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Resident Surgical Assessment

Lifchez, Scott D., MD, FACS

Plastic and Reconstructive Surgery – Global Open: September 2017 - Volume 5 - Issue 9 - p e1468
doi: 10.1097/GOX.0000000000001468
ACAPS Abstracts
United States

From the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Md.

Presented at the American Council of Academic Plastic Surgeons 4th Annual Winter Retreat, December 9–11, 2016, Chicago, Ill.

Disclosure: Dr. Lifchez is on the board of directors and an equity owner in EduMD, LLC, owner of the Operative Entrusability Asseessment. The Article Processing Charge was paid for by the American Council of Academic Plastic Surgeons.

ACAPS: American Council of Academic Plastic Surgeons (ACAPS) Winter Retreat, in Chicago, Illinois, December 9–11, 2016.

Scott D. Lifchez, MD, FACS, 4940 Eastern Avenue, Room A518, Baltimore, MD 21224, E-mail:

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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The plastic surgery Milestones assessment was introduced as a required program activity in 2014. Due to reports of pilot testers that the assessment took 1 hour per resident, there were concerns that members of the clinical competency committee (CCC) of programs with larger amounts of residents might need to spend large amounts of to assess all of their residents in a fair and objective manner.

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We created a real-time surgical assessment tool to be used after every procedure, the operative entrustability assessment (OEA). The resident identifies the procedure and the attending and self-assesses. The attending then assesses the resident, links the score to the appropriate clinical area of the Milestones, and provides feedback to the resident.

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Two thousand six hundred OEAs were completed over a 2-year period. Pilot data confirmed OEA performance correlated with resident year of training, which was expected. Improved score correlated with decreased operative time for procedures that were performed frequently. Ninety-two percentage of trainees reported at least as much or more feedback provided after surgeries after implementation of the OEA. Data from the OEA allowed the CCC to do Milestones assessments of residents in 11.5 minutes per resident, far faster than the 1 hour per resident reported by the Milestones pilot testers.

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The OEA provides real-time assessment of residents after each surgery and shows validity with correlation to operative time as a proxy of improved surgical performance. Residents also noted more feedback is being provided as a secondary benefit with use of the OEA. Data generated by the OEA allowed the CCC to assess residents more efficiently, a necessity for programs with large numbers of residents. Additional benefits have been the ability of residents to track their performance over time to see progress with scores on the same procedures in subsequent years of training.

Copyright © 2017 The Author. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.