Establishing Learning Curves for General Surgery Residents

Project: Research project

Description

We pioneered System for Improving and Measuring Procedural Learning (SIMPL), a mobile device platform that incorporates reliable and valid instruments for rating resident performance on a case-by-case basis. SIMPL is available in 36 general surgery programs through the Procedural Learning and Safety Collaborative (PLSC). However, despite ease of use, data capture is low. Barriers stem from SIMPL’s dependence on user-initiation.4 At our institution, an earlier iteration of SIMPL that was automatically triggered by the electronic health record (EHR) after each operation had a 92% completion rate.5 Therefore, we aim to:

1. Integrate SIMPL into the major EHR systems in use at U.S. teaching hospitals (e.g. Epic, Cerner) and evaluate the change in completion rate at PLSC programs.
Hypothesis 1: SIMPL completion rate will increase after EHR-integration.
2. Implement EHR-integrated SIMPL in 152 Flexibility In duty hour Requirements for Surgical Trainees (FIRST) Trial general surgery residency programs and use the frequent assessment data to estimate individual cumulative sum (CUSUM) learning curves for residents.
Hypothesis 2: CUSUM charts of individual resident performance, generated from frequent assessments, will demonstrate technical progress (or lack thereof) over time.
3. Establish post-graduate year (PGY)-specific benchmarks for technical performance based upon nationally aggregated data.
Hypothesis 3: Individuals with statistically significant variation from PGY-specific national norms will be detectable using CUSUM charts.
StatusActive
Effective start/end date1/1/1912/31/20

Funding

  • Association for Surgical Education Foundation (Grant No. 18-01)

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Learning Curve
Learning
Electronic Health Records
Safety
Benchmarking
Internship and Residency
Teaching Hospitals
Equipment and Supplies