Are Residents Prepared for Surgical Cases? Implications in Patient Safety and Education

Mundschenk, Minh-Bao; Odom, Elizabeth B.; Ghosh, Tanmay; Kleiber, Grant M.; Yee, Andrew; Patel, Kamlesh B.; Mackinnon, Susan E.; Tenenbaum, M; Buck, Donald W.

doi:10.1016/j.jsurg.2017.07.001

Cited by 25 publications

(16 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A large proportion of trainees pointed out that case complexity and predicted autonomy in the case also affected their preparation, for which they utilized variable resources as per availability and fastidiousness (Meyerson et al, 2017;Pernar et al, 2011). Many of them utilized video content and reviewed books, while senior trainees preferred current literature (Mundschenk et al, 2018). According to Archibald et al (2014), incorporation of technology such as an iPad can help in teaching and learning, although need for further and more extensive studies was found to be deficient.…”

Section: Discussionmentioning

confidence: 99%

“…Through our survey among the surgical trainees and as per the literature, it is clear that their preparation changes over time as they progressed in their surgical training, and learning through trial & error with advice from a senior resident, is of utmost importance in the training period and after training from a colleague (Mundschenk et al, 2018). Trainees learn skills and procedures step by step with a portion of it learned in year one of training, while progressing to complete knowledge of it until the final year of training.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Trainee’s Approach for Effective Operating Room Learning

Tahir

Haroon

Mobin

et al. 2021

ESJ

View full text Add to dashboard Cite

Introduction: Surgical training has gone through a paradigm shift in recent years. The trends have shifted from an apprenticeship model to a new era of self-teaching and an attitude-driven learning. In this study, we aim to comprehensively investigate the knowledge and attitude pertaining to the perception of preparation required for the operating room and how the residents prepare themselves for it. Method: A quantitative study was conducted via predefined questionnaire. Surgical residents at a single tertiary care institution were asked to complete the survey via Google forms that was distributed by means of email to residents of the general surgery department. Inclusion and exclusion criteria were defined. Results: Forty surgical residents opted to participate in the survey. The majority of the residents had a similar perception of operating room preparation. The most prominent theme that emerged following the discussion was that the residents learned through trial and error, and advice solicited from co-residents, which in the majority of the cases, were senior level resident. The resources defined by the residents were similar among majority and factors that affected their preparation were variable. An important aspect highlighted through the discussion was that the level of postgraduate training affected the preparation done by residents in order to better perform in operation theatres. Conclusion: Knowledge and attitude regarding operating room preparation was quite similar among the surgical residents. They varied in their practice for preparation.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Trainee’s Approach for Effective Operating Room Learning

Tahir

Haroon

Mobin

et al. 2021

ESJ

View full text Add to dashboard Cite

show abstract

“…A study that evaluated resident autonomy in over 7000 operations found that the resident's performance in a particular case was the single biggest predictor of how much autonomy the attending granted during that operation [53], which suggests engaging in deliberate practice to improve technical skills is one of the most effective strategies residents can employ to increase their level of operative autonomy. Residents hoping to be granted autonomy during an operation should "hold themselves accountable for entering the operating room as prepared as possible; this should intuitively include review of the patient history" [54]. Preparation for the operating room should also include appropriate knowledge of the relevant anatomy for the case and familiarity with the steps of the operation to be performed.…”

Section: Trainee Responsibilities When Being Granted Autonomymentioning

confidence: 99%

“…Preparation for the operating room should also include appropriate knowledge of the relevant anatomy for the case and familiarity with the steps of the operation to be performed. Discussing the surgical plan with the attending prior to surgery is also a valuable step in preparation [54] (Figure 2).…”

Section: Trainee Responsibilities When Being Granted Autonomymentioning

confidence: 99%

Resident Autonomy

Cooper¹,

Allen²

2019

Contemporary Topics in Graduate Medical Education

View full text Add to dashboard Cite

Autonomy in medical training is required to develop independent and competent physicians. The way in which this incremental level of independence is granted to a trainee must be thoughtful and deliberate to ensure appropriate supervision and patient safety. Theories that support the role of autonomy will be introduced and discussed in this chapter. Ethical considerations that describe the implications of balancing the necessary independence for trainees and an attending physician's responsibility to the patient and the patient's safety will also be considered. The level of autonomy that is granted is the responsibility of both the attending physician and trainee so that it is not only appropriate but also wellearned. There are multiple tools that may be used to objectively measure one's competence and necessary level of autonomy based on performance that will be discussed within this chapter. Finally we will demonstrate that encouraging and striking the balance of supervision and autonomy may be done safely with appropriate patient outcomes and trainee development into independent physicians. These outcomes will help to encourage autonomy amongst medical trainees, no matter one's specialty, to train and develop competent, independent physicians of the future.

show abstract

“…Formal instruction for preoperative preparation remains sparse and undertheorised. In surgical curricula, residents rarely receive guidance, feedback or explicit expectations on how to prepare for the OR 12‐14 . Additionally, residents and faculty may not agree on what optimal preoperative preparation entails 15 .…”

Section: Introductionmentioning

confidence: 99%

Before the scalpel: Exploring surgical residents' preoperative preparatory strategies

2021

View full text Add to dashboard Cite

Objective This study sought to increase understanding of preoperative preparatory strategies utilised by senior surgical residents and identify how social and material forces come together to shape practice. Summary/Background Data Preoperative preparation can play a powerful role in operative learning. Residents rarely receive guidance, feedback, or explicit expectations on how to prepare for the OR. Understanding current practice and how to support preoperative preparation represents an important gap in our efforts to improve surgical training. Methods Constructivist grounded theory with sensitizing concepts from sociomateriality guided data collection and analysis. Fifteen senior surgical residents from a range of surgical disciplines were purposefully sampled and participated in an in‐depth individual interview. Two return‐of‐finding focus groups followed with seven residents. Rigor was enhanced through constant comparison, theoretical sampling, pursuit of discrepant data, and investigator triangulation. Results Residents utilised a range of strategies addressing four areas of focus: develop technical skills, improve procedural knowledge, enhance patient‐specificity, and know surgical preferences. However, residents also described receiving limited guidance on what it means to ‘be prepared’ and experience significant challenges in achieving preparedness. A mix of social and material things that enabled or constrained preparatory efforts influenced individual strategies. These included rotation structure, relationships, the OR list, and time. Conclusions Our findings offer possible solutions by elaborating on preparatory variability and considerations for residents, faculty, and programs to improve practice. As a first step, we suggest programs begin to engage in explicit dialogue and reflection with their residents, faculty, and residency program committees.

show abstract

Are Residents Prepared for Surgical Cases? Implications in Patient Safety and Education

Cited by 25 publications

References 6 publications

A Trainee’s Approach for Effective Operating Room Learning

A Trainee’s Approach for Effective Operating Room Learning

Resident Autonomy

Before the scalpel: Exploring surgical residents' preoperative preparatory strategies

Contact Info

Product

Resources

About