C4 - 03: CASE LOGGING HABITS AMONGST GENERAL SURGERY RESIDENTS ARE DISCORDANT AND INCONSISTENT
Brittany Bankhead-Kendall, MD, MS1, Ruth Gerola2, John Uecker, MD1, John Falcone, MD, MS3; 1University of Texas at Austin, 2St. Joseph Mercy Oakland, 3Owensboro Health
PURPOSE: General surgery residents are required to fill out Association Council of Graduate Medical Education (ACGME) case logs based on their operative experience and classify their participation as “first assist” (FA) or “primary surgeon” (PS). These case logs are used to assess the experience of the residents in fulfillment of their graduation requirements and as a quantitative tool to gauge their training. This study will evaluate the current quantitative and qualitative case logging practices of residents.
METHODS: Modified Delphi technique was used in the creation of a questionnaire, and focus groups surveyed to ensure no ambiguity. Surveys were distributed online to multiple institutions via the APDS. Descriptive analyses of resident case logging habits were obtained, and information about how residents log the same operative scenario was ascertained.
RESULTS: There were 363 residents that completed the survey. Program participation included academic (219) and community (120) institutions. Over 90% of residents do not know the current ACGME definition of primary surgeon, and only 18% of residents log cases daily. About 50% stated they had heard of another resident over-reporting on case logs, and 56% stated they personally had been encouraged to log a case as primary surgeon that they did not feel was warranted. Almost half (43%) had been encouraged to do so by a faculty member. Only 4.1% felt the current logging system was “very accurate.” When given the same operative scenario for a laparoscopic cholecystectomy, residents did not log the case the same; 44% chose PS, while 35% chose FA. Residents varied widely in how they chose whether to log a case as FA or PS, and 58% stated they had never received formal training on how to log cases.
CONCLUSION: General surgery residents do not know the current ACGME definition of PS. Case logs should be an objective and quantitative means of comparing residents and programs, and ensure residents have adequate operative exposure. However, logging cases may actually be more complex than previously recognized. Further evaluation of the current logging system, and education of residents on logging should be at the forefront of the surgical education agenda.