S. Sullivan1, J. Steiman1, C. Pugh1 1University Of Wisconsin,Madison, WI, USA
Introduction: The operating room (OR) has traditionally been a place of discovery learning. However, prior reports have shown that residents spend less than 15% of their total residency hours in the OR. Furthermore, use and development of new surgical devices and technologies limits residents’ participation in certain procedures as part of their general training. As such, the OR must increasingly become a place of active, focused learning with each experience. Effective communication should occur prior to the operation to identify learning needs. The goal of this study was to investigate pre-operative communication between attendings and residents.
Methods: Categorical surgery residents (n=20) completed a 39-item survey assessing the following related to operative preparation: 1) when they prepare and the amount of time they spend preparing, 2) what they focus on when preparing, 3) interaction with attendings before the operative case 4) resource use to prepare for the operation and 5) identification of perceived case weaknesses. A 5 point Likert scale was used, with 1= Hardly Ever and 5= Almost Always. In the sample, there were 12 males (60%), and the average age was 32. The majority of the residents (6) were in their program year (PGY) 1, with 4 in both PGY 2 and PGY 3, and 3 in both PGY4 and PGY5.
Results: All of the respondents (see Table 1) said that they usually prepare for operative cases. The majority of residents identify the critical steps of an operation prior to the case. Only a small percentage, however, review these with the attending with regularity, and 95% state they do not typically discuss who will perform these critical steps. Fourteen residents (70%) stated that discussion of personal educational goals prior to cases occurs infrequently. The majority of residents typically do not discuss what parts of the case they will do with the attending beforehand (85%). That being said, most residents reported hardly ever asking to do a certain part prior to operating and stated that weakness identification pre-operatively does not generally occur. Finally, only 30% of residents were largely satisfied with the amount of interaction with attendings prior to cases.
Conclusion: We have identified major deficits in communication between residents and attendings. Explicit communication is therefore needed to improve teaching and learning within the OR. Though patient centric, the OR is also a learning environment for surgical residents. Overall, residents would like more opportunities for pre-operative discussions with attendings. Potential targets for these discussions include residents’ case participation and personal educational goals.
