Abstract
Background
Surgery residents are required to achieve performance milestones to advance in their residency. Level-specific, technical performance norms that could be used as milestones, however, do not currently exist. Our aim was to develop level-specific, technical performance norms for general surgery residents on select simulated tasks across multiple institutions.
Study Design
An IRB-approved, prospective, multi-institutional collaborative study with voluntary participation of residents was undertaken at the start of the 2011–2012 academic year. General surgery residents (PGY I–V) from seven institutions were tested on three laparoscopic and five open simulated surgical tasks, and their performance was assessed based on task time and errors. Means and standard deviations of performance for each resident level were calculated and compared. Residents with performance 1 standard deviation below the mean were considered outliers.
Results
A total of 147 residents were evaluated. Mean resident age was 28 ± 3 years; 42 % were female; and they had attended 74 different medical schools. Senior residents (PGY III–V) had more clinical and simulator experience than junior residents (PGY I–II) (p < 0.001). Resident performance scores progressively increased in all tasks reaching a plateau at a lower PGY level for open tasks. Depending on the task, 0–18 % of residents were outliers. When surveyed, 66 % of residents agreed that national performance norms for residents should exist.
Conclusions
Performance norms were established for select tasks in a representative sample of US surgery residents. Such performance norms allow a more informed assessment of resident skill through comparison to national data and enable the identification of outliers who may benefit from additional training.
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Abbreviations
- ACGME:
-
Accreditation Council for Graduate Medical Education
- ABS:
-
American Board of Surgery
- ANOVA:
-
Analysis of variance
- APDS:
-
Association of Program Directors in Surgery
- ASE:
-
Association for Surgical Education
- UTSW:
-
Fundamentals of Laparoscopic Surgery (FLS), University of Texas Southwestern’s
- IRB:
-
Institutional review board
- OR:
-
Operating room
- PGY:
-
Post-graduate year
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Acknowledgments
We thank Rich Milner for help with data collection and Amanda Walters for help with statistical analysis. This study was funded by the first collaborative grant of the Association for Surgical Education and Association for Program Directors in Surgery.
Disclosures
Drs. Edelman, Korndorffer, Sievers, Grewal, and Scott have no conflicts of interest or financial ties to disclose. Dr. Stefanidis is on the speakers’ bureau of Gore and Bard and has a completed grant from Ethicon. Dr. Paige is a co-editor for Simulation in Radiology (Oxford University Press), and Dr. Nepomnayshy is the recipient of a collaborative research grant from ASE/APD.
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This study was funded by the first collaborative grant of the ASE/APDS and was presented from the podium at the 2012 ASE meeting in San Diego, CA.
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Stefanidis, D., Grewal, H., Paige, J.T. et al. Establishing technical performance norms for general surgery residents. Surg Endosc 28, 3179–3185 (2014). https://doi.org/10.1007/s00464-014-3582-y
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DOI: https://doi.org/10.1007/s00464-014-3582-y