Abstract
Increased patient exposure has been shown to improve residency training as determined
by better patient outcomes. The transition of John Peter Smith Hospital from a level
II to a level I trauma center in 2009 provided a unique opportunity to investigate
the direct effects of increased patient exposure on residency training in a relatively
controlled setting. We evaluated the effect of the transition to a level I trauma
center on residency training. In 2014, we examined the annual facility reports and
separated the data into 2 groups: level II (2001 to 2008) and level I (2010 to 2013).
The primary outcome measures were patient volume, surgical volume, patient acuity,
and scholarly activity by the residents. The patient volume in all units increased
significantly (p < .05 for all) after the transition to a level I center. The surgical volume increased
significantly for the general surgery, orthopedics, and podiatry departments (p < .05 for all) but remained unchanged in the gynecology and oral maxillofacial surgery
departments. The volume measures were performed on all 98 residents (100%). Patient
acuity and scholarly activity increased by 17% and 52%, respectively; however, the
differences in these data were not statistically significant. The scholarly activity
per resident was measured for the orthopedic and podiatry departments. For those departments,
the total number of residents was 30, and scholarly activity was measured for 100%
of them. Overall, resident education improved when the hospital transitioned to a
level I trauma center, although certain subspecialties benefited more than did others
from this transition.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: September 06, 2017
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Previously presented as a poster at the John Peter Smith Hospital Research Day, 2014.
Identification
Copyright
© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
