Geographic location, program type (academic, community, or military), and the racial/ethnic compositions of the faculty and residency members were not associated with the likelihood of experiencing discrimination. Residents who experienced discrimination reported higher rates of burnout (51.6% vs 40.0%; P < .001), thoughts of attrition (16.2% vs 10.1%; P < .001), and suicidal thoughts (6.5% vs 3.8%; P < .001).
Key Points
Question
How can implementation frameworks such as the Theoretical Domains Framework be used to identify domains associated with the adoption of best practices in surgery?
Findings
This qualitative study used abdominal wall hernia as a case study and found that the surgeon knowledge, beliefs about the consequences, social or professional role and identity, environmental context and resources, and social influences domains were associated with decision-making.
Meaning
These findings suggest that implementation frameworks offer a method for better understanding which factors motivate behavior change among surgeons.
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