“Towards the Assessment of Core Procedural Competencies amongst Canadian Plastic Surgery Residents.”

Background: Plastic surgery residency training programs are working towards integrating competency-based education into program curriculum and training, a key component of which involves establishing Core Procedural Competencies. This study aims to determine the exposure of graduating Canadian plastic surgery residents to established Core Procedural Competencies. Methods: A retrospective review of case log procedure data using three databases (T-Res, POWER, New Innovations) from graduating residents at all 10 Canadian English-speaking plastic surgery training programs between 2004-2014 was completed. Case logs were coded according to 177 Core Procedural Competencies identified as 'Core' by the Delphi Method amongst an expert panel of Canadian plastic surgeons. Results: A total of 59,405 procedures were logged by 55 graduating residents across Canada between 2004-2014 (average 1,080 ± 352 procedures per resident). Of thirteen plastic surgery domains, 44% of all procedures were within either Hand, Upper Extremity & Peripheral Nerve (28.3%) or Non-Aesthetic Breast (16.1%). The most frequently performed Core Procedural Competencies (average case logs per resident) included: breast reduction (65.3 ± 33.9), open carpal tunnel release (46.7 ± 34.2), breast reconstruction – implant-based (39.6 ± 20.5), and wound management (35.7 ± 28.6). Sixty-two of 177 procedures were logged on average less than once in 5 years of residency, including: escharotomy, temporal parietal fascia flap, Guyon's canal release and soft tissue fillers. Conclusions: This study identifies areas of exposure and underexposure to plastic surgery Core Procedural Competencies, and can help focus surgical education on areas of greater need for surgical skills training and acquisition. Financial Disclosure Statement:D Courtemanche is a shareholder and board member of Resilience Software. Resilience Software makes and supports T-Res. Presented at: 70th Annual Meeting of the Canadian Society of Plastic Surgeons 2016 in Ottawa, Ontario. Acknowledgements: We would like to thank the Postgraduate Medical Education Office, program directors and database vendors at University of Toronto and Western University for their assistance and support in extracting data from the POWER (©Knowledge4YouCorporation) and New Innovations (©New Innovations, Inc.) databases, respectively. In addition to participating in the research involved in this study, Dr. Courtemanche also generated the anonymous data set for the other 9 Canadian plastic surgery training programs that use T-Res. Corresponding Author: Jessica G. Shih, MD, The Division of Plastic & Reconstructive Surgery, 149 College Street, 5th Floor, Suite 508, Toronto, Ontario M5T 1P5, e-mail address: jessica.shih@utoronto.ca ©2018American Society of Plastic Surgeons