Disparity Between Resident and Faculty Surgeons' Perceptions of Preoperative Preparation, Intraoperative Teaching, and Postoperative Feedback

Rose, Joel; Waibel, Brett H.; Schenarts, Paul J.

doi:10.1016/j.jsurg.2011.04.003

Cited by 95 publications

(48 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Unfortunately, these goals are often not well defined nor are they always associated with detailed feedback to aid in meeting these achievement milestones. 8,18,20 Providing timely and structured feedback to neurosurgery residents may help accelerate their learning curve. 5,8 For this reason, we also aim to use this tool to provide residents with a better understanding of the level of their surgical skills as compared with the expectations for their stage of training, as well as helpful information to guide further improvement.…”

Section: Limitations and Future Directionsmentioning

confidence: 99%

Use of a formal assessment instrument for evaluation of resident operative skills in pediatric neurosurgery

Hadley

Lam

Briceño

et al. 2015

PED

View full text Add to dashboard Cite

OBJECT Currently there is no standardized tool for assessment of neurosurgical resident performance in the operating room. In light of enhanced requirements issued by the Accreditation Council for Graduate Medical Education’s Milestone Project and the Matrix Curriculum Project from the Society of Neurological Surgeons, the implementation of such a tool seems essential for objective evaluation of resident competence. Beyond compliance with governing body guidelines, objective assessment tools may be useful to direct early intervention for trainees performing below the level of their peers so that they may be given more hands-on teaching, while strong residents can be encouraged by faculty members to progress to conducting operations more independently with passive supervision. The aims of this study were to implement a validated assessment tool for evaluation of operative skills in pediatric neurosurgery and determine its feasibility and reliability. METHODS All neurosurgery residents completing their pediatric rotation over a 6-month period from January 1, 2014, to June 30, 2014, at the authors’ institution were enrolled in this study. For each procedure, residents were evaluated by means of a form, with one copy being completed by the resident and a separate copy being completed by the attending surgeon. The evaluation form was based on the validated Objective Structured Assessment of Technical Skills for Surgery (OSATS) and used a 5-point Likert-type scale with 7 categories: respect for tissue; time and motion; instrument handling; knowledge of instruments; flow of operation; use of assistants; and knowledge of specific procedure. Data were then stratified by faculty versus resident (self-) assessment; postgraduate year level; and difficulty of procedure. Descriptive statistics (means and SDs) were calculated, and the results were compared using the Wilcoxon signed-rank test and Student t-test. A p value < 0.05 was considered statistically significant. RESULTS Six faculty members, 1 fellow, and 8 residents completed evaluations for 299 procedures, including 32 ventriculoperitoneal (VP) shunt revisions, 23 VP shunt placements, 19 endoscopic third ventriculostomies, and 18 craniotomies for tumor resection. There was no significant difference between faculty and resident self-assessment scores overall or in any of the 7 domains scores for each of the involved residents. On self-assessment, senior residents scored themselves significantly higher (p < 0.02) than junior residents overall and in all domains except for “time and motion.” Faculty members scored senior residents significantly higher than junior residents only for the “knowledge of instruments” domain (p = 0.05). When procedure difficulty was considered, senior residents’ scores from faculty members were significantly higher (p = 0.04) than the scores given to junior residents for expert procedures only. Senior residents’ self-evaluation scores were significantly higher than those of junior residents for both expert (p = 0.03) and novice (p = 0.006) procedures. CONCLUSIONS OSATS is a feasible and reliable assessment tool for the comprehensive evaluation of neurosurgery resident performance in the operating room. The authors plan to use this tool to assess resident operative skill development and to improve direct resident feedback.

show abstract

Section: Limitations and Future Directionsmentioning

confidence: 99%

Use of a formal assessment instrument for evaluation of resident operative skills in pediatric neurosurgery

Hadley

Lam

Briceño

et al. 2015

PED

View full text Add to dashboard Cite

show abstract

“…In the university setting, residents receive operative feedback to sharpen technical and decision-making skills. Residents and staff see the benefits to feedback; however, incongruity exists between the amount and the quality of feedback provided (16, 17). While studies have identified the importance of feedback, little work has explored how often residents and staff believe feedback should be given and what barriers they perceive to providing and receiving feedback exist in the current operative environment.…”

Section: Introductionmentioning

confidence: 99%

Integrating Postoperative Feedback Into Workflow: Perceived Practices and Barriers

Nathwani

Glarner

Law

et al. 2017

Journal of Surgical Education

View full text Add to dashboard Cite

Objective Previous studies have found that both resident and staff surgeons highly value post-operative feedback; and that such feedback has high educational value. However, little is known about how to consistently deliver this feedback. Our aim was to understand how often surgical residents should receive feedback and what barriers are preventing this from occurring. Design Surveys were distributed to residents and attending surgeons. Questions focused on the current frequency of post-operative feedback, desired frequency and methods of feedback, and perceived barriers. Quantitative data were analyzed with descriptive statistics, and text responses were examined using coding. Setting University-based general surgery department at a Midwestern institution Participants General surgery residents (n=23) and attending surgeons (n=22) participated in this study. Results Residents reported receiving and staff reported giving feedback for procedure specific performance after 25% versus 34% of cases, general technical feedback after 36% versus 32%, and non-technical performance after 17% versus 18%. Both perceived procedure-specific and general technical feedback should be given over 80% of the time, and non-technical feedback should happen for nearly 60% of cases. Verbal feedback immediately after the operation was rated as best practice. Both parties identified time, conflicting responsibilities, lack of privacy, and discomfort with giving and receiving meaningful feedback as barriers. Conclusions Both resident and staff surgeons agree that post-operative feedback is given far less often than it should. Future work should study intraoperative and post-operative feedback to validate resident and attending perceptions such that interventions to improve and facilitate this process can be developed.

show abstract

“…27 There is also an intrinsic selection bias in O-SCORE administration by residents to select for cases they are proficient at to obtain good evaluations. 28 Plastic surgery residents are exposed to a set of unique challenges due to the variety of operations encountered, including hand, craniofacial, breast, and microsurgery, which was a source of concern from residents regarding generalizability of the assessment tool. In addition, each supervising surgeon may have individual preferences for the same procedure, thus complicating reliability of feedback considerations.…”

Section: Discussionmentioning

confidence: 99%

A literature review of educational feedback in the operating room: plastic surgery residents’ perception of feedback from the O-SCORE

Sardiwalla¹,

Joukhadar²,

Tang³

2019

J Surg Simul

View full text Add to dashboard Cite

show abstract

Disparity Between Resident and Faculty Surgeons' Perceptions of Preoperative Preparation, Intraoperative Teaching, and Postoperative Feedback

Cited by 95 publications

References 21 publications

Use of a formal assessment instrument for evaluation of resident operative skills in pediatric neurosurgery

Use of a formal assessment instrument for evaluation of resident operative skills in pediatric neurosurgery

Integrating Postoperative Feedback Into Workflow: Perceived Practices and Barriers

A literature review of educational feedback in the operating room: plastic surgery residents’ perception of feedback from the O-SCORE

Contact Info

Product

Resources

About