Exploring Senior Residents’ Intraoperative Error Management Strategies: A Potential Measure of Performance Improvement
| Autor: | Douglas A. Wiegmann, Katherine E. Law, Shannon M. DiMarco, Elaine R. Cohen, Anne-Lise D. D'Angelo, Rebecca D. Ray, Elyse Linsmeier, Carla M. Pugh |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Operative Time Standard deviation Education 03 medical and health sciences 0302 clinical medicine medicine Humans 030212 general & internal medicine Intraoperative Complications Simulation Training Herniorrhaphy Retrospective Studies Medical Errors business.industry Significant difference Attendance Late stage Internship and Residency Videotape Recording Surgical training Hernia Ventral Education Medical Graduate Error Management 030220 oncology & carcinogenesis Physical therapy Female Laparoscopy Surgery Clinical Competence Performance improvement Error detection and correction business Social psychology |
| Zdroj: | Journal of Surgical Education. 73:e64-e70 |
| ISSN: | 1931-7204 |
| Popis: | Objective The study aim was to determine whether residents' error management strategies changed across 2 simulated laparoscopic ventral hernia (LVH) repair procedures after receiving feedback on their initial performance. We hypothesize that error detection and recovery strategies would improve during the second procedure without hands-on practice. Design Retrospective review of participant procedural performances of simulated laparoscopic ventral herniorrhaphy. A total of 3 investigators reviewed procedure videos to identify surgical errors. Errors were deconstructed. Error management events were noted, including error identification and recovery. Setting Residents performed the simulated LVH procedures during a course on advanced laparoscopy. Participants had 30 minutes to complete a LVH procedure. After verbal and simulator feedback, residents returned 24 hours later to perform a different, more difficult simulated LVH repair. Participants Senior ( N = 7; postgraduate year 4-5) residents in attendance at the course participated in this study. Results In the first LVH procedure, residents committed 121 errors ( M = 17.14, standard deviation=4.38). Although the number of errors increased to 146 ( M = 20.86, standard deviation=6.15) during the second procedure, residents progressed further in the second procedure. There was no significant difference in the number of errors committed for both procedures, but errors shifted to the late stage of the second procedure. Residents changed the error types that they attempted to recover ( χ 2 5 =24.96, p Conclusion Residents' error management strategies changed between procedures following verbal feedback on their initial performance and feedback from the simulator. Errors and recovery attempts shifted to later steps during the second procedure. This may reflect residents' error management success in the earlier stages, which allowed further progression in the second simulation. Incorporating error recognition and management opportunities into surgical training could help track residents' learning curve and provide detailed, structured feedback on technical and decision-making skills. |
| Databáze: | OpenAIRE |
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