Postoperative complications at a university hospital: is there a difference between patients operated by supervised residents vs. trained surgeons?

Santibañes, Martín de; Alvarez, Fernando A.; Sieling, Esteban; Vaccarezza, Hernán; Santibañés, Eduardo de; Vaccaro, Carlos

doi:10.1007/s00423-014-1261-z

Cited by 17 publications

(13 citation statements)

References 21 publications

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“…In combination with concerns about trainees handling portions of the case, this suggests that in the minds of patients, the desire for surgery "done by the attending" is a proxy for a desire for "good outcomes." Although this logic is understandable, available data suggests that trainee participation [18][19][20][21] and OS 22,23 generally have equivalent outcomes. What is unknown at this point is whether discussing such data would be sufficient to make most patients comfortable with trainee independence.…”

Section: Discussionmentioning

confidence: 99%

Patient opinions regarding surgeon presence, trainee participation, and overlapping surgery

et al. 2018

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Objectives To explore patient opinions and underlying values regarding overlapping surgery (OS) scenarios, specifically evaluating the effect of attending surgeon presence and availability, as well as trainee participation on patient comfort level and willingness to consent. Study Design Mixed methods. Methods Forty adults participated in semi‐structured interviews. Interviews included vignettes involving three scenarios of OS (1: attending present; 2: attending absent for wound closure; 3: attending absent and unavailable for wound closure, with covering attending), visual analog scale ratings of participants’ comfort with scenarios, and cognitive debriefing. Themes and subthemes were identified using hierarchical coding of transcripts, and quantitative and qualitative analyses were conducted. Results Quantitative analysis revealed anticipated decreases in comfort with decreasing attending presence/availability (mean comfort level 94% vs. 78% vs. 63% for scenarios 1 vs. 2 vs. 3, P < 0.005), although many patients reported improved comfort with scenario 3 if meeting the covering attending. Participants demonstrated a preference for less trainee involvement (P < 0.005, scenario 1) and greater trainee experience (P < 0.05, all scenarios). However, not all individuals were uncomfortable with attending absence or trainee independence. Themes important for decision making included trust in the surgeon, surgeon experience, trainee involvement, disease severity, cost, and wait time. Conclusion Patients varied highly in their willingness to consent to OS scenarios. In settings of trainee independence and covering surgeons, many patients desired meeting these members of the treatment team, which improved comfort for some. For some patients, tradeoffs and incentives of timeliness, cost, and convenience modified their willingness to have OS. Level of Evidence 4 Laryngoscope, 129:1337–1346, 2019

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Section: Discussionmentioning

confidence: 99%

Patient opinions regarding surgeon presence, trainee participation, and overlapping surgery

et al. 2018

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“…The impacts of surgical resident (RES) on complication rates and outcomes are controversial [2,6,7]. Of note, operation time and complication rates are crucial economic factors.…”

Section: Introductionmentioning

confidence: 99%

Education in thyroid surgery: a matched-pair analysis comparing residents and board-certified surgeons

Reinisch

Malkomes

Liese

et al. 2016

Langenbecks Arch Surg

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“…Consequently, surgical techniques and skills were transmitted step by step in both countries [11]. Santibanes et al discovered no negative impact on postoperative patient outcome if the surgery was conducted by a trainee under supervision of an instructor and the training can therefore be considered as ethical and safe [6]. However, along with residents performing the surgery, there is also is an obvious financial impact and an undeniable inter-variability of teaching and transmission of skills associated [4,7,9].…”

Section: Discussionmentioning

confidence: 95%

Acquisition of diagnostic and surgical skills in otorhinolaryngology: a comparison of France and Germany

Oker

Escabasse

Alotaibi

et al. 2015

Eur Arch Otorhinolaryngol

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With the coalescing of the European countries, among many others, official initiatives have been launched to propose minimum requirements for Otolaryngology, Head and Neck surgery (ORL) specialty training by creating an European log book. This study was initiated to assess and compare the acquisition of basic medical key diagnostic and surgical skills by residents and recent ORL specialists in France (FRA) and Germany (GER) and to determine whether gender-specific differences exist. For this, an anonymous questionnaire with questions to basic medical, diagnostic and surgical procedures specific to ORL was developed. 120 FRA and 125 GER questionnaires were returned from participants with a median training experience of 4 years. The female to male ratio was 1.3:1 and 78% of respondents were residents and 22% recent specialists. Concerning diagnostic procedures, there was no significant overall difference. Germans performed better in basic medical skills, while study participants from FRA had performed surgical procedures significantly more often in a more independent manner than German respondents in the areas of otology, rhinology and head and neck. Only in septoplasty, as part of rhinology, the Germans had a light advantage compared to the French. No difference was found for trauma surgery. No gender-specific difference became apparent. Taken together, in FRA, ORL training is far more surgically orientated than in GER. It remains unclear at what time, the Germans may catch up with their skills. Initiatives should be taken in GER to secure an adequate acquisition of surgical skill and experience to maintain a high level of ORL-specific competence.

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Postoperative complications at a university hospital: is there a difference between patients operated by supervised residents vs. trained surgeons?

Abstract: Supervised resident participation, as operating surgeon, does not negatively impact postoperative patient outcome. Residency training may therefore be considered as an ethical and safe learning methodology whenever implemented in the framework of an academic teaching hospital.

Cited by 17 publications

References 21 publications

Patient opinions regarding surgeon presence, trainee participation, and overlapping surgery

Patient opinions regarding surgeon presence, trainee participation, and overlapping surgery

Education in thyroid surgery: a matched-pair analysis comparing residents and board-certified surgeons

Acquisition of diagnostic and surgical skills in otorhinolaryngology: a comparison of France and Germany

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