Safety and feasibility of the teaching assistant role of senior surgical residents: a prospective randomized study

Abstract

Objective: The objective of the study was to assess the teaching assistant role of senior surgical residents.

Design: The study was designed in a prospective randomized fashion. All patients undergoing laparoscopic appendectomy were asked for consent. Consenters were assigned randomly to group A (attending directed) or group B (senior resident directed). In group A, all laparoscopic appendectomies were performed by junior residents (PGY-1, -2, or -3) with the attending faculty as the assistant. In group B, all cases were performed by junior residents (PGY-1, -2, or -3) with the chief resident or PGY-4 acting as a teaching assistant. The allocation sequence was generated before the study by random permutations of 120 assignments, 60 to each arm. The study ended after 60 laparoscopic appendectomies were recorded in each arm.

Setting: The study was conducted at San Joaquin General Hospital. This 200-bed, county teaching hospital has sponsored the general surgery residency program for the past 60 years.

Results: No significant difference in duration of surgery, hospital stay, postoperative complication, or baseline values was found between group A (attending faculty) or group B (senior resident).

Conclusions: Senior surgical residents can act safely as teaching assistants for junior residents. Under faculty supervision, this teaching role can potentially enhance technical skills acquisition for senior residents in training programs without compromising patient safety.