FACTS Survey: Focused Assessment With Sonography in Trauma Use Among Canadian Residents Training in General Surgery

Abstract

A survey of all Canadian residents training in general surgery was conducted to determine the prevalence and nature of focused assessment with sonography in trauma (FAST) training. A cross-sectional survey of all 549 residents in 16 Canadian general surgery programs was administered using the Tailored Design Method between December 2008 and February 2009. With a response rate of 58.5% (321 of 549), the prevalence of FAST training among Canadian residents was 21.2% (95% confidence interval: 17.2-25.2). The median number of practice and patient examinations completed was 5 (interquartile range [IQR]: 2-10.5) and 11.5 (IQR: 1.75-50), respectively. Only 38.8% of residents with training felt comfortable making treatment decisions based on their FAST examinations. Those residents who were comfortable had completed more practice and patient examinations (median, 12.5 vs. 4, p = 0.001 and 30 vs. 4.5, p ≤ 0.001, respectively) and were less likely to have didactic only training (7.7% vs. 19.5%, p = 0.002). Most residents (80%) indicated that they would need 20 practice examinations or more (median, 30 examinations; IQR, 20-40) before they would feel comfortable. Residents with FAST training were more likely to be from a program that offered FAST training (54.5% vs. 10%, p ≤ 0.001) and were less likely to perceive a turf war with other specialties over FAST use (29.9% vs. 48.2%, p = 0.007). The situation with FAST training in Canada seems inadequate with few general surgery residents being trained, and of those trained, only a few are comfortable with the technique. If FAST skills are to be expected of future surgeons, initiatives must be put in place to address barriers and improve training opportunities.