Prospective validation of the safety of a laparoscopic cholecystectomy training paradigm featuring incremental autonomy
| Autor: | Audra T. Clark, Jonathan B. Imran, Michael W. Cripps, Tarik D. Madni, Holly B. Cunningham, Stephen S. Luk, Herbert Phelan, Alana Christie, Evan Barrios, Luis R. Taveras |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty media_common.quotation_subject Operative Time 03 medical and health sciences 0302 clinical medicine Acute care Surveys and Questionnaires Chi-square test medicine Humans 030212 general & internal medicine Prospective Studies Laparoscopic cholecystectomy media_common business.industry Gallbladder General surgery Internship and Residency General Medicine Perioperative Surgical training Texas Test (assessment) medicine.anatomical_structure Cholecystectomy Laparoscopic Education Medical Graduate 030220 oncology & carcinogenesis Surgery Female Clinical Competence Patient Safety business Autonomy |
| Zdroj: | American journal of surgery. 217(4) |
| ISSN: | 1879-1883 |
| Popis: | Surgical training is under scrutiny for the effect increased resident autonomy may have on patient outcomes. We hypothesize that as laparoscopic cholecystectomy (LC) difficulty increases, there will be increased involvement by senior residents and attending physicians with no differences in complications.Ten acute care surgeons were asked to fill out a postoperative questionnaire regarding surgical difficulty after every LC between 11/9/2016 and 3/30/2017. Either the Jonckheere-Terpstra test, Mantel-Haenzel chi square test, or ANOVA was used to test for the association between perioperative data and surgical difficulty.A total of 190 LCs were analyzed. PGY level, percent of surgery time with attending surgeon involvement, partial cholecystectomy rate, and length of operation all significantly rose with increasing level of difficulty (p 0.001) with no significant differences in 60-day emergency room bounce-backs, readmission, or complication rates.We found that as LC difficulty increases, so does attending surgeon and/or senior resident involvement, without increased morbidity. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect