Abstract
Background
As surgical training shifts toward a competency-based paradigm, deliberate practice
for procedures must be a point of focus. The purpose of this study was to assess the
impact of an educational time-out intervention on educational experience and operative
performance in endocrine surgery.
Methods
For 12 months, third-year general surgery residents used the educational time-out
to establish an operative step of focus for thyroidectomy and parathyroidectomy procedures.
Data were collected using the System for Improving and Measuring Procedural Learning
application and post-rotation surveys. The Zwisch scale was used to classify supervision,
with meaningful autonomy defined as passive help or supervision only.
Results
Eight residents and 3 attending surgeons performed the educational time-out for a
total of 211 operations (93% completion rate). At the end of each rotation, there
was improvement in the frequency of goal setting. There was strong agreement (90%)
that the intervention strengthened the educational experience. For most cases (52%),
the residents were rated at active help. Residents performed a median of 3/6 thyroidectomy
steps at meaningful autonomy and a median of 2/5 parathyroidectomy steps at meaningful
autonomy. Review of the qualitative data revealed that optimal feedback was provided
in 46% of cases.
Conclusion
The educational time-out strengthened educational experiences. Stepwise procedural
data revealed the varying levels of supervision that exist within an operation. Broader
implementation of this intervention could facilitate competency-based procedural education.
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Article info
Publication history
Published online: October 07, 2022
Accepted:
July 19,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
