Brentley Q Smith1, Ingrid Woelfel2, Ritu Salani3, Alan Harzman2, Xiaodong Chen2. 1. Division of Gynecologic Oncology, The Ohio State University The James Comprehensive Cancer Center, Columbus, Ohio. Electronic address: bqsmith87@gmail.com. 2. Department of General Surgery, The Ohio State University Wexner Medical Center, The Ohio State University Wexner Medical Center, Columbus, Ohio. 3. Division of Gynecologic Oncology, The Ohio State University The James Comprehensive Cancer Center, Columbus, Ohio.
Abstract
INTRODUCTION: Entrustment is a key component connecting to resident preparedness for surgical practice in the operating room (OR). Residents' self-entrustment of their surgical competencies closely associates with their OR training experience and granted autonomy. Some recent studies have investigated how attending surgeons entrusted residents in the OR. There is little to no data, however, in examining these issues from the resident perspective. The goal of this study was to identify the perception and expectations of autonomy from residents' perspective, as well as the self-entrustment of their surgical competencies in obstetrics (OB) and gynecologic (GYN) procedures. METHODS: Focus group interviews of OB/GYN residents were performed. Residents were selected by convenience sampling. Audio recordings of each interview were transcribed, iteratively analyzed, and emergent themes identified, using a framework method. RESULTS: A total of 123 minutes of interviews were recorded. Eight junior residents (PGY1-2) and 12 senior residents (PGY3-4) participated. Our data illustrated that (1) the perception of autonomy shifted significantly throughout residency training; (2) residents demonstrated higher expectations and self-entrustment for OB surgical procedures than for GYN surgical procedures upon graduation; and (3) case volume, modalities of OR teaching and mutual communication are 3 factors influencing resident self-entrustment of their surgical competencies. CONCLUSIONS: Residents showed disparities in their self-entrustment and expectations of autonomy between OB and GYN surgical procedures. Better understanding these differences and the 3 influencing factors could help programs develop a potential solution for improvement in resident entrustment and autonomy upon graduation.
INTRODUCTION: Entrustment is a key component connecting to resident preparedness for surgical practice in the operating room (OR). Residents' self-entrustment of their surgical competencies closely associates with their OR training experience and granted autonomy. Some recent studies have investigated how attending surgeons entrusted residents in the OR. There is little to no data, however, in examining these issues from the resident perspective. The goal of this study was to identify the perception and expectations of autonomy from residents' perspective, as well as the self-entrustment of their surgical competencies in obstetrics (OB) and gynecologic (GYN) procedures. METHODS: Focus group interviews of OB/GYN residents were performed. Residents were selected by convenience sampling. Audio recordings of each interview were transcribed, iteratively analyzed, and emergent themes identified, using a framework method. RESULTS: A total of 123 minutes of interviews were recorded. Eight junior residents (PGY1-2) and 12 senior residents (PGY3-4) participated. Our data illustrated that (1) the perception of autonomy shifted significantly throughout residency training; (2) residents demonstrated higher expectations and self-entrustment for OB surgical procedures than for GYN surgical procedures upon graduation; and (3) case volume, modalities of OR teaching and mutual communication are 3 factors influencing resident self-entrustment of their surgical competencies. CONCLUSIONS: Residents showed disparities in their self-entrustment and expectations of autonomy between OB and GYN surgical procedures. Better understanding these differences and the 3 influencing factors could help programs develop a potential solution for improvement in resident entrustment and autonomy upon graduation.
Keywords:
Autonomy; Entrustment; Graduate medical education; Interpersonal and Communication Skills; Patient Care; Practice-Based Learning and Improvement; Resident; Systems-Based Practice
Authors: Ingrid A Woelfel; Brentley Q Smith; Ritu Salani; Alan E Harzman; Amalia L Cochran; Xiaodong Phoenix Chen Journal: Am J Surg Date: 2021-03-18 Impact factor: 3.125