Characterizing Attending Feedback Styles in General Surgery: A Residency-Wide Survey and Needs Assessment

To characterize the intraoperative feedback styles of general surgery attendings using a resident-facing assessment tool grounded in the "debriefing with good judgment" framework, and to evaluate associations between feedback style and faculty characteristics.

Cross-sectional survey study employing a needs assessment approach and incorporating structured resident education on feedback theory prior to survey administration.

A general surgery residency program at a university affiliated teaching hospital.

Forty General surgery residents (PGY1-6) were surveyed for perceived intraoperative feedback styles of individual attending surgeons.

About 80% of residents (33/41) completed evaluations of 42 attendings. Most attendings (95.3%) were perceived to use more than 1 feedback style. While 51.9% of total feedback interactions were categorized as effective (good judgment), 85.7% of attendings delivered ≥25% ineffective feedback (judgmental or nonjudgmental). Male attendings were significantly more likely to deliver effective feedback compared to female attendings (U = 0.5, p < 0.001), and thoracic surgeons were less likely to provide effective feedback (OR = 0.55, p = 0.033). Faculty with ≥20 years of clinical experience were significantly more likely to deliver effective feedback (OR = 1.50, p = 0.037). No gender-based differences were found among residents in their perception of feedback.

Intraoperative feedback was frequently ineffective, with differences by attending gender, subspecialty, and seniority. These patterns indicate that feedback delivery may be a modifiable, teachable skill shaped by experience and context, emphasizing faculty development and sustained engagement as critical avenues to strengthen the culture and quality of surgical education.