Abstract
To assess competency of residents prior to graduation, the Accreditation Council for Graduate Medical Education (ACGME) maintains a case log system, where residents self-report cases they perform. This mechanism results in underreporting of resident involvement in patient care. To determine if an intraoperative case log reminder would increase the frequency of ACGME case logging amongst anesthesiology residents. An intraoperative ACGME case log reminder was implemented on March 13, 2019. The authors collected data for all 53 PGY2-4 anesthesiology residents at the authors’ institution from July 14, 2018 to July 16, 2019 from the electronic medical record and ACGME system to calculate the proportion of cases logged and the “lag time” between case occurrence and logging. Data was analyzed for all residents, classes, and individuals. A total of 16,342 anesthetics were performed, and a total of 11,713 cases were logged. The reminder did not improve overall logging rates. Case-logging rates amongst PGY2 residents remained unchanged and declined for PGY3 and PGY4 residents. The lag time between case occurrence and logging increased. An automatic reminder did not improve logging frequency. This may be because residents are unable to log cases intraoperatively in many instances, or they may not feel as though they have participated enough in a case to log it. Additionally, senior residents may log cases less frequently once they have met required case minimums. An automatic case-logging system that transmits resident information directly to the ACGME may be the best way to increase logging accuracy.
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Data obtained during this study is available upon request from corresponding author.
References
Program Requirements for Graduate Medical Education in Anesthesiology http://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/040_Anesthesiology_2019.pdf?ver=2019-06-17-094411-477. Accessed 31 Mar 2020.
Naik ND, Abbott EF, Aho JM, et al. The ACGME Case Log System May Not Accurately Represent Operative Experience Among General Surgery Interns. Journal of surgical education. Nov - Dec 2017;74(6):e106-e110.
McPheeters MJ, Talcott RD, Hubbard ME, Haines SJ, Hunt MA. Assessing the accuracy of neurological surgery resident case logs at a single institution. Surgical neurology international. 2017;8:206.
Okike K, Berger PZ, Schoonover C, RV OT. Do Orthopaedic Resident and Fellow Case Logs Accurately Reflect Surgical Case Volume? Journal of surgical education. Jul - Aug 2018;75(4):1052–1057.
Nygaard RM, Daly SR, Van Camp JM. General Surgery Resident Case Logs: Do They Accurately Reflect Resident Experience? Journal of surgical education. Nov-Dec 2015;72(6):e178-183.
Salazar D, Schiff A, Mitchell E, Hopkinson W. Variability in Accreditation Council for Graduate Medical Education Resident Case Log System practices among orthopaedic surgery residents. The Journal of bone and joint surgery. American volume. Feb 5 2014;96(3):e22.
Bankhead-Kendall B, Brown CV, Gerola R, et al. Case logging habits among general surgery residents are discordant and inconsistent. American journal of surgery. Oct 10 2019.
Cadish LA, Fung V, Lane FL, Campbell EG. Surgical Case Logging Habits and Attitudes: A Multispecialty Survey of Residents. Journal of surgical education. May-Jun 2016;73(3):474-481.
Wolf KR, Taylor ZA, Placek SB, Tsai MW, Franklin BR, Ritter EM. Do Resident Case Logs Meet ACGME Requirements? A Comparison Between Acute Care and Elective Cases. Journal of surgical education. Nov - Dec 2017;74(6):e45-e50.
DesRoches CM, Worzala C, Joshi MS, Kralovec PD, Jha AK. Small, nonteaching, and rural hospitals continue to be slow in adopting electronic health record systems. Health affairs. May 2012;31(5):1092-1099.
Adler-Milstein J, DesRoches CM, Kralovec P, et al. Electronic Health Record Adoption In US Hospitals: Progress Continues, But Challenges Persist. Health affairs. Dec 2015;34(12):2174–2180.
Adler-Milstein J, Holmgren AJ, Kralovec P, Worzala C, Searcy T, Patel V. Electronic health record adoption in US hospitals: the emergence of a digital "advanced use" divide. Journal of the American Medical Informatics Association : JAMIA. Nov 1 2017;24(6):1142-1148.
Bhattacharya P, Van Stavern R, Madhavan R. Automated data mining: an innovative and efficient web-based approach to maintaining resident case logs. Journal of graduate medical education. Dec 2010;2(4):566-570.
Seufert TS, Mitchell PM, Wilcox AR, et al. An automated procedure logging system improves resident documentation compliance. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. Oct 2011;18 Suppl 2:S54-58.
Brown DL. Using an anesthesia information management system to improve case log data entry and resident workflow. Anesthesia and analgesia. Feb 2011;112(2):260-261.
Tom Richter, ACGME Senior Director for Data Systems and Data Analysis, personal communication, December 2018.
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M.D.M is a member of the medical advisory board of Takeda Pharmaceuticals. A.M.P, C.L.G, K.S.R, B.J.G, and J.P.W have no relevant financial or non-financial disclosures.
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Pregnall, A.M., Gruss, C.L., Ramanujan, K.S. et al. ACGME Case Log Reminder Does Not Improve Resident Accuracy in Logging Cases. J Med Syst 46, 1 (2022). https://doi.org/10.1007/s10916-021-01791-y
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DOI: https://doi.org/10.1007/s10916-021-01791-y