Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY; Department of Epidemiology and Environmental Health, Division of Health Services Policy and Practice, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY; Department of Health Professions Education, MGH Institute for Health Professions Education, Boston, MA.
Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY; Department of Health Professions Education, MGH Institute for Health Professions Education, Boston, MA.
J Surg Educ. 2024 Oct;81(10):1362-1373. doi: 10.1016/j.jsurg.2024.07.004. Epub 2024 Aug 21.
Gossip-evaluative talk about an absent third party-exists in surgical residency programs. Attending surgeons may engage in gossip to provide residents with feedback on performance, which may contribute to bias. Nevertheless, the perspectives of attending surgeons on gossip has not been studied.
In this qualitative study, semi-structured interviews about gossip in surgical training were conducted with attending surgeons. We performed a reflexive thematic analysis of transcripts with a grounded theory approach to describe attendings' perceptions of their role in gossip within surgical residency.
Interviews were conducted from September 23, 2023, to November 27, 2023 via Zoom™.
Eighteen surgery attendings associated with 7 surgical training programs were interviewed.
Six themes were developed: 1) Attendings typically view gossip with a negative lens; thus, well-intended conversations about resident performance that meet the academic definition of gossip are not perceived as gossip; 2) Gossip can damage attendings' reputations as surgeons and educators; 3) Mitigating the negative impacts of gossip by maintaining accurate and objective standards of honest communication is hard; 4) Attendings express concerns about hearing other attendings' impressions of residents prior to formulating their own opinion; 5) The surgical hierarchy restricts the volume and content of gossip that reaches attendings, which may limit their knowledge of program culture; and 6) It is very difficult to mitigate gossip at the program level. Ultimately, attendings utilize gossip (e.g. triangulating their experience) with the goal of providing residents feedback.
Defining important conversations about resident performance as gossip should not discourage these critically important conversations but rather underscore the importance of combating harmful gossip through 3 behaviors: 1) committing to objective communication; 2) limiting or reframing information about resident performance that is shared with attendings who have yet to formulate their own opinions; and 3) regulating gossip in particular high-stakes microenvironments (e.g. the operating room).
关于不在场的第三方的闲聊评价——在外科住院医师培训计划中存在。主治医生可能会闲聊以提供有关绩效的反馈，这可能会导致偏见。然而，主治医生对闲聊的看法尚未得到研究。
在这项定性研究中，我们对外科培训中的闲聊与主治医生进行了半结构化访谈。我们采用扎根理论方法对转录本进行反思性主题分析，以描述主治医生在外科住院医师培训中闲聊的角色感知。
访谈于 2023 年 9 月 23 日至 11 月 27 日通过 Zoom™进行。
对 7 个外科培训计划的 18 名外科主治医生进行了访谈。
提出了六个主题：1）主治医生通常以消极的眼光看待闲聊；因此，关于住院医生表现的善意谈话，如果符合学术上闲聊的定义，则不会被视为闲聊；2）闲聊会损害主治医生作为外科医生和教育者的声誉；3）通过保持诚实沟通的准确和客观标准来减轻闲聊的负面影响是困难的；4）主治医生对在形成自己的意见之前听到其他主治医生对住院医生的印象表示担忧；5）外科等级制度限制了到达主治医生的闲聊量和内容，这可能限制了他们对项目文化的了解；6）在项目层面上很难减轻闲聊。最终，主治医生利用闲聊（例如，三角测量他们的经验）来为住院医生提供反馈。
将关于住院医生表现的重要谈话定义为闲聊不应阻止这些至关重要的谈话，而应通过 3 种行为来强调通过打击有害闲聊的重要性：1）承诺进行客观沟通；2）限制或重新构建与尚未形成自己意见的主治医生分享的关于住院医生表现的信息；3）在特定高风险的微观环境（例如手术室）中规范闲聊。
