Resident Operative Autonomy in Robotic Surgery Training: Unpacking Gender Disparities and Training Trends.

Autor: Nimer M; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Abreu AA; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Tyler LA; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., AbdelFattah KR; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Polanco PM; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Bhat SG; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: Sneha.bhat@utsouthwestern.edu.
Jazyk: angličtina
Zdroj: Journal of surgical education [J Surg Educ] 2024 Dec; Vol. 81 (12), pp. 103312. Date of Electronic Publication: 2024 Oct 24.
DOI: 10.1016/j.jsurg.2024.103312
Abstrakt: Objective: This study evaluated resident and program-level factors associated with resident-reported robotic operative autonomy at our institution.
Design: This retrospective cohort study evaluates self-reported residents' robotic case logs detailing case type, console time, and portions of the case completed. The analysis included three procedures: pancreaticoduodenectomies, hernia repairs, and low anterior resection. Each procedure was divided into four key portions. Outcomes measured included minutes at the console and High Resident Autonomy (HRA), defined as >50% resident case participation. Independent variables included graduation cohort, pursued fellowship type, attending gender, underrepresented minority status, and hospital type. Univariable and multivariable logistic regression were performed.
Setting: This study took place at the University of Texas Southwestern Medical Center General Surgery Residency between 2021 and 2023.
Participants: Twenty-nine chief residents (postgraduate year 5).
Results: Of the 541 cases, 61% were hernia repairs, 26% were low anterior resections, and 13% were pancreaticoduodenectomies. Female residents were present in 60% of the cases. Male residents reported more HRA (76% vs. 54%) and longer console times (150 vs 120 minutes; p < 0.01). Multivariable analysis indicated female gender was associated with 74% lower odds of HRA (95% CI: 0.15 - 0.45; p < 0.001) and 18 fewer minutes of console time versus males (p < 0.01). The 2023 cohort had significantly higher odds of HRA than the 2021 cohort (OR: 4.46, 95% CI: 2.34 - 8.51; p < 0.001) and 15 more console minutes. Residents with aligned fellowships spent 37 more console minutes than those without (p < 0.001). No significant differences were found between attending gender, hospital, and minority status.
Conclusions: Our findings reveal significant gender disparities in self-reported operative autonomy and console time. The recent cohort showed improved training outcomes, and fellowship alignment with the case positively impacted console time. This suggests a need to refine training approaches, ensuring equity and optimizing training efficacy.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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