Whiteboard Time Out (WBTO) Improves Resident Operative Performance.

Abstract

Objective: The Whiteboard Time Out (WBTO) is a resident-centered operative educational tool designed to improve resident knowledge and attending teaching, ultimately enhancing resident operative performance and autonomy. Prior study has demonstrated that both residents and attending perceive the WBTO as a valuable and effective educational tool. The present study aims to evaluate its impact on resident autonomy. Prior study has demonstrated that both residents and attending perceive the WBTO as a valuable and effective educational tool. The present study aims to evaluate its impact on resident autonomy. We hypothesized that residents were more likely to receive higher performance scores after the implementation of WBTO.

Design: Residents prepared for cases focusing on indications, key steps, and possible complications. This was then outlined on a whiteboard in the operating room and discussed with the attending prior to the case. A picture of the WBTO was uploaded to an online platform. The resident and attending independently completed evaluations of the WBTO and the resident's operative performance. The Firefly Lab, a surgical educational platform, was used to keep track of resident evaluations and map their progression over time.

Setting: WBTO was first implemented in July 2021 by the general surgery residency at Maimonides Medical Center (MMC), a 700-bed university-affiliated, academic, tertiary medical center in Brooklyn, New York.

Participants: General surgery residents at MMC and the department's associated faculty participated in this study.

Results: Residents were 1.5 times more likely to receive the highest rating ("auto") following the implementation of WBTO compared to before its initiation (95% CI: 1.516-1.523, p < 0.001). Residents who had a higher rating on their WBTO correlated to a higher level of operative autonomy.

Conclusion: The implementation of the Whiteboard Time Out (WBTO) demonstrates a significant positive impact on resident operative autonomy. By integrating WBTO into intraoperative education, surgery residency programs may foster more consistent faculty engagement, optimize intraoperative teaching, and accelerate the development of surgical competency.