731 The Wound Rounds Survey: Measuring Burn Wound Reading Skills

Abstract

Abstract Introduction The assessment of burn depth and the prediction of spontaneous wound healing potential is one of the most important roles of any provider assessing burn wounds. In an attempt to determine whether burn wound reading by physical exam to determine best clinical treatment is a skill that can be measured, this article describes a method developed and employed at this urban burn center for assessment of burn wounds. Methods This study was conducted from August 8, 2019 to September 19, 2019. Study participants were attending physicians, fellows, residents and physician assistants. Cases were anonymized by the removal of personal identifiers, and participants were sent an SMS via mobile phone of a link to a Google Forms survey. After in person examination of the burn wounds, participants voted on each patient seen. Survey answer choices were 1 (healing without need for surgery), 2 (unsure), and 3 (need for surgical excision). Wound evaluations with unanimous responses were felt not to demonstrate the skill of burn wound assessment, as some wounds were obviously in need of surgery or were going to heal to even the most inexperienced examiner. The participants were grouped into expert, intermediate and novice groups, and the responses were classified as correct or incorrect based on the final outcome of the patient. Mean percentage of correct responses were calculated for each group, and statistical analysis of the means was performed using a one-way weighted ANOVA test. Results During the study period a total of 56 voting events were recorded, 26 of which were excluded based on exclusion criteria. The percentage of correct responses was 58.5 ±8.2% in the expert group (n=94), 50.8 ±11.7% in the intermediate group (n=65), and 41.7 ±16.8% in the novice group (n=72). ANOVA analysis showed that these were statistically significant differences (p < 0.01). Conclusions This pilot study shows that the current survey method of assessing burn wounds resulted in higher scores in experts when compared to intermediate and novice level practitioners, suggesting that burn wound reading is a skill that can be measured. Further development of a formative assessment could aid in the development of an educational module to improve wound reading skills. Applicability of Research to Practice Utilizing a daily survey as an instrument of formative assessment on burn wound reading.