Residency program under scrutiny-how do residents prepare for elective operations?

Abstract

A wide variety of technical, emotional and organizational aspects of the residency program are aligned with "learning and teaching operations". When aresident is assigned as an operator to the operation program, many chances are provided for teaching and learning with preparation, intraoperative and postoperative care. But the moment when aresident starts preparing for an operation, heterogeneous and partly old-fashioned attitudes as well as contradictory practices must be faced in the clinical context. In the daily practice there is no consensus about a structured preparation for an operation. There have been no scientific investigations on this topic so far. From February to April 2015 questionnaires were sent to all trauma and orthopedic surgeons in the trauma network of East Bavaria (27clinics, 255 physicians). Using Likert scales, the participants could rate the importance of certain elements of preparation for two elective operations and the intensity of how the residents succeeded in these. The aim was to objectify if and to what extent the aspirations diverge from clinical reality. A total of 150 forms could be analyzed (response rate 59%). The surgical approach, patient examinations, study of patient files, discussion with the consultant and the operation technique were considered to be the most important elements; however, approximately half of the participants stated that they did not sufficiently accomplish these elements. Gender-specific differences or differences between the age groups could only be sporadically detected. Amismatch could be recognized between aspiration and reality concerning the personal preparations of residents for operations. Hospital-specific concepts and a standardized, preoperative dialogue between residents and consultants could be an important element in asuccessful preparation for interventions.