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Use of portable video technology in call sign out
Nosrati N, Wooden W, Flores R, Sood R, Tholpady S
Indiana University
2014-03-13
Presenter: Naveed Nosrati
Affidavit:
Study initiated, conducted, and written by resident.
Director Name: Rajiv Sood
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Residency provides many opportunities for graded performance and decision making. Maxillofacial call provides residents an opportunity to evaluate imaging, formulate a surgical plan, and relay the relevant images. In this study we reviewed the ability of residents to accurately relay the slices supporting their plan and then provided the attending with a video of the complete facial CT.
Using the sign out system, facial fractures were identified. Resident images used for sign out were extracted. The corresponding CT films were recorded using a Pantech P4100 tablet. Three craniofacial staff were then shown the images and asked to decide on a management plan. They were subsequently shown the video and asked if their management changed. Analysis was performed on the results.
15 films were identified. Based on selected slices only, staff 1 6 operative cases, staff 2 had 7 cases, and staff 3 had 8 cases. After viewing the entire film their plans changed 40%, 20%, and 6.7%, respectively. All staff independently agreed on the same 7 operative patients after viewing films. Average change of plans was 22.2%.
As resident level progressed, selection of crucial slices of imaging improved. However, even senior residents had some discordance. Seniority of attending also improved concordance. While CT is not the sole factor in management of craniofacial trauma, it does play a significant role. In areas where information systems do not allow for easy viewing of images, the transmission of video with a full CT provides an alternate method to evaluate and change resident plans.
