Identifying Strategies for Struggling Surgery Residents

Santosa, Katherine B.; Lussiez, Alisha; Bellomo, Tiffany R.; Matusko, Niki; Gauger, Paul G.; Sandhu, Gurjit

doi:10.1016/j.jss.2021.12.026

Cited by 6 publications

(3 citation statements)

References 22 publications

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“…While this idea is theoretically sound, program directors are often ill-equipped in terms of training, resources, and incentives to handle remediation needs of struggling residents. [47][48][49] The development of remediation programs necessitates complex systems of instruction and support systems that may be daunting. 49 Furthermore, programs are not necessarily incentivized to take on learners who require more support; there is no reward for how well a program fosters the development of a learner, only the outcome of that learner.…”

Section: Why 5: Gme Programs Are Not Adequately Resourced Nor Incenti...mentioning

confidence: 99%

Competency-Based Medical Education in a Norm-Referenced World: A Root Cause Analysis of Challenges to the Competency-Based Paradigm in Medical School

Ryan¹,

Lomis²,

Deiorio³

et al. 2023

Academic Medicine

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Competency-based medical education (CBME) requires a criterion-referenced approach to assessment. However, despite best efforts to advance CBME, there remains an implicit, and at times, explicit, demand for norm-referencing, particularly at the junction of undergraduate medical education (UME) and graduate medical education (GME). In this manuscript, the authors perform a root cause analysis to determine the underlying reasons for continued norm-referencing in the context of the movement toward CBME. The root cause analysis consisted of 2 processes: (1) identification of potential causes and effects organized into a fishbone diagram and (2) identification of the 5 whys. The fishbone diagram identified 2 primary drivers: the false notion that measures such as grades are truly objective and the importance of different incentives for different key constituents. From these drivers, the importance of norm-referencing for residency selection was identified as a critical component. Exploration of the 5 whys further detailed the reasons for continuation of norm-referenced grading to facilitate selection, including the need for efficient screening in residency selection, dependence upon rank-order lists, perception that there is a best outcome to the match, lack of trust between residency programs and medical schools, and inadequate resources to support progression of trainees. Based on these findings, the authors argue that the implied purpose of assessment in UME is primarily stratification for residency selection. Because stratification requires comparison, a norm-referenced approach is needed. To advance CBME, the authors recommend reconsideration of the approach to assessment in UME to maintain the purpose of selection while also advancing the purpose of rendering a competency decision. Changing the approach will require a collaboration between national organizations, accrediting bodies, GME programs, UME programs, students, and patients/societies. Details are provided regarding the specific approaches required of each key constituent group.

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Section: Why 5: Gme Programs Are Not Adequately Resourced Nor Incenti...mentioning

confidence: 99%

Competency-Based Medical Education in a Norm-Referenced World: A Root Cause Analysis of Challenges to the Competency-Based Paradigm in Medical School

Ryan¹,

Lomis²,

Deiorio³

et al. 2023

Academic Medicine

View full text Add to dashboard Cite

show abstract

“…For example, physicians in specialties such as internal medicine, family medicine, and surgical subspecialties routinely work up to 80 hours per week during inpatient portions of training. In a 2023 study on surgical residents, Gates et al (2023) found that surgical residents reported a median 78 total patient care hours per week. As the share of physicians that are women has steadily increased (Figure 1A) it is unknown if birth outcomes of physician mothers, in particular surgeon mothers, are affected as a result of their physically demanding occupation.…”

Section: Introductionmentioning

confidence: 99%

Occupational Hazard? An Analysis of Birth Outcomes Among Physician Mothers

Jena,

Slusky,

Springer

2023

SSRN Journal

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“…These residents, who are so vulnerable to begin with, then feel helpless, and their only one goal in mind-to graduate on time by flying "under the radar"-renders them incompetent and dejected. [12][13][14] The sense of disparagement and fear of not being good enough then starts to consume the resident, thus affecting their ability to focus at work and concentrate on studying, and ultimately affects their performance. They start to fear that perhaps those in power can scathe their chances of matching into a competitive fellowship or landing in a highly sought job after graduation.…”

mentioning

confidence: 99%

Addressing the Fears of a Surgical Resident

Khaitan

2022

Innovations�(Phila)

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Identifying Strategies for Struggling Surgery Residents

Cited by 6 publications

References 22 publications

Competency-Based Medical Education in a Norm-Referenced World: A Root Cause Analysis of Challenges to the Competency-Based Paradigm in Medical School

Competency-Based Medical Education in a Norm-Referenced World: A Root Cause Analysis of Challenges to the Competency-Based Paradigm in Medical School

Occupational Hazard? An Analysis of Birth Outcomes Among Physician Mothers

Addressing the Fears of a Surgical Resident

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