Residents' surgical performance during the laboratory years: an analysis of rule-based errors
| Autor: | Brett Wise, Shannon M. DiMarco, Margaret Garren, Carla M. Pugh, Nicole Van Beek, Jay N. Nathwani, Hossein Mohamadipanah |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment 030230 surgery Specialties Surgical Learning experience 03 medical and health sciences 0302 clinical medicine Assessment data medicine Humans Grading (education) Medical education Ventral hernia repair business.industry Research Process Assessment Health Care Academic development Internship and Residency Rule-based system Hernia repair Checklist 030220 oncology & carcinogenesis Physical therapy Surgery Female Clinical Competence business |
| Zdroj: | The Journal of surgical research. 219 |
| ISSN: | 1095-8673 |
| Popis: | Background Nearly one-third of surgical residents will enter into academic development during their surgical residency by dedicating time to a research fellowship for 1-3 y. Major interest lies in understanding how laboratory residents' surgical skills are affected by minimal clinical exposure during academic development. A widely held concern is that the time away from clinical exposure results in surgical skills decay. This study examines the impact of the academic development years on residents' operative performance. We hypothesize that the use of repeated, annual assessments may result in learning even without individual feedback on participants simulated performance. Methods Surgical performance data were collected from laboratory residents (postgraduate years 2-5) during the summers of 2014, 2015, and 2016. Residents had 15 min to complete a shortened, simulated laparoscopic ventral hernia repair procedure. Final hernia repair skins from all participants were scored using a previously validated checklist. An analysis of variance test compared the mean performance scores of repeat participants to those of first time participants. Results Twenty-seven (37% female) laboratory residents provided 2-year assessment data over the 3-year span of the study. Second time performance revealed improvement from a mean score of 14 (standard error = 1.0) in the first year to 17.2 (SD = 0.9) in the second year, (F[1, 52] = 5.6, P = 0.022). Detailed analysis demonstrated improvement in performance for 3 grading criteria that were considered to be rule-based errors. There was no improvement in operative strategy errors. Conclusions Analysis of longitudinal performance of laboratory residents shows higher scores for repeat participants in the category of rule-based errors. These findings suggest that laboratory residents can learn from rule-based mistakes when provided with annual performance-based assessments. This benefit was not seen with operative strategy errors and has important implications for using assessments not only for performance analysis but also as a learning experience. |
| Databáze: | OpenAIRE |
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