Emergency Frozen Section: Development of a Standardized Teaching Module for Residents
Nicholas E Sunderland, Martin D Hyrcza, C Blake Gilks. University of British Columbia, Vancouver, BC, Canada; Vancouver General Hospital, Vancouver, BC, Canada
Background: Emergency frozen section is likely the most demanding and stressful task facing a pathologist, yet this aspect is rarely systematically addressed by residency programs. Residents may go through an entire residency without experiencing after-hours frozen section due to their low frequency. Moreover, the emergent frozen sections are likely to involve a distinct set of specimens from surgical procedures for conditions not typically encountered on routine frozen sections. To fill this gap in the current curriculum of the Anatomic Pathology residency training program at the University of British Columbia, we identified thematic categories of surgical specimens submitted for emergency frozen sections at our institution and created a teaching module centered around these categories.
Design: Retrospective analysis of the emergency frozen sections performed on weekends for non-neuropathology cases at large teaching hospital between June 2010 and Aug 2012 revealed eighteen cases representing four major types of specimens with distinct clinical implications and diagnoses. Through consultation with surgeons and pathologists we developed a teaching module centered around the four themes. The module explains the typical clinical scenario, the differential diagnoses likely to be involved, and information required by the surgeon at the time of frozen section. Each module includes digitally scanned original frozen section slides (40x, Aperio scanner) made available to residents online utilizing the Aperio Spectrum server associated with the local pathology learning center. The module was presented to the residents in years 2-5 of training during a one-hour teaching session.
Results: Residents were asked to complete the initial test set of 18 cases by providing diagnoses and appropriate feedback to the surgeon. Following the test, the didactic portion was presented with four themes: acute general surgery cases, spinal cord compression, head and neck masses with acute neurologic deficits, and mediastinal masses causing SVC syndrome or cardiac symptoms. Additional related cases were presented. Objective measures of improvement in responses from pre- and post-tests as well as participants' feedback will be reported.
Conclusions: Pathology resident training in the area of emergency frozen sections is currently sporadic and random. We have developed a teaching module to help fill this gap in residency training and to develop confidence in a difficult and uncertain area of practice.
Monday, March 4, 2013 9:30 AM
Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 78, Monday Morning