Promoting Resident Education Priorities With an Acute Care Surgery Service Dashboard

Karen Trang; Logan Pierce; Elizabeth C Wick; Lan Vu; Rochelle Dicker; Marissa A Boeck; Kent Garber; Kenzo Hirose

doi:10.1016/j.jsurg.2024.103342

Promoting Resident Education Priorities With an Acute Care Surgery Service Dashboard

J Surg Educ. 2024 Dec 6;82(2):103342. doi: 10.1016/j.jsurg.2024.103342. Online ahead of print.

Authors

Karen Trang¹, Logan Pierce², Elizabeth C Wick¹, Lan Vu¹, Rochelle Dicker¹, Marissa A Boeck¹, Kent Garber¹, Kenzo Hirose³

Affiliations

¹ Department of Surgery, University of California San Francisco, San Francisco, California.
² Division of Hospital Medicine, University of California San Francisco, San Francisco, California.
³ Department of Surgery, University of California San Francisco, San Francisco, California. Electronic address: Kenzo.Hirose@ucsf.edu.

PMID: 39644700
DOI: 10.1016/j.jsurg.2024.103342

Abstract

Objective: To advance surgical education priorities by using electronic health record (EHR) reporting and data visualization on an Acute Care Surgery (ACS).

Design: Operational data from the EHR for the ACS service was displayed on an ACS dashboard using Tableau software. This data included new ACS consults (reason for consult, consult note author - attending surgeon and resident) and operations generated by those consults (type of operation, primary attending surgeon, and assisting resident). All surgeons on the service were included on the dashboard. In collaboration with service and educational leaders, the dashboard was used to address two deficiencies. First, to reduce the administrative burden for residents on ACS service, the new dashboard replaced manually generated weekly consult and operative case lists. Second, as a part of a pilot program to enable faculty assessment of residents' Entrustable Professional Activities (EPAs) regarding pre-operative evaluation of acute surgical conditions, all faculty on the ACS service had access to the dashboard and received weekly reminders at the end of their service week. To assess the impact of the dashboard on these two education outcomes, resident surveys were used to determine average time spent on weekly consult and operative lists, and the number of EPA assessments completed were compared before, during, and after the pilot program.

Setting: Academic quaternary care hospital with a general surgery residency program comprising 50 clinically active residents.

Participants: Residents and faculty who rotated on the ACS service during the study period.

Results: The dashboard was made available to all faculty on the ACS service and automatically emailed on Saturdays. The dashboard reduced weekly resident administrative work by an average of 60 (range 30-360) minutes per week by obviating the need for manual list creation. Completed perioperative/nonoperative EPA assessments increased from zero to 5.3/month during the pilot period and continued at 2.3/month in the 3 months after the pilot ended.

Conclusion: The ACS dashboard reduced resident workload and enhanced EPA assessment. More opportunities to align resident education with EHR operational tools are likely if surgical education specialists collaborate with healthcare system and/or informatics leadership. When possible, advances in healthcare system technology should also be designed to promote training and education.

Keywords: Acute care surgery; Clinical informatics; Entrustable professional activities; Resident evaluation; Surgical education.