Whose operation is it anyway? Consensus for surgical supervision code use
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Authors
Cohen, H.
Simson, R.
Bamford, R.
Issue Date
2025-02-27
Type
Article
Language
en
Keywords
Alternative Title
Abstract
INTRODUCTION
Operative numbers are critical for training programme applications, the annual review of competence progression and the Certificate of Completion of Training. This study sought to determine whether there is a consensus among surgeons for supervision codes being applied to general surgical operations.
METHODS
A survey including ten vignettes (representing common surgical procedures) was distributed to doctors who use the surgical e-logbook. Participants were asked to indicate for each vignette whether they would code the operation as ‘assisted’ (A) or ‘supervised with trainer scrubbed’ (STS).
RESULTS
A total of 261 responses were received from doctors across all grades. For an appendicectomy vignette describing involvement at each key step but no dissection, 58% of respondents coded it as A and 42% as STS. For a laparoscopic cholecystectomy vignette that described dissecting the gallbladder off the liver and closing the ports, 61% coded it as A and 39% as STS. Consultants were more likely to record a vignette as STS (59% vs 49%, p<0.001), as were male surgeons (53% vs 47%, p=0.004). Only 20% of respondents agreed with the statement “I find it easy to understand what supervision code I should record in my logbook”.
CONCLUSIONS
This study reveals that there is little consensus on supervision codes for general surgical operations and considerable ambiguity in the system. The description of the codes on the e-logbook is not fit for purpose and guidance from the Intercollegiate Surgical Curriculum Programme is minimal. Clearer guidelines are required to enable surgeons in training to apply coding consistently to ensure validity in the use of indicative numbers for applications and as a marker of progress in training.
Description
CC BY 4.0 - https://creativecommons.org/licenses/by/4.0/
Citation
Cohen, H.; Simson, R. and Bamford, R. (2025) 'Whose operation is it anyway? Consensus for surgical supervision code use', The Bulletin of the Royal College of Surgeons of England 107(4) pp. 216-222. Available At: https://doi.org/10.1308/rcsbull.2025.26
Publisher
The Royal College of Surgeons of England
License
Journal
Volume
Issue
PubMed ID
ISSN
1478-7075