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 PS82. Graduating Vascular Surgery Trainees Have Low Self-reported Operative Confidence for Index Procedures

​Cassidy Duran1, Jean Bismuth1, Erica L. Mitchell2
1The Methodist DeBakey Heart & Vascular Center, Houston, TX; 2Oregon Health & Science University, Portland, OR.

OBJECTIVES: We sought to evaluate operative experience (OE) and operative confidence (OC) levels for senior vascular surgery (VS) trainees’ performance of index procedures and attitudes toward simulation.

METHODS: A Web survey querying national OE (reported as range of procedures performed during VS training: 0, 1-5, 6-10, 11-20, 21-50, 51-100), self-reported OC levels (measured by Likert Scale; 0-not confident/needs close supervision, 3-somewhat confident/needs some supervision, 5-confident to perform unsupervised) and perceived need for simulation, was sent to all VS trainees. OE was compared with OC and data reported for senior (≥PGY7) level trainees for open and endovascular procedures.

RESULTS: A total of 183/326 (56%) responses were received; 51 (41%) of 2012 graduates. OC was higher for procedures with higher OE (r=.78) however 35% indicated that they feel unprepared to practice the full spectrum of open VS and many do not feel confident to perform key index procedures independently (Table 1). Eighty-six percent believe simulation training (primarily endovascular simulation and cadaver dissections) is valuable for enhancing their surgical skill.

CONCLUSIONS: While OC levels appear to correlate with OE, many senior residents including those with higher case volumes do not feel confident to perform index cases independently. Simulation could be used to augment training.

AUTHOR DISCLOSURES: J. Bismuth, Nothing to disclose; C. Duran, Nothing to disclose; E. L. Mitchell, Nothing to disclose.

Procedure
OE (Median)
OC (Mean)
% OC=5
CEA
21-50
4.5
54%
CAS
6-10
2.9
6%
Carotid-Scl
1-5
2.9
10%
Open AAA
11-20
3.7
21%
EVAR
21-50
4.3
54%
Open TAA
1-5
1.9
0%
TEVAR
6-10
3.8
35%
Visceral Bypass
1-5
3.0
6%
Visceral stent
6-10
3.7%
25%
AortoFem Bypass
6-10
4.0
31%
Tibial Bypass
11-20
4.1
42%
Tibial PTA/stent
11-20
4.3
52%

 

Posted April 2012

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