Are Residents Prepared for Surgical Cases? Implications in Patient Safety and Education
Minh-Bao Le, MD, Trina Ghosh, MD, Elizabeth Odom, MD, Grant Kleiber, MD, Susan Mackinnon, MD, Marissa Tenenbaum, MD, Donald W. Buck, M.D..
Washington University School of Medicine, St. Louis, MO, USA.
The purpose of this study is to assess plastic surgery resident’s level of preparedness for operative cases, and their methods for preparation.
A 26-question survey was distributed to all plastic surgery residents and fellows in our Division. Responses were collected anonymously.
Results: 100% of residents prepare the night before cases. 70% feel they are prepared prior to an operation to list some of the patient’s medical history, while only 20% feel their preparation is thorough enough to list all pertinent aspects of the medical history, imaging results, and anticipated postoperative concerns. 50% of respondents always review the patient’s medical record prior to the operation. Only 20% of residents feel that sign-out of the patient postoperatively to on-call residents is thorough, and includes all pertinent details of the patient’s medical history and anticipated postoperative concerns. Only 36% of residents think patient safety is the most important reason for case preparation. 100% of residents taught themselves how to prepare for cases. 75% would not feel comfortable telling faculty they are not prepared.
Most residents are underprepared for cases and cannot provide thorough postoperative patient sign-out to on-call residents. While this information carries important implications in patient safety, it also represents a critical lapse in our current residency educational curricula. Residents have never been properly trained on how to prepare and what faculty define as “being prepared”. As hospitals continue to put more emphasis on patient safety and quality improvement, training of residents in case preparation will become important.
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