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Declining Resident Surgical Autonomy and Improving Surgical Outcomes: Correlation Does Not Equal Causality by Joseph B. Oliver; Jamal L. McFarlane; Anastasia Kunac; Devashish J. Anjaria is a Medicine article available to read on EtoBox.

What is Declining Resident Surgical Autonomy and Improving Surgical Outcomes: Correlation Does Not Equal Causality about?

OBJECTIVE The volume of cases that residents perform independently have decreased leaving graduating chief residents less prepared for independent practice. Outcomes are not worse when residents are given autonomy with appropriate supervision, however it is unknown if outcomes are worsening with decreasing operative autonomy experience. We hypothesize that resident autonomous cases parallel the improving outcomes in surgical care over time, however, are less complex and on lower acuity patients. DESIGN Retrospective study utilizing the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database. SETTING Operative cases performed on teaching services within the VASQIP database from July 1, 2004 to September 30, 2019, were included. PARTICIPANTS All adult patients who underwent a surgical procedure from July 1, 2004, to September 30, 2019, at a VA hospital on a service that included residents were initially included. After inclusions and exclusions, there were 1,346,461 cases. Cases were divided into 3 sequential 5 year eras (ERA 1: 2004-2008 n = 415,614, ERA 2: 2009-2013 n = 478,528, and ERA 3: 2014-2019 n = 452,319). The main exposure of interest was level of resident s

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Author

Joseph B. Oliver; Jamal L. McFarlane; Anastasia Kunac; Devashish J. Anjaria

Publisher

Elsevier BV

Published

2023

Language

EN

Field

Medicine (Health Sciences)