Identifying gaps in the initial surgical evaluation of elderly patients: the L.I.S.T.E.N. survey
DOI:
https://doi.org/10.18203/2349-2902.isj20252281Keywords:
Geriatric surgery, Surgical education, Resident training, Elderly, Patient-centered careAbstract
By 2030, 20% of the global population will be over 65 years old. Elderly surgical patients face unique challenges, including reduced functional capacity, communication barriers, comorbidities, and social vulnerabilities. There are educational gaps in surgical resident training regarding the evaluation of geriatric-specific risk factors which can negatively affect outcomes. We present the results of the L.I.S.T.E.N. survey based on the ACS NSQIP model to address these gaps. A 12-question survey was administered to our surgical residents. The L.I.S.T.E.N. survey evaluated resident inquiries into: living conditions (disposition and baseline functional status), incidents (falls, ED visits), sensory deficits and skin integrity, thoughts (cognition, depression), enteral needs (nutrition, medications) and nurture needs (goals of care, surrogate decision-making). Results were analyzed for frequency of inquiry, comparing junior and senior residents. All residents frequently inquired about patient living situations (92%), medication (92%), surrogacy (75%). Key areas were significantly overlooked: depression (83% never assessed), sensory deficits (92% rarely or never assessed). Senior residents compared to juniors assessed baseline functional status (100% vs. 50%) and goals of care (83% vs. 33%). Junior residents more frequently inquired about prior emergency room visits or hospitalizations (83% vs. 66.7%). The study identifies areas of deficiencies in the initial evaluation of geriatric patients by surgical residents, varying by postgraduate level. Targeted educational interventions are needed to improve geriatric-specific competencies. Future research should focus on linking these educational efforts to patient-centered outcomes.
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