Using Windows 95 and Paradox 7.0, a dedicated relational database was developed which allows for the recording of each surgical procedure completed by the resident; evaluations of program material submitted by the resident; evaluations of residents by surgeons and presentation lecture evaluations. Each surgical procedure is entered into a log book by the resident indicating the procedure, date of the procedure, their role in the procedure (i.e. surgeon, 1st, 2nd, 3rd Assistant, teacher), and the name of the chief surgeon. This information is then transferred from their log book into the Surgical Residency Database System (SRDS) by a data manager. At McMaster the residents evaluate their rotation every three months and similarly, are evaluated by their supervisor during the specified time frame. These forms are submitted to the data manager and are subsequently input in the SRDS. The teaching session evaluations are collected weekly from the residents and are tracked in the SRDS as well. The database is constructed to allow for a user-friendly environment.

The data input is centralized for data integrity reasons. It was thought that if a data interface was created in each teaching hospital the residents would have access to a computer terminal to allow for entry into the SRDS. It was decided that this system could not be implemented due not only to data integrity issues but also for confidentiality reasons. A more centralized data management system allows for accurate information to be recorded and, subsequently, distributed. Reports are generated on a regular basis and are available for each resident, department chairs and resident supervisers. Confidentiality is maintained at all times by the Director of the Surgical Residency Programme who monitors the flow of information from one source to the other.

Our concept is that the surgical resident learns to their full potential when operative experience reflects their level of residency. A resident who performs less as a surgeon during a rotation or a PGY year, as a result of a surgeon not allowing them to operate, suffers from a lack of knowledge and hands-on experience. This results in a decrease in educational effectiveness throughout the program and ultimately, affects the level of healthcare provided to the public by that residency program. Traditionally, program directors have not had tools to define the effectiveness of one residency service over another and have been handicapped by it. With the implementation of the Surgical Residency Database System, program directors now have the information they need to ensure that quality teaching is taking place for surgical residents in all services. As this project was implemented in September, results will be availabe for presentation at the conference.