Belonging in Surgery: A Validated Instrument and Single Institutional Pilot

Area of Science:

• Medical Education
• Psychology
• Surgical Training

Background:

• Belonging is a fundamental human need linked to well-being, performance, and motivation.
• No validated tools currently exist to assess belonging among surgical residents.
• Understanding belonging is crucial for improving the surgical training environment.

Purpose of the Study:

• To develop and validate a reliable instrument for measuring Belonging in Surgery.
• To assess the psychometric properties of the developed belongingness scale.
• To explore demographic and experiential factors associated with belonging in surgical residency.

Main Methods:

• An expert panel adapted an existing belonging instrument for surgical residents.
• A 28-item instrument was administered to surgical residents, followed by psychometric analyses (Cronbach's alpha, principal component analysis).
• The instrument was refined to an 11-item version by the expert panel.

Main Results:

• The final 11-item instrument demonstrated strong internal consistency (Cronbach's alpha = 0.90).
• Exploratory analyses identified one dominant component explaining 70% of the variance.
• Lower belonging scores were associated with Black and Asian residents compared to White residents, and with higher resident stress levels.

Conclusions:

• A validated 11-item instrument for measuring Belonging in Surgery in residents has been developed.
• This validated instrument allows for the investigation of belonging as a factor influencing surgeon well-being and performance.
• Findings highlight potential disparities in belonging based on race and factors like cohort graduation, warranting further attention.