Analysing the operative experience of basic surgical trainees in Ireland using a web-based logbook

Abstract

BackgroundThere is concern about the adequacy of operative exposure in surgical training programmes, in the context of changing work practices. We aimed to quantify the operative exposure of all trainees on the National Basic Surgical Training (BST) programme in Ireland and compare the results with arbitrary training targets.MethodsRetrospective analysis of data obtained from a web-based logbook (http://www.elogbook.org) for all general surgery and orthopaedic training posts between July 2007 and June 2009.Results104 trainees recorded 23,918 operations between two 6-month general surgery posts. The most common general surgery operation performed was simple skin excision with trainees performing an average of 19.7 (± 9.9) over the 2-year training programme. Trainees most frequently assisted with cholecystectomy with an average of 16.0 (± 11.0) per trainee. Comparison of trainee operative experience to arbitrary training targets found that 2-38% of trainees achieved the targets for 9 emergency index operations and 24-90% of trainees achieved the targets for 8 index elective operations. 72 trainees also completed a 6-month post in orthopaedics and recorded 7,551 operations. The most common orthopaedic operation that trainees performed was removal of metal, with an average of 2.90 (± 3.27) per trainee. The most common orthopaedic operation that trainees assisted with was total hip replacement, with an average of 10.46 (± 6.21) per trainee.ConclusionsA centralised web-based logbook provides valuable data to analyse training programme performance. Analysis of logbooks raises concerns about operative experience at junior trainee level. The provision of adequate operative exposure for trainees should be a key performance indicator for training programmes.

Libro informático del residente de cirugía: Un paso adelante

“…El Reino Unido dispone de un registro electró nico centralizado en la web http://www.elogbook.org, accesible a diferentes especialidades quirú rgicas (online y a travé s de dispositivos mó viles), de uso obligado por los residentes desde 2003, y controlado por el Real Colegio de Cirujanos de Edimburgo [8][9][10] . A diferencia del LIRQ, el eLogbook registra operaciones completadas y no procedimientos, lo que es considerado un punto dé bil en los trabajos realizados acerca de eLogbook, sin embargo, sí que tienen cuidado en registrar el nivel de participació n (p.…”

“…Los datos registrados sirven para generar informes individuales o globales, los cuales se revisan y comentan 2 veces al añ o, del mismo modo que realizamos en nuestro servicio. Actualmente, má s de 22.000 cirujanos del Reino Unido, de diferentes especialidades quirú rgicas, usan el eLogbook y hay registradas má s de 10 millones de intervenciones quirú rgicas [8][9][10] .…”

“…En 2011, Lonergan et al 8 realizaron un trabajo descriptivo sobre la experiencia del uso del eLogbook en Irlanda durante los 2 primeros añ os de formació n de residentes quirú rgicos, trabajo de similares características al multicé ntrico españ ol 7 , y que demostró que los residentes de los primeros añ os tenían un dé ficit de actividad quirú rgica en comparació n con los está ndares establecidos por el Real Colegio de Cirujanos de Irlanda, principalmente porque participaban en la mayoría de las intervenciones quirú rgicas como ayudantes. Situació n que de momento no sucede en nuestro servicio, ya que los residentes de primer y segundo añ o participan como cirujanos .…”

First Year Specialist Anaesthesia Training in Ireland: A Logbook Analysis

“…Given the practical nature of the specialty, competency in a new range of skills must be developed. The use of electronic logbooks to record clinical experience is well-established, both in anaesthesia and other procedure-based specialties (Watt JM, Watt WM, 1998) (Lonergan PE, Mulsow J, Tanner WA, Traynor O, Tierney S, 2011). Specific logbook targets have been developed in other jurisdictions, but do not currently exist for early anaesthesia trainees in Ireland.…”

Trainees Should Go on Holiday with their Consultant

“…It has been shown that operating experience is one of the key factors that can be used to quantify and assess training. 5 Over a period of 2 weeks, we performed a survey of 228 elective operating lists throughout our training region, covering 11 hospitals and all elective orthopaedic specialties. During this time, 41 lists were not used or attended by a trainee when they should have been: 31 were not used owing to consultants or trainees being on leave, 7 owing to trauma workload in the trust leading to elective cancellations, and 3 for other reasons such as departmental audit meetings.…”