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Maintaining operative efficiency while allowing sufficient time for residents to learn.
Gary Sutkin1, Eliza B Littleton2, Steven L Kanter1
1University of Missouri-Kansas City School of Medicine, 2411 Holmes St, Kansas City, MO, 64108, USA.
American Journal of Surgery
|December 8, 2018
Summary
Attending surgeons balance efficiency and training by guiding surgical residents. They encourage speed to maintain flow but slow residents down for critical steps and skill development, ensuring patient safety.
Area of Science:
- Medical Education
- Surgical Training
- Operating Room Dynamics
Background:
- Surgical residents aim for independent operating experience.
- Attending surgeons must balance resident training with efficient case times.
Purpose of the Study:
- To analyze attending surgeon strategies for managing surgical resident pace.
- To provide recommendations for optimizing teaching and surgical flow in the operating room.
Main Methods:
- Analysis of over 400 video and interview segments of attending surgeons during resident-led procedures.
- Examination of themes related to timing and pace during resident operations.
Main Results:
- Attending surgeons accelerated residents when slow pace risked patient safety.
- Residents were slowed for crucial steps or to foster independence, using mini-lectures and Socratic questioning.
- Speed was encouraged through concise communication, physical actions, and Intelligent Cooperation.
Conclusions:
- Effective surgical teaching requires balancing speed for efficiency with deliberate slowing for skill acquisition and safety.
- Recommendations are provided for maintaining surgical flow while ensuring safe and effective resident training.
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