Surgical Case Logging Habits and Attitudes: A Multispecialty Survey of Residents

Cadish, Lauren A.; Fung, Vicki; Lane, Felicia; Campbell, Eric G.

doi:10.1016/j.jsurg.2015.09.007

Cited by 46 publications

(37 citation statements)

References 6 publications

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“…Resident case volume reporting is subject to variation as prior reports have suggested residents may consider themselves the primary surgeon if they are merely present at the operation. [9] Thus, there is a possibility that the actual number of ablation surgeries predominantly performed by a trainee is less than reported in our findings. Additionally, the survey may have captured residents with an additional 1-2 years of training remaining so those responders may graduate with a greater case volume.…”

Section: Original Researchmentioning

confidence: 52%

Cardiothoracic Surgery Residency Training in Surgical Ablation for Atrial Fibrillation

DeBoard

Varghese

Doty

et al. 2019

Journal of Atrial Fibrillation

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Background : As no standardized curriculum exists for training cardiothoracic surgery residents in surgical ablation for atrial fibrillation, there is potential for variation in operative technique, patient selection, and overall application. Thus we sought to assess the exposure of current residents in order to identify areas for improvement in their education. Methods : A survey was emailed to residents inquiring about their training experience in surgical ablation for atrial fibrillation. Residents were asked about case volume, procedural variety, and guideline-based clinical scenarios where they felt ablation would be appropriate. Residents were also queried about their abilities to perform various lesion sets and overall satisfaction with training. Results : The respondents performed a median of five cases during training with pulmonary vein isolation the most common lesion set. Seventy seven percent of residents are unable to independently perform a bi-atrial (Cox-Maze IV) lesion set. Residents are neutral regarding their satisfaction with training in surgical ablation for atrial fibrillation. Conclusions : The findings of low case volume, incomplete lesion set use, and lack of training satisfaction suggests residents are being insufficiently exposed to surgical ablation of atrial fibrillation. These findings should inform educators on the importance of a more thorough experience during training given the increasing prevalence of atrial fibrillation and the need for appropriate and durable surgical intervention.

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Section: Original Researchmentioning

confidence: 52%

Cardiothoracic Surgery Residency Training in Surgical Ablation for Atrial Fibrillation

DeBoard

Varghese

Doty

et al. 2019

Journal of Atrial Fibrillation

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show abstract

“…In contrast, the resident physicians in some training programs have not attained the minimal requirements of the ACGME [20]. Cadish et al investigated multiple specialty residents in a single training institution and found that nearly two-thirds of resident physicians considered the "case logs" work to be highly arduous, which affected the willingness, frequency, and accuracy of registration [21]. Dermody et al conducted an anonymous questionnaire survey of all otolaryngology-head and neck surgery residents and program directors (PDs) in the US; the survey revealed that most of the residents and PDs believed that accuracy was not high for online surgical case logs prescribed by the ACGME [22].…”

Section: Discussionmentioning

confidence: 99%

Attainment of Core Competencies Milestones in Otolaryngology Residency Training in Taiwan: A Pilot Study

