Poster5 - 08: PERCEPTIONS OF SUPERVISION BY SENIOR SURGICAL RESIDENTS DURING INVASIVE BEDSIDE PROCEDURES
Elizabeth Dauer, MD1, Daohai Yu, PhD1, Xiaoning Lu, MS1, Lisa Schlitzkus, MD2; 1Lewis Katz School of Medicine at Temple University, 2University of Nebraska Medical Center
Introduction: In teaching hospitals nationwide, invasive bedside procedures are performed commonly by junior surgical residents with senior residents serving in a supervisory role. The perception of the supervision the junior residents receive is unknown. The goal of this study was to assess how junior surgical residents perceive the supervision they receive from senior residents during invasive bedside procedures and to delineate areas of deficiency in supervision that may lead to complications.
Methods: We performed a cross sectional online survey of PGY1-3 general surgery residents from programs throughout the United States. Survey questions focused on demographics, resident experience, supervision, and resident comfort level with the procedures. The procedures of interest were central venous catheters (CVC) and tube thoracostomy (TT).
Results: 120 residents completed the survey. The different post-graduate levels were represented (PGY1 n=35, PGY2 n=34, PGY3 n=51), as well as type of residency program (university n=64, university affiliated n=31, community n=25). The majority of respondents had received simulator training (80.8%) and had a procedural check-off requirement prior to performing procedures on patients (66.6%). Most of the residents were satisfied with the level of supervision they received from their senior residents for all the procedures (87.5% CVC, 85.8% TT) and felt they often or always received the appropriate level of supervision (80.8%). When queried about specific events while being supervised, most recounted that their supervisors failed to review the steps of the procedure prior to the start of the procedure (69.1% CVC, 52.5% TT), failed to have the supervisee verbalize the steps of the procedure prior to starting (71.7% CVC, 54.2% TT) and failed to provide constructive feedback at the completion of the procedure (52.5% CVC, 43.3% TT). Though complications occurred during these procedures (51 CVC, 40 TT), only 8 respondents attributed these complications to the supervision they received.
Conclusions: Residents in their early years of training perceive the supervision they receive from senior residents during invasive bedside procedures as adequate. They recount deficiencies in the quality of supervision the senior residents provide. Despite the general perception of adequate supervision, senior residents should receive further training about appropriate supervision skills.