624 A Simple Survey for Tracking Burn Wound Assessment Skill

Abstract

Abstract Introduction The assessment of burn wound surgical need is a critical skill of a burn provider. In an attempt to determine whether burn wound reading by physical exam is a skill that can be measured, this article describes a simple, survey-based method developed and employed at a single, high-volume urban burn center for gauging and tracking success at predicting surgical need. Methods This study was conducted from August 8, 2019 to October 31, 2019. Study participants were care team providers, including attending physicians, fellows, residents and physician assistants. They were divided into expert and novice groups according to prior burn wound care experience. After in person examination of the burn wounds, participants were sent an electronic link to a de-identified survey. Survey answer choices included: 1 (surgical excision not required), 2 (unsure need for excision), and 3 (clear need for excision). Correctness was judged by whether or not the patient ultimately required surgery. Evaluation surveys that were unanimous among all expert and novice providers were excluded, as these were deemed inadequate for assessing wound reading skill. Weighted group mean success rates were calculated, and statistical analysis of the means was performed using a weighted, two-tailed t-test. Results During the study period a total of 112 survey events were recorded, 23 of which met exclusion criteria. The percentage of correct responses was 63±3% in the expert group (n=440 votes) and 48±15% in the novice group (n=304 votes). Weighted, two-tailed t-test analysis revealed a statistically significant difference between the expert and novice groups (p < 0.01). Conclusions This pilot study demonstrates that the current survey method of assessing burn wound surgical need was able to discriminate the wound reading skill of a group of expert providers from that of a group of novices, suggesting that burn wound reading is a skill that can be quantitatively measured. Further development of a formative assessment could aid in the formulation of an educational module to improve wound reading skills.