Operative Objectives-A Pilot Study

INTRODUCTION: Surgical graduate medical education requires residents to learn a wide array of skills and apply them practically in a progressively independent manner, ultimately allowing them to practice independently. We devised "Operative-Objectives" as a tool to define the learning goals for each resident at a particular epoch of their training. This approach is operationalized, measurable, and consistently carried over time. METHODS: The Residents at a neurosurgical training program set their "Operative-Objectives" at the beginning of each 3-month rotation. These goals were then reviewed by the Program Director (PD) and faculty and appropriately tailored and finalized--forming a compact between residents and faculty whereby their commitment to the learning and teaching objectives are defined. The outcomes are reviewed with the PD following each rotation and scored. Residents and faculty were provided a pre-and post-implementation survey that sought to understand the impact of implementing "Operative-Objectives" on resident preparedness, objectives for improvement, resident satisfaction with, and objective improvement in resident's surgical skills. RESULTS: A total of eight residents and five faculty completed both a pre-and post-implementation survey. Residents reported significantly increased case preparedness (p = .048), ability to track improvement (p = .044), clear objectives for improvement (p = .021), and satisfaction with improvement in surgical skill (p = .044). The faculty reported a significant increase in resident preparedness for surgery (p = .049), ability to track improvement (p=.044), focus for improvement (p=.033), and goals for improvement (p = .033). CONCLUSIONS: "Operative Objectives" provide a focused delineation and tracking of a resident's surgical learning at the intersection of three vectors: level of training, location, and ability. The deliverables are measurable. They can be followed over time and allow for an organized and focused framework for improvement and feedback. As such, they can significantly improve the learning skills of the residents as well as the teaching abilities of the faculty.