Impact of Surgeon-Specific Data Reporting on Surgical Training

Department of Cardiothoracic Surgery, Southampton General Hospital, Southampton, UK.
Annals of The Royal College of Surgeons of England (Impact Factor: 1.27). 11/2007; 89(8):796-8. DOI: 10.1308/003588407X232080
Source: PubMed


Since April 2002, collection and publication of surgeon-specific data in adult cardiac surgery has become mandatory in the UK. It has been suggested that this may discourage consultants from allowing trainees to perform cases. The aim of this study was to attempt to analyse the effect of the introduction of surgeon-specific data (SSD) on surgical training in a large cardiac surgical centre.
A retrospective analysis was performed on 2111 consecutive patients undergoing elective coronary artery bypass surgery, aortic and mitral valve surgery at Southampton General Hospital between April 2000 and April 2004. Results were analysed and compared over a 2-year period prior to and a 2-year period following the introduction of SSD.
There were no changes in the overall mortality rate following the introduction of SSD. SSD was associated with a reduction in the overall proportion of cases performed by trainees (49% versus 42.8%; P = 0.004) and, in particular, a reduction in the proportion of aortic and mitral valve procedures performed by trainees. In addition, the proportion of cases performed by the trainees without consultant supervision declined significantly following SSD (18.7% versus 10.4%; P < 0.001).
Publication of surgeon-specific data has coincided with a decrease in both the proportion and variety of cases performed by trainees.

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Available from: Srikanth Iyengar, Mar 17, 2014
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    • "If surgeons are guarding their performance outcomes, they may reduce the training opportunities available rather than risk complications being listed under their name. Currently, only one study has explored the UK audit databases from this training perspective, which examined the impact of cardiothoracic surgeon-specific data reporting on surgical training at a single hospital centre [15]. Outcomes for 2111 consecutive patients were examined 2-years prior and 2-years following its introduction, and a significant reduction in the overall proportion of cases performed by trainees was reported. "
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