Operative Confidence Among U.S General Surgery Residents

Area of Science:

• Medical Education
• Surgical Training
• Resident Education

Background:

• General surgery residents (GSRs) require operative autonomy for independent practice.
• Assessing GSRs' perceived confidence and operative autonomy is crucial.
• Identifying factors influencing these perceptions can improve surgical training.

Purpose of the Study:

• To investigate factors influencing perceived confidence and operative autonomy in general surgery residents.
• To identify key elements that positively impact GSRs' self-assurance in surgical procedures.
• To inform strategies for enhancing surgical skill development in residency programs.

Main Methods:

• Anonymous online survey distributed to 23 US general surgery residency programs.
• Data collected from 120/558 (21.5%) GSR respondents.
• Multivariable logistic regression used to calculate adjusted odds ratios (aOR) for binary outcomes.

Main Results:

• Higher operative case volume (>200 cases) correlated with increased confidence in both minor and major cases (P=.05, P=.02).
• Residents performing both minor and major surgeries reported higher confidence (85.7%) compared to those specializing (64.7%, 62.5%).
• Early surgical experience (PGY 1-2) with >50 minor surgeries was linked to lower confidence in major cases (aOR: 19.98). Community teaching hospital residents reported higher confidence than those at university or combined programs.

Conclusions:

• Increased case volume, performing diverse case types, and early surgical experience positively influence GSR confidence.
• Training at community teaching hospitals appears to enhance perceived operative confidence and autonomy.
• These findings have implications for optimizing surgical residency curricula and future surgeon development.