Using Concurrent Complication Reporting to Evaluate Resident Critical Thinking and Enhance Adult Learning

Area of Science:

• Medical Education
• Surgical Training
• Healthcare Quality Improvement

Background:

• Assessing critical thinking in surgical residents is challenging.
• Traditional morbidity and mortality reporting has limitations in evaluating analytical skills.
• A need exists for a quantifiable method to track cognitive development in residency.

Purpose of the Study:

• To design and implement a HIPAA-compliant system for assessing residents' critical thinking.
• To longitudinally evaluate the development of critical thinking skills in surgical residents.
• To identify specific domains of cognitive strength and weakness in resident performance.

Main Methods:

• Developed a secure electronic platform for weekly adverse outcome reporting.
• General surgery residents (PGY 1-5) critiqued 1932 surgical cases over 4 years.
• Utilized a standardized critique algorithm, with faculty review and graded feedback.

Main Results:

• Residents excelled in identifying ACGME competencies and Clavien-Dindo scores.
• Significant improvement was observed in recording data for error identification (p < 0.00001).
• Senior residents consistently outperformed junior residents across all assessed domains.

Conclusions:

• An electronic critique algorithm effectively measures residents' critical thinking skills.
• Feedback and progressive experience correlate with improved performance.
• The system allows for individualized assessment and potential enhancement of M&M conferences.