the content of this article.
Address for correspondence: Dr. Daniel Jones; E-mail: firstname.lastname@example.org