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Training surgeons and safeguarding patients

J R Anderson1, D J Parker, M J Unsworth-White

  • 1Department of Cardiothoracic Surgery, St George's Hospital, London.

Annals of the Royal College of Surgeons of England
|May 1, 1996
PubMed
Summary
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This audit of cardiac surgery training found that while trainees gained experience, valve surgery cases were disproportionately low. Reviewing case delegation ensures valuable operative experience without compromising patient safety.

Area of Science:

  • Cardiothoracic Surgery
  • Surgical Education

Background:

  • Surgical trainees require diverse operative experience and supervision.
  • Cardiac surgery training is often dominated by coronary bypass procedures.
  • There's a need to balance trainee education with patient safety.

Purpose of the Study:

  • To audit trainee exposure and supervision in cardiac surgery.
  • To assess the types of cases delegated to surgical trainees.
  • To evaluate the impact of case delegation on patient outcomes.

Main Methods:

  • Audit of surgical cases over a 20-month period.
  • Analysis of case delegation percentages to senior registrars and registrars.
  • Assessment of consultant/senior colleague assistance during trainee-operated cases.

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Main Results:

  • 35.2% of cardiac surgery cases were delegated to trainees.
  • Delegated cases were predominantly low-risk coronary bypass procedures.
  • Valve surgery delegation was disproportionately low compared to the overall case mix.

Conclusions:

  • Trainees gained experience in low-risk procedures with low morbidity/mortality.
  • Current case delegation practices may limit exposure to complex procedures like valve surgery.
  • Reviewing case selection for delegation can enhance trainee experience while maintaining patient safety.