J. N. Nathwani1, K. E. Law2, B. J. Wise1, S. Lian1, M. E. Garren1, S. M. DiMarco1, C. M. Pugh1,2 1University Of Wisconsin,Surgery,Madison, WI, USA 2University Of Wisconsin,Industrial And Systems Engineering,Madison, WI, USA
Introduction: Nearly one-third of surgical residents will enter into academic development during their surgical residency, by dedicating time to a research fellowship for one to three years. Multiple motivations exist for going into academic development; including interest in an academic surgical career, requirements by surgical training programs, or taking time away from clinical years. Major interest lies in understanding how laboratory residents’ surgical skills are affected by minimal clinical exposure during academic development. A widely held concern is that the time away from clinical exposure results in surgical skills decay. This study examines the impact of the academic development years on residents’ operative performance. We hypothesize that performance will improve as laboratory residents progress through their academic years.
Methods: Surgical performance data were collected from laboratory residents (post graduate years [PGY] 2-5) in Midwest general surgery training programs during the summers of 2014 and 2015. Residents had 15 minutes to complete two steps of a simulated laparoscopic ventral hernia (LVH) repair procedure. Hernia skins from all participants were scored using a previously validated checklist. An analysis of variance (ANOVA) test compared the mean performance scores of repeat participants and one time participants.
Results:A total of 76 laboratory residents (49% female) participated. All participants completed the simulated LVH in the allotted time. Fifteen of the 76 participants performed this procedure in both 2014 and 2015, while 61 participants performed the procedure once. The first time performance for all participants on the LVH simulator was a mean of 13.9 points (SD=5.3) out of a maximum 24 points for repair quality and completion. One time participants scored a mean of 13.4 points (SD=5.2). Repeat participants in their second performance scored a mean of 17.1 points (SD=5.9). ANOVA analysis demonstrates a statistical difference between one time performers and repeat participants in their second year (F(2, 88)=4.2, p=.016).
Conclusion:Comparing repaired hernia skins of one time participants and repeat participants shows improvement in performance while in laboratory years. Higher scores for repeat participants suggests that laboratory residents continue to improve their surgical skills despite time away from clinical exposure. This improvement in performance could be explained by personal efforts, program-specific call duties, acquisition of moonlighting opportunities, or artifact of repeated exposure to a simplified surgical task.