Scut to Scholarship: Can Operative Notes be Educationally Useful?

Area of Science:

• Medical Education
• Surgical Training
• Qualitative Research

Background:

• Competency-based medical education (CBME) necessitates novel workplace-based assessment methods.
• Operative notes are a potential, yet underexplored, data source for evaluating surgical learning.
• Understanding procedural variation is key to improving surgical training and patient care.

Purpose of the Study:

• To explore procedural variations in tonsillectomy using qualitative analysis of operative notes.
• To assess the utility of operative notes as a reliable data source for learning and assessment in surgical residency.

Main Methods:

• Grounded theory-based mixed methods approach.
• Qualitative analysis of operative notes from 65 tonsillectomies.
• Intraoperative observations and semi-structured interviews with surgeons and residents.

Main Results:

• Significant intersurgeon procedural variations exist even in a simple procedure like tonsillectomy.
• Operative notes capture procedural variations incompletely.
• Surgeons and residents informally use operative notes for education, indicating potential for formalization.

Conclusions:

• Analysis of operative notes can be a high-yield strategy for learning and assessment in CBME.
• Coaching residents and surgeons to use operative notes more reliably and efficiently is crucial.
• Optimizing the use of operative notes can shift informal educational practices into the formal domain.