Objective scoring of an electronic surgical logbook: Analysis of impact and observations within a surgical training body

Am J Surg. 2017 Nov;214(5):962-968. doi: 10.1016/j.amjsurg.2017.07.028. Epub 2017 Jul 21.

Abstract

Background: Historically, evaluating operative-volumes has proven difficult due to mass-variability in operative-complexities and participation. This study aimed to introduce a national scoring interface for residents' operative-logs while forming meaningful observations on specialities, training-institutes and technical competency.

Methods: A weighted-scoring algorithm was applied prospectively to residents' operative volumes since July 8th, 2013 with daily web-based quantitative feedback. Pre and post intervention analyses were performed with historical volumes. Operative volumes were correlated with work-based and university technical-skills' assessments.

Results: Ninety-five residents completed two-year preliminary training since 2013 recording 79,490 operations. These residents recorded significant (p < 0.050) increases in mean-score (case-load), total, performed and assisted operations of >16,528 (50%), 234 (45%), 115 (66%) and 113 (33%) respectively. The number of resident-performed operations was a significant predictor of performance in work-based and university technical-skills assessments (p < 0.050). There were no associations between these measures and the volume of assisted-operations.

Conclusions: Open-benchmarking of surgical-volumes stimulates residents to actively pursue operative-opportunities and record those experiences. It provides objective performance data on residents and training-institutes while providing evidence that level of operative participation is significant in technical skills development.

Keywords: Electronic logbooks; Objective assessment; Operative experience; Resident competencies; Resident monitoring.

MeSH terms

  • Clinical Competence*
  • Data Collection / methods*
  • Humans
  • Internship and Residency*
  • Prospective Studies
  • Records
  • Surgical Procedures, Operative / education
  • Surgical Procedures, Operative / standards*
  • Surgical Procedures, Operative / statistics & numerical data*