C4 - 02: ACGME CASE LOG LINK IMPROVES OPERATIVE ASSESSMENT COMPLIANCE AND TIMELINESS
Damon S Cooney, MD, PhD, Scott D Lifchez, MD, Carisa M Cooney, MPH; Johns Hopkins University School of Medicine

Background: A crucial measure of surgical trainee performance is maturation of operative skill. This is tracked via the Accreditation Council for Graduate Medical Education’s (ACGME) case log. While providing a vital description of resident operative experience, the case log contains no assessments of resident performance. In 2013 we developed and subsequently validated the Operative Entrustiblity Assessment (OEA), a simple web-based evaluation that enables rapid, frequent assessment of resident operative performance. The OEA uses a 5-point scale, is linked to the NAS milestones, and can be used to follow resident performance over time and compare residents to their peers within MileMarkerTM. Residents initiate and pass or email assessments to the attending; evaluations take less than 1 minute to complete. Despite ease of use, obtaining and maintaining user compliance is challenging. To facilitate resident compliance, in April 2017 we incorporated an ACGME case log link into MileMarkerTM. We performed the current study to ascertain the impact of the ACGME case log link on assessment entry and time lapsed from case performance to assessment entry.

Methods: All OEAs completed by a plastic surgery resident at our institution were extracted for the same 3-month time period 12 months apart: May 1-July 31, 2016 (pre-ACGME link implementation) and May 1-July 31, 2017 (post-ACGME link implementation). Average time and the range (min/max) from date case performed to date case entered were calculated.

Results: During the pre-ACGME link time period, 22 (out of 33, 67%) residents completed 316 OEAs. The average time between when the case was performed and when it was entered into MileMarkerTM was 58.6 hours (range: 0-408 hours). During the post-ACGME link time period, 25 (out of 31, 81%) residents completed 776 OEAs. The average time between when the case was performed and when it was entered was 43.5 hours (range: 0-338.5 hours).

Discussion: Timely and frequent evaluation is vital to documenting and improving trainees’ operative skills.  By linking a simple, frequent evaluation to the ACGME case log we doubled resident evaluation entry and reduced entry delay by 26%. This has improved resident feedback and our program’s ability to assess trainee progress in real-time.