The Effect of Patient Education on the Perceptions of Resident Participation in Surgical Care

Kempenich, Jason W.; Willis, Ross E.; Blue, Robert J.; Fayyadh, Mohammed J. Al; Cromer, Robert; Schenarts, Paul J.; Sickle, Kent R. Van; Dent, Daniel L.

doi:10.1016/j.jsurg.2016.05.005

Cited by 39 publications

(21 citation statements)

References 23 publications

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“…5–7 It is not uncommon for patients to ask surgeons if residents will be involved in their case. 8 While adjustments in duty hours sought to remedy these concerns, staff and trainees worry what the impact of reduced work hours may have on trainees’ ability to practice independently. 9 A study that surveyed program directors demonstrated that many felt general surgery residents were not prepared to enter the workforce as independent surgeons following their five years of training.…”

Section: Introductionmentioning

confidence: 99%

Put Me in the Game Coach! Resident Participation in High-risk Surgery in the Era of Big Data

Cobb

Eguia

Janjua

et al. 2018

Journal of Surgical Research

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Background With the emphasis on quality metrics guiding reimbursement, concerns have emerged regarding resident participation in patient care. This study aimed to evaluate whether resident participation in high-risk elective general surgery procedures is safe. Materials and Methods The American College of Surgeons NSQIP database (2005-2012) was used to identify patients undergoing one of five high-risk general surgery procedures. Resident and non-resident groups groups were created using a 2:1 propensity score match. Postoperative outcomes were calculated using univariate statistics and multivariable logistic regression for the two groups. Predictors of mortality and morbidity were identified using machine learning in the form of decision trees. Results 25,363 patients met our inclusion criteria. Following matching, each group contained 500 patients and were comparable for matched characteristics. 30-Day mortality was similar between the groups (2.4% v. 2.6% p=0.839). Deep surgical site infection (0% v. 1.6% p=0.005), urinary tract infection (5% v. 2.5% p=0.029), and operative time (275.6 min v.250 min p=0.0064) were significantly higher with resident participation. Resident participation was not predictive of mortality or complications; while age, ASA class, and functional status were leading predictors of both. Conclusions Despite growing time constraints and pressure to perform, surgical resident participation remains safe. Residents should be given active roles in the operating room, even in the most challenging cases.

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Section: Introductionmentioning

confidence: 99%

Put Me in the Game Coach! Resident Participation in High-risk Surgery in the Era of Big Data

Cobb

Eguia

Janjua

et al. 2018

Journal of Surgical Research

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“…Despite these guidelines, previous studies have shown that attendings and resident physicians rarely make their roles, level of training, and expected level of participation in procedures or that of their trainees explicitly known to patients [26,27]. Multiple other studies have shown, however, that patients want to know if residents are going to be involved in their care, particularly if they are going to be involved in an operation they are having [28][29][30]. Several studies have also found that although the general public is overwhelmingly supportive of physicians-in-training learning through hands on practice, even among patients being treated in teaching hospitals, a significant number of them report they do not want residents involved in their care [31,32], particularly if that care involves an operation and the resident involved is an intern [2,29,33].…”

Section: Ethical Considerationsmentioning

confidence: 99%

“…Several studies have also found that although the general public is overwhelmingly supportive of physicians-in-training learning through hands on practice, even among patients being treated in teaching hospitals, a significant number of them report they do not want residents involved in their care [31,32], particularly if that care involves an operation and the resident involved is an intern [2,29,33]. Many of these studies have found that the general public has a limited level of understanding of the level of training of residents [28,31,32], but if education is provided about the role of residents and their extent of training, comfort levels with resident participation in their care greatly increases [28,30].…”

Section: Ethical Considerationsmentioning

confidence: 99%

Resident Autonomy

Cooper¹,

Allen²

2019

Contemporary Topics in Graduate Medical Education

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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.

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“…Patients often desire the most experienced physician, especially in the intra-operative setting where iatrogenic complications are more likely to lead to morbidity or mortality [4]. Although it has been demonstrated that resident participation in surgical cases, particularly neurosurgical cases, does not increase morbidity or mortality, many patients continue to be apprehensive about having residents involved in their surgeries [5,6].…”

Section: Introductionmentioning

confidence: 99%

Patient Perspectives on the Participation of Neurosurgery Resident Physicians in Their Care

Cathel

Arshad

Hadi

et al. 2020

Cureus

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Introduction Surgical residents play vital roles in day-today patient care as well as in the operating room. However, there is a paucity of literature regarding patients' perspectives on neurosurgical residents and their participation in their care. This current study investigates the knowledge, attitudes, and beliefs of patients regarding neurosurgical residents and their involvement in their healthcare process. Methods Patients older than 18 years who had undergone brain or spine surgery were requested to complete a survey questionnaire. The 7-point Likert scale response ranging from "strongly agree", "agree", "more or less agree", "undecided", more or less disagree", "disagree" to "strongly disagree" was used. The primary objective was to assess patient understanding and attitudes towards resident participation in surgical and medical care within the specialty of neurosurgery. The duration of the study was eight months. Patients having prior exposure to an informed-consent procedure by a neurosurgery team within a year prior to this study were excluded. Data were analyzed using Student's t-test, one-way analysis of variance (ANOVA), and standard averaging of responses.

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The Effect of Patient Education on the Perceptions of Resident Participation in Surgical Care

Cited by 39 publications

References 23 publications

Put Me in the Game Coach! Resident Participation in High-risk Surgery in the Era of Big Data

Put Me in the Game Coach! Resident Participation in High-risk Surgery in the Era of Big Data

Resident Autonomy

Patient Perspectives on the Participation of Neurosurgery Resident Physicians in Their Care

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