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Progressive Surgical Autonomy in a Plastic Surgery Resident Clinic

BACKGROUND: Resident clinics are thought to catalyze educational milestone achievement through opportunities for progressively autonomous surgical care, but studies are lacking for general plastic surgery resident clinics (PSRCs). We demonstrate the achievement of increased surgical autonomy and con...

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Autores principales: Day, Kristopher M., Scott, Jillian K., Gao, Lani, Lee, Tara M., Waldrop, Jimmy L., Sargent, Larry A., Kennedy, J. Woody, Rehm, Jason P., Brzezienski, Mark A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5459631/
https://www.ncbi.nlm.nih.gov/pubmed/28607848
http://dx.doi.org/10.1097/GOX.0000000000001318
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author Day, Kristopher M.
Scott, Jillian K.
Gao, Lani
Lee, Tara M.
Waldrop, Jimmy L.
Sargent, Larry A.
Kennedy, J. Woody
Rehm, Jason P.
Brzezienski, Mark A.
author_facet Day, Kristopher M.
Scott, Jillian K.
Gao, Lani
Lee, Tara M.
Waldrop, Jimmy L.
Sargent, Larry A.
Kennedy, J. Woody
Rehm, Jason P.
Brzezienski, Mark A.
author_sort Day, Kristopher M.
collection PubMed
description BACKGROUND: Resident clinics are thought to catalyze educational milestone achievement through opportunities for progressively autonomous surgical care, but studies are lacking for general plastic surgery resident clinics (PSRCs). We demonstrate the achievement of increased surgical autonomy and continuity of care in a PSRC. METHODS: A retrospective review of all patients seen in a PSRC from October 1, 2010, to October 1, 2015, was conducted. Our PSRC is supervised by faculty plastic surgery attendings, though primarily run by chief residents in an accredited independent plastic surgery training program. Surgical autonomy was scored on a 5-point scale based on dictated operative reports. Graduated chief residents were additionally surveyed by anonymous online survey. RESULTS: Thousand one hundred forty-four patients were seen in 3,390 clinic visits. Six hundred fifty-three operations were performed by 23 total residents, including 10 graduating chiefs. Senior resident autonomy averaged 3.5/5 (SD = 1.5), 3.6/5 (SD = 1.5), to 3.8/5 (SD = 1.3) in postgraduate years 6, 7, and 8, respectively. A linear mixed model analysis demonstrated that training level had a significant impact on operative autonomy when comparing postgraduate years 6 and 8 (P = 0.026). Graduated residents’ survey responses (N = 10; 100% response rate) regarded PSRC as valuable for surgical experience (4.1/5), operative autonomy (4.4/5), medical knowledge development (4.7/5), and the practice of Accreditation Council of Graduate Medical Education core competencies (4.3/5). Preoperative or postoperative continuity of care was maintained in 93.5% of cases. CONCLUSION: The achievement of progressive surgical autonomy may be demonstrated within a PSRC model.
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spelling pubmed-54596312017-06-12 Progressive Surgical Autonomy in a Plastic Surgery Resident Clinic Day, Kristopher M. Scott, Jillian K. Gao, Lani Lee, Tara M. Waldrop, Jimmy L. Sargent, Larry A. Kennedy, J. Woody Rehm, Jason P. Brzezienski, Mark A. Plast Reconstr Surg Glob Open Special Topic BACKGROUND: Resident clinics are thought to catalyze educational milestone achievement through opportunities for progressively autonomous surgical care, but studies are lacking for general plastic surgery resident clinics (PSRCs). We demonstrate the achievement of increased surgical autonomy and continuity of care in a PSRC. METHODS: A retrospective review of all patients seen in a PSRC from October 1, 2010, to October 1, 2015, was conducted. Our PSRC is supervised by faculty plastic surgery attendings, though primarily run by chief residents in an accredited independent plastic surgery training program. Surgical autonomy was scored on a 5-point scale based on dictated operative reports. Graduated chief residents were additionally surveyed by anonymous online survey. RESULTS: Thousand one hundred forty-four patients were seen in 3,390 clinic visits. Six hundred fifty-three operations were performed by 23 total residents, including 10 graduating chiefs. Senior resident autonomy averaged 3.5/5 (SD = 1.5), 3.6/5 (SD = 1.5), to 3.8/5 (SD = 1.3) in postgraduate years 6, 7, and 8, respectively. A linear mixed model analysis demonstrated that training level had a significant impact on operative autonomy when comparing postgraduate years 6 and 8 (P = 0.026). Graduated residents’ survey responses (N = 10; 100% response rate) regarded PSRC as valuable for surgical experience (4.1/5), operative autonomy (4.4/5), medical knowledge development (4.7/5), and the practice of Accreditation Council of Graduate Medical Education core competencies (4.3/5). Preoperative or postoperative continuity of care was maintained in 93.5% of cases. CONCLUSION: The achievement of progressive surgical autonomy may be demonstrated within a PSRC model. Wolters Kluwer Health 2017-05-04 /pmc/articles/PMC5459631/ /pubmed/28607848 http://dx.doi.org/10.1097/GOX.0000000000001318 Text en Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Special Topic
Day, Kristopher M.
Scott, Jillian K.
Gao, Lani
Lee, Tara M.
Waldrop, Jimmy L.
Sargent, Larry A.
Kennedy, J. Woody
Rehm, Jason P.
Brzezienski, Mark A.
Progressive Surgical Autonomy in a Plastic Surgery Resident Clinic
title Progressive Surgical Autonomy in a Plastic Surgery Resident Clinic
title_full Progressive Surgical Autonomy in a Plastic Surgery Resident Clinic
title_fullStr Progressive Surgical Autonomy in a Plastic Surgery Resident Clinic
title_full_unstemmed Progressive Surgical Autonomy in a Plastic Surgery Resident Clinic
title_short Progressive Surgical Autonomy in a Plastic Surgery Resident Clinic
title_sort progressive surgical autonomy in a plastic surgery resident clinic
topic Special Topic
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5459631/
https://www.ncbi.nlm.nih.gov/pubmed/28607848
http://dx.doi.org/10.1097/GOX.0000000000001318
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