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How do supervising surgeons evaluate guidance provided in the operating room?

Xiaodong Phoenix Chen¹, Reed G Williams, Hilary A Sanfey

¹Department of Surgery, Southern Illinois University School of Medicine, PO Box 19638, Springfield, IL 62794, USA. xchen36@illinois.edu

American Journal of Surgery

|November 15, 2011

Summary

Surgeons often underestimate the guidance they provide in the operating room (OR). This guidance decreases with resident experience and impacts operative performance ratings, crucial for training.

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Area of Science:

Medical Education
Surgical Training
Operative Performance

Background:

Operating room (OR) guidance is critical for surgical resident development.
Understanding the relationship between OR guidance, resident experience, and performance is essential.

Purpose of the Study:

To explore the amount of guidance provided to surgical residents in the OR.
To examine the correlation between OR guidance, postgraduate year (PGY) level, and operative performance rating (OPR).

Main Methods:

Data collected via OPR instruments from supervising surgeons post-performance.
External experts blindly rated guidance from 5 videotaped resident performances.
Analysis of 368 performances across 5 procedures involving 26 residents and 16 surgeons.

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Main Results:

Guidance varied by surgical procedure and supervising surgeon.
The amount of guidance decreased as residents' postgraduate year (PGY) level increased.
A significant correlation (0.62) was found between guidance rating and overall operative performance.
Supervising surgeons frequently underestimated the guidance provided.

Conclusions:

The amount of surgeon guidance is a key factor in resident training and evaluation.
Accounting for guidance levels is vital for accurately assessing resident performance and readiness for independent practice.