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Novel Surgery Resident Education Management Platform Improves Case Logging
Vol. 225, No. 4S1, October 2017
Scientific Forum Abstracts
S179
preferred that the “wellness half-days” (quarterly afternoons off work to attend dental/medical appointments, counseling, wellness-related seminars, etc) be mandatory. The main reason for mandatory preference was ease of explaining their absence to surgery attendings. Residents preferring optional participation (16%, n ¼ 4), expressed concerns about missing an interesting afternoon case. All residents (100%) supported ongoing development of the program and a reimbursement fund for pre-approved wellness-related activities. Residents planned to spend their funds on a combination of physical activities, stress reduction education, and outdoor/exercise equipment. A portion of residents experienced complaints from others about their wellness half-day (29.6%, n ¼ 8). CONCLUSIONS: One-hundred percent of residents supported implementation of a wellness program. The majority of residents desired mandatory implementation of certain program aspects in order to address potential barriers to change in surgical culture.
CONCLUSIONS: Our platform improved usability for residents and shortened the case logging lag time, allowing availability of more up-to-date information on resident operative exposure. Future enhancements include integration of easy-to-use operative evaluation tools.
Novel Surgery Resident Education Management Platform Improves Case Logging Ruchi Thanawala, MD, Jonathan L Jesneck, PhD, Gladys L Fernandez, MD, Ross E Willis, PhD, Neal E Seymour, MD, FACS Baystate Medical Center, Springfield, MA
Postoperative Surgical Trainee Opioid Prescribing Practices: An Institutional Study David J Hall III, MD, Kevin R Olsen, MD, Juan C Mira, MD, Patrick W Underwood, MD, Terrie Vasilopoulos, PhD, Ajay B Antony, MD, George A Sarosi, Jr, MD, FACS University of Florida, Gainesville, FL
INTRODUCTION: Accreditation Council for Graduate Medical Education (ACGME) case logs are a vital tool used to track surgery resident operative experience. It is the resident’s responsibility to log cases in a timely fashion. However, residency programs encounter logging delays, with lags ranging from days to months. We describe a technology-based solution for this difficult problem. METHODS: We built a HIPAA-compliant web-based platform for comprehensive management of resident education information including case experience. Weekly case schedules are loaded into the platform, allowing for quick case assignment to specific residents. At the end of each case, the platform presents to each operating resident case information (procedure name, role, CPT suggested by booking and platform intelligence of resident and attending practice patterns). The resident confirms or adjusts suggested operation details as needed. The platform then automatically logs the cases into the ACGME system. We compared logging habits via our platform (Sep 2016-Feb 2017) vs ACGME using the residents’ ACGME logs (Jul 2008-Feb 2017). We investigated the lag times (median: Kruskal-Wallis and mean: independent t-test) between the case date and logging date (Figure). RESULTS: Median lag to case logging improved with use of the platform (median lag 7 10 days ACGME, 2 3 days platform, p < 0.001). The mean lag to case logging improved more dramatically (34 80 days to 18 38 days, p < 0.001).
INTRODUCTION: Rising mortality from opioid overdoses has prompted increased focus on prescribing practices of physicians. Unfortunately, resident physicians rarely receive formal education in effective opioid prescribing practices or pain management. Data to inform surgical training programs regarding the utility and feasibility of formal training are lacking. METHODS: After IRB approval, a single institution’s resident physicians who had completed at least 1 surgical rotation were surveyed to assess knowledge of pain management and evaluate opioid prescribing practices. RESULTS: Fifty-two respondents (67% male, 33% female) completed the survey. Most respondents denied receiving formal instruction in opioid pain medication prescribing practices during either medical school (61.5%) or residency (57.7%); however, 89% of respondents stated they were aware of the side effects of opioid pain medications and 69% felt confident in their knowledge of opioid pharmacokinetics and pharmacodynamics. Of the respondents, 46% either “agreed” or “strongly agreed” that they prescribed more opioid medications than necessary to patients being discharged after a surgical procedure. Over 75% of respondents felt that patients’ comorbidities influenced their prescribing practices. Individual case scenario responses demonstrated variability in number of doses prescribed across different general surgery procedures (p < 0.001, Figure).
