Abstract
Level of competence by procedure. Trauma is one of the leading causes of death in the world and proper surgical care is critical to impact mortality. In Chile, trauma associated death ranks first as mortality cause in population between 20 and 59 years old. Appropriate surgical skills are required to deal with these complex patients. Self-confidence to practice trauma procedures after the General Surgery Residency have not been reported in our country. Describe the level of self-confidence to deal with trauma procedures of surgeons who recently graduated from a General Surgery Residency. Descriptive cross-sectional study. We designed and applied a survey in 2015, 2016 and 2017 to recently graduated surgeons, to inquire about self-confidence of surgical skills to deal with trauma scenarios. Eighteen trauma surgery procedures (including cervical, thoracic, abdominal and vascular procedures) were evaluated using a 5-grade Likert scale. The number of procedures performed during the residency was also queried. Eighty-eight recently graduated surgeons from 11 different training programs in Chile were included. The report of competencies was high in procedures such as intestinal injuries, were 98% felt competent or very competent in their repair. On the other hand, in complex traumas such as major vessel injury, up to 76% reported not being competent. Self-confidence on procedures was directly associated with the number of procedures performed during residency. Recently graduated surgeons from General Surgery Programs report high levels of confidence to deal with low and intermediate complexity traumas, but a lower level of confidence to treat high complexity cases.
Highlights
During 2013 a total of 55 million people died worldwide, being four million (8,7%) caused by trauma[26]
This study aims to describe the level of selfconfidence to deal with trauma procedures of surgeons who recently graduated from a General Surgery Residency
The listed procedures were selected according to frequent trauma cases and in line with the recommendation from the Chilean Surgical Society of minimum surgical skills required by a general surgeon[14,31]
Summary
During 2013 a total of 55 million people died worldwide, being four million (8,7%) caused by trauma[26]. In the same year and concerning patients between 20 and 59 years old, the number of deaths associated with a road accident and assault (1.889) exceeds other common diseases such as ischemic cardiovascular disease (1.477) and hepatic cirrhosis (1.881)[7]. According to this data, trauma became the first cause of mortality in young patients with the consequent highest potentially productive years of life lost[2]. The surgeon’s skills in the fast control of bleeding represent the critical step in reducing mistakes and, deaths This approach is the primary focus of big trauma centers protocols[11,29]. Most of these cases concentrate outside of working hours, making it even harder to obtain advice from a senior collegues[25,40]
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