Your browser doesn't support javascript.
loading
Quantification of Resident Work in Colorectal Surgery.
Bailey, Elizabeth A; Johnson, Adam P; Leeds, Ira L; Medbery, Rachel L; Ahuja, Vanita; VanderMeer, Thomas; Wick, Elizabeth C; Irojah, Busayo; Kelz, Rachel R.
Afiliación
  • Bailey EA; Department of Surgery, Hospital of the University of Pennsylvania, Center for Surgery and Health Economics, Philadelphia, Pennsylvania. Electronic address: Elizabeth.Mollo@uphs.upenn.edu.
  • Johnson AP; Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
  • Leeds IL; Department of Surgery, Johns Hopkins University Hospital, Baltimore, Maryland.
  • Medbery RL; Department of Surgery, Emory University Hospital, Atlanta, Georgia.
  • Ahuja V; Department of Surgery, WellSpan York Hospital, York, Pennsylvania.
  • VanderMeer T; Department of Surgery, Guthrie Robert Packer Hospital, Sayre, Pennsylvania.
  • Wick EC; Department of Surgery, Johns Hopkins University Hospital, Baltimore, Maryland.
  • Irojah B; Department of Surgery, WellSpan York Hospital, York, Pennsylvania.
  • Kelz RR; Department of Surgery, Hospital of the University of Pennsylvania, Center for Surgery and Health Economics, Philadelphia, Pennsylvania.
J Surg Educ ; 75(3): 564-572, 2018.
Article en En | MEDLINE | ID: mdl-28986275
OBJECTIVE: To examine resident intraoperative participation, perceived autonomy, and communication patterns between residents and attending surgeons using a novel survey tool. DESIGN: This was a prospective multi-institutional study. Operative residents completed the survey tool immediately after each colorectal resection performed during the study period. Resident intraoperative participation was quantified including degree of involvement in the technical aspects of the case, self-perception of autonomy, and communication strategies between the resident and attending. SETTING: This study was conducted at 7 general surgery residency programs: 5 academic medical centers, and 2 independent training programs. PARTICIPANTS: Residents and fellows rotating on a colorectal surgery service or general surgery service. RESULTS: Sixty-three residents participated in this study with 417 surveys completed (range 19-79 per institution) representing a 95.4% response rate across all sites. Respondents ranged from clinical year 1 (CY1) to fellows. CY3s (35.7%) and CY5s (34.7%) were most heavily represented. Residents completed ≥50% of the skin closure in 88.7% of cases, ≥50% of the fascial closure in 87.1%, and t ≥ 50% of the anastomosis in 78.4% of the cases. Increasing resident participation was associated with advancing resident CY across all technical aspects of the case. This trend remained significant when controlling for site (p < 0.001). Resident self-perception of autonomy revealed learners of all stages: Observer (11.5%, n = 48), Assistant (53.7%, n = 224), Surgeon (33.8%, n = 141), and Teacher (0.96%, n = 4). Level of perceived autonomy increased with resident CY when controlling for site (p < 0.001). Residents who discussed the case before the day of surgery were twice as likely to rate themselves as Surgeon or Teacher (OR = 2.01) when controlling for CY (p = 0.011). CONCLUSIONS: Brief surveys can easily capture resident work in the operating room. Resident intraoperative involvement and perceived autonomy are associated with CY. Early communication with the attending is significantly associated with increased perception of autonomy regardless of CY.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Encuestas y Cuestionarios / Competencia Clínica / Cirugía Colorrectal / Educación de Postgrado en Medicina / Internado y Residencia Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: J Surg Educ Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Encuestas y Cuestionarios / Competencia Clínica / Cirugía Colorrectal / Educación de Postgrado en Medicina / Internado y Residencia Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: J Surg Educ Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos