Repeat Attending Exposure Influences Operative Autonomy in Endocrine Surgical Procedures.

Area of Science:

• Surgical Education
• Surgical Training
• Medical Simulation

Background:

• Graduating surgery residents may lack preparedness for independent practice.
• Assessing resident competency in thyroidectomy and parathyroidectomy is crucial.
• Understanding predictors of surgical skill acquisition is vital for effective training.

Purpose of the Study:

• Identify predictors of performance, autonomy, and readiness for independence in surgical trainees.
• Evaluate the impact of repeated resident-attending exposure on these ratings.
• Test the hypothesis that increased exposure with a specific attending enhances resident autonomy.

Main Methods:

• Collected operative performance evaluations using the Zwisch scale for thyroidectomy and parathyroidectomy.
• Assessed trainee readiness for practice as a binary variable.
• Utilized Chi-squared, Fisher's exact, Wilcoxon, Kruskal-Wallis tests, and random effects logistic regression for analysis.

Main Results:

• Readiness for practice correlated with chronological procedure number but not gender or case difficulty.
• Resident-attending exposure, not just procedure count, significantly predicted practice readiness.
• Trainees deemed ready for independence had completed a median of 7 parathyroidectomies and 5 thyroidectomies.

Conclusions:

• Increased resident-attending exposure positively impacts performance and autonomy ratings.
• Repeated exposure can complicate the prediction of resident ability based solely on procedure volume.
• Learning curves demonstrate the progression from novice to proficient surgical skills.