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Related Experiment Videos

Variable Operative Experience in Hand Surgery for Plastic Surgery Residents.

Jason Silvestre1, Ines C Lin1, Lawrence Scott Levin1

  • 1Division of Plastic Surgery, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Journal of Surgical Education
|April 2, 2017
PubMed
Summary

Plastic surgery residents show variable hand surgery experience, with some not meeting case minimums, particularly for congenital deformities. Standardizing training is crucial for ensuring competency in hand surgery upon graduation.

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Area of Science:

  • Plastic Surgery
  • Hand Surgery
  • Surgical Education

Background:

  • Standardizing hand surgery training within plastic surgery residency programs presents ongoing challenges.
  • Significant variability exists in the operative hand experience among U.S. plastic surgery residency programs.

Purpose of the Study:

  • To analyze the variability of operative hand surgery experience across U.S. plastic surgery residency programs.
  • To assess trends in hand surgery case volume and identify potential gaps in resident training.

Main Methods:

  • Operative case logs from 818 chief residents in U.S. plastic surgery programs (2011-2015) were analyzed.
  • Graphical assessment of fold differences in hand surgery case volume between the 10th and 90th percentiles of residents.
  • Calculation of residents meeting hand surgery case minimums for 2015 using percentile data.
Keywords:
ACGMEPatient CarePractice-Based Learning and Improvementcase loghandplastic surgeryresident

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Main Results:

  • Decreasing variability in case volume was observed across most hand surgery procedure categories over time.
  • By 2015, fold differences for most hand surgery procedures were below 10-fold.
  • Congenital deformity cases exceeded 10-fold variability for independent/combined residents; approximately 10% did not meet minimums for arterial repair and congenital deformity.

Conclusions:

  • Variability in operative experience may limit adequate hand surgery exposure for some plastic surgery residents.
  • Establishing empiric case minimums is recommended to ensure hand surgery competency for graduating residents.