A Systematic Review on the Implementation and Educational Value of Resident Aesthetic Clinics

Abstract

Background: Resident aesthetic clinics (RACs) provide plastic surgery residents with hands-on aesthetic surgery training. Although RACs have demonstrated successful surgical outcomes without compromising patient care, few studies have evaluated the efficacy or educational value of RACs to increase resident confidence and competence in procedures. In addition, clinic structures vary widely among institutions, with each clinic offering a unique patient volume, caseload, and degree of resident autonomy that impacts the clinic's educational value. This systematic review identifies existing RAC practices, compares clinic structures, and proposes a curriculum framework to maximize educational value for residents. Methods: Following PRISMA guidelines, we performed a systematic review of plastic surgery residency training program RACs. We queried PubMed, Embase, and Web of Science from January 2000 to April 2020. Eligible articles were original articles that discussed RAC structure and educational value. Data abstracted included details on clinic structure (eg, volume, location, cost, clinic operations) and trainee-perceived educational value (eg, resident satisfaction, resident confidence in procedures). Results: Of 1199 identified publications, 10 met the inclusion criteria: 6 singlesite studies and 4 national survey studies. Among the single-site studies, annual volumes ranged from 22 to 68 patients/year and 35 to 81 cases/year. Resident aesthetic clinics were all staffed by full-time academic faculty (100%); onethird also were staffed by adjunct faculty and 17% also by community plastic surgeons. Resident involvement varied by hours in clinic and degree of autonomy. The survey studies found that RACs increase resident confidence and competence in performing aesthetic procedures and identified critical challenges to RAC implementation (eg, financial viability, continuity of care) that limited RAC educational value. Based on this review's findings, we propose a 6-step RAC curriculum framework for training programs seeking to establish an RAC and maximize the clinic's educational value. Conclusions: Resident aesthetic clinics are increasingly important for providing plastic surgery residents with aesthetic training. Patient and case volume, degree of resident autonomy, and clinic attending physicians are critical determinants of the educational value of RACs. We hope our findings can aid plastic surgery training programs in better organizing educational and sustainable RACs.

Productivity and Efficiency of a Department Resident Aesthetic Plastic Surgery Clinic

“…Other institutions have typically reported their findings over several years, averaging to 44-81 procedures per year. 8 , 12 , 14 This discrepancy in output may be partially attributable to our definition of a procedure; however, it is difficult to compare to previously reported studies as they do not transparently define what was counted as a procedure. Under our definition, bilateral surgeries were counted as 2 separate procedures.…”

A 10-Year Review of Surgical Outcomes at the Johns Hopkins and University of Maryland Resident Aesthetic Clinic

“…A recent systematic review by Chen et al assessed 4 national surveys from the literature that evaluated resident perspectives toward the RAC. 22 Based on these findings—as well as 6 single-site RAC studies—they proposed a 6-step curriculum framework on how to establish and sustain a successful RAC that maximizes educational value for residents. Novel studies such as this emphasize the growing importance of RACs in achieving AGMCE's increased aesthetic surgical training while also providing actionable data for programs looking to create or improve their own RAC.…”

“…Early literature such as the pilot case study of this resident clinic is important in providing a framework for implementing similar clinic models, while recent studies such as Chen et al provide refined protocols for RACs that can be adapted for resident-run clinics outside the field of plastic surgery. 22 , 25 …”