A New Model for Surgical Consensus Generation
Publication Title: Leading Consortiums from the Ground Up: Leveraging Trainee Collaboration to Create Consensus Guidelines
Summary
- Question
- This study examined the collaborative process used by the Peritoneal Surface Malignancy (PSM) Consortium to create updated clinical care guidelines for managing peritoneal surface malignancies. The researchers aimed to evaluate the effectiveness of a trainee-driven model in generating consensus guidelines across multiple disease types, such as appendiceal, gastric, colorectal, and neuroendocrine tumors, as well as peritoneal mesothelioma.
- Why it Matters
- Peritoneal surface malignancies are rare but complex cancers that affect the lining of the abdominal cavity. Clear and updated guidelines are essential for clinicians to provide consistent, evidence-based care. This research highlights the value of involving trainees in leadership roles to tackle complex medical challenges, offering a potential model for improving collaboration and innovation in healthcare. The findings are significant for advancing patient care, fostering mentorship, and streamlining the development of clinical guidelines.
- Methods
- The study used a trainee-driven, multidisciplinary approach over 17 months. A 317-member team, including residents, fellows, faculty, and patient advocates, employed a modified Delphi method, a structured process for achieving consensus. Trainees served as disease-site leaders, managing small, focused teams to develop recommendations. These teams conducted systematic reviews and collaborated to update five existing guidelines and create one new guideline for malignant gastrointestinal obstruction.
- Key Findings
- The trainee-driven model successfully produced updated clinical care guidelines supported by 11 systematic reviews. The organizational structure featured a flat hierarchy with a ‘small-world network’ design, allowing efficient communication and decision-making. Trainees demonstrated dynamic leadership, with responsibilities ranging from synthesizing feedback to managing interdisciplinary teams. Collaborative processes, such as hybrid communication strategies and peer mentoring, contributed to the model’s effectiveness.
- Implications
- This study underscores the feasibility and benefits of a trainee-led model in developing complex, evidence-based guidelines. It demonstrates how empowering trainees with leadership roles can enhance collaboration, accelerate decision-making, and foster professional growth. The approach may serve as a template for other fields requiring consensus-driven research, potentially improving healthcare delivery and innovation.
- Next Steps
- The authors recommend further exploration of trainee-led models in different medical and non-medical settings. They also suggest adapting this framework for smaller institutions or non-academic environments by involving early-career professionals or contributors from diverse fields to replicate its success.
- Funding Information
- This research was supported by the National Institutes of Health (award 1L30CA294369-01 and T32 CA233414). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Additional funding was provided by the Irving Harris Foundation. Yale University also provided funding and support for this research.
Full Citation
Godfrey E, Schultz K, Bansal V, Su D, Butensky S, Brown L, Godley F, Mahoney F, Wilkins S, Izquierdo F, Gunderson C, Turaga K. Leading Consortiums from the Ground Up: Leveraging Trainee Collaboration to Create Consensus Guidelines. Annals Of Surgical Oncology 2026, 1-4. PMID: 42069992, DOI: 10.1245/s10434-026-19740-9.
This AI-assisted summary has been reviewed and approved by at least one of the study's authors to ensure it accurately reflects the research.
Authors
Elizabeth Godfrey, MD
First AuthorHospital Resident
Kiran Turaga, MD, MPH
Last AuthorProfessor of Surgery (Oncology)