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Trainee Operative Autonomy in Plastic Surgery.

Christina R Vargas1, Tobias C Long, Anand R Kumar

  • 1From the Division of Plastic and Reconstructive Surgery, University Hospitals Cleveland Medical Center, School of Medicine, Case Western Reserve University, Cleveland, OH.

Annals of Plastic Surgery
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Summary
This summary is machine-generated.

Plastic surgery trainees report varying operative autonomy, with many not achieving full independence in core procedures. Faculty perceptions often differ from trainee self-assessments, highlighting a need for standardized evaluation.

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Area of Science:

  • Plastic Surgery Training
  • Surgical Education
  • Operative Autonomy Assessment

Background:

  • Progressive trainee autonomy is essential for developing competent plastic surgeons.
  • The evaluation of operative autonomy in plastic surgery trainees is understudied.

Purpose of the Study:

  • To assess operative autonomy in plastic surgery trainees using a standardized metric.
  • To compare trainee self-perceptions of autonomy with faculty assessments.
  • To identify discrepancies in case logging and autonomy progression.

Main Methods:

  • Developed parallel survey instruments based on the Zwisch metric for operative autonomy.
  • Electronically distributed surveys to trainees and faculty in accredited plastic surgery programs.
  • Queried trainees on autonomy in 17 core procedures and perceived practice readiness; faculty assessed final-year trainees.

Main Results:

  • Trainees reported highest autonomy in breast tissue expander reconstruction and carpal tunnel release, least in facelift and rhinoplasty.
  • A mean of 40% of final-year trainees reached 'supervision only' autonomy, with none in rhinoplasty.
  • Faculty-reported trainee autonomy was higher than trainee self-reports for 82% of procedures.

Conclusions:

  • Most final-year plastic surgery trainees do not achieve 'supervision only' autonomy in core procedures.
  • Significant discrepancies exist between trainee and faculty perceptions of operative autonomy.
  • Standardization of case logging and autonomy assessment is recommended for plastic surgery training.