Pilot Study to Improve Resident Experience on Vascular Surgery by Standardizing Dissemination of Operative Steps.

ABSTRACT

OBJECTIVE: Many surgical residencies have passed along attendings preferences and procedural knowledge as a highly utilized but informal resource. The objective was to assess the effect of providing operative steps and attending preferences on surgical resident performance. DESIGN: This was a prospective observational study with a survey-based design. SETTING: We created and shared vascular surgery operative steps including institutional and attending preferences with junior residents at the Massachusetts General Hospital. PARTICIPANTS: There were a total of 31 residents who completed a survey to assess self-perception of performance in operative knowledge and Accreditation Council for Graduate Medical Education (ACGME) Milestone criteria. RESULTS: Advice from colleagues was the most utilized resource, followed by web-based materials. Of the web-based materials, almost all residents utilized Google searches over other web-based resources designed to specifically help surgical trainees. The vascular surgery resource was used by 90% of residents more than 3 times per week to prepare for operative cases. There was significant improvement in patient positioning, instrument selection, operative field exposure, anatomy, sequence of procedure, procedure choices, and peri-operative care knowledge. CONCLUSIONS: Development of institutional resources that specifically capture attending surgeon procedural variations can improve resident performance, encourage resident autonomy, and provide a catalog of approaches to challenging operative situations.