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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
gain up to the 20 th procedure (Fig. 1). Conclusion: There is evidence for educational effectiveness and safety of the programme. Although a similar setup is feasible for Switzerland, certain considerations have to be taken into account due to the differences in the structure of the two healthcare systems. Figure 1. The CUSUM chart for conversion rate demonstrates no detrimental effect due to experience (adjusted for 7% conversion rate). The assessment of the learning process using a score, however, demonstrates a proficiency gain curve up the 20 th procedure. 40.6 Will we have enough surgeons in the future? A. Businger, C. Buser, U. Güller (Berne) Objective: The interest to pursue a career in Surgery has waned and many surgical departments are facing staff shortage. Reasons were inter alia relatively little exposure to lectures in Surgery and oneon-one tutorials during education, the perception that surgeons’ lives are stressful and that lifestyle is not controllable. The aim was to investigate the impact of a clerkship on students’ interest in a surgical career. Methods: A survey was submitted to students at the beginning (T1) and at the end (T2) of their surgical clerkships at 17 randomly approached departments in Switzerland. The survey addressed the aspired career and evaluated the reasons for choosing a career. Of 233 students, 185 returned the completed questionnaire (79.4%). Results: In all, 62.2% were female. The median age was 26 (22-37) years. At T1, 12 (6.5%) and 30 (16.2%) of students considered a career in general surgery (GS) or a surgical subspecialty, respectively. At T2, 16 (8.6%) and 32 (17.3%) of students considered a career in GS or a surgical subspecialty, respectively; men indicated a career in a surgical field significantly more often as career goal than women (P
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Covidien Switzerland Limited multip
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