See one, do one, but never teach one? An analysis of resident teaching assist cases under various levels of attending supervision.
Blood Loss, Surgical
/ statistics & numerical data
Clinical Competence
Faculty, Medical
Hospitals, Military
Humans
Internship and Residency
/ organization & administration
Intraoperative Complications
Length of Stay
/ statistics & numerical data
Operative Time
Postoperative Complications
Professional Autonomy
Retrospective Studies
Surgical Procedures, Operative
/ statistics & numerical data
Surveys and Questionnaires
Teaching
Washington
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
28
10
2018
revised:
18
01
2019
accepted:
18
01
2019
pubmed:
4
2
2019
medline:
18
12
2019
entrez:
4
2
2019
Statut:
ppublish
Résumé
Surgical training has traditionally relied on increasing levels of resident autonomy. We sought to analyze the outcomes of senior resident teaching assist (TA) cases performed with a structured policy including varying levels of staff supervision. Retrospective review at a military medical center of TA cases from 2009 to 2014. The level of staff supervision included staff scrubbed (SS), staff present and not scrubbed (SP), or staff not present but available (NP). Operative variables were analyzed. An anonymous survey of residents and attendings at 6 military programs regarding experience and opinions on TA cases was distributed. 389 TA cases were identified. The majority (52%) were performed as NP. Operative times were shorter for NP cases (p < 0.05). Overall complication rate and length of stay were not different between groups (p > 0.05). Survey results demonstrated agreement amongst staff and residents that allowing selective NP was critical for achieving resident competence. There were no identified adverse effects on intraoperative or postoperative complications. This practice is a critical component of training senior residents to transition to independent practice.
Sections du résumé
BACKGROUND
Surgical training has traditionally relied on increasing levels of resident autonomy. We sought to analyze the outcomes of senior resident teaching assist (TA) cases performed with a structured policy including varying levels of staff supervision.
METHODS
Retrospective review at a military medical center of TA cases from 2009 to 2014. The level of staff supervision included staff scrubbed (SS), staff present and not scrubbed (SP), or staff not present but available (NP). Operative variables were analyzed. An anonymous survey of residents and attendings at 6 military programs regarding experience and opinions on TA cases was distributed.
RESULTS
389 TA cases were identified. The majority (52%) were performed as NP. Operative times were shorter for NP cases (p < 0.05). Overall complication rate and length of stay were not different between groups (p > 0.05). Survey results demonstrated agreement amongst staff and residents that allowing selective NP was critical for achieving resident competence.
CONCLUSION
There were no identified adverse effects on intraoperative or postoperative complications. This practice is a critical component of training senior residents to transition to independent practice.
Identifiants
pubmed: 30711192
pii: S0002-9610(18)31387-4
doi: 10.1016/j.amjsurg.2019.01.012
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
918-922Commentaires et corrections
Type : CommentIn
Informations de copyright
Published by Elsevier Inc.