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What Is Proper Training For Surgical Assistants?

What Is Proper Training For Surgical Assistants?

By Dan Bump SA-C, CSFA: In my January 18, 2015 blog post, we discussed what surgeons really need from their first assistants. Some surgeons have learned to make do with just an extra pair of hands. But that doesn't address everything a surgeon needs and deserves from an assistant. The American College of Surgeons (ACS) and the American Medical Association (AMA) have issued some pertinent and cogent statements in this regard that are eye opening in a big way.

The official ACS statement on surgical assistants says in part, "The first assistant during a surgical operation should be a trained individual who is able to participate in and actively assist the surgeon in completing the operation safely and expeditiously by helping to provide exposure, maintain hemostasis, and serve other technical functions. The qualifications of the person in this role may vary with the nature of the operation, the surgical specialty, and the type of hospital or ambulatory surgical facility.

The American College of Surgeons supports the concept that, ideally, the first assistant at the operating table should be a qualified surgeon or a resident in an approved surgical education program. Residents at appropriate levels of training should be provided with opportunities to assist and participate in operations. If such assistants are not available, other physicians who are experienced in assisting may participate.

It may be necessary to utilize non-physicians as first assistants. Surgeon's Assistants (SA's) or physician's assistants (PA's) with additional surgical training should meet national standards and be credentialed by the appropriate local authority. These individuals are not authorized to operate independently."

The AMA concurs when stating, "Ideally, the first assistant to the surgeon at the operating table should be a qualified surgeon or resident in an education program that is accredited by the Accreditation Council for Graduate Medical Education (ACGME) and/or the American Osteopathic Association (AOA). Other appropriately credentialed physicians who are experienced in assisting the responsible surgeon may participate when a trained surgeon or a resident in an accredited program is not available. The AMA recognizes that attainment of this ideal in all surgical care settings may not be practicable. In some circumstances it is necessary to utilize appropriately trained and credentialed unlicensed physicians and non-physicians to serve as first assistants to qualified surgeons " (emphasis added by ACE). See

Both the ACS and the AMA recognize non-physicians with proper surgery-specific training and credentials as appropriate for qualified surgeons to utilize in surgery as surgical assistants. Certainly, Surgical Technologists and OR Nurses require additional training to become surgical assistants. But even mid-level healthcare professionals such as PAs and NPs require additional surgery training to meet the ACS and AMA standards for surgical assistants. The same is true of unlicensed physicians. At some hospitals, it will be enough for PAs, NPs, and unlicensed physicians to demonstrate successful attendance at a surgical lab to acquire the necessary surgical skills. Other hospitals may require them to earn a surgical assistant credential such as CSA, SA-C, CSFA, or CRNFA. In those cases, graduating from a full surgical assistant program is required in order to qualify for the certifying exam.

So what is proper training and how does it address all the needs a surgeon may have for an assistant? There are two models of training and both seek to fill these needs but in different ways. Your challenge is to choose the training model that works best for your particular needs and situation.

Proper training addresses the ideal as set out by the ACS. They identify the ideal surgical assistant as a second 'surgeon or a surgical resident.' In fact, historically the surgical assistant was indeed the surgeon's partner or a surgical resident. Given that ideal, the mission of proper training would be to help the non-physician provide a service as close as possible to the service provided by a second surgeon.

Model One provides the standard minimal training as outlined by either the Association of Surgical Assistant's (ASA) Core Curriculum for Surgical Assisting or the Association of periOperative Registered Nurses' (AORN) Core Curriculum for RN First Assistants . After instructing their students according to the prescribed minimums, model one programs leave it up to the surgeon(s) their graduate will be working with to teach them the more advanced skills the surgeon wants them to have. A weakness in this method is the graduate may end up being very good for that surgeon but not for others. Of course, any program using the above curricula can go above and beyond the outlined standards if they wish.

Model Two looks at the ideal surgical assistant as described by the ACS and AMA and takes full responsibility for all the training required to bring their graduates as close to the ideal as possible. Very little if any of the training is left up to the surgeon(s) they'll end up working with. This model also manages a nagging issue prevalent in the industry. Surgeons judge you on the very first case you assist them on. If the surgeon sees you need additional training, they may limit your opportunities to work with them on a deeper level. If however the surgeon observes that you already perform very well, two good things happen. 1) they relax and let you be more involved on a deeper level in the procedure and, 2) since they don't have to teach you the things they expect you to know already, they can focus on teaching you their unique techniques and trade secrets – the things that make them the best at what they do. This is the ultimate goal of model two training.

You are a unique individual. And as such, you have so much to offer as a properly trained surgical assistant. You have to decide which model of training would work best for you. If you want to get more details regarding what a genuine model two program would look like, read more about the ACE program on this website. Then, whether you choose our program or you think another one might be better for you, you'll have a much clearer and detailed picture to help you make an educated decision for your career advancement.

As always, I welcome your comments and suggestions on this blog. I really want to hear from you and get a conversation going on this subject. You can also feel free to call us at 888-920-0447 if you want to learn more about our uniques model of training.

Are you interested in becoming a surgical assistant? Contact ACE Surgical Assisting today to request more information and to learn more about advancing your career.