A New Home at
James C. Rosser, Jr., MD, FACS and Robyn M. Gardner, MHE, PA-C
The Top Gun Advanced Laparoscopic Skills and Suturing course recently celebrated its 20 year anniversary and is pleased to announce that James “Butch” Rosser, MD, FACS and Top Gun have a new home at the Nicholson Center/Celebration Health Hospital just outside of Orlando, Florida. Dr Rosser has joined Jay Redan, MD, FACS and Advanced Laparoscopic Surgeons at Celebration Health.
The Top Gun program has distinguished itself by using a training methodology that has superior skill and knowledge transfer capability. If you undertake developing the intracorporeal suturing skill set on your own, published reports predict that it can take up to 350 hours. With Top Gun, the process is shortened to a remarkable 12 hours. How does TOP GUN do it? It employs a methodology never seen before in medicine called Stealth Learning <http://stealthlearningcompany.com >.
With Stealth Learning, the student learns by being maximally challenged while having fun. Dr. Rosser’s book, Playin’ to Win: A Scientist, Surgeon and Parent Examines the Upside of Video Games, goes into great detail on how this pedagogy was developed.
Deeply rooted in the training philosophy of the Navy’s historic fighter pilot training program, TOP GUN uses progressive, layered, redundant, training techniques that feature pre- and post-evaluation of the cognitive skills needed for suturing. A multimedia-assisted tutorial session establishes how to perform the tasks, validated preparatory drills improve your skills to execute the TOP GUN suturing algorithm, and a boot camp-like laboratory training environment allows every participant to receive “equal time with multiple repetitions.” The Top Gun Laparoscopic Skills and Suturing Program is known the world over for its ability to efficiently establish suturing capability, not only in surgeons, but also nurses, PAs, surgical technologists and students (even at the high school level). Laparoscopic suturing is the most difficult of skill sets, and Top Gun enables significantly quicker proficiency (Watch the Top Gun Video). There is a 7000 physician database that allows participants to receive a skills performance report that documents their percentile ranking compared to the surgeons who have taken the course over the years. Essentially, it is a surgeon report card that represents where the participants stand amongst their peers regardless of queried extent of training or number of cases/experience (Click the images below to see a larger view).
Why is Top Gun still needed in 2013? In spite of current efforts, the adoption rates of certain advanced minimally invasive procedures are not progressing. One of the theorized causes for this is the fact that surgeons do not process the skill sets to accomplish these procedures efficiently with excellent outcomes. Another is that surgeons lack the confidence to handle intraoperative complications that might require intracorporeal suturing. In studies by Rosser et al., only 18% of self-proclaimed advanced laparoscopic surgeons could tie an intracorporeal knot in 10 minutes. Although it is 2013, there is evidence that skill and confidence continue to be legitimate issues surrounding adoption rates. In spite of the focus on simulation and training, resident activity time restraints and decreasing case experience limit mastery of basic and advanced skills. To address this challenge it is imperative that surgeons are equipped with the advanced skill sets required for MIS, including the ability to intracorporeally suture. With training in proper tactics and techniques, more patients can receive a minimally invasive approach. Top Gun establishes these skill sets in record time.
Top Gun Embraces New Specialties with New Features
Historically, Top Gun targeted all surgical specialties, but with the move to the Nicholson Center, world renowned gynecologist, Steven McCarus, MD has now become one of the co-directors of the program. With his involvement, it is hoped that Top Gun will aggressively infiltrate the gynecological market. Dr. McCarus has been concerned about safety in the accelerated adoption of gynecological procedures and has gone through Top Gun himself. Once he experienced the program, he became one of its most vibrant supporters. It was a natural extension to join forces with the Top Gun Surgeon Movement and he will serve as an instructor at the course ( Download Top Gun Course Brochure ) .
