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ID: 734 (Conflict of Interest: K)

Zufriedenheit chirurgischer Assistenzärzte mit der OP Planung – Eine Bestandsaufnahme

J.Doerner1, C.Schneider2, M.Strik2, M.Stumpf3, Y.Dittmar4, J. K.Seifert5, H. Zirngibl6, J.-P.Ritz7, F.Koch7
1HELIOS Universitätsklinikum Wuppertal, Wuppertal
2HELIOS Klinikum Berlin-Buch, Berlin
3HELIOS Klinikum Pforzheim, Pforzheim
4HELIOS Klinikum Meiningen, Meiningen
5HELIOS Klinikum Siegburg, Siegburg
6HELIOS Klinikum Wuppertal, Wuppertal
7HELIOS Kliniken Schwerin, Schwerin

Einleitung

Performing surgical procedures under structured supervision is a critical component of surgical training. However, surgeons in training frequently may not perform procedures due to economical (time) and qualification requirements. Moreover, increasing use of laparoscopic surgery further impairs timely access to surgical training. Decision-making regarding assignation of procedures to individuals and teams has a significant impact not only on acquisition of skills, but also on overall motivation. The satisfaction of surgical residents in Germany has not been interrogated systematically as yet.  

Material und Methoden

We performed a prospective study by modifying the usual process of assignment by senior peers, to the proactive involvement of surgical residents in day-to-day procedural planning of elective surgical cases.  During the intervention period, planning was performed jointly by a resident physician and the senior peer in charge of the assignments. Satisfaction was determined using a 30-item anonymized online questionnaire. The survey included mostly quantitative questions across different areas related to satisfaction with OR planning. 41 individuals spanning all levels of training from 6 participating centers were eligible to participate. Participating centers included two primary care hospitals, one specialized care center, two tertiary care and one university hospital. The questionnaire was sent to the participants at baseline and in a slightly modified version after three months, after completion of the interventional period. Here we report the baseline results.

Ergebnisse

There was a 73% response rate. All senior physicians responsible for OR planning were male. Sex distribution among participants was equal (48% male, 52% female). Only one third (31%) of participants was fairly or totally satisfied with their surgical training in general, 42% were satisfied with guidance during the surgical procedures. 62% of participants had performed their first training appendectomy and open hernia repair during the first year of training, 65% of participants had performed supervised cholecystectomy after their second year of training. Chief and senior surgeons only infrequently (38% and 55% respectively: never or rarely) let trainees perform easier sub-steps (like open cholecystectomy) during more extended and complex procedures. 79% of participants reported that they had rarely or never been assigned to perform procedures they felt inadequately prepared for. Overall satisfaction was associated with perceived systematic training surgery planning, equal distribution of training procedures among all residents of a unit and sub-step assistance.

Schlussfolgerung

Surgical residents feel well prepared for procedures they are entrusted to perform. Systematic planning, equal distribution of teaching procedures amongst residents and assistance of sub-steps may result in improved overall satisfaction of surgical residents. Shortly, we hope to report on the effect of the intervention regarding resident satisfaction and hope to see an improvement owed to more active involvement in the decision of distribution of surgeries in a unit.