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"Do one, teach one" the new paradigm in general surgery residency training
Emile A Picarella1, Jon D Simmons, Karen R Borman
1Department of Surgery, The University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.
Journal of Surgical Education
|February 23, 2011
Summary
Duty hour restrictions (DHR) for surgical residents led to a significant decrease in their total operative procedures and assistant surgeon roles. Resident experience as primary surgeon or teaching assistant remained unchanged.
Area of Science:
- Medical Education
- Surgical Training
- Resident Operative Experience
Background:
- Duty hour restrictions (DHR) aim to improve resident well-being but may impact surgical training.
- Existing literature primarily examines the overall number of procedures performed by residents.
- The effect of DHR on residents' roles as assistant surgeons requires further investigation.
Purpose of the Study:
- To assess the impact of DHR on the number of surgical procedures in which residents act as first assistants.
- To analyze changes in operative experience categories for general surgery residents post-DHR implementation.
Main Methods:
- Retrospective analysis of general surgery resident operative logs from 2002-2008.
- Data categorized into Surgeon Chief (SC), Surgeon Junior (SJ), Teaching Assistant (TA), and First Assistant (FA).
- Linear regression analysis used to evaluate trends over the 7-year study period.
Main Results:
- A significant decline was observed in the total number of operative procedures performed by residents (p < 0.05).
- The number of procedures in which residents served as First Assistant (FA) significantly decreased (p < 0.05).
- Resident participation as primary surgeon (SC, SJ) or Teaching Assistant (TA) remained consistent.
Conclusions:
- Implementation of DHR correlated with a reduction in residents' First Assistant (FA) operative experience.
- The study concludes that overall cumulative operative experience for surgical residents has declined post-DHR.
- This decline in assistant surgical roles may impact comprehensive surgical skill development.
