title: [Transparent operative training in visceral surgery : Analysis at a German university medical center].
abstract: BACKGROUND
  Practical operative training in the discipline of visceral surgery is currently under discussion. Aside from surveys, data on this topic in Germany are sparse. The aim of the study was an objective collation of surgical residents' practical training in the operating room in our department.
  
  
  METHODS
  All surgical cases from 2015 were prospectively included. Procedures were stratified into resident and non-resident operations and complex cases with sub-steps which could potentially be performed by residents. We analyzed whether an operation or surgical sub-steps were performed by a resident. If this was not achieved, the reasons were analyzed. An anonymous online survey was conducted among employees in the surgery department regarding surgical training.
  
  
  RESULTS
  Out of 2896 surgical cases 1141 (39.4 %) were classified as potential resident training operations, which were actually performed by a resident in 743 cases (65.1 %). The survey showed an underestimation of this proportion, where sub-steps were assisted in 30.3 % (n = 265) of 876 potential cases. This proportion significantly increased during the observation period (p < 0.001); however, it was highly overestimated by residents as well as fellows and senior consultants. Often organizational reasons were responsible when resident operations or sub-steps were not performed by a trainee (13.1 % and 30.0 %, respectively).
  
  
  CONCLUSIONS
  The monocentric analysis per se resulted in an improvement in practical surgical training. In the training environment, assisting with sub-steps provides a great potential. Multicenter studies are needed.
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland. werner.kneist@unimedizin-mainz.de.
authors.forename: W
authors.initials: W
authors.lastname: Kneist
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Huber
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Paschold
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Bartsch
authors.affiliation: Zentrum für Qualitätssicherung und -entwicklung (ZQ), Hochschulevaluierungsverbund Süd-West e. V., Johannes Gutenberg-Universität Mainz, Mainz, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Herzer
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Lang
mesh_terms: D000046:Academic Medical Centers; D003479:Curriculum; D013505:Digestive System Surgical Procedures / Q000193:education*; D004503:Education, Medical, Graduate / Q000379:methods*; D005180:Faculty, Medical; D005858:Germany; D006801:Humans; D007396:Internship and Residency; D010823:Physician Assistants; D011446:Prospective Studies; D014781:Viscera / Q000601:surgery*
keywords: Career choice; Human resources management; Postgraduate education; Surgical education; Visceral surgery