T. S. Sathe1, M. Shah1, R. W. Crum1, S. Krishnamoorthy1, C. McManus1 1Columbia University College Of Physicians And Surgeons, Surgery, New York, NY, USA
Introduction:
The operative readiness of trainees is an important metric for residency programs to track. Concerns about autonomy have prompted the American Board of Surgery to transition from volume-based to competency-based assessment of residents. However, baseline operative readiness for commonly performed operations is not currently reported at the majority of programs. We describe a brief survey to assess operative readiness and an open-source platform that can display this data in a transparent manner.
Methods:
A quality improvement survey was administered to General Surgery categorical residents at a single institution. Participants were asked to rate their level of comfort in 28 operative, procedural, or clinical competencies using the standard entrustable professional activity (EPA) scale: ((1) Observation Only, (2) Direct Supervision, (3) Indirect Supervision, (4) Unsupervised Practice, or (5) Supervising Others).
Results:
40 of 46 residents (87%) responded to the survey. Mean perceived comfort level generally increased with PGY year across all competencies. Residents reached a mean perceived level of 'unsupervised practice' by PGY5 year in 15 of 28 competencies of various complexity levels. Data for each competency is shown in the figure. The platform is a web tool that allows users to filter the data in the figure by PGY year and competency.
Conclusion:
While residents are not expected to achieve 'unsupervised practice' in all of the described competencies, creating a transparent platform for reporting this information provides programs a tool to guide educational quality improvement efforts. In addition, it allows for program directors to have greater resolution into the operative advancement of residents outside of their own specialty. In the future, aggregating data from multiple institutions in an open format can inform the development of national competency standards.
