Quantification of Resident Work in Colorectal Surgery
| Autor: | Elizabeth C. Wick, Adam P. Johnson, Vanita Ahuja, Elizabeth A. Bailey, Thomas J. VanderMeer, Rachel R. Kelz, Ira L. Leeds, Busayo Irojah, Rachel L. Medbery |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Operating Rooms media_common.quotation_subject Interprofessional Relations Patient care Perceived autonomy Education 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires Medicine Humans Professional Autonomy 030212 general & internal medicine Prospective Studies Colorectal resection media_common Response rate (survey) Academic Medical Centers business.industry Survey tool Internship and Residency Resident education Colorectal surgery United States Logistic Models Education Medical Graduate 030220 oncology & carcinogenesis Family medicine Multivariate Analysis Surgery Female Clinical Competence business Colorectal Surgery Autonomy |
| Zdroj: | Journal of surgical education. 75(3) |
| ISSN: | 1878-7452 |
| Popis: | To examine resident intraoperative participation, perceived autonomy, and communication patterns between residents and attending surgeons using a novel survey tool.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.This study was conducted at 7 general surgery residency programs: 5 academic medical centers, and 2 independent training programs.Residents and fellows rotating on a colorectal surgery service or general surgery service.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 (p0.001). 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 (p0.001). 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).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. |
| Databáze: | OpenAIRE |
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