Beyond the Surgical Time-Out: A National Needs Assessment of Preoperative Communication in US General Surgery Residency Programs.

Autor: Lillemoe HA; Vanderbilt University Medical Center, Department of Surgery, Nashville, Tennessee. Electronic address: heather.a.lillemoe@vumc.org., Lynch KA Jr; Alpert Medical School at Brown University, Department of Surgery, Providence, Rhode Island., Schuller MC; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Meier AH; Department of Pediatric Surgery, SUNY Upstate Medical University, Syracuse, New York., Potts JR 3rd; Accreditation Council for Graduate Medical Education, Chicago, Illinois., Fryer JP; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Harrington DT; Alpert Medical School at Brown University, Department of Surgery, Providence, Rhode Island.
Jazyk: angličtina
Zdroj: Journal of surgical education [J Surg Educ] 2020 Nov - Dec; Vol. 77 (6), pp. e172-e182. Date of Electronic Publication: 2020 Aug 24.
DOI: 10.1016/j.jsurg.2020.08.004
Abstrakt: Objective: Perioperative communication is critical for procedural learning. In order to develop a periprocedural faculty development tool, we aimed to characterize the current status of preoperative communication in US General Surgery residency programs.
Design: After Association of Program Directors in Surgery approval, a survey was distributed to general surgery programs. Participants were asked about perioperative communication, including the frequency of preoperative briefings, defined as dedicated educational discussions prior to a procedure. Data were analyzed using descriptive statistics.
Setting: An anonymous electronic survey was distributed to interested programs in early 2019.
Participants: US General Surgery trainees and attending surgeons.
Results: A total of 348 responses were recorded from 27 programs: 199 (57%) attending surgeons and 149 (43%) surgical trainees. Most respondents (83%) were from a university-affiliated program. Attending surgeons indicated a higher frequency of performing preoperative briefings compared to trainees (p < 0.001). Both trainees and attending surgeons were more likely to select their own group when asked who initiates a preoperative briefing. The majority of respondents (58%) agreed that discussing autonomy preoperatively improves resident autonomy for the case. In regards to the timing of preoperative briefings, most took place in/adjacent to the operating room, with only 60 participants (17%) participating in preoperative briefings the day/night prior to the operation. The most frequent topic discussed during preoperative briefings was "procedural content." Most participants selected "time constraints" as the greatest barrier to preoperative briefings and indicated that attending surgeon engagement was necessary to facilitate their use. Trainees were less likely to report engaging in immediate postoperative feedback, but more likely to report postoperative self-reflection.
Conclusions: Preoperative briefings are not necessarily routine and attendings and trainees differ on their perceptions related to their content and frequency. Efforts to address timing and scheduling and encourage dual-party engagement in perioperative communication are key to the development of tools to enhance this important aspect of procedural learning.
(Copyright © 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: