Zwisch Surgery

An app to evaluate surgery resident autonomy and performance

The operating room (OR) remains primarily a master/apprentice-based learning environment for surgical residents. This app puts into practice a simple model for teaching and assessing residents in the OR to guide faculty and resident interaction and to help determine a trainee's earned level of autonomy for a given procedure. It is based on an original paper published out of Northwestern University Feinberg School of Medicine and the University of Kentucky College of Medicine (Debra A. DaRosa, PhD, Joseph B. Zwischenberger, MD, Shari L. Meyerson, MD, et al. A Theory-Based Model for Teaching and Assessing Residents in the Operating Room, Journal of Surgical Education, Volume 70(1), 2012.)

The resident surgeon initiates the assessment by logging the date, type of procedure, attending surgeon and hospital. (S)he is then asked to self rate their level of participation (Zwisch option) and the degree of difficulty of the procedure. This information is transmitted by SMS to the attending surgeon who then provides his or her Zwisch option, degree of difficulty, operative performance, and procedural milestone data for the same case, with no knowledge of the resident's contribution. The attending surgeon's assessment is then stored along with the resident's assessment for future analysis.

The app is functional only for university programs that have adopted this assessment tool.