The Zwisch stages of progressive autonomy for surgical learners have been widely used in general surgery residency programs since 2013, often through the SIMPL app for feedback. Dr. Akshay Govind and Dr. Joseph Zwischenberger have modified these stages using an ABCDE framework to better guide learners. In this framework, the teacher/attending and learner share responsibilities for cutting, decisions and exposure. This modification also includes specific applications for oral and maxillofacial surgery, such as the distribution of duties during a Le Fort I osteotomy. The predictive value of these assessments will be discussed, along with plans for personalized educational pathways and future research on the relationship between resident autonomy, performance, and patient outcomes.
Learning Objectives:
At the conclusion of this presentation, participants should be able to:
Describe the attending and learner duties in the Zwisch stages: Show and Tell, Active Help, Passive Help and Supervision Only.
Explain the ABCDE modification to the Zwisch stages: Person A (teacher/attending), Person B (learner), Cutting, Decisions and Exposure.
Apply the ABCDE modification to the Zwisch stages to an oral and maxillofacial surgery procedure, such as a Le Fort I osteotomy.
Discuss the evidence base behind use of microassessments.
.jpg "Akshay Govind, DMD, MD, MPH, FACS (he/him/his) photo")