Perioperative self-reflection among surgical residents

Area of Science:

• Medical Education
• Surgical Training
• Professional Development

Background:

• Meaningful self-reflection is crucial for surgical resident development.
• Prevalence and predictors of this skill remain understudied.
• Interventions may enhance resident self-reflection.

Purpose of the Study:

• To determine the prevalence and predictors of meaningful self-reflection among surgical residents.
• To assess the impact of prompting and structured interventions on resident self-reflection skills.

Main Methods:

• 1032 self-reflective comments from 120 surgical residents across six programs were analyzed.
• Meaningful self-reflection was defined as identifying learning or areas for improvement.
• Data were analyzed considering postgraduate year (PGY) level, gender, and study phase (pre/post-intervention).

Main Results:

• Meaningful self-reflection occurred in 40.6% of entries.
• PGY5 residents reflected less meaningfully (26.1%) than junior residents (49.6%).
• Phase 2 (post-intervention) entries were 4.7 times more likely to be meaningful, showing a 236% increase.

Conclusions:

• Meaningful self-reflection is uncommon among surgical residents, even with prompts.
• Chief residents (PGY5) reflect less than junior residents.
• Training and iterative interventions can substantially improve and sustain resident self-reflection.