Factors necessary for entrustment decision-making in surgical operating rooms: A modified Delphi study

Area of Science:

• Medical Education
• Surgical Training
• Patient Safety

Background:

• Resident autonomy in the operating theatre is crucial for patient safety.
• Supervisors require clear criteria for entrusting residents with independent surgical tasks.

Purpose of the Study:

• To identify factors for resident entrustment decisions from a supervisor's perspective.
• To develop a validated checklist for assessing resident readiness for independent work in surgery.

Main Methods:

• A mixed-method Delphi approach combining literature review, qualitative study, and expert panel validation.
• Two rounds of Delphi study with 20 expert panelists to refine entrustment factors.
• Content validation and statistical analysis to establish checklist reliability.

Main Results:

• Identified 49 resident-related factors, reduced to 46 after validation.
• A final 23-item checklist was developed, encompassing cognitive, psychomotor, and affective domains.
• Key factors include 'risk manager,' 'general manager,' 'ability to pick critical findings,' and 'accountable.'

Conclusions:

• A novel checklist for surgical resident entrustment decisions was created.
• The checklist provides a guideline for evaluating resident progress and readiness for independent practice.
• The tool demonstrates good content validity for entrustment assessment in surgical residency programs.