As the training programs associated with Dell Medical School expand, some health care professionals who have not previously been involved in training medical students, residents and fellows have asked about how to incorporate trainees effectively and efficiently into their clinical workflow.
General Surgery Residency Program Director John M. Uecker, MD, FACS, co-authored the following post with insight on the process. Both Dr. Uecker and Dr. Wolf practice at University Medical Center Brackenridge.
Through a variety of methods, Dell Medical School is striving to ensure that clinical educators cultivate skills needed to incorporate trainees into clinical work in a manner that benefits the trainer, the trainee and, most importantly, the patient. The good news is that integrating trainees appears to improve clinical care, so providers and patients alike can be reassured that the process is worthwhile. Let’s go through several of the most frequently asked questions.
How do trainees impact the performance of surgery?
Integrating assistants with advanced skills (such as fellows or residents) likely enhances the quality of surgery because the physicians and surgeons providing training must be in top form. We both recall examples of a resident or fellow improving a surgical procedure, such as simply preparing the operative field in a way that facilitated a smooth operation or thoughtfully asking profound questions that caused us to re-evaluate and improve our practices. Additionally, the participation of trainees prompts improved communication, greater focus on evidence-based decision-making and real-time feedback, all of which enhance care. Published evidence from our own Surgery Residency Program suggests that adding trainees does not extend operation times and may improve the efficiency of post-operative care.1
How can trainees contribute to the team?
Well-performed operations rely on a team. Along with the primary surgeon, students, technicians, physician assistants, nurses, residents, fellows and other attending physicians each fulfill important aspects of care. These include many hands-on activities that are critical in helping the primary surgeon perform the operation – and might even include participating directly in the surgery. The attending surgeon is directing the entire procedure, even when someone else’s hands are doing certain steps in the operation— similar to what occurs when a surgical technician assists a surgeon during a procedure.
Will patients know about trainee participation in their surgery(s)?
Patients are notified during the informed consent process that trainees will participate by assisting or performing portions of the surgery. There is a pre-printed notation to this effect on the Seton Healthcare Family consent forms.
What impact do trainees have on health in Central Texas?
The creation of Dell Medical School has already sparked a boom in the number of medical residents providing care in Travis County, expanding the pipeline of physicians who will serve generations of Central Texans. Health care in our community, and surgical care in particular, will continue to improve with the expansion of Dell Medical School training programs.
Learn more about Dell Med’s Surgery Residency Program and resident opportunities to Lead Care Transformation through Innovation, Leadership & Discovery.
1 – Uecker, J., Luftman, K., Ali, S., Brown, C.: Comparable operative times with and without surgery resident participation. Journal of Surgical Education, 70:696-699, 2013.