Can one hour of education fix the surgeon’s ASA scoring errors: A proof-of-concept pilot study
- 1Department of Anesthesiology, Bilkent Research and Training Hospital Faculty, University of Health Sciencies, Ankara, Türkiye Turkey
- 2Department of General Surgery, Bilkent Research and Training Hospital Faculty, University of Health Sciencies, Ankara, Türkiye Turkey
Abstract
Background: The American Society of Anesthesiologists (ASA) physical status classification is a cornerstone of perioperative risk management and surgical patient safety. In clinical practice, the initial assessment is frequently documented by surgical teams, leading to interdisciplinary variability. This study evaluated baseline ASA scoring accuracy among practicing surgeons and assessed the immediate impact of a brief, focused educational module on preventing documentation errors.
Methods: In this prospective, pre-post interventional study conducted at a tertiary academic hospital, 50 practicing surgeons from various specialties evaluated ten validated, borderline clinical case scenarios to establish baseline scoring accuracy. A senior anesthesiologist then delivered a focused, one-hour interactive lecture addressing the updated ASA definitions, subjective boundaries, common pitfalls, and the emergency (“E”) modifier. Immediately following the session, a post-test with randomized scenario orders was administered. Accuracy rates were analyzed using the McNemar and Fisher’s exact tests.
Results: The one-hour educational session led to substantial, statistically significant improvements across all categories. Correct classifications for ASA II rose from 67.3% to 81.2% (p < 0.05). The most dramatic improvement occurred in ASA III scenarios (e.g., morbid obesity combined with severe obstructive sleep apnea), where baseline error rates dropped from 24.5% to 5.0%, yielding a final accuracy of 95.0% (p < 0.001). Accuracy for ASA IV improved from 61.2% to 88.3% (p < 0.001), and correct application of the “E” modifier increased from 77.6% to 88.6% (p < 0.05). Baseline scoring accuracy did not differ significantly between junior specialists and senior academic faculty (p > 0.05).
Conclusion: A minimal, one-hour educational investment can drastically reduce surgeon documentation errors in high-risk categories. Incorporating structured perioperative risk modules into surgical residency training represents a low-cost, high-yield strategy to establish a reliable cross-disciplinary language and protect institutional data integrity.
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BibTeX
@article{aydin2026hour,
title = {{Can one hour of education fix the surgeon’s ASA scoring errors: A proof-of-concept pilot study}},
author = {Eda Uysal Aydin and Oguz Ugur Aydin},
journal = {Patient Safety in Surgery},
year = {2026},
month = aug,
doi = {10.1186/s13037-026-00502-1},
url = {https://doi.org/10.1186/s13037-026-00502-1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Can one hour of education fix the surgeon’s ASA scoring errors: A proof-of-concept pilot study
AU - Eda Uysal Aydin
AU - Oguz Ugur Aydin
PY - 2026
DA - 2026/08/05
JO - Patient Safety in Surgery
DO - 10.1186/s13037-026-00502-1
UR - https://doi.org/10.1186/s13037-026-00502-1
AB - Background: The American Society of Anesthesiologists (ASA) physical status classification is a cornerstone of perioperative risk management and surgical patient safety. In clinical practice, the initial assessment is frequently documented by surgical teams, leading to interdisciplinary variability. This study evaluated baseline ASA scoring accuracy among practicing surgeons and assessed the immediate impact of a brief, focused educational module on preventing documentation errors. Methods: In this prospective, pre-post interventional study conducted at a tertiary academic hospital, 50 practicing surgeons from various specialties evaluated ten validated, borderline clinical case scenarios to establish baseline scoring accuracy. A senior anesthesiologist then delivered a focused, one-hour interactive lecture addressing the updated ASA definitions, subjective boundaries, common pitfalls, and the emergency (“E”) modifier. Immediately following the session, a post-test with randomized scenario orders was administered. Accuracy rates were analyzed using the McNemar and Fisher’s exact tests. Results: The one-hour educational session led to substantial, statistically significant improvements across all categories. Correct classifications for ASA II rose from 67.3% to 81.2% (p < 0.05). The most dramatic improvement occurred in ASA III scenarios (e.g., morbid obesity combined with severe obstructive sleep apnea), where baseline error rates dropped from 24.5% to 5.0%, yielding a final accuracy of 95.0% (p < 0.001). Accuracy for ASA IV improved from 61.2% to 88.3% (p < 0.001), and correct application of the “E” modifier increased from 77.6% to 88.6% (p < 0.05). Baseline scoring accuracy did not differ significantly between junior specialists and senior academic faculty (p > 0.05). Conclusion: A minimal, one-hour educational investment can drastically reduce surgeon documentation errors in high-risk categories. Incorporating structured perioperative risk modules into surgical residency training represents a low-cost, high-yield strategy to establish a reliable cross-disciplinary language and protect institutional data integrity.
SN - 1754-9493
ER -