What are we trying to teach? A content analysis of pediatric surgery rotation objectives in general surgery training

Pediatric surgery is mandatory for general surgery residents; however, no standardized curriculum exists. Written goals and objectives (G&O) can be useful to communicate expectations, but it is unclear how these are utilized in pediatric surgery. Our aim was to assess the content and quality of pediatric surgery educational curricula as expressed in orientation materials for general surgery residents.

We conducted a survey of ACGME-accredited programs and a mixed methods analysis of pediatric surgery orientation materials. Content was coded across 28 categories. G&O quality was rated using the adapted I-SMART framework encompassing specificity, importance, feasibility, and measurability, on a 0-3 scale/category.

Documents were obtained from 17 programs (4.6%), ranging in size and location. Seven (41%) programs had a document dedicated to G&O, 4 (24%) had a section on G&O within an orientation document, and 6 (35%) lacked G&O. Overall quality of G&O was low, with an average total score of 5.0. Content analysis revealed a focus on knowledge of specific diseases (94% of programs), patient care (94%), and practical knowledge (88%). Least represented were cost awareness (18%), patient advocacy (18%), and critical thinking (24%). 35% of programs lacked G&O related to technical skills.

The presence, quality, and content of G&O for residents on pediatric surgery rotations vary substantially. When provided, G&O often lacked a delineation of importance, a realistic plan to achieve the goals, and measurable outcomes. There is significant opportunity to optimize general surgery residents' education through high-quality G&O.