Capturing intra-operative safety information using surgical wikis

Abstract

Background

Expert surgeons use a mass of intra-operative information, as well as pre- and post-operative information to complete operations safely. Trainees acquired this intra-operative knowledge at the operating table, now largely diminished by the working time directive. Wikis offer unexplored approaches to capturing and disseminating expert knowledge to further promote safer surgery for the trainee.

Methods

Grafting an abdominal aortic aneurysm represents a potentially high-risk operation demanding extreme safety measures. Operative details, presented on a surgical wiki in the form of a script and content analysed to classify types of safety information.

Results

The intra-operative part of the script contained 2,743 items of essential surgical information, comprising 21 sections, 405 steps and 2,317 items of back-up information; 155 (5.7%) of them were also specific intra-operative safety checks. Best case scenarios consisted of 1,077 items of intra-operative information, 69 of which were safety checks. Worse case and rare scenarios required a further 1,666 items of information, including 86 safety checks.

Conclusions

Wikis are relevant to surgical practice specifically as a platform for knowledge sharing and optimising the available operating time of trainees, as a very large amount of minutely detailed information essential for a safe major operation can be captured.

Keywords:

• Education
• intra-operative care
• safety
• surgical procedures
• wiki

Acknowledgements

We gratefully acknowledge the help and encouragement of Mr Robin Knox who allowed us to witness him performing an aortic aneurysm operation and document the operative details.

Declaration of Interest: The authors report no conflict of interest.