In 1995, Dr. Rosser introduced to the world of computer-based training his CD-ROM Multimedia Interactive Program: The Art of Laparoscopic Suturing, Oxford, England: Radcliffe Medical Press, 1995. At the time, it was a revolutionary training asset that thousands still use today to help teach them how to intracorporeally suture. Now, Rosser will take that tutorial to another level with an updated program that uses Apple’s iBook publishing platform. This is a joint effort by the Society of Laparoendoscopic Surgeons and the Stealth Learning Company and it will be shown for the first time at the upcoming SLS annual meeting in Washington, DC, August 28-31. The iBook platform offers expanded features in comparison to the CD-ROM version with greater accessibility at a lower price. This will now serve as the mandatory textbook for Top Gun (Watch the Top Gun iBook Video).
The third generation of the Top Gun training simulator (Called the Top Gun Stealth Trainer) has recently passed validation trials and will now be used in all the Top Gun courses. It has a new, sleek, “stealth theme” that features an enlarged scoreboard to display time and errors. The validated, improved, self-training capability, represented by the buzzer and lights, has been enhanced for more effective error situational awareness. The Top Gun Stealth Trainer is a big step forward in table top physical trainers, monitoring and stressing error suppression, as well as efficiency. With all of these new features, Top Gun is poised to serve the training needs of all surgeons far into the future.
- Go PM, Payne JH Jr, Satava RM, Rosser JC. Teleconferencing bridges two oceans and shrinks the surgical world. Surg Endosc. 1996 Feb;10(2):105-6.
- Rosser JC, Olive DL, Zreik T, Duleba A, Arici A, Rutherford T, Palter SF. Decreased Performance of Skilled Laparoscopic Surgeons at Microlaparoscopy versus Traditional Laparoscopy. J Am Assoc Gynecol Laparosc. 1996 Aug;3(4, Supplement):S44.
- Rosser J. CD-ROM multimedia-The step before virtual reality. Surg Endosc-Ultras. 1996 Oct; 10(10):1033-1035.
- Rosser J Jr, Wood M, Payne J, Fullum T, Lisehora G, Rosser L, Barcia T, Savalgi R. Telementoring: pushing the telemedicine envelope. J Assoc Acad Minor Phys. 1997;8(1):11-5.
- Rosser JC, Rosser LE, Savalgi RS. Skill acquisition and assessment for laparoscopic surgery. Arch Surg. 1997 Feb;132(2):200-4.
- Rosser JC, Wood M, Payne JH, Fullum TM, Lisehora GB, Rosser LE, Barcia PJ, Savalgi RS. Telementoring. A practical option in surgical training. Surg Endosc. 1997 Aug;11(8):852-5.
- Rosser JC Jr, Rosser LE, Savalgi RS. Objective evaluation of a laparoscopic surgical skill program for residents and senior surgeons. Arch Surg. 1998 Jun;133(6):657-61.
- Rosser JC Jr, Murayama M. The Impact of Technology on the Resolution of Minimally Invasive Training and Credentialing Challenges of the 21st Century. Surg Technol Int. 2000;IX:47-53.
- Rosser JC, Herman B, Risucci DA, Murayama M, Rosser LE, Merrell RC. Effectiveness of a CD-ROM multimedia tutorial in transferring cognitive knowledge essential for laparoscopic skill training. Am J Surg. 2000 Apr;179(4):320-4.
- Rosser JC Jr, Prosst RL, Rodas EB, Rosser LE, Murayama M, Brem H. Evaluation of the effectiveness of portable low-bandwidth telemedical applications for postoperative followup: initial results. J Am Coll Surg. 2000 Aug;191(2):196-203.
- Rosser J, Herman B, Ehrenwerth C. An overview of videostreaming on the internet and its application to surgical education. Surg Endosc-Ultras. 2001 Jun;15(6):624-629.
- Rosser JC Jr, Gabriel N, Herman B, Murayama M. Telementoring and teleproctoring. World J Surg. 2001 Nov;25(11):1438-48.
- Rosser JC Jr, Herman B, Giammaria LE. Telementoring. Semin Laparosc Surg. 2003 Dec;10(4):209-17. Review.
- Rosser JC Jr, Young SM, Klonsky J. Telementoring: an application whose time has come. Surg Endosc. 2007 Aug;21(8):1458-63. Epub 2007 May 5.