Liu

Hsieh

Chen

et al. 2019

Preprint

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Background: Competency-based medical education has emerged as a mainstream method for educating and assessing the next generation of physicians. This study aims to initiate and examine the preliminary results of an integrated Traditional Chinese Otolaryngology Milestone Project in Taiwan. Methods: This prospective study enrolled 18 participants in an academic hospital setting from July 2017 to August 2019. Participants included twelve attending and six resident physicians. Using the Integrated Traditional Chinese Otolaryngology Milestones (ITCOM), five biannual evaluations involved independent self-assessments by the resident doctors, which the chief resident and attending physicians independently reevaluated. A Kruskal–Wallis test was used to compare the results of the five assessments. Results: The average scores of attained milestones for the five assessments were as follows for residents PGY1– PGY6: PGY1 (1.48 ± 0.24; 1.69 ± 0.10, P = 0.01), PGY2 ( 1.24 ± 0.12; 1.51 ± 0.23; 1.75 ± 0.06; 1.98 ± 0.21; 2.47 ± 0.18 , P < 0.0001), PGY3 (2.19 ± 0.24; 2.36 ± 0.25; 2.80 ± 0.19; 2.96 ± 0.24; 3.33 ± 0.23, P < 0.0001), PGY4 (2.68 ± 0.17; 2.96 ± 0.09; 3.35 ± 0.13; 3.58 ± 0.10; 4.17 ± 0.08, P < 0.0001), PGY5 (3.07 ± 0.24; 3.38 ± 0.12; 3.58 ± 0.10; 4.05 ± 0.09, P < 0.0001) and PGY6 ( 3.30 ± 0.27; 3.61 ± 0.28; 4.22 ± 0.20, P = 0.0001). The score results for patient care, medical knowledge, and professionalism were more likely to indicate heightened attainment of milestone levels as the program progressed. However, the curves of the score results for system-based practice, problem-based learning and improvement, and interpersonal and communication skills were more horizontal, showing that the milestones might indicate a better performance than expected, even in residents with low training seniority. Conclusions: The results of the five biannual assessments revealed that all resident physicians demonstrated a significant improvement. Further study involving large-scale participants and multiple institutions is warranted.

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“…In addition to the potential for inaccurate coding, multiple studies have demonstrated inconsistencies in the logging habits of orthopaedic surgery trainees beyond coding inaccuracy. [22][23][24] A procedural change in the way residents log cases occurred during the study and is discussed previously. Estimates for the number of procedures required to attain levels of competence are largely based off single-surgeon or single-institution experiences and may not be generalizable to residency training programs as a whole.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopy Volume in United States Residency Programs: Are New Trainees Prepared?

et al. 2019

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Arthroscopy is a technically demanding procedure with a prolonged learning curve. The purpose of this study is to determine if current arthroscopic case volume over the course of an orthopaedic surgery residency is sufficient to meet the number of cases required to achieve competence and/or mastery in complex arthroscopic tasks as well as hip arthroscopy. Publicly available Accreditation Council for Graduate Medical Education case log data for arthroscopic procedures from accredited orthopaedic residencies were reviewed from 2007 to 2017. Linear and segmental regression analyses were used to identify temporal trends, with significance set to p < 0.05. From 2007 to 2013, there was a significant increase in the median number of shoulder and knee arthroscopy case logs (p < 0.001). A sharp decline in the median number of shoulder and knee arthroscopy case logs was seen in 2013 to 2014 (p < 0.001), and the number remained low from 2014 to 2017 (p = 0.02, p = 0.03). The median number of hip arthroscopy procedures logged increased significantly from zero cases in 2012 (range: 0–48 cases) to five cases in 2017 (range: 0–76 cases) (p = 0.02). Over the study period, the median number of total arthroscopic procedures decreased from 301 to 186 (p = 0.01). In the United States, the majority of orthopaedic surgery residents graduate with case log numbers that meet theoretical minimum requirements for competence in basic diagnostic arthroscopy of the shoulder, hip, and knee. Resident experience with hip arthroscopy has increased; however, the majority of residents are graduating with little to no hip arthroscopy experience. Moreover, the median number of total arthroscopic procedures has declined to the point where the average graduate may not be able to perform complex hip or shoulder arthroscopy tasks based on previously published data. These findings support the need for further investigation into the best methods for training residents interested in performing arthroscopy as part of their careers. This was a level of evidence III, retrospective cohort study.

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Surgical Case Logging Habits and Attitudes: A Multispecialty Survey of Residents

Cited by 46 publications

References 6 publications

Cardiothoracic Surgery Residency Training in Surgical Ablation for Atrial Fibrillation

Cardiothoracic Surgery Residency Training in Surgical Ablation for Atrial Fibrillation

Attainment of Core Competencies Milestones in Otolaryngology Residency Training in Taiwan: A Pilot Study

Arthroscopy Volume in United States Residency Programs: Are New Trainees Prepared?

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