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Readiness of Graduating General Surgery Residents To Perform Common Pediatric Surgery Procedures.

Rebecca Moreci1, Alyssa Pradarelli1, Kayla Marcotte2

  • 1Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, MI.

Journal of Surgical Education
|November 10, 2024
PubMed
Summary

Graduating general surgery residents demonstrate high competence in pediatric umbilical hernia repairs. However, their proficiency in pediatric inguinal hernia repairs varies, particularly for infants under six months old.

Keywords:
autonomyestimated competencyinguinal herniaumbilical hernia

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Area of Science:

  • Pediatric Surgery
  • Surgical Education
  • General Surgery Training

Background:

  • A significant portion of pediatric surgical procedures are performed in adult hospitals.
  • Assessing the readiness of graduating general surgery residents for pediatric procedures is crucial.

Purpose of the Study:

  • To evaluate the competence of graduating general surgery residents in performing common pediatric surgery procedures.
  • To identify specific pediatric procedures where resident competence may vary.

Main Methods:

  • Analysis of 113,621 operative assessments for inguinal hernia (IH) and umbilical hernia (UH) repairs from 7,032 residents (2015-2023).
  • Utilized Bayesian generalized linear mixed models to analyze competence probabilities.
  • Data sourced from the Society for Improving Medical and Professional Learning (SIMPL) collaborative.

Main Results:

  • Graduating residents showed high competence in adult IH repairs (94.3%) and all UH repairs (adults: 97.6%, pediatric: 97.3%-97.6%).
  • Competence probabilities for pediatric IH repairs varied by age: 79.5% for <6 months, 89.6% for 6 months-5 years, and 89.9% for >5 years.
  • Competence in pediatric UH repairs was consistently high across age groups.

Conclusions:

  • Graduating general surgery residents are generally competent to perform pediatric umbilical hernia repairs.
  • Competence in pediatric inguinal hernia repairs is variable, with lower probabilities observed in infants under six months.
  • Further training or targeted assessment may be needed for pediatric inguinal hernia repairs in younger populations.