Scut to Scholarship: Can Operative Notes be Educationally Useful?

Apramian, Tavis; Ott, Mary; Roth, Kathryn; Lingard, Lorelei; Tipnis, Rajas; Cristancho, Sayra

doi:10.1016/j.jsurg.2020.07.004

Cited by 4 publications

(6 citation statements)

References 42 publications

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“…In 2018, Nyamulani and Mulwafu conducted a prospective review of the quality of operative record identifying critical de ciencies in operative documentation and concluded that educating doctors and using proforma would improve their completeness (25). Apramian et al conducted a qualitative analysis of operative records in patients undergoing tonsillectomy and found operative records while essential for documentation can be used as a learning and assessment tool (17).…”

Section: Discussionmentioning

confidence: 99%

“…Synoptic operative records provide a data base for research into patient surgery and its impact on outcome. Synoptic operative records enhance residents training by prompting identi cation of key stages of procedures that need to be completed and documented (17). Currently, however, few synoptic operative reporting systems are in place (11,18) and for this reason this study undertook a systematic review of the literature to determine current availability of synoptic operative reporting and secondly to develop a synoptic template for the operative record documenting emergency laparotomy.…”

Section: Introductionmentioning

confidence: 99%

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Enhancing Operative Documentation of Emergency Laparotomy: A Systematic Review and Development of a Synoptic Reporting Template

Elamin,

Walker,

Sugrue

et al. 2023

Preprint

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Introduction: Currently operative reports are narrative, often hand-written making interpretation difficult and potentially omitting key steps of the procedure. This study undertook a systematic review to determine current availability of synoptic operative reporting and develop a synoptic operative record template for emergency laparotomy (EL). Methods: A PROSPERO registered study from January 1st, 2012, to December 31st, 2022, was conducted using PubMed, Scopus, and Web of Science databases in February 2023. Keywords included: emergency laparotomy AND operation notes OR operative notes OR documentation OR report OR proforma OR narrative OR synoptic OR digital OR audio-visual. Studies of paediatric or pregnant patients as well as systematic reviews, meta-analyses, case reports, editorial comments, and letters were excluded. A synoptic operative record was designed to include key standards in documentation as suggested by the Colleges of Surgeons. Results: The literature search produced 4,687 articles and no relevant published articles were found. A detailed synoptic template was developed, including 111 fields related to patient demographics, operative findings, intervention, and documentation of key variables associated with patient outcomes. 11 were text boxes, two related to digital audio-visual uploads and three facilitating digital scoring/grading of findings. Conclusion: This systematic review identified a limited number of publications reporting synoptic operative reporting and none relating to emergency laparotomy. The novel operative template provides a platform for clear documentation of the surgery performed during emergency laparotomy, potentially facilitating data analysis, resident training, and research and in turn leading to a better understanding of patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Enhancing Operative Documentation of Emergency Laparotomy: A Systematic Review and Development of a Synoptic Reporting Template

Elamin,

Walker,

Sugrue

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…As an example, Apramian et al stressed that surgeons show variation in standard surgical procedures and have their own preferences when conducting surgery. [44][45][46] Surgical trainees must observe and develop their operative habits watching these attending surgeons' preferences. They must learn to distinguish between non-negotiable surgical principles and negotiable surgical preferences.…”

Section: Competence At Layer 3: Personalised Knowledge Skills Interes...mentioning

confidence: 99%

“…It builds on, and further creates a distinct professional personality and unique behaviour. As an example, Apramian et al stressed that surgeons show variation in standard surgical procedures and have their own preferences when conducting surgery 44–46 . Surgical trainees must observe and develop their operative habits watching these attending surgeons' preferences.…”

