Trends in Pediatric Surgery Operative Volume among Residents and Fellows: Improving the Experience for All

Talutis, Stephanie D.; McAneny, David; Chen, Catherine; Doherty, Gerard M.; Sachs, Teviah E.

doi:10.1016/j.jamcollsurg.2015.11.034

Cited by 15 publications

(6 citation statements)

References 24 publications

(39 reference statements)

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“…We hypothesize that there is a difference in operative case volume between female and male residents in otolaryngology residencies in the United States. Case log data have been used to make broad observations about the state of surgical education in many disciplines . While operative experience and case logs in residency do not necessarily correlate to surgical competency, these data do provide a marker for operative experience.…”

Section: Introductionmentioning

confidence: 99%

“…Case log data have been used to make broad observations about the state of surgical education in many disciplines. 9,[12][13][14][15] While operative experience and case logs in residency do not necessarily correlate to surgical competency, these data do provide a marker for operative experience. The objective of this study is to evaluate gender disparity in surgical case volume, as determined by surgical case logs, in otolaryngology residencies in the United States.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating gender parity in operative experience for otolaryngology residencies in the United States

et al. 2019

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Objectives Gender disparity exists in medicine, such as differences in pay and promotion opportunities. We hypothesize that there is also a gender difference in graduate medical education as manifested by operative case volume. This study compares surgical case volume by gender for graduating US otolaryngology residents. Study Design Cohort study. Methods With data use approval from the Accreditation Council for Graduate Medical Education, we evaluated the key indicator case log summaries of graduating otolaryngology residents from 2009–2017. Mean and standard deviation were used for all cases, and t‐tests were used to compare cases by resident gender. The Bonferroni method was used to adjust for multiple comparisons across years. Results Data from 1740 male and 804 female residents were evaluated. Across all years, the average number of key indicator cases reported was 778.8 and 813.6 by female and male residents, respectively, with an average difference of 34.8 cases per graduating year (95% confidence interval [CI] 19.4, 50.2; P < .001). When a resident self‐reported the role of resident surgeon/supervisor, the average number of key indicator cases reported was 602.6 and 643.9 by female and male residents, respectively, with an average difference of 41.3 cases per graduating year (95% CI, 28.0, 54.6; P < .001). Conclusion Gender‐based discrepancies in surgical case volume exist among graduating otolaryngology residents. This disparity is partially attributed to the self‐reported role in the surgery. This study has identified those discrepancies so that training programs can implement strategies to ensure improved gender parity. Level of Evidence 2b Laryngoscope, 130:1651–1656, 2020

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluating gender parity in operative experience for otolaryngology residencies in the United States

et al. 2019

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“…In addition, the development of minimally invasive techniques in neonatal surgery (such as thoracoscopic correction of esophageal atresia) has led to a tendency for these pathologies to be centralized and to be operated by senior consultants, which limits the training possibilities for residents. The different training models depending on each country also condition this training: there are places like Spain where Pediatric Surgery is a complete surgical specialty with a 5-year training, while in other centers Pediatric Surgery is a fellowship derived from General Surgery [7,8].…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a realistic type III esophageal atresia simulator for the training of pediatric surgeons

