Purpose
Core procedural competencies (CPCs) in hand surgery have been previously described.
However, it is unknown whether plastic surgery residents receive sufficient operative
experience with these procedures. This study aimed to determine whether Canadian plastic
surgery residents are receiving adequate exposure to CPCs in hand surgery during residency
training.
Methods
Hand surgery case logs recorded by graduating plastic surgery residents at 10 Canadian
English-speaking training programs between 2004 and 2014 were reviewed from 3 databases.
For each CPC in hand surgery, perceived resident role and self-competence scores were
collected and analyzed. Core procedural competencies encompass core essential procedural
competencies (CEPCs) and nonessential procedural competencies.
Results
There were 55 graduating plastic surgery residents included in the study. A total
of 14,909 procedures were logged for 42 CPCs, with an average of 271 procedures/resident.
When grouped by subdomain within hand surgery, procedures with the most exposure were
related to traumatic finger injuries (29%) and neuropathies (22%). The least common
procedures were related to flap reconstructions (0.3%) and muscle release (0.1%).
Many residents reported receiving no operative experience (range, 2% to 100%) or between
1 and 10 cases of CEPCs (range, 7% to 50%). Most graduating residents (58% to 72%)
did not feel competent independently performing 60% of the most common procedures.
There were weak to moderate correlations between role and self-competence, and between
postgraduate year and self-competence.
Conclusions
Currently, many plastic surgery residents graduate from training programs with little
to no exposure for over half of the CEPCs in hand surgery.
Clinical relevance
Given the great diversity in hand surgery CPCs, it is difficult for residents to gain
adequate operative experience during their residency in all of the CPCs.
Key words
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Article info
Publication history
Published online: July 08, 2020
Accepted:
May 5,
2020
Received:
February 23,
2019
Footnotes
D. J. Courtemanche is a board member, shareholder, and director of Resilience Software, which owns, markets, and supports the app T-Res, which residents used to track activities during training. In addition, he is template administrator for T-Res Plastic Surgery, Canada, a voluntary position. No benefits in any form have been received or will be received by the other authors related directly or indirectly to the subject of this article.
Identification
Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
