Department of Surgery, Stanford University, CA, USA.
Department of Surgery, Howard University, Washington, DC, USA.
Am Surg. 2023 Jul;89(7):3098-3103. doi: 10.1177/00031348231157862. Epub 2023 Feb 21.
A 2020 survey of post-graduate year 5 (PGY5) general surgery residents linked to the American Board of Surgery In-Training Examination (ABSITE) revealed significant deficits in self-efficacy (SE), or personal judgment of one's ability to complete a task, for 10 commonly performed operations. Identifying whether this deficit is similarly perceived by program directors (PDs) has not been well established. We hypothesized that PDs would perceive higher levels of operative SE compared to PGY5s.
A survey was distributed through the Association of Program Directors in Surgery listserv; PDs were queried about their PGY5 residents' ability to perform the same 10 operations independently and their accuracy of patient assessments and operative plans for components of several core entrustable professional activities (EPAs). Results of this survey were compared to PGY5 residents' perception of their SE and entrustment based on the 2020 post-ABSITE survey. Chi-squared tests were used for statistical analysis.
108 responses were received, representing ∼32% (108/342) of general surgery programs. Perceptions from PDs of PGY5 residents' operative SE were highly concordant with resident perceptions; no significant differences were observed for 9 of 10 procedures. Both PGY5 residents and PDs perceived adequate levels of entrustment; no significant differences were observed for 6 of 8 EPA components.
These findings show concordance between PDs and PGY5 residents in their perceptions of operative SE and entrustment. Though both groups perceive adequate levels of entrustment, PDs corroborate the previously described operative SE deficit, illustrating the importance of improved preparation for independent practice.
2020 年,一项针对美国外科住院医师年度考核(ABSITE)中第五年住院医师(PGY5)的调查显示,在 10 项常见手术中,他们的自我效能(SE),即个人对完成任务能力的判断,存在显著不足。尚未明确这种缺陷是否同样被项目主任(PDs)所察觉。我们假设 PDs 对手术 SE 的感知水平会高于 PGY5。
通过外科项目主任协会的电子邮件列表分发了一份调查;PDs 被询问他们的 PGY5 住院医师独立完成相同的 10 项手术的能力,以及他们对患者评估和几个核心委托专业活动(EPA)部分手术计划的准确性。该调查结果与 PGY5 住院医师根据 2020 年 ABSITE 后调查对 SE 和委托的感知进行了比较。使用卡方检验进行统计分析。
共收到 108 份回复,代表了约 32%(108/342)的普通外科项目。PDs 对 PGY5 住院医师手术 SE 的看法与住院医师的看法高度一致;在 10 项手术中有 9 项没有观察到显著差异。PGY5 住院医师和 PDs 都认为委托程度足够;在 8 个 EPA 部分中有 6 个没有观察到显著差异。
这些发现表明 PDs 和 PGY5 住院医师在手术 SE 和委托方面的看法一致。尽管两组都认为委托程度足够,但 PDs 证实了之前描述的手术 SE 不足,这说明了提高独立实践准备的重要性。