Feedback Perceived by General Surgery Residents: What is the Influence of Program Characteristics?

Studies investigating residents' perceptions of feedback received are sparse. We explored general surgery residents' (GSR) perceptions of feedback based on program characteristics, such as region, size, and type in a national sample.

An optional survey following the American Board of Surgery In-Training Exam (ABSITE) was administered in January 2023 querying feedback quality, amount, and timeliness on GSRs' self-identified best and worst rotations, overall feedback satisfaction, and frequency of feedback. Program characteristics included geographic location, program type, and size grouped into quartiles(Q). Bivariate and multivariable analyses were performed with Chi-square, Kruskal-Wallis, and ordinal regression, as appropriate.

Responses from 9854 individuals representing 348 programs were received. Most respondents (n = 3259) and programs (n = 110) were from the Northeast (NE). While most respondents trained at University-based programs (n = 4961), most programs were University-affiliated (n = 130). Mean overall feedback satisfaction decreased as program size increased (7.4, 7.3, 7.2, and 6.9 in Q1-4, respectively). On ordinal regression, residents from Q4 had 0.7x lower odds of overall satisfaction compared to Q1 (p < 0.05). Residents from University-affiliated, Independent academic centers, and those from Southeast, had 1.2x higher odds of overall feedback satisfaction compared to University-based and Northeast (p < 0.05). Multivariable analysis of best rotation feedback showed 1.3-1.5x higher odds of satisfaction in regions outside the Northeast (NE) (p < 0.05 for all). Residents from the largest programs (Q4) had 0.8x lower odds of satisfaction compared to those from the smallest (Q1). Multivariable analysis of intra-operative feedback showed Midwest residents and those in Q3 and Q4 had 0.8, 0.8, and 0.7x lower odds of reporting positive feedback, respectively, compared to reference (p < 0.05 for all).

Program characteristics like location, type, and size affect feedback satisfaction, but no consistent trends were found in their interactions. This can guide program leaders in raising awareness and advocating for feedback improvements, with further research needed to understand underlying factors.