title: The Impact of a Frailty Education Module on Surgical Resident Estimates of Lobectomy Risk.
abstract: BACKGROUND
  Frailty is a risk factor for adverse events after surgery. Residents' ability to recognize frailty is underdeveloped. We assessed the influence of a frailty education module on surgical residents' estimates of lobectomy risk.
  
  
  METHODS
  Traditional track cardiothoracic surgery residents were randomly allocated to take an online short course on frailty (experimental group) or to receive no training (control group). Residents read a clinical vignette, made an initial risk estimate of major complications for lobectomy, and rated clinical factors on their importance to their estimates. They viewed a video of a standardized patient portraying the patient in the vignette, randomly selected to exhibit either vigorous or frail behavior, and provided a final risk estimate. After rating five vignettes, they completed a test on their frailty knowledge.
  
  
  RESULTS
  Forty-one residents participated (20 in the experimental group). Initial risk estimates were similar between the groups. The experimental group rated clinical factors as "very important" in their initial risk estimates more often than did the control group (47.6% versus 38.5%; p < 0.001). Viewing videos resulted in a significant change from initial to final risk estimates (frail 50% ± 75% increase, p = 0.008; vigorous 14% ± 32% decrease, p = 0.043). The magnitude of change in risk estimates was greater for the experimental group (10.0 ± 8.1 versus 5.1 ± 7.7; p < 0.001). The experimental group answered more frailty test questions correctly (93.7% versus 75.2%; p < 0.001).
  
  
  CONCLUSIONS
  A frailty education module improved resident knowledge of frailty and influenced surgical risk estimates. Training in frailty may help educate residents in frailty recognition and surgical risk assessment.
authors.affiliation: Department of Surgery, University of Chicago Medicine, Chicago, Illinois; Cancer Research Center, University of Chicago Medicine, Chicago, Illinois. Electronic address: mferguso@surgery.bsd.uchicago.edu.
authors.forename: Mark K
authors.initials: MK
authors.lastname: Ferguson
authors.affiliation: Department of Medicine, University of Chicago Medicine, Chicago, Illinois.
authors.forename: Katherine
authors.initials: K
authors.lastname: Thompson
authors.affiliation: Department of Medicine, University of Chicago Medicine, Chicago, Illinois.
authors.forename: Megan
authors.initials: M
authors.lastname: Huisingh-Scheetz
authors.affiliation: Department of Medicine, University of Chicago Medicine, Chicago, Illinois.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Farnan
authors.affiliation: Department of Medicine, University of Chicago Medicine, Chicago, Illinois.
authors.forename: Joshua
authors.initials: J
authors.lastname: Hemmerich
authors.affiliation: Center for Research Informatics, University of Chicago Medicine, Chicago, Illinois.
authors.forename: Julissa
authors.initials: J
authors.lastname: Acevedo
authors.affiliation: Department of Anesthesia and Critical Care, University of Chicago Medicine, Chicago, Illinois; Center for Simulation, University of Chicago Medicine, Chicago, Illinois.
authors.forename: Stephen
authors.initials: S
authors.lastname: Small
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D016330:Frail Elderly; D006801:Humans; D007396:Internship and Residency; D008297:Male; D011013:Pneumonectomy; D018570:Risk Assessment; D013903:Thoracic Surgery / Q000193:education*