WTP6.12 Registrars Perceptions on Performance and Patient Outcome with regard to Appendicectomies

Aims

Trainees are encouraged to reflect on performance on a personal level as well as formally by work based assessments such as the procedure based assessment. The Joint Committee of Surgical Training state “There is no place for a PBA form to be completed days, weeks or months after the event. It must be immediate”.

Although an operation may have appeared to go well - early or late complication may still occur or unexpected result may be obtained on histology. Therefore it may also be beneficial to reflect after a period of time when final outcomes are known.

We assessed registrars perceptions on performance and outcomes compared to actual figures with regard to appendicectomies performed.

Methods

Data on all appendicectomies over 9 months obtained from electronic patient and theatre records. Questionnaire regarding registrar perceptions on performance, complications and outcomes given to registrars to complete. Quantitative and qualitative analysis through Microsoft excel.

Results

8/9 middle grade registrars participated with the study. Of which 7 were male and 4 trained within the UK holding national training numbers. The majority overestimated number procedures performed whilst underestimating time taken to perform. The majority underestimated post op complications, post op interventions required as well as post op re-attendance/readmission. There was no significant difference between trainees and non trainees with regard to over or underestimating.

Conclusions

Insight into performance and outcomes post appendix surgery is poor amongst registrars. Such insights may be better in other procedures especially elective and cancer surgery. Systems to notify registrars of post op problems may aid reflection and learning.