Public Perception of General Surgery Resident Autonomy and Supervision.

Karen J Dickinson, Barbara L Bass, Duc T Nguyen, Edward A Graviss, Kevin Y Pei
Author Information
  1. Karen J Dickinson: Department of Surgery, Houston Methodist Hospital, Houston, TX. Electronic address: kjdickinson@houstonmethodist.org.
  2. Barbara L Bass: George Washington University School of Medicine and Health Services, Washington, DC.
  3. Duc T Nguyen: Department of Pathology and Genomic Medicine, Houston Methodist Research Institute, Houston, TX.
  4. Edward A Graviss: Department of Surgery, Houston Methodist Hospital, Houston, TX; Department of Pathology and Genomic Medicine, Houston Methodist Research Institute, Houston, TX.
  5. Kevin Y Pei: Department of Graduate Medical Education, Parkview Health, Fort Wayne, IN.

Abstract

BACKGROUND: Despite patients being important stakeholders in surgical training, little is known about the public's perception of trainee participation in surgical care. This study evaluates the public's perception of surgical resident autonomy and supervision.
STUDY DESIGN: An anonymous electronic survey was sent to adult panelists older than 18 years in the US using SurveyGizmo. The design of the survey used Dillman's Tailored Design Method to optimize response rate. Participants completed surveys including demographic characteristics and perceptions toward general surgery resident autonomy. Univariable and multivariable analyses were used as appropriate.
RESULTS: Survey response rate was 93% (2,005 of 2,148). Demographic characteristics including age, gender, race or ethnicity, and highest level of education were nationally representative. Most respondents (87%) had health insurance. On multivariable logistic regression analysis, factors associated with participants who would never allow a resident to perform any portion of the operation include: female gender (odds ratio [OR] 1.58; 95% CI, 1.28 to 1.95), no health insurance (OR 1.38; 95% CI, 1.03 to 1.84), Black race (OR 1.82; 95% CI, 1.38 to 2.41), and Hispanic ethnicity (OR 1.49; 95% CI, 1.03 to 2.15). Participants who were younger than 50 years (OR 1.57; 95% CI, 1.24 to 1.98), male (OR 1.90; 95% CI, 1.56 to 2.32), of Black race (OR 1.45; 95% CI, 0.10 to 1.91), Hispanic ethnicity (OR 1.49; 95% CI, 1.05 to 2.11), working in healthcare (OR 2.18; 95% CI, 1.67 to 2.86), or insured (OR 1.46; 95% CI, 1.07 to 1.99) were more likely to believe that resident involvement increases complications.
CONCLUSIONS: Among survey participants broadly representing the US population, resident participation in operations is not universally accepted. Public perception of surgical resident autonomy and supervision is important, as GME continues to evolve to address readiness for independent practice.

MeSH Term

Adolescent
Adult
Aged
Aged, 80 and over
Attitude to Health
Female
General Surgery
Humans
Internship and Residency
Male
Middle Aged
Professional Autonomy
Surveys and Questionnaires
United States
Young Adult

Word Cloud

Created with Highcharts 10.0.0195%CIOR2residentsurgicalperceptionautonomysurveyraceethnicityimportantpublic'sparticipationsupervision18yearsUSusedresponserateParticipantsincludingcharacteristicsmultivariablegenderhealthinsuranceparticipants3803BlackHispanic49PublicBACKGROUND:DespitepatientsstakeholderstraininglittleknowntraineecarestudyevaluatesSTUDYDESIGN:anonymouselectronicsentadultpanelistsolderusingSurveyGizmodesignDillman'sTailoredDesignMethodoptimizecompletedsurveysdemographicperceptionstowardgeneralsurgeryUnivariableanalysesappropriateRESULTS:Survey93%005148Demographicagehighestleveleducationnationallyrepresentativerespondents87%logisticregressionanalysisfactorsassociatedneverallowperformportionoperationinclude:femaleoddsratio[OR]58289584824115younger50572498male90563245010910511workinghealthcare6786insured460799likelybelieveinvolvementincreasescomplicationsCONCLUSIONS:AmongbroadlyrepresentingpopulationoperationsuniversallyacceptedGMEcontinuesevolveaddressreadinessindependentpracticePerceptionGeneralSurgeryResidentAutonomySupervision

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