Resident Operative Experience at Independent Academic Medical Centers—A Comparison to the National Cohort

Joshi, Amit; Trickey, Amber W.; Jarman, Benjamin T.; Kallies, Kara J.; Josloff, Robert; Dort, Jonathan; Kothuru, Ravi

doi:10.1016/j.jsurg.2017.05.020

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…Residents in academic programs have unique opportunities to manage complex patients and participate in NIH-funded research, and they perform well on American Board of Surgery Examinations, but are less satisfied with their operative experience and less confident in their ability to operate independently compared with residents in community programs. 10 , 11 , 12 , 13 Confidence allows individuals to have a positive perception of their abilities and has important implications for job satisfaction and performance. In addition, the COVID-19 pandemic substantially decreased elective operative volumes, supporting the premise that surgical training cannot depend exclusively on cases performed in the operating room.…”

Section: Introductionmentioning

confidence: 99%

Performance Improvement With Implementation of a Surgical Skills Curriculum

Loftus

Filiberto

Upchurch

et al. 2021

Journal of Surgical Education

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Objective To assess the efficacy of an intern surgical skills curriculum involving a boot camp for core open and laparoscopic skills, self-guided practice with positive and negative incentives, and semiannual performance evaluations. Design Longitudinal cohort study. Setting Academic tertiary care center. Participants Intervention group ( n = 15): residents who completed the intern surgical skills curriculum and had performance evaluations in fall of intern year, spring of intern year, and fall of second year. Control group ( n = 8): second-year residents who were 1 year ahead of the intervention group in the same residency program, did not participate in the curriculum, and had performance evaluations in fall of second year. Results In fall of second year of residency, the intervention group had better performance (presented as median values with interquartile ranges) than the control group on one-hand ties (left hand: 9.1 [6.3-10.1] vs 14.6 [13.5-15.4] seconds, p = 0.007; right hand: 8.7 [8.5-9.6] vs 11.5 [9.9-16.8] seconds, p = 0.039). The intervention group also had better performance on all open suturing skills, including mattress suturing (vertical: 33.4 [30.0-40.0] vs 55.8 [50.0-67.6] seconds, p = 0.001; horizontal: 28.7 [27.3-39.9] vs 52.7 [40.7-57.8] seconds, p = 0.003), and a water-filled glove clamp, divide, and ligate task (28.0 [25.0-31.0] vs 59.1 [53.0-93.0] seconds, p < 0.001). Finally, the intervention group had better performance on all laparoscopic skills, including peg transfer (66.0 [59.0-82.0] vs 95.2 [87.5-101.5] seconds, p = 0.018), circle cut (82.0 [69.0-124.0] seconds vs 191.8 [155.5-231.5] seconds, p = 0.002), and intracorporeal suturing (195.0 [117.0-200.0] seconds vs 359.5 [269.0-450.0] seconds, p = 0.002). Conclusions Implementation of a comprehensive surgical skills curriculum was associated with improved performance on core open and laparoscopic skills. Further research is needed to understand and optimize motivational factors for deliberate practice and surgical skill acquisition.

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Section: Introductionmentioning

confidence: 99%

Performance Improvement With Implementation of a Surgical Skills Curriculum

Loftus

Filiberto

Upchurch

et al. 2021

Journal of Surgical Education

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“…These include exposure to a variety of cases, managing critically ill patients, involvement in decision-making, operative volume, program type (university vs hospital based vs military), and the presence of fellows on service; all these in uence the development of con dence in surgical residents. (11)(12)(13)(14)(15) It has been proposed that it may be possible to reduce the variation in con dence among surgical residents by standardizing their operative experience and clinical responsibilities in surgical training centers (10) however, this may not always be practical.…”

Section: Introductionmentioning

confidence: 99%

SCARS Study: Surgical Confidence when operating Among Residents in Surgery – A Cross-Sectional Study

Awlia

Alotaibi

Hawsa

et al. 2022

Preprint

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Background Self-confidence, one of the critical variables influencing surgical resident’s abilities, and lack of confidence maybe a reason for not entering medical practice immediately. Measuring the level of confidence of senior surgical residents (SSRs) is a crucial step in assessing preparedness to practice. In this study, we aim to measure their confidence level and the factors that might contribute to it. Methods Cross-sectional survey conducted at King Abdulaziz University Hospital on SSRs in Saudi Arabia (SA). Results Response rate was 89.4%. Among surveyed residents, 66% had completed < 750 cases as a primary surgeon. More than 90% of SSRs were confident in performing appendectomy, open inguinal hernia repair, laparoscopic cholecystectomy, and trauma laparotomy, while 88% were confident in being on-call in level-I trauma center. No difference was noted in confidence level in relation to the number of performed cases. Residents from the Ministry of Health accounted for 56.3% of the study population and showed a higher confidence level compared to others. 94% of SSRs plan to pursue fellowship training program. Conclusion The study showed that the confidence of SSRs in performing common general surgery procedures was as expected. However, it’s important to recognize that confidence doesn’t necessarily reflect competence. Considering the majority of SSRs planned to pursue fellowship training programs, it may be time to consider changing the structure of surgical training in SA to a modular format to allow earlier and more intensive exposure.

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