Disparity Between Resident and Attending Physician Perceptions of Intraoperative Supervision and Education

Abstract

A significant proportion of surgical skills training during residency occurs as on-the-job training, and operating room time provides a key learning opportunity. This report demonstrates that there is a noteworthy difference in the perception of attending physicians and residents about the quality of teaching and feedback that is currently occurring in the operating room. The difference in perspectives among residents and attending physicians reported in this survey suggests a need for improved communication and systematic feedback in order to capitalize on operating room time as a critical surgical skills training arena.

Disparity Between Resident and Faculty Surgeons' Perceptions of Preoperative Preparation, Intraoperative Teaching, and Postoperative Feedback

“…Similar findings have also been found in the operative training of obstetrics and gynecology residents. 10 Previous comparison studies have also found disparities between residents and faculty with respect to intraoperative learning needs. The top 5 learning needs in the operating room as perceived by surgical residents in descending order of importance were instrument use and selection, selection of suture material, operative field exposure, patient positioning, and sequence of procedure.…”

“…In our study, residents and faculty agreed that intraoperative feedback was constructive, although with a p-value of only 0.06, this might suggest a trend toward disagreement. Levinson et al 10 in their 2010 study of obstetric and gynecology residents found that faculty and residents' opinions differed most in perceptions of intraoperative feedback. In our study, a significant disparity was found between the residents and faculty with respect to both positive and negative feedback in the postoperative period.…”

“…10 Because the original survey was designed for obstetrics and gynecology residents and faculty, our modifications involved changing the wording of the previous survey making it appropriate to general surgery residents and faculty. To ensure the revised survey was also valid, a pilot survey was conducted using a sample of obstetrics and gynecology residents and faculty.…”

“…Such intraoperative and postoperative feedback is fundamental to the development of surgical skills. 7 Despite the obvious importance of intraoperative teaching, several studies [8][9][10] showed an apparent disparity between surgical resident perceptions of the quality of intraoperative education and those of the faculty. This situation is made more complex by differing resident and faculty perceptions about the learning needs of surgical residents.…”

Discordance Between Resident and Faculty Perceptions of Resident Autonomy

“…11,12,[23][24][25][26] Descriptions of Generation Y (individuals born after 1982 12 ) predict some of the attitudes expressed by our residents: For example, our residents indicated that they would like faculty to provide more specific work expectations, more support, better explanations when residents' treatment plans are changed, and frequent feedback. However, we did not design this study for generational analysis: Although most of the responding residents belong to Generation Y, the faculty are a composite of generations.…”