Intraoperative communication of residents with faculty: perception versus reality.

Full Abstract

INTRODUCTION:
During a surgical procedure, an attending may propose a surgical treatment that a resident believes is not the standard of care based on previous readings, discussions with other faculty, or experience. We hypothesized that resident disagreements over intraoperative management are common and are handled differently by residents than faculty members perceive.

METHODS:
Surveys were sent to 68 residents (82% response) and 45 faculty (91% response) in general surgery and seven subspecialties. Questions were asked to determine the frequency of disagreements and the differences in perceptions of how residents should act when they have disagreements over the intraoperative decisions of attendings. Significance was defined using Fisher's exact test at P < 0.05.

RESULTS:
Residents reported having major disagreements with faculty over intraoperative decisions as often as monthly (41%) or two to three times per year (37%). Estimates of the frequency of major resident disagreements did not differ between attendings and residents. Fewer residents felt comfortable asking the faculty to discuss their intraoperative decisions than was perceived by faculty members (41% vs 78%, P < 0.001). Residents at all levels are less comfortable than perceived by their mentors in discussing intraoperative decisions even when residents believe that patient injury may result. Residents felt that most of their disagreements occurred because of attending knowledge deficit, while most attendings attributed these differences to resident knowledge deficits.

CONCLUSION:
Residents frequently have disagreements with faculty over intraoperative management. Education to improve preoperative and intraoperative communication between surgical residents and faculty is needed.

Learn Faster Today Improve your study skills

Author information

Author/s: Coats, Richard D (RD); Burd, Randall S (RS);

Affiliation: Division of Pediatric Surgery, Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903, USA.

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: The Journal of surgical research (J Surg Res), published in United States. (Language: eng)

Reference: 2002-May; vol 104 (issue 1) : pp 40-5

Dates: Created 2002/04/24; Completed 2002/06/11; Revised 2006/11/15;

PMID: 11971676, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

This article has not been indexed for related articles as yet, however you can still use the live related article search links below.

See 100+ related articles.