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Operating Room Times For Teaching and Nonteaching Cases are Converging: Less Time for Learning?
Jordan D Bohnen1, David C Chang2, Brian C George3
1Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Journal of Surgical Education
|August 5, 2020
Summary
Operating room times for teaching and non-teaching general surgery cases are converging. This 36% reduction in time difference suggests a need to preserve resident surgical education during operating room procedures.
Area of Science:
- Surgical Education
- Health Services Research
- Operating Room Efficiency
Background:
- Teaching cases historically require more operating room (OR) time than non-teaching cases due to resident involvement.
- Increasing focus on OR efficiency and patient safety may impact the time available for resident surgical training.
- The extent to which OR times for teaching and non-teaching cases are converging is not well-defined.
Purpose of the Study:
- To compare operating room (OR) times between teaching and non-teaching general surgery cases over a seven-year period.
- To test the hypothesis that OR times for teaching and non-teaching cases are converging due to decreased time for resident education.
- To quantify the change in OR time difference between teaching and non-teaching cases.
Main Methods:
- Retrospective review of the National Surgical Quality Improvement Program (NSQIP) database from 2006 to 2012.
- Inclusion of the 30 most common general surgery procedures, categorizing cases as teaching or non-teaching.
- Multivariable regression and difference-in-difference analyses to assess trends in OR time differences, controlling for relevant variables.
Main Results:
- A total of 693,223 cases were analyzed. Average OR time was 98.89 minutes for teaching cases versus 74.22 minutes for non-teaching cases.
- The difference in OR time between teaching and non-teaching cases decreased from 21.94 minutes in 2006 to 13.95 minutes in 2012.
- This convergence represented an approximate 8-minute reduction per case, a 36% decrease in the time difference over the study period.
Conclusions:
- Operating room times for teaching and non-teaching general surgery cases have converged significantly over the study period.
- This convergence highlights a potential reduction in the time dedicated to intraoperative resident education.
- Further research is needed to understand the drivers of this convergence and ensure the preservation of surgical trainee learning experiences.
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