Comparing Operative Performance between Independent and Integrated Plastic Surgery Residents
Bibliographic record
Abstract
BACKGROUND: Anecdotally, faculty report that independent residents' operative skills differ from those of their integrated peers. This study compared operative competency between integrated (postgraduate years 4 to 6) and independent plastic surgery residents. METHODS: The authors compared independent (postgraduate years 1 to 3) and integrated (postgraduate years 4 to 6) plastic surgery residents at their institution using operative performance data from the Operative Entrustability Assessment, a validated five-point assessment tool that provides residents with real-time feedback about their operative performance, documenting performance at the point of care. Independent postgraduate year 1, 2, and 3 residents were categorized as postgraduate year 4, 5, and 6 residents, respectively, for comparison. The authors analyzed attending physician (evaluator) Operative Entrustability Assessment scores over time using the independent t test. RESULTS: From July 1, 2013, to June 30, 2018, Operative Entrustability Assessments were completed at one training program for residents in postgraduate years 4 to 6: 1886 (47.4 percent) by independent [n = 12 (37.5 percent)] and 2094 (52.6 percent) by integrated [n = 20 (62.5 percent)] residents. Evaluator scores were lower for independent track residents throughout the first two quarters of postgraduate year 4 (quarter 1 delta, -0.49 point, p < 0.001; quarter 2 delta, -0.36 point, p < 0.001). However, this difference was no longer statistically significant during the third and fourth quarters of postgraduate year 4 (p = 0.192 and p = 0.228, respectively). No difference was detectable at postgraduate year 5 (p = 0.095) or postgraduate year 6 (p = 0.877). CONCLUSIONS: Operative Entrustability Assessment data demonstrate that differences between independent and integrated plastic surgery residents regarding operative skills (0.49 of 5 points) and amount of time needed for independent residents to catch up (6 months) is minimal and resolves during the third quarter of independent postgraduate year 1. Programs can design curricula to facilitate independent residents' plastic surgery skill acquisition during their first two quarters.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".