TY - JOUR
T1 - Relationship of procedural numbers with meaningful procedural autonomy in general surgery residents
AU - Stride, Herbert P.
AU - George, Brian C.
AU - Williams, Reed G.
AU - Bohnen, Jordan D.
AU - Eaton, Megan J.
AU - Schuller, Mary C.
AU - Zhao, Lihui
AU - Yang, Amy
AU - Meyerson, Shari L.
AU - Scully, Rebecca
AU - Dunnington, Gary L.
AU - Torbeck, Laura
AU - Mullen, John T.
AU - Mandell, Samuel P.
AU - Choti, Michael
AU - Foley, Eugene
AU - Are, Chandrakanth
AU - Auyang, Edward
AU - Chipman, Jeffrey
AU - Choi, Jennifer
AU - Meier, Andreas
AU - Smink, Douglas
AU - Terhune, Kyla P.
AU - Wise, Paul
AU - DaRosa, Debra
AU - Soper, Nathaniel
AU - Zwischenberger, Jay B.
AU - Lillemoe, Keith
AU - Fryer, Jonathan P.
N1 - Publisher Copyright:
© 2017
PY - 2018/3
Y1 - 2018/3
N2 - Background: Concerns exist regarding the competency of general surgery graduates with performing core general surgery procedures. Current competence assessment incorporates minimal procedural numbers requirements. Methods: Based on the Zwisch scale we evaluated the level of autonomy achieved by categorical PGY1-5 general surgery residents at 14 U.S. general surgery resident training programs between September 1, 2015 and December 31, 2016. With 5 of the most commonly performed core general surgery procedures, we correlated the level of autonomy achieved by each resident with the number of procedures they had performed before the evaluation period, with the intent of identifying specific target numbers that would correlate with the achievement of meaningful autonomy for each procedure with most residents. Results: Whereas a definitive target number was identified for laparoscopic appendectomy (i.e. 25), for the other 4 procedures studied (i.e. laparoscopic cholecystectomy, 52; open inguinal hernia repair, 42; ventral hernia repair, 35; and partial colectomy, 60), target numbers identified were less definitive and/or were higher than many residents will experience during their surgical residency training. Conclusions: We conclude that procedural target numbers are generally not effective in predicting procedural competence and should not be used as the basis for determining residents’ readiness for independent practice.
AB - Background: Concerns exist regarding the competency of general surgery graduates with performing core general surgery procedures. Current competence assessment incorporates minimal procedural numbers requirements. Methods: Based on the Zwisch scale we evaluated the level of autonomy achieved by categorical PGY1-5 general surgery residents at 14 U.S. general surgery resident training programs between September 1, 2015 and December 31, 2016. With 5 of the most commonly performed core general surgery procedures, we correlated the level of autonomy achieved by each resident with the number of procedures they had performed before the evaluation period, with the intent of identifying specific target numbers that would correlate with the achievement of meaningful autonomy for each procedure with most residents. Results: Whereas a definitive target number was identified for laparoscopic appendectomy (i.e. 25), for the other 4 procedures studied (i.e. laparoscopic cholecystectomy, 52; open inguinal hernia repair, 42; ventral hernia repair, 35; and partial colectomy, 60), target numbers identified were less definitive and/or were higher than many residents will experience during their surgical residency training. Conclusions: We conclude that procedural target numbers are generally not effective in predicting procedural competence and should not be used as the basis for determining residents’ readiness for independent practice.
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U2 - 10.1016/j.surg.2017.10.011
DO - 10.1016/j.surg.2017.10.011
M3 - Article
C2 - 29277387
AN - SCOPUS:85038815376
SN - 0039-6060
VL - 163
SP - 488
EP - 494
JO - Surgery (United States)
JF - Surgery (United States)
IS - 3
ER -