Improving the Intraoperative Educational Experience: Understanding the Role of Confidence in the Resident-Attending Relationship

15:27

via Journal of Surgical Education

Publication date: Available online 27 June 2019
Source: Journal of Surgical Education
Author(s): Juyeon Park, Siddarth Ponnala, Eric Fichtel, Kian Tehranchi, Shimae Fitzgibbons, Sarah Henrickson Parker, Nathan Lau, Shawn D. Safford

Objective

With recent changes to graduate medical education, the balance between resident autonomy and need for supervision impacts the educational and training experience of residents. The objective of this study was to understand the relationship between the confidence of attendings and residents and their different perspectives of perceived educational experience and autonomy in the operating room (OR). We hypothesized that the attending's confidence in the resident would be an important factor in improving the educational experience and resident's autonomy in the OR.

Design

Self-reported confidence-rating and operative experience surveys were administered to teams of post-graduate year (PGY 1) through PGY 5 surgical residents and attendings in two temporal sets (Early: Sept-Dec 2015, n = 20; Late: Jan-Apr 2016, n = 22). A second “end-of-year” survey was distributed to residents (n = 9, 37.5% response) and attendings (n = 10, 35% response) asking questions regarding their educational experience and operative experience during the past year.

Setting

Large rural teaching hospital.

Participants

Nineteen general surgery residents (PGY 1 - 5) and 14 general surgery attendings.

Results

Resident perception of confidence differs from junior to senior residents, and that there was discordance between resident's confidence and skill as perceived by attendings, particularly in senior residents. Results also showed that attending's confidence in residents was positively correlated with attending's perceived educational experience in the OR. Residents and attendings both indicated attending's confidence in residents as an important factor in increasing resident autonomy in the OR, thus the attending's confidence in residents could have a positive impact on resident autonomy and educational experience in the OR.

Conclusions

We have demonstrated a relationship between self-confidence for residents and improved confidence from attendings in residents’ capabilities. Based on these findings, we would propose identifying methods to expand resident's awareness of surgical situations and develop attending's confidence in residents.