ArticleAnnals of surgery2019
Changing Autonomy in Operative Experience Through UK General Surgery Training: A National Cohort Study.
Article in Annals of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Preoperative educational briefings: systematic review and novel evidence-based framework.The British journal of surgery · 2025Pooled it
- Association between surgeon experience, level of supervision, and outcomes after hip fracture.Bone & joint open · 2026Article
- Changes in operative and in-hospital outcome of proximal femoral fractures before and after the implementation of work hour restrictions in Switzerland.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Trainee involvement in laparoscopic pyloromyotomy does not compromise outcomes: evidence from a longitudinal institutional experience.Pediatric surgery international · 2026Article
- Surgical residents' career interests in transplantation surgery in Germany - a nationwide survey.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Operative Outcomes and Training Equity in Appendicectomy: Are Core Surgical Trainees Getting a Fair Chance?Cureus · 2025Article
- Trainee as trainer in paediatric laparoscopic appendicectomy.Annals of the Royal College of Surgeons of England · 2025Article
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- Consultant versus trainee led surgery and impact on outcome following an emergency colonic resection.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Article
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- Supporting laparoscopic general surgery training with digital technology: The United Kingdom and Ireland paradigm.BMC surgery · 2021Review
- Assessment of Autonomy in Operative Procedures Among Female and Male New Zealand General Surgery Trainees.JAMA surgery · 2020Article
- The reality of general surgery training and increased complexity of abdominal wall hernia surgery.Hernia : the journal of hernias and abdominal wall surgery · 2019Review
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Abstract
objectivesTo determine the operative experience of UK general surgery trainees and assess the changing procedural supervision and acquisition of competency assessments through the course of training.
backgroundCompetency assessment is changing with concepts of trainee autonomy decisions (termed entrustment decisions) being introduced to surgical training.
methodsData from the Intercollegiate Surgical Curriculum Programme and the eLogbook databases for all UK General Surgery trainees registered from August 1, 2007 who had completed training were used. Total and index procedures (IP) were counted and variation by year of training assessed. Recorded supervision codes and competency assessment outcomes for IPs were assessed by year of training.
resultsWe identified 311 trainees with complete data. Appendicectomy was the most frequently undertaken IP during first year of training [mean procedures (mp) = 26] and emergency laparotomy during final year of training (mp = 27). The proportion of all IPs recorded as unsupervised increased through training (P < 0.05) and varied between IPs with 91.2% of appendicectomies (mp = 20), 40.6% of emergency laparotomies (mp = 27), and 17.4% of segmental colectomies (mp = 15) recorded as unsupervised during the final year of training. Acquisition of competency assessments increased through training and varied by IP.
conclusionsThe changing autonomy of trainees through the course of an entire training scheme, alongside formal competency assessments, may provide evidence of changing entrustment decisions made by trainers for different key procedures. Other countries utilizing electronic logbooks could adopt similar techniques to further understanding of competency attainment amongst their surgical trainees.
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