Inclusion of Medical Students in the Operating Room, Are Patients at Risk? A Retrospective Comparison of Short-Term Patient Outcomes Following Total Knee Arthroplasty.

Abstract

Introduction: With the advent of virtual clerkships, the ability of medical students to be involved in direct patient care continues to be scrutinized. One such area that has come under scrutiny is the role medical students should play in the operating room. The major critiques brought up by OR staff and surgeons are potential increases in contamination rates and operative times. In this study, we hope to reveal that medical students do not significantly increase postoperative infections or operative times for total knee arthroplasty (TKA).

Methods: TKA cases were collected from 3 separate surgeons between 2021 and 2022. Operative times for TKA were compared when medical students were present and when students were not. The same was then done to compare the 2 groups for 30-day and 90-day emergency department (ED) visits and readmissions as well as 1-year deep/superficial infection rates.

Results: Five hundred eighty-five cases met inclusion criteria. When averaging the operative times of the 3 surgeons with and without medical students, we found that medical student-assisted cases took 84.6 minutes and without students took 80.1 minutes (p value = 0.0056). Complication rates were higher in the student group (3.73% vs 11.67%, p-value = 0.004). When comparing infection rates, we found that there was a slight reduction in infection rate, 0.37% vs 0.63% with students present (student vs no student; p-value = 1.00).

Discussion: This study appears to reassure hospital systems and operating room staff that medical students do not significantly alter infection rates in TKA. In addition, while they do extend operative times, on average, it was less than 5 minutes per case, which seems to be a reasonable amount of time to sacrifice in light of no increase to aggregate complications within 1 year.