Objective scoring of an electronic surgical logbook: Analysis of impact and observations within a surgical training body.

BACKGROUND

Historically, evaluating operative-volumes has proven difficult due to mass-variability in operative-complexities and participation. This study aimed to introduce a national scoring interface for residents' operative-logs while forming meaningful observations on specialities, training-institutes and technical competency.

METHODS

A weighted-scoring algorithm was applied prospectively to residents' operative volumes since July 8th 2013 with daily web-based quantitative feedback. Pre and post intervention analyses were performed with historical volumes. Operative volumes were correlated with work-based and university technical-skills' assessments.

RESULTS

Ninety-five residents completed two-year preliminary training since 2013 recording 79,490 operations. These residents recorded significant (p < 0.050) increases in mean-score (case-load), total, performed and assisted operations of >16,528 (50%), 234 (45%), 115 (66%) and 113 (33%) respectively. The number of resident-performed operations was a significant predictor of performance in work-based and university technical-skills assessments (p < 0.050). There were no associations between these measures and the volume of assisted-operations.

CONCLUSIONS

Open-benchmarking of surgical-volumes stimulates residents to actively pursue operative-opportunities and record those experiences. It provides objective performance data on residents and training-institutes while providing evidence that level of operative participation is significant in technical skills development.