PS5-07: OPERATING ROOM PREPARATION BY GENERAL SURGERY RESIDENTS: A QUALITATIVE ANALYSIS
Jenaya L Goldwag, MD1, Sarah A Sullivan, PhD2; 1Dartmouth Hitchcock Medical Center, 2University of Wisconsin School of Medicine and Public Health
Background: There are growing concerns that graduating surgical trainees are not fully prepared to practice independently. With the implementation of policy changes, increased attending supervision, and duty hours, time in the operating room (OR) is limited. This leaves residency programs the challenge of optimizing trainee OR experiences to produce competent surgeons. In order for residents to fully utilize their OR training time, they must be prepared for the cases in which they participate. However, research is lacking on preparation strategies to best activate relevant knowledge that can then be applied in the case. We aim to explore how residents prepare for the OR by investigating how they learned to prepare, what factors impact their preparation, what resources they use, and what qualities make resources desirable.
Methods: We conducted a qualitative study using conventional content analysis. We invited surgery residents of all PGY levels at one institution to participate in semi-structured interviews. Each Interview’s audio was recorded and transcribed verbatim. Two researchers inductively examined the transcriptions independently to generate themes.
Results: Fourteen residents elected to participate: Four PGY-1, Three PGY-2, Two PGY-3, One PGY-4, Two PGY-5, and two research residents. All participants similarly defined six topics they should know prior to a case: the patient, the pathophysiology, the anatomy, the indications, the procedural steps, and the common complications. Eight total themes emerged in our four areas of interest. Learned preparation: (1) acquired through “trial and error”. Factors affecting preparation: (2) available time, (3) attending “quirks”, (4) perceived potential autonomy. Resources used: (5) variation within each topic of preparation, (6) variation per PGY level, (7) occasional difficulty finding appropriate resources. Resource qualities: (8) high yield, meaning resources were: concise, easily available, comprehensive, and clear.
Conclusion: Although surgical residents similarly defined topics for operating room preparation, they use a variety of different resources to achieve this, even at one institution. Residents overwhelmingly reported learning to prepare through “trial and error,” defined time as the most significant limiting factor in preparation, and stated it was often difficult to find an appropriate resource. Further investigation should define optimal preparation strategies and resources.