Defining the Deficit in US Surgical Training: The Trainee's Perspective.

INTRODUCTION: Self-efficacy (SE) is the personal judgement of how well one can successfully complete a task. The goal of this study is to assess SE of PGY5 residents for common general surgery operations. We hypothesize there are deficits in SE of PGY5 residents, and SE of a given operation correlates with 1) experience performing the operation without attending assistance (independently) and/or 2) teaching the operation start-to-finish.

METHODS: A survey was linked to the 2020 ABSITE. From the ACGME case log's 15 most commonly performed surgeon-chief operations and AHRQ's 15 most common operations, 10 operations were selected. Residents evaluated their ability to perform these operations independently using a 5-point SE scale. Residents were asked if they had experience performing these operations independently and/or teaching the operation start-to-finish. Descriptive statistics and Pearson correlation were used to examine the relationship between SE and operative experience.

RESULTS: 1145 of 1367 (84%) PGY5 residents responded. Highest SE was in performing wide-local excision (90.24%) and the lowest in performing open thyroidectomy (19.58%) (Table 1). Eighty-eight (7.7%) reported SE in all procedures. Statistically significant positive correlations were identified between experience and SE for cases performed without assistance (r = 0.98, p<0.01) and cases taught (r = 0.91, p<0.01).

CONCLUSIONS: With 5 months left in training, 92.3% of residents report deficits in preparation for practice as defined by SE to complete common procedures independently. Resident SE increased in direct relation to performed cases and cases taught.