Yalini Vigneswaran, Andrew B Schneider, Andrew J Benjamin, Andrew Millis, Kevin K Roggin, Mustafa Hussain. University of Chicago
Purpose: Developing autonomy has been a challenge in surgical training especially with laparoscopic procedures. With the implementation of a new resident acute care surgery service managed by our senior residents with attending supervision, we sought understand if autonomy for laparoscopic procedures had improved and if our residents ranked their confidence and autonomy equivalent to open procedures.
Methods: All general surgery residents over a one-year period completed self evaluations on individual operative case performance. For each procedure, an attending evaluation of the resident’s performance was also submitted. We compared evaluations for laparoscopic abdominal procedures to open abdominal procedures and further analyzed those evaluations specific to the resident acute care surgery service as compared to attending services.
Results: A total of 1775 resident evaluations were collected for abdominal cases. Of these, 1072 cases were laparoscopic cases and 703 were performed open. On average both residents and attendings ranked resident’s performance on laparoscopic procedures significantly higher than open procedures in all categories: knowledge of procedure, intraoperative communication and overall grade. Additionally, Zwisch scale of autonomy was significantly higher for laparoscopy compared to open by both attendings and residents (2.70 vs 2.35 and 2.52 vs 2.19 respectively, p<0.001). When we compared evaluations for laparoscopic cases done under the resident acute care service compared to attending services, residents’ ranking of Zwisch scale of autonomy was significantly higher on the resident acute service (3.27 vs 2.36, p<0.001) and similarly attendings’ ranking of Zwisch scale of autonomy was also higher on the resident service (3.20 vs 2.54, p<0.001).
Conclusions: The highest ratings of autonomy were give to laparoscopic procedures on the resident acute care surgery service when both compared to procedures performed on attending services and when compared to open procedures. We conclude that the structure of a resident acute care surgery service highly increases the autonomy and confidence of chief residents with laparoscopy prior to graduation.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87954
Program Number: P310
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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