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Anesthesia Residents Preferentially Request Operating Room Case Assignments with Complex Cases

  • Education & Training
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Abstract

Self-directed learning is associated with knowledge and performance improvements, increased identification and amelioration of knowledge gaps, and heightened critical appraisal of available evidence. We developed and implemented a decision support system that could support self-directed learning for anesthesia residents by soliciting resident input in case selection. We hypothesized that residents would utilize this system to request complex cases, and that more advanced residents would request more complex cases. Prospective, observational study involving 101 anesthesiology residents. We used a web-based interface, RHINOS [Residents Helping in Navigating Operating Room (OR) Scheduling], which allowed residents to share their rank-ordered preferences for OR assignment. Number of cases per OR, anesthesia base units, time units, and proportion of inpatient cases were used as proxies for case complexity. Data were analyzed using a mixed linear model. Residents requested rooms with fewer cases [F(3,22,350) = 194.0; p < 0.001], more base units [F(3,19,158) = 291.4; p < 0.001], more time units [F(3,19,744) = 186.4; p < 0.001], and a greater proportion of cases requiring inpatient preoperative evaluation [F(3,51,929) = 11.3; p < 0.001]. In most cases, these differences were greater for more advanced residents. As hypothesized, residents requested ORs with higher case complexity, and these cases more often required inpatient preoperative evaluation. More advanced residents exhibited a stronger preference for more educational cases than junior residents.

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Authors and Affiliations

  1. Department of Anesthesiology, University of Wisconsin-Madison, Madison, WI, USA

    Peggy Y. Kim

  2. Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA

    Jonathan P. Wanderer

  3. Department of Anesthesiology, Vanderbilt University Medical Center, 1301 Medical Center Drive, TVC 4648, Nashville, TN, 37204, USA

    Jonathan P. Wanderer

  4. Department of Psychology, DePaul University, Chicago, IL, USA

    David W. Allbritton

  5. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA

    Matthias Eikermann & Keith Baker

Authors
  1. Peggy Y. Kim
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  2. Jonathan P. Wanderer
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  3. David W. Allbritton
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  4. Matthias Eikermann
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  5. Keith Baker
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Corresponding author

Correspondence to Jonathan P. Wanderer.

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Funding

This work was supported by the Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA. Dr. Wanderer is funded by the Foundation for Anesthesia Education and Research (FAER) and the Anesthesia Quality Institute (AQI)‘s Mentored Research Training Grant-Health Services Research (MTRG-HSR).

Conflicts of Interest

None of the authors have any conflicts of interest with this submission within the past 36 months.

Additional information

This article is part of the Topical Collection on Education & Training

IRB Statement : The study protocol was reviewed and approved by the Partners Human Research Committee (HRC), Protocol #: 2012-P-000892/1.

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Kim, P.Y., Wanderer, J.P., Allbritton, D.W. et al. Anesthesia Residents Preferentially Request Operating Room Case Assignments with Complex Cases. J Med Syst 41, 64 (2017). https://doi.org/10.1007/s10916-017-0718-3

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  • DOI: https://doi.org/10.1007/s10916-017-0718-3

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