Best Training Improves the Understanding and Safety of Electrosurgery Use in the Operating Room

Catherine E Beck, MD, Jeffrey L Eakin, MD, Dean Mikami, MD. The Ohio State University

 

Background: In 1928 Drs. Cushing and Bovie invented the standard electrocautery pencil known as the bovie. Since then, great advances have been made in electrosurgical technology generating an abundance of diverse devices and electrosurgical principles, which are used in the majority of surgical procedures today. Nonetheless, standardized training to ensure proper use and safety does not exist. The Basics of Electro Surgery Training (BEST) is a course created at The Ohio State University to provide General Surgery Residents proficiency-based skills training in electrosurgery. BEST provides a standardized learning environment for surgical residents, to ensure a standard assessment of knowledge on the safe use of electrosurgery to ultimately increase patient safety in the operating room.

Methods: First and third year General Surgery Residents at The Ohio State University Medical Center have been completing BEST since 2004 using a standardized format. After completing a pre-test followed by a lecture regarding the science and safety of electrosurgery and discussion of clinical scenarios, the residents participate in an animal lab session to use monopolar, bipolar, ultrasonic and advanced bipolar energy devices. The course is concluded with a post-test assessment. We evaluated the proficiency and course efficacy by comparing pre and post-test scores over a 3 year period.

Results: Interns and third year residents over three years were taken through this course, taking a standardized pre- and post-test to assess the knowledge gained through this course. Over three years, 37 residents participated in the course. The mean of the pre-test scores were 57.29% (Standard Deviation of 13.66) with a 95% confidence interval of (51.53, 63.060). The mean of the post-test scores was 77.67% (Standard Deviation of 12.45) with a 95% confidence interval of (72.41, 82.92). The mean difference of the scores was 20.38% (Standard Devaition of 24.79) with a 95% confidence interval of (15.25, 25.50). The post test scores were significantly greater than the pre-test scores by 20.375% on average (p-value < 0.0001).

Conclusions: The BEST course provides an effective standard learning environment for the safe and proper use of electrosurgery in general surgery residents as demonstrated by the post course assessment values. This will help ensure safe, standard practices of these devices in board eligible residents.


Session Number: Poster – Poster Presentations
Program Number: P152
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