Quantification of Resident Work in Colorectal Surgery

Area of Science:

• Surgical Education
• Resident Training
• Operative Room Dynamics

Background:

• Assessing resident involvement in surgical procedures is crucial for effective training.
• Understanding factors influencing resident autonomy and participation is key to improving surgical education.

Purpose of the Study:

• To evaluate resident intraoperative participation and perceived autonomy.
• To analyze communication patterns between residents and attending surgeons.
• To introduce a novel survey tool for assessing these factors.

Main Methods:

• Prospective, multi-institutional study involving 7 general surgery residency programs.
• Operative residents completed post-procedure surveys after colorectal resections.
• Quantified resident participation in technical aspects, self-perceived autonomy, and communication strategies.

Main Results:

• Increasing resident participation in technical aspects (closures, anastomosis) correlated with advancing clinical year (CY).
• Perceived autonomy levels (Observer, Assistant, Surgeon, Teacher) significantly increased with CY.
• Preoperative case discussion doubled the likelihood of residents rating themselves as Surgeon or Teacher (OR = 2.01).

Conclusions:

• Brief surveys effectively capture resident operative room experiences.
• Resident intraoperative involvement and autonomy are linked to CY.
• Early communication with attending surgeons enhances resident perceived autonomy.