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Developing Four Year Surgical Skill Learning Curves: Modeling a Process in OB/GYN Residency Using myTIPreport

Purpose: To develop a process for procedural learning curve construction in a national cohort of OB/GYN residents from PGY1 through PGY4

Background: Descriptions of resident surgical proficiency have been limited by subjective experience and surrogates such as operative time or numbers of completed cases. Objective data describing number of procedures required to achieve proficiency for OB/GYN procedures are limited.

Methods: This descriptive study was a secondary analysis of the myTIPreport database from July, 2015 – June, 2019 for the graduating PGY-class of 2019. Feedback included in this database was characterized by residents receiving procedure-specific surgical proficiency scores, rated 1-5. Surgical proficiency was defined as Level 4 (“Supervision Only”). Using database time stamps, chronologic case numbers were generated. Fitted Linear Modeling generated an approximate number of cases to achieve proficiency. To reduce type I error, specific procedures were examined only when 100 or more feedback encounters were reported. Procedures were subsequently excluded when the model-predicted number of cases needed to achieve proficiency was not achieved or when a negative modeling slope was noted.

Results: Of the 3599 feedback encounters reported, 5 procedures met inclusion criteria. Using the above modeling for these 5 procedures, the number of cases needed to achieve proficiency, a Level 4 rating, was: D&C -9, operative hysteroscopy-11, diagnostic laparoscopy-9, laparoscopic BSO-11, and SVD-11.

Discussions: These data demonstrate a process using myTIPreport to begin the innovative work of procedural learning curve construction. Such a process could ultimately be used to build program-specific learning curves and potentially help identify at-risk learners.

Topics: CREOG & APGO Annual Meeting, 2020, Resident, Faculty, Residency Director, Patient Care, Systems-Based Practice & Improvement, Interpersonal & Communication Skills, GME, Assessment,

General Information

Resident,Faculty,Residency Director,
Patient Care,Systems-Based Practice & Improvement,Interpersonal & Communication Skills,
Clinical Focus

Author Information

Kevin Schuler, MD; TriHealth; Ganga Devaiah, MS; Lee Learman, MD, PhD; AnnaMarie Connolly, MD

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