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Feedback
Some studies have shown that feedback may improve the quality of care delivered
and improve operative skill in surgical residents. Particularly today when trainees
are spending less time in the operating room than in previous generations of resi-
dents, feedback is important. In a systematic review, Trehan et al. (2015) found that
formal feedback was a powerful method to improve performance by reducing total
procedure time and improve economy of movement, as well as several improve-
ments in laparoscopic simulator parameters. Feedback may come in a variety of
forms including oral or written feedback, self-assessment, video footage review,
reviewing outcomes of treatments or surgical procedures, or comparing assessment
to peers in the same training program [ 20 ]. In the current age of mobile device use,
mobile devices may be important in feedback dissemination though there is limited
literature regarding this topic.
Journal Club
Evidence-based theory is at the core of quality improvement and patient safety,
and intermittent journal clubs (often resident led) are thought to be an effective
way to evaluate current literature and to decide whether or not data should be used
to impact patient care. Many surgical residencies utilize journal clubs as a
component of QI/PS [ 21 ]. Generally, a journal article is identified, disseminated
for a group to read, presented with an independent interpretation of the methods,
results, and conclusions, and finally discussed in a group setting. Although journal
clubs have been in existence for many years, formats vary widely even within the
same institution, ranging from formal education conferences to informal
gatherings. There is no data supporting one type of journal club format over
another; however, Al Achkar et al. (2016) offered suggestions for optimizing
journal club, including following the same systematic approach for every resident
presentation and involvement of a faculty mentor in article selection, as well as
article discussion [ 22 ].
Promoting Teamwork in Medicine
The scope of medicine has expanded drastically over the last several decades,
demanding division of medicine into various specialties that must work together to
care for patients. Teamwork and shared expertise lead to better outcomes for patients
[ 23 ]. Resident participation in interdisciplinary conferences, such as tumor boards,
can be beneficial [ 24 ]. In addition, resident participation in management huddles
with nursing, pharmacists, therapists, and other members of the patient care team
helps to ensure the best possible care [ 11 ].
E.L. Ferguson and C.P. Sundaram