Plastic Surgery Online Tool Could Transform Resident Training

Carisa Cooney knew it was coming: a brand-new accreditation system to evaluate graduate medical education in 26 different medical specialties, including plastic surgery. So she and colleagues developed an online tool to deal with it.

Published in Insight - December 2014 and Insight - September 2016

An assistant professor of plastic surgery, Cooney says plastic surgery residents now have 36 milestones to reach before graduating. Moreover, each milestone contains 10 to 20 separate benchmarks on which resident progress is assessed.

Aware that the milestones were down the road, Cooney and colleagues Rick RedettScott Lifchez and Damon Cooney brainstormed a concept in 2012 to manage residents’ self-assessments and the attending surgeons’ evaluations of resident performance.

Thanks to a grant from the Johns Hopkins University School of Medicine’s Institute for Excellence in Education, they began working on a tool that utilized secure Web portals and hand-held technologies to quickly collect data.

“Ideally,” she says, “residents could simply hand the mobile device to the attending, who could complete the 5-point scale assessment in just a few taps or clicks.”

The idea is simple: Right after completing a surgical procedure, like a nipple reconstruction, residents could complete their own self-assessment and then ask the attending surgeon to evaluate their performance.

This way, the evaluation can be reviewed immediately and discussed with the attending surgeon if there are any questions. It is also an avenue to prompt communication between residents and attending physicians.

“If residents understand what the attending wants or expects, then that will help them get to that level of competency more quickly,” she says. “We’re also trying to use the tool to more objectively rate the experience.”

If the attending is not physically present at that moment, the tool has the capability to email the attending surgeon.

The Johns Hopkins Department of Plastic and Reconstructive Surgery has been using the tool since January 2014. So far, 38 percent of residents have reported an increase in immediate feedback since using the tool. If successful, the format could be implemented nationally by other procedure-based training programs that must start using the new accreditation system.