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General surgery primary operator rates: a guide to achieving future competency.

Cameron Law1, Jonathan Hong1, David Storey1

  • 1Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

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|August 3, 2017
PubMed
Summary
This summary is machine-generated.

Surgical trainees gain operative experience, but some common procedures show low primary operator rates. Simulation training may improve competency in complex surgical skills.

Keywords:
competencyoperation ratessimulationsurgical trainingworkplace assessment

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Area of Science:

  • Surgical Education and Training
  • Surgical Competency Assessment

Background:

  • Current surgical training assessment relies heavily on procedure numbers, raising concerns about actual competency.
  • Some trainees lack technical skills despite meeting procedural volume benchmarks.

Purpose of the Study:

  • To analyze general surgical trainee operative experience and primary operator rates.
  • To identify trends in surgical skill acquisition among trainees.

Main Methods:

  • Retrospective analysis of 183,319 operations from New South Wales general surgical trainee logbooks (2010-2012).
  • Data grouped by trainee seniority and experience as primary operator versus assistant.
  • Focus on primary operator rates for the top 10 most common procedures.

Main Results:

  • A positive correlation exists between trainee seniority and primary operator rates for common procedures.
  • However, specific procedures like laparoscopic inguinal hernia repair and open cholecystectomy had low primary operator rates across all trainee levels.
  • This suggests potential gaps in technical skill development for certain common operations.

Conclusions:

  • General surgical trainees demonstrate expected progression in operative experience and competency for many procedures.
  • Gaps in primary operator rates for specific common or complex procedures highlight a need for enhanced training strategies.
  • Entrustable professional activities and simulation training are proposed to improve technical expertise for challenging surgical tasks.