An End to “See One, Do One and Teach One” Residency Training Programme – Impact of the Training, Education, Surgical Accreditation and Assessment (TESA) Programme on Medical Care and Patients’ Safety†

Abstract

Introduction: The delivery of optimal and safe medical care is critical in healthcare. The traditional practice of “See one, do one and teach one” residency training programme is no longer acceptable. Materials and Methods: In the past, there was no structured residency training programme in our hospital. There were several cases of organ injuries from surgeries performed by the residents. In 2005, we conducted a pilot study to organise a structured teaching, education, surgical accreditation and assessment (TESA) residency programme for 15 residents in the Division of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital. We performed a written questionnaire survey of the residents on the new programme and patients’ expectation (n = 2926) as subjective outcomes in the 1-year follow-up. We also studied the complication rates of all minor and major surgeries performed by the residents in 2004 and 2005 as an objective outcome. Results: All the residents (n = 15) surveyed supported the TESA programme. Patients’ expectation improved significantly from 71% in 2004 (n = 1559) to 83% in 2005 (n = 1367) (P = 0.03). There were 10,755 surgeries in 2004 and 10,558 surgeries in 2005 performed by our residents, with 6 cases (5.6%) of organ injuries in 2004 compared to 3 cases (2.8%) in 2005. This reduction was not statistically significant. Conclusion: The TESA residency programme in our hospital has an impact on the delivery of optimal and safe medical care while ensuring the training of residents to be competent specialists. Key words: Complication rate, Residents, Safe medical care, Surgery

Outcomes in Medical Education

“…Reflecting on the submissions for this theme issue, the Editorial Committee thought of highlighting 2 features that might be of interest to the readers; firstly, defining and measuring outcome in the context of education and, secondly, the importance of contextual knowledge in medical education research. [1][2][3][4][5][6][7][8][9][10] "Outcomes in education" is a vast and complex construct that continues to challenge the educators. An idealistic view examines outcomes in medical education from the perspective of patient-related measures.…”