Exploring Qualitative Perspectives on Surgical Resident Training, Well-Being, and Patient Care

Kreutzer, Lindsey; Dahlke, Allison R.; Love, Remi; Ban, Kristen A.; Yang, Anthony D.; Bilimoria, Karl Y.; Johnson, Julie K.

doi:10.1016/j.jamcollsurg.2016.10.041

Cited by 20 publications

(12 citation statements)

References 27 publications

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“…[8][9][10][11][12][13] During a 2015 pilot study, the FIRST trial investigators learned in interviews with 100 surgical residents and faculty that by restricting experiences during postgraduate year 1 (PGY1), residents reported feeling less prepared to meet residency program expectations during PGY2. 14 Moreover, some residents suggested that their medical school experience inadequately prepared them for residency.…”

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confidence: 99%

A National Mixed-Methods Evaluation of Preparedness for General Surgery Residency and the Association With Resident Burnout

et al. 2020

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IMPORTANCE Differences in medical school experiences may affect how prepared residents feel themselves to be as they enter general surgery residency and may contribute to resident burnout.OBJECTIVES To assess preparedness for surgical residency, to identify factors associated with preparedness, to examine the association between preparedness and burnout, and to explore resident and faculty perspectives on resident preparedness. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used convergent mixed-methods analysis of data from a survey of US general surgery residents delivered at the time of the 2017 American Board of Surgery In-Training Examination (January 26 to 31, 2017) in conjunction with qualitative interviews of residents and program directors conducted as part of the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial. A total of 262 Accreditation Council for Graduate Medical Education-approved US general surgery residency programs participated. Survey data were collected from 3693 postgraduate year (PGY) 1 and PGY2 surgical residents (response rate, 99%) and 98 interviews were conducted with residents and faculty from September 1 to

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confidence: 99%

A National Mixed-Methods Evaluation of Preparedness for General Surgery Residency and the Association With Resident Burnout

et al. 2020

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“…Though similar lists of best practices and handoff protocols are available in the literature, very few have been generated from the perspectives of residents and fellows, and none have represented such a wide range of specialties. [35][36][37][38][39][40] Systems-level recommendations include providing means for reducing distractions, improving resources (such as space and computers), and protecting housestaff time. As for oversight, respondents recommended that a fellow or attending be present during higher stakes sign-outs such as those in the intensive care unit or emergency department.…”

Section: Discussionmentioning

confidence: 99%

Patient Handoffs and Trainee Perspectives Across an Institution: A Mixed Methods Study Informing Best Practices and an Expanded Conceptual Framework for Handoffs

Williams

Sebok‐Syer

Caretta‐Weyer

et al. 2022

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Background: Safe and effective physician-to-physician patient handoffs are integral to patient safety. Unfortunately, poor handoffs continue to be a major cause of medical errors. Developing a better understanding of challenges faced by health care providers is critical to address this continued patient safety threat. This study addresses the gap in the literature exploring broad, cross-specialty trainee perspectives around handoffs and provides a set of trainee-informed best practices for both training programs and institutions. Methods: Using a constructivist paradigm, the authors conducted an explanatory-sequential mixed method study to investigate trainees’ experiences with patient handoffs across Stanford Health Care, a large academic medical center. The authors designed and administered a survey instrument including Likert-style and open-ended questions to solicit information about trainee experiences from multiple specialties. The authors performed a thematic analysis of open-ended responses. Results: 687/1138 (60.4%) of residents and fellows responded to the survey, representing 46 training programs. There was wide variability in handoff content and process, most notably code status not being consistently mentioned a third of the time for patients who were not full code. Supervision and feedback about handoffs were inconsistently provided. Trainees identified multiple health-systems level issues that complicated handoffs and suggested solutions to these threats. Our thematic analysis identified five important aspects of handoffs: 1) handoff elements, 2) health-systems-level factors, 3) impact of the handoff, 4) agency (duty), and 5) blame and shame. Conclusions: Health systems, interpersonal, and intrapersonal issues affect handoff communication. The authors propose an expanded theoretical framework for effective patient handoffs and provide a set of best practices that training programs and sponsoring institutions should implement to protect patient safety. Cultural and health-systems issues must be prioritized and addressed, as an undercurrent of blame and shame permeates the clinical environment.

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“…What follows is a reflective review about the challenges of accessing women to develop a discussion and collect sensitive data in order to complete the methodology as planned (Hall, 1997;Krippendorff, 2004;Remenyi and Williams, 1998). The findings from the data collection uses thematic analysis and the participant's words are quoted verbatim to enhance validity (Braun et al, 2014;Denzin and Lincoln, 2000;Kreutzer et al, 2017;Hsieh and Shannon, 2005). These emerging themes are categorized and reported in three parts, cultural barriers, research method and researcher resilience.…”

Section: Methodsmentioning

confidence: 99%

Reflexivity and the challenges of collecting sensitive data in India: a research note

Fletcher-Brown

2019

Qualitative Research

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As health advertising researchers we become involved with a variety of health and well-being issues in order to advance social marketing research. Health advertising research involves mainly face-to-face encounters with participants using qualitative methodologies. This article explores the challenges a researcher of British origin faced undertaking fieldwork in India in an effort to collect qualitative data about breast cancer awareness (BCA) and prevention, a culturally taboo subject. Key obstacles included cultural barriers, research method assumptions and researcher resilience. Reflexivity has been recognized as a crucial stage in the process of generating knowledge via qualitative research processes. Thereby applying the critical lens of reflexivity, this article reflects upon the complexities of accessing Indian women (a fiercely private demographic) to participate in discussions about the sensitive topic of breast cancer. The results are discussed and recommendations from this researcher’s experience are presented as a resource to assist future qualitative health advertising inquiry

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Exploring Qualitative Perspectives on Surgical Resident Training, Well-Being, and Patient Care

Cited by 20 publications

References 27 publications

A National Mixed-Methods Evaluation of Preparedness for General Surgery Residency and the Association With Resident Burnout

A National Mixed-Methods Evaluation of Preparedness for General Surgery Residency and the Association With Resident Burnout

Patient Handoffs and Trainee Perspectives Across an Institution: A Mixed Methods Study Informing Best Practices and an Expanded Conceptual Framework for Handoffs

Reflexivity and the challenges of collecting sensitive data in India: a research note

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