Cuan M Harrington1, Dara O Kavanagh2, Donncha Ryan2, Patrick Dicker3, Peter E Lonergan4, Oscar Traynor2, Sean Tierney2. 1. Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland. Electronic address: cuanharrington@rcsi.ie. 2. Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland. 3. Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland. 4. Division of Urology, Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland.
Abstract
BACKGROUND: Historically, evaluating operative-volumes has proven difficult due to mass-variability in operative-complexities and participation. This study aimed to introduce a national scoring interface for residents' operative-logs while forming meaningful observations on specialities, training-institutes and technical competency. METHODS: A weighted-scoring algorithm was applied prospectively to residents' operative volumes since July 8th, 2013 with daily web-based quantitative feedback. Pre and post intervention analyses were performed with historical volumes. Operative volumes were correlated with work-based and university technical-skills' assessments. RESULTS: Ninety-five residents completed two-year preliminary training since 2013 recording 79,490 operations. These residents recorded significant (p < 0.050) increases in mean-score (case-load), total, performed and assisted operations of >16,528 (50%), 234 (45%), 115 (66%) and 113 (33%) respectively. The number of resident-performed operations was a significant predictor of performance in work-based and university technical-skills assessments (p < 0.050). There were no associations between these measures and the volume of assisted-operations. CONCLUSIONS: Open-benchmarking of surgical-volumes stimulates residents to actively pursue operative-opportunities and record those experiences. It provides objective performance data on residents and training-institutes while providing evidence that level of operative participation is significant in technical skills development.
BACKGROUND: Historically, evaluating operative-volumes has proven difficult due to mass-variability in operative-complexities and participation. This study aimed to introduce a national scoring interface for residents' operative-logs while forming meaningful observations on specialities, training-institutes and technical competency. METHODS: A weighted-scoring algorithm was applied prospectively to residents' operative volumes since July 8th, 2013 with daily web-based quantitative feedback. Pre and post intervention analyses were performed with historical volumes. Operative volumes were correlated with work-based and university technical-skills' assessments. RESULTS: Ninety-five residents completed two-year preliminary training since 2013 recording 79,490 operations. These residents recorded significant (p < 0.050) increases in mean-score (case-load), total, performed and assisted operations of >16,528 (50%), 234 (45%), 115 (66%) and 113 (33%) respectively. The number of resident-performed operations was a significant predictor of performance in work-based and university technical-skills assessments (p < 0.050). There were no associations between these measures and the volume of assisted-operations. CONCLUSIONS: Open-benchmarking of surgical-volumes stimulates residents to actively pursue operative-opportunities and record those experiences. It provides objective performance data on residents and training-institutes while providing evidence that level of operative participation is significant in technical skills development.
Authors: Cuan M Harrington; Vishwa Chaitanya; Patrick Dicker; Oscar Traynor; Dara O Kavanagh Journal: Surg Endosc Date: 2018-02-14 Impact factor: 4.584