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Related Experiment Videos

Practice environment and resident operative experience

J S Thompson1, L F Rikkers

  • 1Department of Surgery, University of Nebraska Medical Center, Omaha 68198-3280.

American Journal of Surgery
|April 1, 1994
PubMed
Summary
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Surgeon experience and practice setting influence resident operative responsibility. Time since training is key, with experienced surgeons and those in private practice assigning more complex cases to higher-level residents.

Area of Science:

  • Surgical Education
  • Medical Training
  • Resident Operative Responsibility

Background:

  • Graduated increase in responsibility is crucial for surgical resident training.
  • Resident participation in operations is affected by multiple factors.

Purpose of the Study:

  • To investigate how practice environment and staff perception of surgical skills impact resident operative responsibility assignment.
  • To identify factors influencing the delegation of surgical procedures to residents.

Main Methods:

  • Surveyed 100 surgeons at the University of Nebraska Medical Center regarding practice environment and resident skill requirements for 20 general surgery procedures.
  • Collected data on surgeon experience, practice setting, and perceived resident level for procedure performance.

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Main Results:

  • Surgeons in private practice and affiliated hospitals assigned cases to higher-level residents more often than those at the University Hospital.
  • Surgeons over 15 years post-training assigned procedures to higher-level residents compared to more recently trained surgeons.
  • Multivariate analysis indicated time since training as the primary factor; laparoscopic procedures showed greater disagreement and were assigned to higher-level residents than open procedures.

Conclusions:

  • Staff perception of appropriate resident level for general surgery procedures is more influenced by practice environment factors than surgical aspects.
  • Time since training is a significant determinant in assigning resident operative responsibility.
  • Laparoscopic surgery presents unique challenges in resident training and responsibility assignment.