Operative Autonomy among Senior Surgical Trainees during Infrainguinal Bypass Operations Is Not Associated with Worse Long-term Patient Outcomes

Association of Resident Duty Hour Restrictions, Level of Trainee, and Number of Available Residents with Mortality in the Neonatal Intensive Care Unit

“…Similarly, previous studies in the adult population have found that level of training is associated with procedural abilities but not patient mortality. 19 Furthermore, the number of residents present during the day was not associated with neonatal mortality, which reinforces the hypothesis that the attending staff presence in this hospital is adequate.…”

“…18 First, resident fatigue based on the number of continuous hours worked (24-hour versus 16-hour shifts) has been associated with increased medical errors and may contribute to neonatal outcomes. 10 Second, the level of training of residents may have a confounding effect on this association, 19 since more advanced training has been associated with higher success rates of critical procedures such as intubation. 20,21 Third, the number of available residents may help provide a better physician-to-patient ratio at the time of admission and provide better care.…”

Resident Autonomy in the Operating Room: Expectations Versus Reality

“…Finally, there may be extrinsic factors limiting autonomy. Involvement of residents increases operative times [12]. Given the financial pressures to squeeze in one more case and the social pressures to spend time with family, faculty may limit autonomy and may feel pressure to give less autonomy in late cases from both operating room personnel and their own family.…”

Resident Autonomy

“…Studies across many disciplines of medical training have studied the effects of autonomy among trainees on patient outcomes from in-patient pediatrics, anesthesia as well as surgery. While there are studies that demonstrate less than ideal outcomes related to longer operative times [74], or overall worse outcomes, many studies have demonstrated significant improvement in resident satisfaction and confidence without any detrimental effects on patient outcomes.…”