Self-Appraised Readiness of Senior and Graduating General Surgery Residents to Perform Thoracic Surgery.

Autor: DeBoard ZM; Division of Cardiothoracic Surgery, University of Utah, Salt Lake City, Utah. Electronic address: zach.deboard@hsc.utah.edu., Paisley M; Department of Surgery, Santa Barbara Cottage Hospital, Santa Barbara, California., Thomas DD; Division of Cardiothoracic Surgery, Oregon Health & Science University, Portland, Oregon.
Jazyk: angličtina
Zdroj: Journal of surgical education [J Surg Educ] 2018 Jul - Aug; Vol. 75 (4), pp. 877-883. Date of Electronic Publication: 2017 Dec 19.
DOI: 10.1016/j.jsurg.2017.11.010
Abstrakt: Objective: General surgeons perform up to 50% of noncardiac thoracic surgery (TS). Although data show consistent TS case volume during general surgery (GS) residency it is unknown whether this operative trend will persist given potentially limited subspecialty exposure. We sought to determine if certain aspects of residency programs and resident characteristics were associated with trainees' perceived comfort in performing certain basic TS procedures.
Design: An anonymous survey was distributed to GS residents regarding program characteristics, presence of a TS residency, and intent to pursue thoracic surgical training, and estimated case volumes of individual procedures. Comfort levels for performing video-assisted thoracoscopic surgical (VATS) procedures, open lobectomy, elective thoracotomy, and sternotomy were attained through a 5-point Likert-type scale.
Setting: This survey was administered at 50 training programs with responses recorded via an online form.
Participants: Fourth- and fifth-year GS residents in the United States.
Results: Of 272 respondents 58% were fourth-year residents, 62% of residents trained at university-affiliated programs, and 64% reported a TS residency program at their institution and 16% stated intent to pursue TS. Fifth-year residents performed significantly more cases than fourth-year residents despite no difference in median comfort levels. Residents intending to pursue TS performed significantly more cases and were more comfortable performing a thoracotomy, sternotomy, VATS wedge resection/biopsy, and VATS decortication/pleurodesis (p = 0.044, <0.001, 0.045, 0.025). No characteristics were associated with comfort performing a lobectomy via thoracoscopic or open (thoracotomy) approaches.
Conclusion: Most senior or graduating GS residents state they are comfortable performing certain thoracic procedures with those pursuing additional thoracic surgical training more comfortable overall. No characteristics were associated with comfort performing a lobectomy. These findings may advise residency curriculum design to ensure continued thoracic surgical exposure and recommend against non-fellowship trained surgeons performing a pulmonary lobectomy.
(Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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