Cui Christina L, Reilly Margaret A, Pillado Eric B, Li Ruojia Debbie, Eng Joshua S, Grafmuller Leanne E, DiLosa Kathryn L, Conway Allan M, Escobar Guillermo A, Shaw Palma M, Hu Yue-Yung, Bilimoria Karl Y, Sheahan Malachi G, Coleman Dawn M
Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University, Durham, NC.
Division of Vascular Surgery, Department of Surgery, Northwestern University, Chicago, IL.
J Vasc Surg. 2025 Jan;81(1):243-249.e4. doi: 10.1016/j.jvs.2024.08.057. Epub 2024 Sep 2.
The Vascular Surgery In-Training Examination (VSITE) is a yearly exam evaluating vascular trainees' knowledge base. Although multiple studies have evaluated variables associated with exam outcomes, few have incorporated training program-specific metrics. The purpose of this study is to evaluate the impact of the learning environment and burnout on VSITE performance.
Data was collected from a confidential, voluntary survey administered after the 2020 to 2022 VSITE as part of the SECOND Trial. VSITE scores were calculated as percent correct then standardized per the American Board of Surgery. Generalized estimating equations with robust standard errors and an independent correlation structure were used to evaluate trainee and program factors associated with exam outcomes. Analyses were further stratified by integrated and independent training paradigms.
A total of 1385 trainee responses with burnout data were collected over 3 years (408 in 2020, 459 in 2021, 498 in 2022). On average, 46% of responses reported at least weekly burnout symptoms. On unadjusted analysis, burnout symptoms correlated with a 14 point drop in VSITE score (95% confidence interval [CI], -24 to -4; P = .006). However, burnout was no longer significant after adjusted analysis. Instead, higher postgraduate year level, being in a relationship, identifying as male gender with or without kids, identifying as non-Hispanic white, larger programs, and having a sense of belonging within a program were associated with higher VSITE scores.
Despite high rates of burnout, trainees generally demonstrate resilience in gaining the medical knowledge necessary to pass the VSITE. Performance on standardized exams is associated with trainee and program characteristics, including availability of support systems and program belongingness.
血管外科住院医师培训考试（VSITE）是一项评估血管外科住院医师知识库的年度考试。尽管多项研究评估了与考试结果相关的变量，但很少有研究纳入特定培训项目的指标。本研究的目的是评估学习环境和职业倦怠对VSITE考试成绩的影响。
作为SECOND试验的一部分，在2020年至2022年VSITE考试后进行了一项保密的自愿调查，收集数据。VSITE分数以正确百分比计算，然后根据美国外科委员会的标准进行标准化。使用具有稳健标准误差和独立相关结构的广义估计方程来评估与考试结果相关的学员和项目因素。分析进一步按综合和独立培训模式进行分层。
在3年时间里，共收集了1385份有职业倦怠数据的学员回复（2020年408份，2021年459份，2022年498份）。平均而言，46%的回复报告至少每周出现职业倦怠症状。在未经调整的分析中，职业倦怠症状与VSITE分数下降14分相关（95%置信区间[CI]，-24至-4；P = 0.006）。然而，在调整分析后，职业倦怠不再具有统计学意义。相反，更高的研究生年级、处于恋爱关系、无论有无孩子均为男性、非西班牙裔白人、规模较大的项目以及在项目中有归属感与更高的VSITE分数相关。
尽管职业倦怠率很高，但学员在获取通过VSITE所需的医学知识方面总体上表现出韧性。标准化考试的成绩与学员和项目特征相关，包括支持系统的可用性和项目归属感。
