The Feasibility of Real-Time Intraoperative Performance Assessment With SIMPL (System for Improving and Measuring Procedural Learning): Early Experience From a Multi-institutional Trial

Bohnen, Jordan D.; George, Brian C.; Williams, Reed G.; Schuller, Mary C.; DaRosa, Debra A.; Torbeck, Laura; Mullen, John; Meyerson, Shari L.; Auyang, Edward D.; Chipman, Jeffrey G.; Choi, Jennifer; Choti, Michael A.; Endean, Eric D.; Foley, Eugene F.; Mandell, Samuel P.; Meier, Andreas H.; Smink, Douglas S.; Terhune, Kyla P.; Wise, Paul E.; Soper, Nathaniel J.; Zwischenberger, Joseph B.; Lillemoe, Keith D.; Dunnington, Gary L.; Fryer, Jonathan P.

doi:10.1016/j.jsurg.2016.08.010

Cited by 173 publications

(98 citation statements)

References 22 publications

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“…At the completion of an operative procedure, SIMPL was used to initiate an evaluation. 11 Each evaluation included 1 or more procedures selected from a taxonomy derived from the case log system of the Accreditation Council for Graduate Medical Education. To describe the intrinsic difficulty of different types of procedures, we categorized procedures using the designation by the Surgical Council on Resident Education of Core or Advanced Procedures, with advanced procedures defined as procedures that are not consistently part of general surgery practice.…”

Section: Data Collectionmentioning

confidence: 99%

The effect of gender on operative autonomy in general surgery residents

Meyerson

Odell

Zwischenberger

et al. 2019

Surgery

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110

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Background: Despite an increasing number of women in the field of surgery, bias regarding cognitive or technical ability may continue to affect the experience of female trainees differently than their male counterparts. This study examines the differences in the degree of operative autonomy given to female compared with male general surgery trainees. Methods: A smartphone app was used to collect evaluations of operative autonomy measured using the 4-point Zwisch scale, which describes defined steps in the progression from novice ("show and tell") to autonomous surgeon ("supervision only"). Differences in autonomy between male and female residents were compared using hierarchical logistic regression analysis. Results: A total of 412 residents and 524 faculty from 14 general surgery training programs evaluated 8,900 cases over a 9-month period. Female residents received less autonomy from faculty than did male residents overall (P < .001). Resident level of training and case complexity were the strongest predictors of autonomy. Even after controlling for potential confounding factors, including level of training, intrinsic procedural difficulty, patient-related case complexity, faculty sex, and training program environment, female residents still received less operative autonomy than their male counterparts. The greatest discrepancy was in the fourth year of training.

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Section: Data Collectionmentioning

confidence: 99%

The effect of gender on operative autonomy in general surgery residents

Meyerson

Odell

Zwischenberger

et al. 2019

Surgery

Self Cite

110

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“…The complexity of this concept has led to the development of novel measurements for operative proficiency. 33–36 Although we provide self-reported data, resident surgeons were blind to this study at the time of their dictation and report predominantly objective facts (presence or absence and scrubbed status of attendings). Our approach also differs from those that employ a third party or surgeon’s assessment in that we report the actual official medical record documentation.…”

Section: Discussionmentioning

confidence: 99%

“…40–46 Some innovative studies on techniques used to assess resident operative performance have been conducted recently. 33–36,47 However, due to the novelty of quantifying resident operative competence, extensive research is yet to be conducted in plastic surgery.…”

Section: Discussionmentioning

confidence: 99%

Progressive Surgical Autonomy in a Plastic Surgery Resident Clinic

Day

Scott

Gao

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Background:Resident clinics are thought to catalyze educational milestone achievement through opportunities for progressively autonomous surgical care, but studies are lacking for general plastic surgery resident clinics (PSRCs). We demonstrate the achievement of increased surgical autonomy and continuity of care in a PSRC.Methods:A retrospective review of all patients seen in a PSRC from October 1, 2010, to October 1, 2015, was conducted. Our PSRC is supervised by faculty plastic surgery attendings, though primarily run by chief residents in an accredited independent plastic surgery training program. Surgical autonomy was scored on a 5-point scale based on dictated operative reports. Graduated chief residents were additionally surveyed by anonymous online survey.Results:Thousand one hundred forty-four patients were seen in 3,390 clinic visits. Six hundred fifty-three operations were performed by 23 total residents, including 10 graduating chiefs. Senior resident autonomy averaged 3.5/5 (SD = 1.5), 3.6/5 (SD = 1.5), to 3.8/5 (SD = 1.3) in postgraduate years 6, 7, and 8, respectively. A linear mixed model analysis demonstrated that training level had a significant impact on operative autonomy when comparing postgraduate years 6 and 8 (P = 0.026). Graduated residents’ survey responses (N = 10; 100% response rate) regarded PSRC as valuable for surgical experience (4.1/5), operative autonomy (4.4/5), medical knowledge development (4.7/5), and the practice of Accreditation Council of Graduate Medical Education core competencies (4.3/5). Preoperative or postoperative continuity of care was maintained in 93.5% of cases.Conclusion:The achievement of progressive surgical autonomy may be demonstrated within a PSRC model.

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“…Si se combinaban los cuatro procedimientos en una categoría, el promedio alcanzaba un 84%. Pero ante procedimientos como la apendicectomía o colectomía complicada, los residentes fueron competentes en un nivel mucho más bajo [182][183][184] . Esto podría estar significando que, si bien necesitamos más cirujanos, el producto final no está siendo el más adecuado, lo que llevaría a incrementar el número de años en la residencia.…”

Section: La Tecnología Y La Humanizaciónunclassified

¿quién Y Cómo Se Debe Garantizar La Calidad Del Cirujano?

Padín¹,

Domínguez²

2017

Rev Argent Cirug

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The Feasibility of Real-Time Intraoperative Performance Assessment With SIMPL (System for Improving and Measuring Procedural Learning): Early Experience From a Multi-institutional Trial

Cited by 173 publications

References 22 publications

The effect of gender on operative autonomy in general surgery residents

The effect of gender on operative autonomy in general surgery residents

Progressive Surgical Autonomy in a Plastic Surgery Resident Clinic

¿quién Y Cómo Se Debe Garantizar La Calidad Del Cirujano?

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