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Changing Autonomy in Operative Experience Through UK General Surgery Training: A National Cohort Study.
Elsey, Elizabeth J; Griffiths, Gareth; West, Joe; Humes, David J.
Afiliação
  • Elsey EJ; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Clinical Sciences Building 2, City Hospital, Nottingham, UK.
  • Griffiths G; Ninewells Hospital, Dundee, Scotland, UK.
  • West J; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Clinical Sciences Building 2, City Hospital, Nottingham, UK.
  • Humes DJ; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Ann Surg ; 269(3): 399-406, 2019 03.
Article em En | MEDLINE | ID: mdl-30260805
OBJECTIVES: To determine the operative experience of UK general surgery trainees and assess the changing procedural supervision and acquisition of competency assessments through the course of training. BACKGROUND: Competency assessment is changing with concepts of trainee autonomy decisions (termed entrustment decisions) being introduced to surgical training. METHODS: Data from the Intercollegiate Surgical Curriculum Programme and the eLogbook databases for all UK General Surgery trainees registered from August 1, 2007 who had completed training were used. Total and index procedures (IP) were counted and variation by year of training assessed. Recorded supervision codes and competency assessment outcomes for IPs were assessed by year of training. RESULTS: We identified 311 trainees with complete data. Appendicectomy was the most frequently undertaken IP during first year of training [mean procedures (mp) = 26] and emergency laparotomy during final year of training (mp = 27). The proportion of all IPs recorded as unsupervised increased through training (P < 0.05) and varied between IPs with 91.2% of appendicectomies (mp = 20), 40.6% of emergency laparotomies (mp = 27), and 17.4% of segmental colectomies (mp = 15) recorded as unsupervised during the final year of training. Acquisition of competency assessments increased through training and varied by IP. CONCLUSIONS: The changing autonomy of trainees through the course of an entire training scheme, alongside formal competency assessments, may provide evidence of changing entrustment decisions made by trainers for different key procedures. Other countries utilizing electronic logbooks could adopt similar techniques to further understanding of competency attainment amongst their surgical trainees.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cirurgia Geral / Autonomia Profissional / Competência Clínica / Educação de Pós-Graduação em Medicina Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies Limite: Adult / Female / Humans / Male País/Região como assunto: Europa Idioma: En Revista: Ann Surg Ano de publicação: 2019 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cirurgia Geral / Autonomia Profissional / Competência Clínica / Educação de Pós-Graduação em Medicina Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies Limite: Adult / Female / Humans / Male País/Região como assunto: Europa Idioma: En Revista: Ann Surg Ano de publicação: 2019 Tipo de documento: Article País de publicação: Estados Unidos