J. J. Tackett1, A. L. Fonseca1, W. E. Longo1 1Yale University School Of Medicine,Department Of Surgery,New Haven, CT, USA
Introduction:
General surgery residents’ perceived knowledge base and comfort with intestinal stomas and enterostomal therapy are profiled in the results of a national survey.
Methods:
An anonymous survey was distributed to 734 U.S. general surgery residents through permission of their residency program directors. This anonymous survey explored the existence of formal didactics and training in ostomy creation and stomal care, examined residents’ perceived knowledge base of clinical indications for enterostomal care approaches, and elicited residents’ comfort with performing enterostomal surgeries and mitigating complications. Responses were recorded on a Likert scale. Chi squared test was applied when appropriate.
Results:
Surveys were distributed to 734 residents across the U.S. through their program directors. 218/734 respondents completed the survey (30%): 40% from the Northeast, 22% from the Midwest, 22% from the South, 16% from the West, and 82% with direct university affiliation. Only 12% of respondents stated that they had experienced formal enterostomal therapy training and only 15% had attended a lecture on the subject. Most respondents (86%) stated they routinely worked with enterostomal therapists during the care of patients with ostomies. Only 11% of graduating chiefs felt ‘very confident’ in their knowledge base of clinical indications for enterostomal care and just over half (61%) felt ‘very comfortable’ with the surgical procedures of ostomy creation and closure. Overall, a mere 6% of all residents felt ‘very comfortable’ dealing with common ostomy complications.
Conclusion:
In an era of surgical subspecialization and advanced nursing practice in enterostomal therapy, general surgery residents lack confidence in either their knowledge base or comfort when approaching enterostomal therapy and stomal complications. Resident education across the country should be reformed and formalized to enhance training in these principles that are essential to general surgery practice.