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Surgical Case Preparation Among Hand and Upper Extremity Fellows
Anjum Shaikh, BA
1, Philip E. Blazar, MD
2, Dafang Zhang, MD
2, Brandon Earp, MD
2; Leah Demetri, MD
2(1)University of Connecticut School of Medicine, Farmington, CT, (2)Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA
IntroductionWe sought to evaluate how current hand surgery fellows prepare for surgical cases and analyze resource utilization trends among this cohort.
Materials and MethodsA 13-question survey was designed. Fellows were asked which resources they use to prepare for elective and emergent cases and to compare these resources to what they used as a junior resident. They were also asked to expound on reasons why they may not prepare, self-report on case preparation efficiency and efficacy, and select which additional resources would be most beneficial.
The survey link was distributed to program directors of all ACGME-accredited hand surgery fellowships in the United States. Program directors could then forward the link to their fellows. Survey responses were collected anonymously through REDCap and analyzed.
Results52 respondents completed the survey. Fellows from Northeast programs represented the largest cohort (42%). Online videos (e.g. VuMedi, AAOS, YouTube) were the most popular choice for preparing for an elective case (60%), followed by hand surgery online resources (e.g., Handthology, Hand.e) (56%) and textbooks (48%). When preparing for emergent cases, most fellows preferred to discuss the case with the attending (62%), followed by watching online videos (56%) and reading personal notes or old operative notes from faculty (46%).
58% of respondents increased their use of personal notes and journal articles over the course of postgraduate training. Conversely, 56% decreased their use of general orthopedic education websites like Orthobullets (67%) and surgical atlases (e.g. Netter's Concise Orthopaedic Anatomy).
Most participants rated their preparation as effective or very effective (94%), while only 62% felt it was efficient or very efficient. The median time spent preparing for cases was 5-6 hours per week. 98% of respondents reported that convenience was an important factor in deciding which resources to use. 62% of respondents felt that there is an overwhelming number of existing options, and 48% reported lack of time as a limitation to their preparation. The most common reason why fellows did not prepare for a case was if they had already done the case before (81%). Lastly, 73% of fellows reported that a specialty-specific library of surgical technique videos would improve their learning.
ConclusionsAmong a wide array of learning tools, online videos are increasingly used in surgical case preparation by hand surgery fellows. This information highlights the need for a centralized, specialty-specific online resource of surgical technique videos for hand surgery case preparation.
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