Montero,

Pérez Riveros,

Bueso Asfura

et al. 2024

Preprint

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Background: The technical complexity and limited casuistry of neonatal surgical pathology limit the possibilities of developing the necessary technical competencies by specialists in training. Esophageal atresia constitutes the paradigm of this problem. The use of 3D models for training is a promising line of research, although the literature is limited. Methods: We conceptualized, designed, and produced an anatomically realistic model for the open correction of type III oesophageal atresia. We validated it with two groups of participants (experts and non-experts) through face, construct, and content validity questionnaires. Results: The model was validated by 9 experts and 9 non-experts. The mean procedure time for the experts and non-experts groups was 34.0 and 38.4 minutes respectively. Two non-experts did not complete the procedure at the designed time (45 minutes). Regarding the face validity questionnaire, the mean rating of the model was 3.2 out of 4. Regarding the construct validity, we found statistically significant differences between groups for the equidistance between sutures, 100% correct in the expert group vs. 42.9% correct in the non-expert group (p=0.02), and for the item: Confirms that tracheoesophageal fistula closure is watertight before continuing the procedure, correctly assessed by 66.7% of the experts vs. by 11.1% of non-experts (p=0.05). Concerning content validity, the mean score was 3.3 out of 4 for the experts and 3.3 out of 4 for the non-experts (p=0.32). Conclusions: The present model is a cost-effective, simple to produce, and validated option for the training of open correction of type III oesophageal atresia. Future studies with larger sample sizes and blinded validators are needed before drawing definitive conclusions.

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“…Research time usually performed between the junior and senior levels of residency, while beneficial to the overall education of the trainee, is often obsolete by the time fellowship is completed and does not address the unmet need of improved technical proficiency. The resulting diminution in autonomy carries over into pediatric surgery fellowship training, as evidenced by the fact that teaching cases performed by fellows have decreased 56% [ 27 ]. It is encouraging that pediatric surgical trainees now record more total cases and more minimally invasive surgery cases than ever before [ 28 ].…”

mentioning

confidence: 99%

“…It is encouraging that pediatric surgical trainees now record more total cases and more minimally invasive surgery cases than ever before [ 28 ]. Regrettably, a subset of this increase comes from trainees performing cases previously assigned to general surgery residents [ 27 ]. There was a recent increase in the American Board of Surgery (ABS) Pediatric Surgery Certifying Exam failure rate, approaching 20% in 2018 ( Fig.…”

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confidence: 99%

The Right Child/Right Surgeon initiative: A position statement on pediatric surgical training, sub-specialization, and continuous certification from the American Pediatric Surgical Association

Alaish

Powell

Waldhausen

et al. 2020

Journal of Pediatric Surgery

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The past 50 years have witnessed profound changes in the specialty of pediatric surgery in North America. There has been a marked increase in the number of both pediatric surgical training programs and practicing pediatric general and thoracic surgeons. Despite this trend, the population of children in the United States and the birth rate have recently remained relatively flat. Some pediatric surgeons have become “super specialists”, concentrating their practices in oncology or colorectal surgery. This has the potential to result in a dilution of experience for both pediatric surgical trainees and practicing pediatric surgeons, thus limiting their ability to acquire and maintain expertise, respectively. Coincident with this, there has been a relative paradigm shift in recognition that “quality of life” is based more on maintaining a creative balance in lifestyle and is not “all about work”. There has been a parallel growth in the number of practicing pediatric general and thoracic surgeons in urban settings, but we have not appreciated as much growth in rural and underserved areas, where access to pediatric surgical care remains limited and fewer pediatric general and thoracic surgeons practice. This is a complex issue, as some underserved areas are economically depressed and geographically sparse, but others are just underserved with adult providers taking care of children in settings that are often under resourced for pediatric surgical care. This problem may extend beyond the boundaries of pediatric general and thoracic surgery to other specialties. As the premier association representing all pediatric surgeons in the United States, the American Pediatric Surgical Association (APSA) has concluded that the quality of pediatric surgical care will likely decline should the status quo be allowed to continue. Therefore, APSA has initiated a Right Child/Right Surgeon initiative to consider these issues and propose some potential solutions. What follows is a brief statement of intent.

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Trends in Pediatric Surgery Operative Volume among Residents and Fellows: Improving the Experience for All

Cited by 15 publications

References 24 publications

Evaluating gender parity in operative experience for otolaryngology residencies in the United States

Evaluating gender parity in operative experience for otolaryngology residencies in the United States

Development and validation of a realistic type III esophageal atresia simulator for the training of pediatric surgeons

The Right Child/Right Surgeon initiative: A position statement on pediatric surgical training, sub-specialization, and continuous certification from the American Pediatric Surgical Association

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