Resident and Attending Tube Placement: Is There a Difference?

Objective: To determine if there is a difference in patient outcomes between resident and attending placed ventilation tubes.

Method: Charts of pediatric patients who underwent tube placement between 2003 and 2010 at a tertiary referral center were reviewed. Patients served as self-controls, with the resident and attending each having done one ear. Level of training, ear operated, patient age, operative findings, and findings at first follow-up were recorded.

Results: Of 1488 pediatric patients, 809 met inclusion and exclusion criteria. A total of 59% were boys and residents preferentially operated on the left ear (86%). A total of 160 patients did not follow up in the first 10 weeks. There were no significant differences between attending and resident operated ears with respect to operative findings (P = .09), or findings at first follow-up (P = .35). There was no significance for each operative finding: tube extrusion (P = .32), blocked tube (P = .15), otorrhea (P = .82), and patent tube (P = .09). Comparing the PGY2 residents to the attending also failed to reveal significant differences (P = .30), with a power of greater than 80%.

Conclusion: Differences between tube outcomes between resident and attending placed ventilation tubes were not found to be statistically significant. This suggests that placement of ventilation tubes by resident surgeons can be performed in a safe manner without affecting patient safety or patient outcomes.