Resident Impact on Patient & Surgeon Satisfaction and Outcomes: Evidence for Health System Support for Urology Education

• Published in: Urology (Ridgewood, N.J.) Vol. 132; pp. 49 - 55
• Main Authors: Holland, Bradley C., Patel, Neil, Sulaver, Randy, Stevenson, Bradford, Healey, Jessica, Severino, William, Baron, Thomas, Lieber, David, Roszhart, David, McVary, Kevin T., Köhler, Tobias S.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-2019
• Subjects: Humans; Internship and Residency; Job Satisfaction; Patient Satisfaction; Postoperative Complications - epidemiology; Retrospective Studies; Treatment Outcome; Urologic Surgical Procedures; Urology - education
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2019.04.043

To assess the effect of resident involvement on patient and physician satisfaction, we evaluated the outcomes from a private urology group both prior to and after initiation of resident coverage.
Urologic procedures completed by attending surgeons without residents from October 2010 to December 2011 were compared to the same surgeons working with residents from January 2012 to March 2013. Surgical case times, postoperative complications, readmission rate, length of stay, Press-Ganey consumer assessments, resident and physician self-report of training quality and quality of life were collected.
3316 operative and nonoperative cases were measured.Total 1565 were in preresident periods and 1751 were in postresident periods. With resident coverage, there was an increase in OR times. There was no difference in complications for surgical and nonsurgical cases (P = .2269 and P = 1.000, respectively). There was a statistically significant improvement of readmission rate in nonsurgical patients with resident coverage (P = .0344). Patients’ satisfaction scores were higher in every category and they more often reported that they “always” received quality care (78.6 % vs 82.5%) with resident coverage. Resident and faculty perceptions of training, patient care, and satisfaction increased with resident coverage.
Resident coverage of a private practice urology group resulted in no difference in surgical complications and improvement in readmission rates in nonsurgical patients. It resulted in longer OR times but greater satisfaction of faculty, residents and most important, patients. Our data demonstrate the beneficial effect of resident participation in patient care and provides further justification of residency financial support.