The Effect of a Resident Research Year on Operative Skill
Pathik Aravind, MBBS1; Kimberly H Khoo, BSA2; Scott Lifchez, MD1; Damon S. Cooney, MD, PhD1; Carisa M. Cooney, MPH1
1Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 2Johns Hopkins School of Public Health, Johns Hopkins University School of Medicine, Baltimore, MD
Background: Research is considered an important component of residency training in plastic and reconstructive surgery, so much so that some residency programs have integrated a mandatory research year into their training. However, concerns have been raised regarding whether or not a year away from the operating room negatively impacts trainee operative skills. We performed the current study using operative skill evaluation data to determine if skills decay occurs during plastic surgery residents’ research years.
Methods: Operative Entrustability Assessment (OEA) data were abstracted from MileMarkerTM, a web-based program capable of storing trainee self-assessments and their associated attending assessments of any CPT-coded procedure. Ratings are based on a 5-point scale (1=“observed case,” 5=“can take junior resident through case”); a score of 4 (“resident can perform entire surgery”) demonstrates operative competence. Because the research year at our institution occurs between PGY-2 and PGY-3, residents who had OEA evaluations completed by attending surgeons for both PGY-2 and PGY-3 years of training were eligible for inclusion. OEA scores were compared using the Mann-Whitney U test.
Results: Eighteen residents who participated in research years over a 4-year period were eligible for inclusion in the study. Of these, 10 (55%) residents’ research years involved little-to-no operative activity, 3 (17%) included animal microsurgery, and 5 (28%) included gross animal surgery. Comparison of scores for all CPT-coded procedures showed statistically significantly higher scores for PGY-3 compared to PGY-2 (3.34 vs. 2.88, p<0.001). Stratification by research year operative activity demonstrated increases in operative skills by all residents regardless of operative activity. Conclusions: Our study demonstrates that residents who engage in a research year do not appear to experience operative skills decay regardless of their operative exposure during the research year. Additional studies with larger sample sizes are needed to determine if operative involvement during the research year influences skill retention.
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