Entrustment of General Surgery Residents in the Operating Room: Factors Contributing to Provision of Resident Autonomy

“They Have to Adapt to Learn”: Surgeons’ Perspectives on the Role of Procedural Variation in Surgical Education

“…Given that both residents and faculty acknowledged that a dominant feature of residents' workplace learning is the navigation of thresholds, surgical education should prioritize teaching residents how to negotiate the nuanced variations they would encounter between patients, cases, and surgeons when operating. [49][50][51] The findings of this study indicate that the sociocultural constructs of surgical education may complicate this work.…”

Identification of behaviors and techniques for promoting autonomy in the operating room

“…Recently, the ''Zwisch Model'' has been introduced in the surgery education literature as a simple model to guide faculty teaching and to assess a resident's level of earned autonomy in the OR. 4,13 Both faculty and residents receive this feedback, which may prove to encourage the faculty to impart more operative autonomy. Supervision policies may also be another way in which program directors can increase autonomy.…”

“…In response to forces impacting medical education, current models of supervision could be revised to include deliberate opportunities for residents to experience autonomous practice, 2 as a first step to developing a formal system in which faculty are able to provide supervised graduated responsibility in the OR. 13 Finally, program directors can encourage chairpersons to recruit surgeon teachers who are passionate about teaching. The resident focus groups suggested that chief residents from applicants' current institutions be queried so that chairpersons can get insight about applicants' motivation to be a faculty member in academia.…”

Progressive Independence in Clinical Training: Perspectives of a National, Multispecialty Panel of Residents and Fellows

“…Another factor may be a perception that duty hour limits have produced shiftwork mentality and decreased ownership of patients in residents. 9 There is information indicating that attending physicians significantly restrict the independence of weaker residents, further reducing opportunities for improvement for those who need it most. 10 While this is not an inherently wrong approach, unless accompanied by effective remediation, it does not address the underlying problem of inadequate progression of responsibility and autonomy as learners advance in their training.…”