Quantitative Analysis of Surgical Residency Reform: Using Case-Logs to Evaluate Resident Experience.
J Surg Educ
; 76(1): 25-35, 2019.
Article
em En
| MEDLINE
| ID: mdl-30195662
ABSTRACT
BACKGROUND:
Curricular changes at a mid-sized surgical training program were developed to rebalance clinical rotations, optimize education over service, decrease the size of service teams, and integrate apprenticeship-type experiences. This study quantifies the operative experience before and after implementation as part of a mixed-methods program evaluation. STUDYDESIGN:
Retrospective review of case-log data and data from the Accreditation Council for Graduate Medical Education (ACGME) and the American College of Surgeons National Surgical Quality Improvement Program quality in-training initiative to evaluate case volume pre- and postintervention.RESULTS:
11,365 cases, excluding "first-assistant" and "endoscopic" cases, were logged for an average of 291 and 263 cases/resident pre- and postintervention, respectively. Average case volume increased significantly for postgraduate year (PGY) 3 residents and decreased significantly for PGY 4 residents between the two time periods. Variability was observed among residents at the same PGY level both pre- and postintervention, with coefficients of variation of 6.0% to 34.1% in 2014 to 2015 and 11.2% to 66.8% in 2015 to 2016. Inter-resident variability persisted when comparing a specific procedure between ACGME case-log and quality in-training initiative data sets.CONCLUSION:
The data suggest that inter-resident variability in case load is not an artifact of case logging behavior alone, but may reflect personal preferences and choices in case selection that are not impacted by curriculum change. Logging behavior and accuracy of case-logs may contribute to variability. The shift in case load from PGY 4 to PGY 3 after curriculum implementation requires validation by ongoing analysis of ACGME case-log data.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Especialidades Cirúrgicas
/
Prontuários Médicos
/
Currículo
/
Internato e Residência
Tipo de estudo:
Diagnostic_studies
/
Evaluation_studies
/
Observational_studies
Idioma:
En
Revista:
J Surg Educ
Ano de publicação:
2019
Tipo de documento:
Article