Maintaining operative efficiency while allowing sufficient time for residents to learn

Surgical residents desire independent operating experience but recognize that attendings have a responsibility to keep cases as short as possible. We analyzed video and interviews of attending surgeons related to more than 400 moments in which the resident was the primary operator. We examined these...

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Veröffentlicht in:The American journal of surgery 2019-07, Vol.218 (1), p.211-217
Hauptverfasser: Sutkin, Gary, Littleton, Eliza B., Kanter, Steven L.
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container_title The American journal of surgery
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creator Sutkin, Gary
Littleton, Eliza B.
Kanter, Steven L.
description Surgical residents desire independent operating experience but recognize that attendings have a responsibility to keep cases as short as possible. We analyzed video and interviews of attending surgeons related to more than 400 moments in which the resident was the primary operator. We examined these moments for themes related to timing and pace. Our surgeons encouraged the residents to speed up when patient safety could be jeopardized by the case moving too slowly. In contrast, they encouraged the residents to slow down when performing a crucial step or granting independence. Attending surgeons encouraged speed through economical language, by substituting physical actions for words, and through the use of Intelligent Cooperation. Conversely, they encouraged slowing down via just-in-time mini-lectures and by questioning the trainee. We present recommendations for safe teaching in the operating room while simultaneously maintaining overall surgical flow. Teaching residents to operate quickly can save time and is likely based on an automaticity in teaching. Slowing a resident down is vital for trainee skill development and patient safety. •When teaching, maintain tight control over the pace of the case and safety of the patient.•Encourage residents to slow down when performing a crucial step or granting independence.•Encourage speed with economical language, substituting physical actions, and Intelligent Cooperation.•Slow down via just-in-time mini-lectures and by questioning the trainee.•We present an overall strategy for efficient, safe surgical teaching.
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subjects Automation
Clinical Competence
Cooperation
Education, Medical, Graduate - methods
Efficiency
General Surgery - education
Humans
Internship and Residency
Interviews
Medical personnel
Operating Rooms
Pace
Patient safety
Qualitative research
Safety
Surgeons
Surgeons - education
Surgery
Surgical outcomes
Surgical teaching
Teaching
Videotape
title Maintaining operative efficiency while allowing sufficient time for residents to learn
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