US general surgical trainee performance for representative global surgery procedures

Kenneth L Abbott; Gifty Kwakye; Grace J Kim; John L Luckoski; Andrew E Krumm; Michael Clark; Xilin Chen; Tanvi Gupta; Thomas G Weiser; Brian C George; Society for Improving Medical Professional Learning

doi:10.1016/j.amjsurg.2021.05.016

US general surgical trainee performance for representative global surgery procedures

Am J Surg. 2022 Feb;223(2):224-228. doi: 10.1016/j.amjsurg.2021.05.016. Epub 2021 Jun 9.

Affiliations

¹ Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, MI, USA; University of Michigan Medical School, Ann Arbor, MI, USA.
² Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
³ Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, MI, USA; Department of Learning Health Sciences, University of Michigan, Ann Arbor, MI, USA.
⁴ Consulting for Statistics, Computing, and Analytics Research, University of Michigan, Ann Arbor, MI, USA.
⁵ Stanford University School of Medicine, Department of Surgery, Division of General Surgery, Section of Trauma & Critical Care, Stanford, CA, USA; Department of Clinical Surgery, University of Edinburgh, Edinburgh, UK.
⁶ Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, MI, USA. Electronic address: bcgeorge@med.umich.edu.

PMID: 34119330
DOI: 10.1016/j.amjsurg.2021.05.016

Abstract

Background: Many US general surgery residents are interested in global surgery, but their competence with key procedures is unknown.

Methods: Using a registry managed by the Society for Improving Medical Professional Learning (SIMPL), we extracted longitudinal operative performance ratings data for a national cohort of US general surgery residents. Operative performance at the time of graduation was estimated via a Bayesian generalized linear mixed model.

Results: Operative performance ratings for 12,976 procedures performed by 1584 residents in 52 general surgery programs were analyzed. These spanned 17 of 31 (55%) procedures deemed important for global surgical practice. For these procedures, the probability of a graduating resident being deemed competent to perform a procedure was 0.95 (95% confidence interval 0.86-1.00) but was less than 0.9 for 3 observed procedures.

Conclusion: Our results highlight gaps in the preparedness of US general surgery trainees to perform procedures deemed most important for global surgery settings.

Keywords: General surgery; Global surgery; Performance; Procedure; Resident.

MeSH terms

Bayes Theorem
Clinical Competence
Cohort Studies
Education, Medical, Graduate
General Surgery* / education
Humans
Internship and Residency*