在 ACGME 认可的骨科足踝研究员培训期间进行的手术病例量的变化。

Jason Silvestre, Jared J Reid, Daniel J Scott, Amiethab A Aiyer, Christopher E Gross
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引用次数: 0

摘要

导言:以往的研究表明,足踝外科手术的病例量与疗效之间存在正相关。本研究阐明了美国毕业医学教育认证委员会(ACGME)认可的骨科足踝研究员培训的手术病例量基准:ACGME提供了骨科住院医师和足踝研究员(2018-2021年)的病例记录。报告的研究员病例量的差异被定义为第90百分位数和第10百分位数之间的折差。用参数检验比较不同培训组群之间报告的病例量:结果:共纳入了 65 名骨科足踝研究员和 3146 名骨科住院医师的病例日志。研究员报告的足踝病例在研究员培训期间是住院医师培训期间的 1.3 到 1.5 倍(P < .001)。足踝矫形研究员平均报告了 405.4 个病例,其中大部分是关节置换术(17%)、前足重建术(17%)、中/后足重建术(13%)、肌腱修复/转移术(12%)和创伤性踝关节后足(11%)。差异最大的病例类别是截肢(差异14.8倍)、感染/肿瘤(差异11.6倍)、关节镜(差异9.2倍)和小关节(差异8.7倍):讨论:病例量基准可在足踝矫形培训期间为学员和教师提供帮助。需要进行更多研究,以确定足踝外科自主实践所需的病例最低要求:证据等级:三级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Variability in Surgical Case Volume Performed During ACGME-Accredited Orthopaedic Foot and Ankle Fellowship Training.

Introduction: Previous studies have demonstrated a positive correlation between case volume and outcomes in foot and ankle surgery. This study elucidates surgical case volume benchmarks for Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic foot and ankle fellowship training in the United States.

Methods: The ACGME provided case logs for orthopaedic residents and foot and ankle fellows (2018-2021). Variabilities in reported fellowship case volumes were defined as the fold-difference between 90th and 10th percentiles. Reported case volumes were compared between training cohorts with parametric tests.

Results: Case logs from 65 orthopaedic foot and ankle fellows and 3146 orthopaedic residents were included. Fellows reported 1.3- to 1.5-fold more foot and ankle cases during fellowship training than during residency training (P < .001). On average, orthopaedic foot and ankle fellows reported 405.4 cases and most were arthrodesis (17%), forefoot reconstruction (17%), mid/hindfoot reconstruction (13%), tendon repair/transfer (12%), and trauma ankle hindfoot (11%). Case categories with the highest variabilities were amputation (14.8-fold difference), infection/tumor (11.6-fold difference), arthroscopy (9.2-fold difference), and calcaneus (8.7-fold difference).

Discussion: Case volume benchmarks can assist trainees and faculty during orthopaedic foot and ankle training. More research is needed to determine case minimum requirements needed for autonomous practice in foot and ankle surgery.

Level of evidence: Level III.

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