Impact of recent trends of noninvasive trauma evaluation and nonoperative management in surgical resident education

Background: The use of ultrasonography and nonoperative management of solid organ injury has become standard practice in many trauma centers. Little i s known about the effects of these changes on resident educational experien ce. Methods: We retrospectively reviewed resident evaluation of abdominal traum a and trauma operative experience as reported to the residency review commi ttee between 1994 and 1999, Results: A total of 4,052 patients underwent one or more of three diagnosti c modalities, The nontherapeutic laparotomy rate as a result of positive di agnostic peritoneal lavages decreased from 35% to 14%, Although resident op erative trauma experience was stable because of increases in operative burn s and nonabdominal trauma, the number of abdominal procedures declined. Conclusion: Noninvasive diagnostic tests have allowed more rapid trauma eva luation and fewer nontherapeutic laparotomies, As nonoperative experience g rows, the opportunity for operative experience decreases. These trends may adversely affect the education of residents and suggest that novel approach es are needed to ensure adequate operative experience in trauma.