Anorectal Manometry in 3D NEW! - Swiss-knife.org

length of the learning curve and (2) suggest suitable methods for its description.
Methods: Two databases (MEDLINE, EMBASE) were used for the systematic search using keywords
and MeSH terms. Studies were assessed for inclusion and data was extracted with respect to three
categories: (1) statistical methods utilised (2) outcome parameters and (3) suggested lengths of the
learning curve. Statistical trend analysis of the length of the learning curve was performed using moving
average and CUSUM charts.
Results: The literature search revealed 182 eligible studies, of which 27 met inclusion criteria. (1) With
respect to statistical methods, 16 studies used case grouping methods, 4 used CUSUM charts and
3 simple line graphs for continuous data. (2) All studies used clinical parameters (operating time,
conversion rate and morbidity data). In addition, 13 studies used hospital stay, and 2 studies costs.
(3) The suggested average learning curve was 58.4 cases with a change of trend around the year
2000 (Fig. 1).
Conclusion: The majority of studies used inadequate statistical methods for the description of the learning
curve. CUSUM-type charts are increasingly accepted as a standard method for this purpose. All
studies used clinical parameters as outcome measures. This is important for quality control of the
learning process; however, its educational impact remains unclear. From a clinical viewpoint, it is
highly problematic to describe the learning curve using adverse outcome parameters. There is a statistically
significant trend towards longer learning curves the more recent the studies were performed.
This indicates a more prudent appraisal of a complex technique with increasing experience.
���
���
���
���
���
���
���
��
������������
��������������
�������������
��������������
�������������
�����������
�������������
�������������
not included in this analysis due to lack of data)
�����������
�������������
40.2
Women in surgery in Switzerland – quo vadis?
R. Kaderli, U. Güller, A. Businger (Berne)
36 swiss knife 2010; 7: special edition
���������������
������������
�������������
�������������
������������
����������
����������
��������������
���������
����������
����������
��������
Objective: An increasing proportion of women is working in medicine, whereas only very few choose
surgical specialties. The purpose of this study is to analyze the present situation of female surgeons in
Switzerland and to provide a profile of their personal and professional fulfillment.
Methods: An anonymous survey among board-certified female surgeons, female residents of surgical
departments and female surgeons working in their own practice was conducted from February to April
2008. The questionnaire addressed demographics, professional situation/career, family issues and
work-life-balance. In all, 189/327 (57.8%) questionnaires were returned.
Results: The study sample consisted of 106 (56%) surgical residents and 83 (44%) board-certified
female surgeons. The median age was 33 (25-63) years. Most participants worked in a surgical field
(88%), 3% were employed in a non surgical field (e.g. administration, industry) and 9% indicated family
as field of work. A full time job was practised by 83%, 75% were married or living with a partner,
24% had children. In the subset of female surgeons who are mothers, 78% did rely on non-parental
supervision. Of the participants without a family, 72% aimed for starting one in the future. Assessed on
a 7-point Likert on which “1” indicates “very satisfied” and 7 “very unsatisfied”, the participants were
satisfied both with their professional and personal life situation (2.7 (SD 1.3) vs. 3.0 (1.7); p=0.04). The
most important factors to change to increase the attractiveness in surgery were “amelioration of time
pressure” (26%), “regulation of workload” (20%) and “introduction of structured training programs”
(12%). Overtime work hours were reported by 75% of all female surgeons, 64% would like to work
part-time. Mentor-mentee-relationships were existing in 58% of participants.
Conclusion: There are only few women choosing surgery as a career. However, female surgeons in
Switzerland are satisfied with professional and personal situation. To further improve the indicated
disincentive work-life and family-life factors, more part time jobs and more frequent mentor-mentee
relationships should be sought.
40.3
From coal mines to diamond fields? Assessment of job satisfaction in surgical residency and its implications
M. von Websky 1 , C. Oberkofler 1 , K. Rufibach 1 , D. Raptis 1 , K. Lehmann 1 , G. Lurje 1 , E. Fitzgerald 2 , D. Hahnloser
1 , P.-A. Clavien 1 ( 1 Zurich, 2 London/UK)
Objective: To assess job satisfaction in surgical residency with a validated instrument and identify factors
associated with it.
Methods: A survey among 2050 surgical residents was conducted in 3 European countries assessing
job satisfaction with the validated Global Job Satisfaction Instrument (GJS). We related 22 questions
covering different aspects of surgical residency with the response to GJS (satisfaction yes/no) using
logistic regression analysis.
Results: Response rate among the 3 countries varied (Germany 20%, Switzerland 30%, UK 10%). 71%
of residents were satisfied and 29% were dissatisfied with their job (95% CI: [24%, 34%]). Satisfaction
was associated with good working climate among residents (OR 3.71; p