Does cross-sectional imaging diminish the utility of surgical handover for trainee assessment?

Workplace-based assessments have been widely adopted by surgical training bodies to assess surgical trainees. In this study, we used a handover tool to assess the diagnostic accuracy of admitting surgical trainees, and whether this was impacted by cross-sectional imaging.

Data was retrospectively reviewed from a prospectively maintained database. Details of 979 patients over a 7-month period were reviewed. The primary outcome was concordance between the admitting and discharge diagnoses, as recorded using the surgical handover tool.

The concordance between the admitting and discharge diagnoses was 81.4 %. A positive association was found between diagnostic accuracy and pre-referral cross-sectional imaging (r = 0.67). Obtaining a CT scan before handover was significantly associated with higher diagnostic accuracy (p < 0.0001).

Cross-sectional imaging positively affects the diagnostic accuracy of surgical trainees. Given the availability of cross-sectional imaging, this calls into question whether surgical handovers can be used to assess surgical trainees in the workplace.