Assessing the effort associated with teaching residents

Aibel, Kelli; Truong, Tracy; Shammas, Ronnie L.; Cho, Eugenia H.; Buretta, Kate J.; Pomann, Gina‐Maria; Hollenbeck, Scott T.

doi:10.1016/j.bjps.2017.07.014

Cited by 3 publications

(7 citation statements)

References 39 publications

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“…These outcomes are consistent with other studies assessing the operative time of procedures with surgical resident involvement. 2,5,22 Chamberlain et al 2 evaluated differences in operative times between attendings-only and attendings with resident groups for 19 different mastectomy subcategories. Although the authors identified an increase in operative time for nearly all cases involving surgical residents, this study was limited to a single institution and exclusively mastectomy procedures.…”

Section: Discussionmentioning

confidence: 99%

“…For several surgical specialties, data has shown an increase in operative time, length of stay, and overall cost associated with resident participation in such cases. [1][2][3][4][5][6][7][8][9][10] Given these considerations, it remains paramount to understand the perspective of attending surgeons who must balance commitments to teach residents in surgical cases while optimizing clinical productivity to maintain revenue. [11][12][13][14] Up to date, studies on complications and re-admissions associated with resident involvement have not established a clear pattern.…”

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confidence: 99%

“…[11][12][13][14] Up to date, studies on complications and re-admissions associated with resident involvement have not established a clear pattern. [1][2][3][4][5][6][7][8][9][10] Furthermore, the increasing pressures to maximize clinical productivity, paired with the shift towards bundled payment models and value-based care, may dis-incentivize resident involvement in the operating room thus weakening the mission of academic medicine.…”

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confidence: 99%

“…Given these considerations, it remains paramount to understand the perspective of attending surgeons who must balance commitments to teach residents in surgical cases while optimizing clinical productivity to maintain revenue 11–14 . Up to date, studies on complications and re-admissions associated with resident involvement have not established a clear pattern 1–10 . Furthermore, the increasing pressures to maximize clinical productivity, paired with the shift towards bundled payment models and value-based care, may dis-incentivize resident involvement in the operating room thus weakening the mission of academic medicine.…”

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confidence: 99%

“…The mission of educating and training residents remains at the forefront of academic medical education. For several surgical specialties, data has shown an increase in operative time, length of stay, and overall cost associated with resident participation in such cases 1–10 . Given these considerations, it remains paramount to understand the perspective of attending surgeons who must balance commitments to teach residents in surgical cases while optimizing clinical productivity to maintain revenue 11–14 .…”

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confidence: 99%

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The Opportunity Cost of Resident Involvement in Adult Craniofacial Surgery: An Analysis of Relative Value Units

Khetpal

Phillips

Parsaei

et al. 2021

Journal of Craniofacial Surgery

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Purpose: Within the academic surgical setting resident involvement may confer longer operative times. The increasing pressures to maximize clinical productivity and decreasing reimbursement rates, however, may conflict with these principles. This study calculates the opportunity cost of resident involvement in craniofacial surgery. Methods: Retrospective analysis was conducted with patients who underwent craniofacial procedures from the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2012. Patients were selected based on relevant Current Procedural Terminology codes for craniofacial pathologies (ie, trauma, head and neck reconstruction, orthognathic surgery, and facial reanimation). Variables included patient demographics, operative time, and presence or absence of resident trainee. Average relative value units were calculated to determine the opportunity cost of resident involvement for each craniofacial procedure. Results: In total, 2096 patients were identified through the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2012. Resident involvement was associated with a statistically significant higher operative time (P < 0.001) for facial reanimation, facial trauma, orthognathic surgery, and head and neck reconstruction. The opportunity costs per case associated with resident involvement were the highest for head and neck reconstruction ($1468.04), followed by orthognathic surgery ($1247.03), facial trauma ($533.03), and facial reanimation ($358.32). Resident involvement was associated with higher rate of complications for head and neck reconstruction (P < 0.043). Conclusions: Resident involvement is associated with longer operative times, higher complications, and higher re-operations, compared to attending exclusive surgical care. Future studies may consider how reimbursements should align incentives to promote resident education and training.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

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The Opportunity Cost of Resident Involvement in Adult Craniofacial Surgery: An Analysis of Relative Value Units

Khetpal

Phillips

Parsaei

et al. 2021

Journal of Craniofacial Surgery

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Impact of Residents on Operative Time in Aesthetic Surgery at an Academic Institution

Peterson

Ghosh

Al-Qureshi

et al. 2019

Aesthetic Surgery Journal Open Forum

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Background Duration of surgery is a known risk factor for increased complication rates. Longer operations may lead to increased cost to the patient and institution. While previous studies have looked at the safety of aesthetic surgery with resident involvement, little research has examined whether resident involvement increases operative time of aesthetic procedures. Objectives We hypothesized that resident involvement would potentially lead to an increase in operative time as attending physicians teach trainees during aesthetic operations. Methods A retrospective cohort analysis was performed from aesthetic surgery cases of two surgeons at an academic institution over a 4-year period. Breast augmentation and abdominoplasty with liposuction were examined as index cases for this study. Demographics, operative time, and resident involvement were assessed. Resident involvement was defined as participating in critical portions of the cases including exposure, dissection, and closure. Results A total of 180 cases fit the inclusion criteria with 105 breast augmentation cases and 75 cases of abdominoplasty with liposuction. Patient demographics were similar for both procedures. Resident involvement did not statistically affect operative duration in breast augmentation (41.8 ± 9.6 min vs 44.7 ± 12.4 min, P = 0.103) or cases for abdominoplasty with liposuction (107.3 ± 20.5 min vs 122.2 ± 36.3 min, P = 0.105). Conclusions There was a trend toward longer operative times that did not reach statistical significance with resident involvement in two aesthetic surgery cases at an academic institution. This study adds to the growing literature on the effect resident training has in aesthetic surgery. Level of Evidence: 2

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Impact of Trainee Involvement on Complication Rates Following Pelvic Reconstructive Surgery

Sheyn

Bretschneider

Canfield

et al. 2018

Female Pelvic Med Reconstr Surg

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Assessing the effort associated with teaching residents

Cited by 3 publications

References 39 publications

The Opportunity Cost of Resident Involvement in Adult Craniofacial Surgery: An Analysis of Relative Value Units

The Opportunity Cost of Resident Involvement in Adult Craniofacial Surgery: An Analysis of Relative Value Units

Impact of Residents on Operative Time in Aesthetic Surgery at an Academic Institution

Impact of Trainee Involvement on Complication Rates Following Pelvic Reconstructive Surgery

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