Surgical-technical assistant

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Surgical-technical assistant ( CTA ) is a healthcare profession in Germany. Surgical-technical assistants, after successfully completing their 3-year school education, carry out specialized assistance tasks assigned to them in medical and surgical-technical areas, such as in the operating area , the outpatient department , the surgical ward, under the supervision of a doctor.

The training and examination regulations were adopted on October 1, 2007 by the medical school academia chirurgica GmbH in coordination with the German Society for Surgery (DGCH) . State recognition is required by the professional association, but there is opposition from the ranks of the German Society for Anesthesiology and Intensive Care Medicine (DGAI).

In the respective operational hospitals, CTAs relieve the medical profession by taking over medical activities that can be delegated .

Requirements for participation in the training

In coordination with the German Society for Surgery, the prerequisite for access to the training is the general university entrance qualification or the technical college entrance qualification

Duration and structure of the training

The three-year training takes place at recognized CTA schools as a course with theoretical and practical lessons as well as integrated practical training in the future areas of responsibility.

The training comprises at least 1,900 hours of theoretical training and practical instruction as well as 3,000 hours of practical training at the teaching hospitals .

Content of the training

Among other things, the following subjects are taught:

Exam exams

The exam exams consist of a practical, a written and an oral part. If the candidate passes the exam, he or she will be given a certificate and a certificate that the exam has been passed.

activities

The tasks of a CTA include, among other things

  • the special patient positioning
  • Pre- and post-operative care of the patient
  • the 1st and 2nd surgical assistant (specialist standard must be guaranteed)
  • Efficient and highly professional relief for the surgeon
  • Take on interdisciplinary tasks
  • OR administration / documentation tasks
  • On-call duty (operational on-call service)
  • the processing of tissue with the professional use of surgical instruments
  • Operational node application
  • Independent single and multi-layer wound closures
  • Blood draws
  • Takeover of medical activities that can be delegated
  • Removal of drainage systems
  • Insertion of feeding tubes
  • Insertion of transurethral indwelling urinary catheters
  • diagnostic and therapeutic measures (e.g. auscultation, sonography, etc.) in coordination with the medical service
  • Practical implementation of non-invasive examination procedures
  • Anamnesis (to be checked later with the medical service), physical examination, venipuncture
  • Collection of examination results and participation in writing the doctor's letter for later examination and supplementation of the medical service
  • Participation in and implementation of emergency medical measures to stabilize emergency patients
  • Participation in the rounds and medical curve visits
  • Preparatory OP information (standard interventions)
  • postoperative wound care
  • Wound management z. B. as a managerial function with, for example, the establishment of VAC associations
  • coding of operations and patients (DRG)
  • Participation in quality management
  • the placement of venous indwelling catheters
  • Interface between nursing and medical staff
  • Monitoring of medically initiated therapies

A CTA is not only active in the operating room, but also on the ward.

Criticism of the job description

CTAs take on tasks that were previously performed by interns as part of their training. One fear is that as a result, prospective surgeons will miss the necessary experience and routine in the operating room. The reallocation of assistant doctor positions to CTA positions is in any case real.

Another question is to what extent a doctor is even allowed to transfer activities to a CTA. A specialist standard must always be guaranteed at the inpatient and operational level.

Contrary to the trend towards academization in the health care system (e.g. nursing or midwife), a profession has even been created outside of the previous educational system (vocational school, technical college, technical college, university). The job description only exists in Germany at the moment. The competencies of a trained CTA are similar to those of the historical profession of minor surgeon .

Some CTAs also see the training as a good preparatory waiting position for a study place.

The training opportunities for trained CTAs are also still open. Of course, continuous training is part of the job, but there is a certain professional dead end without formal opportunities for advancement.

The distinction between nursing, doctors and the CTAs is also difficult.

Of course, the profession was not introduced for no reason: the shortage of doctors (especially declining interest in surgery) and rising healthcare costs are serious problems, and the CTA is one way to counteract this.

Certain problems such as state recognition, further training opportunities and the legal regulation of the competencies of the CTAs are interrelated and will clear up over time. For today's CTAs and CTAs in training, however, the precise design of state recognition will also be decisive: If today's qualifications are not (fully) equated with state qualifications, today's CTAs face a problem. Some training centers encounter the problem of state recognition by recognizing parts of their training (e.g. theory) for the qualification for OTA or ATA.

See also

Individual evidence

  1. ↑ NRW wants to state recognition of the profession of surgical technician ( memento of the original from March 6, 2016 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. , Ärzteblatt January 21, 2010 @1@ 2Template: Webachiv / IABot / www.aerzteblatt.de
  2. ^ Surgical assistance in the operating room , interview in nahdran , issue 1/08, Bernecker MediaWare AG, Melsungen
  3. ↑ a b c d e f Professional Association of German Surgeons: CTA - Problem or Perspective ( Memento of the original from July 14, 2014 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.bdc.de
  4. ↑ Alice Hampel: Surgical-Technical Assistance - Curriculum in coordination with the German Society for Surgery , Düsseldorf 2010
  5. ↑ List of all subjects including the number of hours
  6. ↑ Bernward Ulrich, Member of the Presidium of the German Society for Surgery (President 2003 to 2004): Surgical Technician Assistant - New Surgical Partners in the Operating Room? , Lecture in Münster on February 27, 2007
  7. ↑ a b c d e f Non-medical specialist professions in hospitals: help or competition?
  8. ↑ a b c Müller, Helmut: Surgery assistant: counterproductive development. Deutsches Ärzteblatt, 2013; 110 (20): A-995 / B-867 / C-863
  9. ↑ Heilberger, Peter: Surgical assistant: A wrong path. Deutsches Ärzteblatt, 2013; 110 (20): A-995 / B-867 / C-863
  10. ↑ a b Surgical-technical assistants and other non-medical health professions ( memento of the original dated December 2, 2013 in the Internet Archive ) Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (PDF; 504 kB) @1@ 2Template: Webachiv / IABot / www.medsachverstand.de
  11. ↑ Archived copy ( Memento of the original dated December 2, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.academiachirurgicaonline.de