A Team-based Approach to Evaluating Surgical Residents’ Performance in the Operating Room: A Prospective Survey Study
Main Article Content
Abstract
Introduction: The operating room serves as an indispensable arena for the training and assessment of surgical residents, playing a pivotal role in their professional development. Within this high-stakes environment, the surgical team collectively assumes a significant duty towards ensuring patient safety and well-being. Every member of the team, regardless of their role, is in a unique position to offer critical insights that can aid in evaluating and enhancing the competencies of their peers. This collaborative approach not only fosters a culture of continuous learning and improvement but also directly contributes to the advancement of patient care standards. Through such dynamic inter-professional interactions, the operating room becomes a cornerstone for both educational excellence and clinical proficiency, ensuring that surgical residents are well prepared to meet the challenges of their demanding profession.
Methods: This prospective survey study aimed to determine if operating room (OR) nurses evaluate surgical residents differently than attending surgeons. 18 OR nurses and 10 attending surgeons in two hospitals evaluated 15 general surgery residents using seven questions from the ACGME Surgical Milestones (CCC) tool.
Results: A total of 195 evaluations were completed for 15 surgical residents (3 residents from each PGY) by 18 OR nurses and 10 attending surgeons. Significant differences were found in mean scores between attending surgeons and OR nurses in all seven domains: For question 1, patient evaluation and decision making, (4.01 vs. 2.77, P <0.004); question 2, intraoperative care and performance of procedures (3.83 vs. 2.63, P <0.005); question 3, operative patient care and technical skills, (3.86 vs. 2.63, P <0.003); question 4, medical knowledge/anatomy,(3.87 vs. 2.70, P<0.01); question 5, professional behavior and accountability, ( 2.63 vs. 1.59, P <0.002); question 6, interprofessional and team communication, (3.97 vs. 2.70, P<0.002); and question 7, communication within the healthcare system, (4.03 vs. 2.67, P<0.001).
Conclusion: This study reveals significant differences in how OR nurses and attending surgeons evaluate surgical residents across all seven domains of the ACGME Surgical Milestones. Attending surgeons consistently rated residents higher than OR nurses. These findings suggest that incorporating evaluations from a broader range of team members, including OR nurses, could provide a more comprehensive assessment of surgical residents' performance and identify areas for improvement. Enhancing interprofessional feedback mechanisms leads to improved training outcomes and better patient care.
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