Scientific Forum Abstracts
S179
preferred that the “wellness half-days” (quarterly afternoons off work to attend dental/medical appointments, counseling, wellness-related seminars, etc) be mandatory. The main reason for mandatory preference was ease of explaining their absence to surgery attendings. Residents preferring optional participation (16%, n ¼ 4), expressed concerns about missing an interesting afternoon case. All residents (100%) supported ongoing development of the program and a reimbursement fund for pre-approved wellness-related activities. Residents planned to spend their funds on a combination of physical activities, stress reduction education, and outdoor/exercise equipment. A portion of residents experienced complaints from others about their wellness half-day (29.6%, n ¼ 8). CONCLUSIONS: One-hundred percent of residents supported implementation of a wellness program. The majority of residents desired mandatory implementation of certain program aspects in order to address potential barriers to change in surgical culture.
CONCLUSIONS: Our platform improved usability for residents and shortened the case logging lag time, allowing availability of more up-to-date information on resident operative exposure. Future enhancements include integration of easy-to-use operative evaluation tools.
Novel Surgery Resident Education Management Platform Improves Case Logging Ruchi Thanawala, MD, Jonathan L Jesneck, PhD, Gladys L Fernandez, MD, Ross E Willis, PhD, Neal E Seymour, MD, FACS Baystate Medical Center, Springfield, MA
Postoperative Surgical Trainee Opioid Prescribing Practices: An Institutional Study David J Hall III, MD, Kevin R Olsen, MD, Juan C Mira, MD, Patrick W Underwood, MD, Terrie Vasilopoulos, PhD, Ajay B Antony, MD, George A Sarosi, Jr, MD, FACS University of Florida, Gainesville, FL
INTRODUCTION: Accreditation Council for Graduate Medical Education (ACGME) case logs are a vital tool used to track surgery resident operative experience. It is the resident’s responsibility to log cases in a timely fashion. However, residency programs encounter logging delays, with lags ranging from days to months. We describe a technology-based solution for this difficult problem. METHODS: We built a HIPAA-compliant web-based platform for comprehensive management of resident education information including case experience. Weekly case schedules are loaded into the platform, allowing for quick case assignment to specific residents. At the end of each case, the platform presents to each operating resident case information (procedure name, role, CPT suggested by booking and platform intelligence of resident and attending practice patterns). The resident confirms or adjusts suggested operation details as needed. The platform then automatically logs the cases into the ACGME system. We compared logging habits via our platform (Sep 2016-Feb 2017) vs ACGME using the residents’ ACGME logs (Jul 2008-Feb 2017). We investigated the lag times (median: Kruskal-Wallis and mean: independent t-test) between the case date and logging date (Figure). RESULTS: Median lag to case logging improved with use of the platform (median lag 7 10 days ACGME, 2 3 days platform, p < 0.001). The mean lag to case logging improved more dramatically (34 80 days to 18 38 days, p < 0.001).
INTRODUCTION: Rising mortality from opioid overdoses has prompted increased focus on prescribing practices of physicians. Unfortunately, resident physicians rarely receive formal education in effective opioid prescribing practices or pain management. Data to inform surgical training programs regarding the utility and feasibility of formal training are lacking. METHODS: After IRB approval, a single institution’s resident physicians who had completed at least 1 surgical rotation were surveyed to assess knowledge of pain management and evaluate opioid prescribing practices. RESULTS: Fifty-two respondents (67% male, 33% female) completed the survey. Most respondents denied receiving formal instruction in opioid pain medication prescribing practices during either medical school (61.5%) or residency (57.7%); however, 89% of respondents stated they were aware of the side effects of opioid pain medications and 69% felt confident in their knowledge of opioid pharmacokinetics and pharmacodynamics. Of the respondents, 46% either “agreed” or “strongly agreed” that they prescribed more opioid medications than necessary to patients being discharged after a surgical procedure. Over 75% of respondents felt that patients’ comorbidities influenced their prescribing practices. Individual case scenario responses demonstrated variability in number of doses prescribed across different general surgery procedures (p < 0.001, Figure).