Rural general surgeon confidence with managing vascular emergencies: A national survey

Area of Science:

• Vascular Surgery
• Rural Surgery
• Surgical Education

Background:

• Life and limb-threatening vascular emergencies frequently present to rural hospitals lacking specialized vascular services.
• Australian rural general surgical centers manage an estimated 10-20 emergency vascular procedures annually.
• Assessing the confidence of rural general surgeons in managing these emergent procedures is crucial for patient care.

Purpose of the Study:

• To evaluate the confidence levels of Australian rural general surgeons in performing various emergent vascular procedures.
• To identify factors influencing surgeon confidence, including demographics and training background.

Main Methods:

• A survey was distributed to Australian rural general surgeons assessing confidence (Yes/No) in performing procedures like limb revascularization, AAA repair, and amputations.
• Confidence was compared with surgeon demographics and training history.
• Univariate logistic regression was used for variable comparison.

Main Results:

• A 16% response rate (67/410) was achieved among Australian rural general surgeons.
• Increased surgeon age, years since fellowship, and pre-1995 training correlated with higher confidence in complex vascular procedures.
• Surgeons with over six months of vascular training showed greater comfort with specific procedures like SMA/coeliac embolectomy and limb embolectomy.

Conclusions:

• Recently graduated rural general surgeons express a lack of confidence in managing vascular emergencies.
• Integrating additional vascular surgery training into general surgical training and rural fellowships is recommended to address this confidence gap.