Surgeons Don’t Know What They Don’t Know About the Safe Use of Energy in Surgery

Liane S Feldman, MD, Pascal Fuchshuber, MD PhD, Daniel B Jones, MS MD, Jessica Mischna, Steven D Schwaitzberg, MD, Fuse Task Force . McGill University, The Permanente Medical Group,Harvard Medical School, SAGES, Cambridge Heath Alliance


Introduction: Surgeons have not been required to train on the energy-based devices they use in the operating room or document their knowledge of device safety issues. Although many surgeons feel they understand how to use devices properly and therefore safely, this has never been formally tested. The aim of our study was to assess the knowledge of a cohort of gastrointestinal surgeons, and determine if key facts could be learned in a one-day course.
Methods: SAGES piloted a postgraduate CME course on the Fundamental Use of Surgical Energy™ (FUSE) at the 2011 SAGES meeting. An 11-item multiple-choice examination (pretest) was prepared from questions submitted by the course faculty and thought to be critical knowledge. The pretest was administered to members of the SAGES board, Quality, Outcomes and Safety Committee and FUSE Task Force. It was later administered to the PG course participants, who also completed a 10-item posttest covering the same content at the end of the course. Data expressed as median[IQR].
Results: Forty-eight SAGES leaders completed the test. The median number of correct answers out of 11 was 6.5 [IQR 6-8] (range 0 to 11), or 59%. 31% of SAGES leaders did not know how to correctly handle a fire on the patient, 31% could not identify the device least likely to interfere with a pacemaker, 13% did not know that thermal injury can extend beyond the jaws of a bipolar instrument and 10% thought you should cut a dispersive pad to fit a child. Results on the pretest for 27 participants in the postgraduate course were similar, with median 6 [IQR 5-9] correct. Participants were not told the correct answers. At the end of the course, 25 participants completed a different 10-item posttest, with median 9 [IQR 7-9] correct.
Conclusion: When tested, many surgeons have gaps in knowledge related to the safe use of widely employed energy-based devices. A formal curriculum in the safe use of energy devices has the potential to address this knowledge gap and contribute to a safer operating room environment.

Session Number: SS13 – Simulation
Program Number: S072

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