title: Understanding Why Residents May Inaccurately Log Their Role in Operations: A Look at the 2013 In-Training Examination Survey.
abstract: BACKGROUND
  With increased time and quality pressures, it may be more difficult for residents in cardiothoracic surgery residency programs to get independent operative experience. That may lead residents to inaccurately report their role as "surgeon" to meet American Board of Thoracic Surgery (ABTS) case requirements.
  
  
  METHODS
  The 2013 In-Training Examination surveyed 312 cardiothoracic surgery residents and was used to contrast residents in traditional 2-year and 3-year cardiothoracic surgery residencies (traditional, n = 216) with those in 6-year integrated or 3+4-year programs (integrated, n = 96).
  
  
  RESULTS
  Traditional program residents reported a higher percentage of cases that met the ABTS criteria of surgeon than did integrated program residents (p = 0.05) but were less likely to meet requirements if all cases were logged accurately (p = 0.03). The majority of residents in each program believed that their case log accurately reflected their experience as "surgeon." Residents who tended to log cases incorrectly had lower self-reported 2012 In-Training Examination percentiles, were less likely to meet case requirements if logged properly, and felt less prepared for board examinations and eventual practice compared with residents who logged cases correctly (all p < 0.001). Residents who believed they would not meet case requirements if logged correctly cited limited surgical opportunities, poor case diversity, and a compromised training environment but not the 80-hour work week, excessive simulation, or disproportionate number of complex cases as causes.
  
  
  CONCLUSIONS
  Overall cardiothoracic surgery residents appear to be satisfied with their training. There were specific subsets of trainees in both traditional and Integrated programs that are misrepresenting their role on cases because they otherwise may not meet the requirements.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Robich
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Andrew
authors.initials: A
authors.lastname: Flagg
authors.affiliation: University of Virginia, Charlottesville, Virginia.
authors.forename: Damien J
authors.initials: DJ
authors.lastname: LaPar
authors.affiliation: University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: David D
authors.initials: DD
authors.lastname: Odell
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: William
authors.initials: W
authors.lastname: Stein
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Aftab
authors.affiliation: University of Washington, Seattle, Washington.
authors.forename: Kathleen S
authors.initials: KS
authors.lastname: Berfield
authors.affiliation: University of Texas San Antonio, San Antonio, Texas.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Eilers
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Shawn S
authors.initials: SS
authors.lastname: Groth
authors.affiliation: Pinnacle Health CardioVascular Institute, Wormleysburg, Pennsylvania.
authors.forename: John F
authors.initials: JF
authors.lastname: Lazar
authors.affiliation: Duke University Medical Center, Durham, North Carolina.
authors.forename: Asad A
authors.initials: AA
authors.lastname: Shah
authors.affiliation: Northwestern University, Chicago, Illinois.
authors.forename: Danielle A
authors.initials: DA
authors.lastname: Smith
authors.affiliation: Columbia University, New York, New York.
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Stephens
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Cameron T
authors.initials: CT
authors.lastname: Stock
authors.affiliation: Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Walter F
authors.initials: WF
authors.lastname: DeNino
authors.affiliation: University of Rochester Medical Center, Rochester, New York.
authors.forename: Vakhtang
authors.initials: V
authors.lastname: Tchantchaleishvili
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: soltese@ccf.org.
authors.forename: Edward G
authors.initials: EG
authors.lastname: Soltesz
mesh_terms: D002983:Clinical Competence; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010820:Physicians / Q000592:standards*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013903:Thoracic Surgery / Q000193:education*