Competence by Design Strains Surgical Residency Training Programs

Area of Science:

• Medical Education
• Surgical Training
• Competency-Based Medical Education

Background:

• Competence by Design (CBD) is an educational framework transforming surgical residency.
• CBD aims to enhance resident autonomy and practice readiness.
• The impact of CBD on trainee and staff well-being requires evaluation.

Purpose of the Study:

• To assess the effects of Competence by Design (CBD) on surgical residents and staff surgeons at the University of Calgary.
• To investigate the influence of CBD on burnout and overall wellness in surgical training.

Main Methods:

• A cross-sectional survey was administered to surgical residents and staff surgeons.
• The Maslach Burnout Inventory (MBI) and custom wellness items assessed burnout and well-being.
• Quantitative (Chi Square, Fisher's exact tests) and qualitative (thematic analysis) methods were used.

Main Results:

• Residents reported significantly higher burnout (67%) and negative wellness impacts compared to surgeons (38%).
• Most residents attributed burnout to CBD, citing operational burden and psychological distress.
• Few participants felt CBD improved skills, autonomy, or readiness for practice.

Conclusions:

• CBD implementation at the University of Calgary presented challenges impacting resident and staff wellness.
• Findings underscore the need for adjustments to support surgical trainees within the CBD framework.
• Addressing operational burdens and psychological impacts is crucial for successful CBD integration.