Russian Federation
Objective: to improve the system of increasing the quality and safety of surgical care by analyzing adverse outcomes and introducing interdisciplinary educational technologies in the training of surgeons. Material and methods. The authors examined 625 medical records of patients who died in surgical hospitals for compliance of the emergency surgical care with current regulatory requirements. The authors developed and implemented an educational method of additional training of surgical specialists based on gamified forensic medical analyses of criminal "medical" cases from open judicial practice. At the first stage of the game, the task of the students is to immerse themselves in a simulated criminal process, collect details of the incident, analyze the care provided to the patient, possible diagnostic and treatment defects, and also justify, based on the realities of domestic healthcare, the correctness (incorrectness) of the surgical care. At the second stage, an open discussion takes place with the participation of various specialists in a specific criminal case: practicing surgeons, forensic experts, employees of specialized departments, experts from the Ministry of Health and the territorial fund for medical insurance, lawyers. The authors illustrated a similar interdisciplinary analysis of a clinical case of providing emergency surgical care to a victim with penetrating stab wounds to the abdominal cavity. Conclusions. Over the period from 2018 to 2022, there was a decrease in the number of preventable, conditionally preventable deaths and defects in the provision of emergency surgical care, which may be associated with a comprehensive study of adverse outcomes. According to authors’ opinion, the analysis of adverse outcomes can be used as one of the tools to improve the results of surgical care. The use of the innovative educational method of additional training of surgeons proposed by the authors can provide effective assistance in a set of measures to reduce mortality from manageable causes in the "Surgery" profile.
emergency surgical care, acute diseases of abdominal organs, expert assessment, defect in provision
1. Saveliev V. S. Manual of emergency surgery of abdominal cavity organs: Manual for doctors / Ed. by Acad. RAS and RAMS B. C. Savelyev; ed.- compiler Acad. A. I. Kirienko. – 2nd edition, revised and supplemented - Moscow:
2. Kubyshkin V. A. Safe surgery and clinical recommendations. Surgery. 2014;5:4-6. (In Russ.).
3. Murashko M. A. Qality of medical care: time to change. Vestnik Roszdravnadzora. 2017;1:10-21. (In Russ.).
4. Benyan A. S., Korymasov E. A., Chertukhina O. B., Khranovsky D. G., Medvedchikov-Ardiia M. A. Surgical safety: effectiveness based on collective intelligence and implementation challenges (review). Public Health.
5. Khranovsky D. G., Benyan A. S., Korymasov E. A., Chertukhina O.B., Medvedchikov-Ardiya M. A. Modern concept and culture of surgical safety. Polytrauma. 2023;(3):6-13. doihttps://doi.org/10.24412/1819-1495-2023-3-6-13.
6. Otdelnov L. A., Mukhin A. S. The results of the survey of surgeons on generalSurgery. 2023;29(2):39-45. (In Russ.). doihttps://doi.org/10.17116/endoskop20232902139.
7. Revishvili A. Sh., Olovyanniy V. E., Markov P. V., Gurmikov B. N., Kuznetsov A. V. Potentially preventable causes of mortality in acute calculous cholecystitis: a population-based study. Pirogov Russian Journal of Surgery.2024;
8. Shabunin A. V., Berseneva E. A., Logvinov Yu. I., Gorbunova E. A. Problematic aspects in improving the training of medical personnel and their role in the surgical treatment of patients. Virtual Technologies in Medicine. 2023;
9. Spiridonov V. A., Anisimov A. A. Clinical and legal analyzes of adverse cases in medical care on criminal cases: an innovative educational activity. Russian Journal of Forensic Medicine. 2021;7(2):120–126. (In Russ.).
10. Anisimov A. A., Spiridonov V. A. Gamification in the Process of Legal Training of Medical Specialists. Virtual Technologies in Medicine. 2023; (3). doihttps://doi.org/10.46594/2687-0037_2023_3_1687.
11. Anisimov A. A., Ivanov R. V., Voronin M. V., Spiridonov V. A. Legal Training of Surgeons of the Republic of Tatarstan Based on the Experience of Participation in Criminal Proceedings in “Medical” Cases. Russian Sklifosovsky
12. Federal Law «About obligatory medical insurance in Russian Federation» from https://www.consultant.ru/document/cons_doc_LAW_107289. (Accessed February 5, 2025).
13. Federal Law «About fundamentals of health care in Russian Federation» from https://www.consultant.ru/document/cons_doc_LAW_121895. (Accessed February5, 2025).
