Background: Anesthesiology residents in the United States are required to fulfill graduation requirements outlined by the Accreditation Council for Graduate Medical Education (ACGME) and manually log cases corresponding to these requirements. Published studies have shown that these case logs are inaccurate, so we expected less than 50% of residents at our institution to have accurate logs as defined by having a case total greater than or equal to the number of cases they had performed according to our Anesthesia Information Management System (AIMS) database. We hypothesized that residents who received AIMS case data via email would have more accurate case logs than those who did not receive emails, with a persistent effect beyond the period of intervention.
Methods: We conducted systematic reviews of the ACGME graduation requirements and the information within our AIMS database to create an algorithm that suggests a category for a given case. We collected data over four weeks to establish a baseline accuracy of case logs. We randomized 64 anesthesiology residents at our institution into intervention and control arms, with 31 residents receiving emails containing AIMS case data every two weeks and 33 residents receiving no emails for a total of eight weeks. We collected data for an additional four weeks to assess persistence of any intervention effect.
Results: During the baseline, intervention, and post-intervention study periods, a higher percentage of residents in the intervention arm than the control arm had accurate case logs (69% vs. 52% during baseline, 74% vs. 58% during intervention, and 68% vs. 48% post-intervention). However, this difference was not statistically significant during any of these periods (p = 0.16 during baseline, p = 0.16 during intervention, and p = 0.07 post-intervention). Residents in the intervention arm were surveyed following the study, and the majority (83%) wanted to continue receiving emails.
Conclusion: Although no significant difference in case log accuracy was found between the intervention and control arms, accuracy in both arms exceeded our expectation, and a greater percentage of residents in the intervention arm had accurate logs throughout the study. A survey of residents in the intervention arm found that the majority wanted to continue receiving emails.