Section: Competence At Layer 3: Personalised Knowledge Skills Interes...mentioning

confidence: 99%

Medical competence as a multilayered construct

ten Cate,

Khursigara‐Slattery,

Cruess

et al. 2023

Medical Education

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BackgroundThe conceptualisation of medical competence is central to its use in competency‐based medical education. Calls for ‘fixed standards’ with ‘flexible pathways’, recommended in recent reports, require competence to be well defined. Making competence explicit and measurable has, however, been difficult, in part due to a tension between the need for standardisation and the acknowledgment that medical professionals must also be valued as unique individuals. To address these conflicting demands, a multilayered conceptualisation of competence is proposed, with implications for the definition of standards and approaches to assessment.The modelThree layers are elaborated. This first is a core layer of canonical knowledge and skill, ‘that, which every professional should possess’, independent of the context of practice. The second layer is context‐dependent knowledge, skill, and attitude, visible through practice in health care. The third layer of personalised competence includes personal skills, interests, habits and convictions, integrated with one's personality. This layer, discussed with reference to Vygotsky's concept of Perezhivanie, cognitive load theory, self‐determination theory and Maslow's ‘self‐actualisation’, may be regarded as the art of medicine.We propose that fully matured professional competence requires all three layers, but that the assessment of each layer is different.ImplicationsThe assessment of canonical knowledge and skills (Layer 1) can be approached with classical psychometric conditions, that is, similar tests, circumstances and criteria for all. Context‐dependent medical competence (Layer 2) must be assessed differently, because conditions of assessment across candidates cannot be standardised. Here, multiple sources of information must be merged and intersubjective expert agreement should ground decisions about progression and level of clinical autonomy of trainees. Competence as the art of medicine (Layer 3) cannot be standardised and should not be assessed with the purpose of permission to practice. The pursuit of personal excellence in this level, however, can be recognised and rewarded.

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“…Synoptic operative records provide a database for research on patient surgery and its impact on the outcomes. Synoptic operative records enhance residents’ training by prompting the identification of key stages of procedures that must be completed and documented [ 17 ]. Currently, however, few synoptic operative reporting systems are in place [ 11 , 18 ]; therefore, this study undertook a systematic review of the literature to determine the current availability of synoptic operative reporting and develop a synoptic template for the operative record documenting emergency laparotomy.…”

Section: Introductionmentioning

confidence: 99%

Enhancing operative documentation of emergency laparotomy: a systematic review and development of a synoptic reporting template

Elamin,

Walker,

Sugrue

et al. 2023

World J Emerg Surg

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Introduction Currently, operative reports are narrative and often handwritten, making interpretation difficult and potentially omitting key steps of the procedure. This study undertook a systematic review to determine the current availability of synoptic operative reporting and develop a synoptic operative record template for emergency laparotomy (EL). Methods A PROSPERO registered study from January 1st, 2012, to December 31st, 2022, was conducted using PubMed, Scopus, and Web of Science databases in February 2023. Keywords: emergency laparotomy AND operation notes OR operative notes OR documentation OR report OR pro forma OR narrative OR synoptic OR digital OR audio-visual. Studies on paediatric or pregnant patients, systematic reviews, meta-analyses, case reports, editorial comments, and letters were excluded. A synoptic operative record was designed to include key standards in the documentation, as suggested by the Colleges of Surgeons. Results The literature search yielded 4687 articles, and no relevant published articles were found. A detailed synoptic template was developed, which included 111 fields related to patient demographics, operative findings, interventions, and documentation of key variables associated with patient outcomes. 11 were text boxes, two were related to digital audio-visual uploads, and three facilitated the digital scoring/grading of findings. Conclusion This systematic review identified a limited number of publications reporting synoptic operative reporting, and none related to emergency laparotomy. This novel operative template provides a platform for clear documentation of the surgery performed during emergency laparotomy, potentially facilitating data analysis, resident training, and research, in turn leading to a better understanding of patient outcomes.

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Scut to Scholarship: Can Operative Notes be Educationally Useful?

Cited by 4 publications

References 42 publications

Enhancing Operative Documentation of Emergency Laparotomy: A Systematic Review and Development of a Synoptic Reporting Template

Enhancing Operative Documentation of Emergency Laparotomy: A Systematic Review and Development of a Synoptic Reporting Template

Medical competence as a multilayered construct

Enhancing operative documentation of emergency laparotomy: a systematic review and development of a synoptic reporting template

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