Surgical Case Logging Habits and Attitudes: A Multi-Specialty Survey of Residents

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Abstract

BACKGROUND:

The Accreditation Council for Graduate Medical Education measures surgical residents' experience by mandating that residents log each procedure in which they have participated. This system is the primary mechanism by which breadth and depth of surgical training are documented.

METHODS:

Investigators developed and administered a voluntary, 45-item survey to all general surgery, obstetrics and gynecology, orthopedics, urology, neurosurgery, otolaryngology, and plastic surgery residents at a large academic medical center. Resident demographic data, program details, logging behaviors, and attitudes were examined using descriptive statistics. Authors used multivariate logistic regression to assess characteristics associated with logging habits.

RESULTS:

Eighty-two of 126 surgical residents participated, yielding a response rate of 65%. Overall, 7.5% considered the system highly inaccurate, 28.8% somewhat inaccurate, 52.5% somewhat accurate, and 11.3% highly accurate. Nearly half (48.1%) use an incorrect metric to log their role as surgeon or assistant. Half logged monthly or less frequently. The longest time residents reported falling behind ranged from less than a week to more than a year, with about half (51.4%) reporting backlogs of 3 months or longer. Approximately two-thirds considered the system difficult to navigate (64.2%) and burdensome (68.8%).

DISCUSSION:

Inconsistency of logging habits and perceived lack of accuracy raise concerns about use of the system for assessing surgical preparedness or accrediting training programs.

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