Outcomes Associated With Resident Involvement in Partial Colectomy

Iannuzzi, James C.; Rickles, Aaron S.; Deeb, Andrew–Paul; Sharma, Abhiram; Fleming, Fergal J.; Monson, J. R. T.

doi:10.1097/dcr.0b013e318276862f

Cited by 58 publications

(31 citation statements)

References 18 publications

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“…The majority of patients also perceived LS to be quicker, cheaper and with fewer complications, compared with open surgery, which opposes the literature 16. Although not widely recognised by our participants, complications are possibly increased for LS compared with open surgery and also increased for trainee surgeons compared with consultants 5. Indeed, studies demonstrate that operative times for trainees are 20%–47% longer than for consultants 18.…”

Section: Discussionmentioning

confidence: 76%

“…Longer operations may be an acceptable trade-off for addressing educational needs and represent increased cost with decreased surgical throughput. Increased operative time itself may lead to poorer outcomes and may be part of the causal pathway for other downstream adverse outcomes when multivariate analysis of major complications is adjusted for operative time 5. Trainees are however fundamental to the healthcare system both in terms of their current roles within the healthcare team and to supply the future surgeon workforce.…”

Section: Discussionmentioning

confidence: 99%

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Patients and hospital managers want laparoscopic simulation training to become mandatory before live operating: a multicentre qualitative study of stakeholder perceptions

et al. 2018

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BackgroundSurgical procedures are complex and susceptible to human error. Individual surgical skill correlates with improved patient outcomes demonstrating that surgical proficiency is vitally important for patient safety. Evidence demonstrates that simulation training improves laparoscopic surgical skills; however, projects to implement and integrate laparoscopic simulation into core surgical curricula have had varied success. One barrier to successful implementation has been the lack of awareness and prioritisation of simulation initiatives by key stakeholders.ObjectiveTo determine the knowledge and perceptions of patients and hospital managers on laparoscopic surgery and simulation training in patient safety and healthcare.MethodA qualitative study was conducted in the Southwest of England. 40 semistructured interviews were undertaken with patients attending general gynaecology clinics and general surgical and gynaecology hospital managers.ResultsSix key themes identified included: positive expectations of laparoscopic surgery; perceptions of problems and financial implications of laparoscopic surgery; lack of awareness of difficulties with surgical training; desire for laparoscopic simulation training and competency testing for patient benefit; conflicting priorities of laparoscopic simulation in healthcare; and drawbacks of surgical simulation training. Patients and managers were largely unaware of the risks of laparoscopic surgery and challenges for training. Managers highlighted conflicting financial priorities when purchasing educational equipment. Patients stated that they would have greater confidence in a surgeon who had undertaken mandatory surgical simulation training and perceived purchasing simulation equipment to be a high priority in the National Health Services. Most patients and hospital managers believed trainees should pass an examination on a simulator prior to live operating.ConclusionsCompetency-based mandatory laparoscopic simulation was strongly supported by the majority of stakeholders to augment the initial learning curve of surgeons.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Patients and hospital managers want laparoscopic simulation training to become mandatory before live operating: a multicentre qualitative study of stakeholder perceptions

et al. 2018

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“…[6][7][8][9][10] These factors are all listed in Table I, and their precise definitions are provided in the legend. Complications that occurred after discharge were not included because they likely represent the reason for readmission and would thus not be considered a predictive factor.…”

Section: Methodsmentioning

confidence: 99%

Risk scoring can predict readmission after endocrine surgery

Iannuzzi

Fleming

Kelly

et al. 2014

Surgery

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“…Multiple evaluations of the NSQIP by general surgeons have found an increase in 30‐day complication rates associated with resident involvement in a broad array of general surgery procedures . Increased morbidity associated with resident operative involvement has been seen in orthopedics, plastic surgery, and urology .…”

Section: Discussionmentioning

confidence: 99%