Developing a Needs Assessment for Standardized Surgical Resident Training in Basic Electrosurgical Principles

Jeffrey L Eakin, MD, Catherine E Beck, MD, Rebecca Detorre, Dean J Mikami, MD. The Ohio State University Medical Center

Introduction: Unintended electrosurgical injuries are preventable complications that may be a direct result of an insufficient fund of knowledge pertaining to electrophysics and electrosurgical equipment. In fact, some studies estimate that electrosurgical injuries may be responsible for 3 to 5 injuries per 1000 cases in varying surgical specialties. Currently, there is no standard in General Surgery training or proficiency requirement for electrosurgical principles. We performed a survey of General Surgery Residents at The Ohio State University who have been undergoing the Basics of Electro Surgery Training at The Ohio State University, to provide a needs assessment of proficiencies or deficiencies that exist, as perceived by current resident trainees.

Methods: After receiving approval from the Institutional Review Board at Ohio State University, we performed an anonymous survey of current categorical and preliminary General Surgery Residents at The Ohio State University utilizing Google Forms. Statistical analysis was performed using Microsoft® Excel® 2008 for Macintosh.

Results: Our survey response rate was 60% and included trainees in Post-Graduate Year (PGY) 1 through 6. Ninety-two percent (92%) of residents claimed they never received electrosurgical training during medical school while 40% felt they had inadequate training during residency. Fifteen percent (15%) of residents felt they had been involved in a case where the improper use of electrosurgery caused a direct complication to the patient. Sixty-five percent (65%) of residents felt that a training course in electrosurgery would be most helpful during the PGY-2 or PGY-3 years. The other 35% indicated a training course would be most helpful during their PGY-1 year, and 35% overall felt they need an annual refresher course. Moreover, 65% of residents felt they were rarely to never taught electrosurgical principles in the operating room. When polled on how well they felt their attending physician understood basic electrosurgical principles, residents gave their attending physician an average of 3.5 on a 5-point scale. Similarly, they felt their peers’ general knowledge of electrosurgery was a 2.8 on a 5-point scale. Finally, 25 out of 26 (96%) residents felt a course in electrosurgery should be a necessary component of a general surgery residency.

Discussion: Injuries related to the improper use of electrosurgery may be the direct result of inadequate to no pre-residency education in the basics of electrophysics and inadequate training in electrosurgical techniques and equipment during training. Injuries related to electrosurgery could possibly be reduced by providing standardized training in electrosurgery during PGY 1 through 3 years of General Surgery residency with annual refresher courses, as well as increased efforts to teach basic electrosurgical principles, techniques and technologies to trainees in the operating room.

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