Resident Perception of Standardization and Credentialing for High Risk
Bedside Procedures in Cardiothoracic Surgery: Results from an
Institutional Pilot Study
Abstract
Objectives: Though guidelines are set by the American Board of Thoracic
Surgery for the operative cases that cardiothoracic surgery residents
must perform to be board-eligible, no such recommendations exist to
assess competency for the wide range of high-risk bedside procedures.
Our department created and implemented a multi-disciplinary developed
course designed to standardize common high-risk bedside procedures and
credential our residents. The aim of this study was to survey the
attitudes of residents to and query the efficacy of such a course.
Methods: The course was designed with the goal of standardizing
endotracheal intubation, arterial line insertion (radial and femoral),
central venous line insertion, pigtail tube thoracostomy and nasogastric
tube placement. The course consisted of an online module followed by a
4-hour hands on simulation session. Knowledge based pre and post
evaluations were administered as well as Likert based survey regarding
multiple aspects of the residents’ perceptions of the course and the
procedures. Results: Twenty-three (7 traditional and 16 integrated)
cardiothoracic surgical residents participated in the course. Residents
reported that 48% of the time, bedside procedures were historically
taught by other trainees rather than faculty. All residents endorsed
increased standardization of all procedures after the course. Likewise,
residents showed increased confidence in all procedures except for
pigtail and thoracentesis as well as nasogastric tube placement. 43.5%
of the participants demonstrated improvement in the pre and post-test
knowledge-based evaluations. ConclusionCardiothoracic residents have
favorable attitudes towards standardization and credentialing for high
risk bedside procedures and utilizing such courses may help standardize
procedural techniques.