Does cross-sectional imaging diminish the utility of surgical handover for trainee assessment?

Introduction: Workplace-based assessments have been widely adopted by surgical training bodies to assess surgical trainees. In this study, we used a handover tool to assess the diagnostic accuracy of admitting surgical trainees, and whether this was impacted by cross-sectional imaging.

Methods: Data was retrospectively reviewed from a prospectively maintained database. Details of 979 patients over a 7-month period were reviewed. The primary outcome was concordance between the admitting and discharge diagnoses, as recorded using the surgical handover tool.

Results: The concordance between the admitting and discharge diagnoses was 81.4 %. A positive association was found between diagnostic accuracy and pre-referral cross-sectional imaging (r = 0.67). Obtaining a CT scan before handover was significantly associated with higher diagnostic accuracy (p < 0.0001).

Conclusion: Cross-sectional imaging positively affects the diagnostic accuracy of surgical trainees. Given the availability of cross-sectional imaging, this calls into question whether surgical handovers can be used to assess surgical trainees in the workplace.