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Defining the Deficit in US Surgical Training: The Trainee's Perspective
Tiffany N Anderson1, Davis H Payne2, Daniel L Dent3
1Department of Surgery, University of Florida, Gainesville, FL.
Journal of the American College of Surgeons
|January 1, 2021
Summary
Most PGY5 residents lack self-efficacy for common general surgery procedures. Confidence in performing operations independently and teaching them directly correlates with surgical experience, highlighting a need for targeted training interventions.
Area of Science:
- Medical Education
- Surgical Training
- Resident Education
Background:
- Self-efficacy, a key component of competence, is defined as an individual's belief in their ability to succeed in specific tasks.
- Assessing the self-efficacy of postgraduate year 5 (PGY5) residents in general surgery is crucial for evaluating preparedness for independent practice.
- This study investigated potential deficits in PGY5 residents' self-efficacy for common general surgery operations.
Purpose of the Study:
- To evaluate the self-efficacy of PGY5 residents concerning common general surgery operations.
- To determine if residents' self-efficacy correlates with their experience performing procedures independently and teaching them.
- To identify gaps in resident preparedness for independent surgical practice.
Main Methods:
- A survey was administered to PGY5 residents, linked to the 2020 American Board of Surgery In-Training Examination.
- Residents rated their ability to perform 10 selected common general surgery operations independently on a 5-point scale.
- Data on independent operative experience and experience teaching procedures were collected and analyzed using descriptive statistics and Pearson correlation.
Main Results:
- A high response rate (84%) was achieved, with 1,145 PGY5 residents participating.
- Highest self-efficacy was reported for wide-local excision (90.24%), while lowest was for open thyroidectomy (19.58%).
- Significant positive correlations were found between self-efficacy and experience (performed independently: r=0.98, p<0.01; taught: r=0.91, p<0.01).
Conclusions:
- A substantial majority of PGY5 residents (92.3%) reported feeling unprepared for practice due to deficits in self-efficacy for common procedures.
- Resident self-efficacy demonstrated a direct, positive relationship with the number of cases performed and taught.
- Findings underscore the importance of operative volume and teaching experience in building resident confidence and competence for independent surgical practice.
