General Surgery Resident Case Logs: Do They Accurately Reflect Resident Experience?

Area of Science:

• Medical Education
• Surgical Training
• Graduate Medical Education

Background:

• Operative experience during residency is crucial for future practice and specialty training.
• Accurate record-keeping in the Accreditation Council for Graduate Medical Education (ACGME) case log system is essential for general surgery residents.
• This study addresses discrepancies in resident operative logs and introduces an intervention to improve data accuracy.

Purpose of the Study:

• To examine the operative experience of general surgery residents.
• To detail the results of an intervention designed to improve resident record-keeping in the ACGME case log system.
• To ensure resident logs accurately reflect their surgical experience.

Main Methods:

• An audit of operative logs identified discrepancies in resident case recording.
• An intervention was implemented, including educational sessions, weekly progress graphs, and modified logging procedures (e.g., adding a first assistant column).
• Resident-reported reasons for discrepancies were collected and analyzed.

Main Results:

• The initial audit revealed discrepancies in 24.2% of general surgery resident case logs.
• Chief residents demonstrated higher accuracy (95.9%) compared to junior residents (50.3%).
• The intervention led to improved logging rates (72.7%-94.0%) and a 13.3% increase in logged cases post-intervention. First assistant case logging increased by 70.5%.

Conclusions:

• Weekly case log reviews and feedback significantly enhance operative record-keeping accuracy for general surgery residents, especially junior residents.
• Integrating tools like a 'first assistant' column in logs and regular audits can further improve the accuracy of reported surgical experience.
• Accurate logging is vital for assessing resident competency and ensuring adequate preparation for independent surgical practice.