SE19 CAN THE TRAINEE OPERATIVE LOGBOOK BE USED AS AN ASSESSMENT TOOL OF THE LEVEL OF SUPERVISION PROVIDED BY TRAINING CENTRES?

Abstract

Purpose Specialist trainees and the specialty boards of the College of Surgeons expect that levels of supervision will not remain static during training. As training progresses the level of supervision will change, from an assistant role and direct supervision towards independent practice with consultation available as required. The Summary of Operative Experience may provide a de facto measurement of this.Methodology Assessment of the surgical logbook of an individual trainee to document the changes in the level of supervision that occur during a training term, the factors that influence it, and the degree of variation between posts.Results Upon arrival at a new institution supervision for most cases is direct. For minor and intermediate surgery that supervision is rapidly relaxed once it has been confirmed the trainee has acquired and demonstrated the required skills. In areas of complex surgery (such as neonatal surgery) there is a clear progression observable over the training period. In the early part of the term the trainee is assisting in complex surgery, with the surgeon supervisor operating. By the end of the term those roles may have reversed, but there are significant variations between posts.Conclusion It is possible to use the operative logbook as an indicator of the supervision provided by training centres to trainees. This could provide one mechanism to enable specialty boards to confirm that supervision for trainees is appropriate to their needs as they progress through their training. It also allows an indirect measure of the quality of the post for specialty training.