How do Perceptions of Autonomy Differ in General Surgery Training between Faculty, Senior Residents, Hospital Administrators, and the General Public? A Multi-Institutional Study

Jason W. Kempenich, Ross E. Willis, Robert Rakosi, John Wiersch, Paul J Schenarts

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Objective Identify barriers to resident autonomy in today's educational environment as perceived through 4 selected groups: senior surgical residents, teaching faculty, hospital administration, and the general public. Design Anonymous surveys were created and distributed to senior residents, faculty, and hospital administrators working within 3 residency programs. The opinions of a convenience sample of the general public were also assessed using a similar survey. Setting Keesler Medical Center, Keesler AFB, MS; the University of Texas Health Science of San Antonio, TX; and the University of Nebraska Medical Center, Omaha, NE. Participants A total of 169 responses were collected: 32 residents, 50 faculty, 20 administrators, and 67 general public. Results Faculty and residents agree that when attending staff grant more autonomy, residents' self-confidence and sense of ownership improve. Faculty felt that residents should have less autonomy than residents did (p < 0.001). When asked to reflect on the current level of autonomy at their institution, 47% of residents felt that they had too little autonomy and 38% of faculty agreed. No resident or faculty felt that residents had too much autonomy at their institution. The general public were more welcoming of resident participation than faculty (p = 0.002) and administrators (p = 0.02) predicted they would be. When the general public were asked regarding their opinions about resident participation with complex procedures, they were less welcoming than faculty, administrators, and residents thought (p < 0.001). The general public were less likely to think that resident involvement would improve their quality of care (p < 0.001). Conclusion Faculty and senior residents both endorse resident autonomy as important for resident development. The general public are more receptive to resident participation than anticipated. However, with increasing procedural complexity and resident independence, they were less inclined to have residents involved. The general public also had more concerns regarding quality of care provided by residents than the other groups had.

Original languageEnglish (US)
Pages (from-to)e193-e201
JournalJournal of Surgical Education
Volume72
Issue number6
DOIs
StatePublished - Jan 1 2015

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Hospital Administrators
surgery
autonomy
resident
Administrative Personnel
Quality of Health Care
Hospital Administration
Ownership
Internship and Residency
Teaching Hospitals
participation
Health

Keywords

  • Key Words graduate surgical education ownership
  • autonomy
  • patient care

ASJC Scopus subject areas

  • Surgery
  • Education

Cite this

How do Perceptions of Autonomy Differ in General Surgery Training between Faculty, Senior Residents, Hospital Administrators, and the General Public? A Multi-Institutional Study. / Kempenich, Jason W.; Willis, Ross E.; Rakosi, Robert; Wiersch, John; Schenarts, Paul J.

In: Journal of Surgical Education, Vol. 72, No. 6, 01.01.2015, p. e193-e201.

Research output: Contribution to journalArticle

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title = "How do Perceptions of Autonomy Differ in General Surgery Training between Faculty, Senior Residents, Hospital Administrators, and the General Public? A Multi-Institutional Study",
abstract = "Objective Identify barriers to resident autonomy in today's educational environment as perceived through 4 selected groups: senior surgical residents, teaching faculty, hospital administration, and the general public. Design Anonymous surveys were created and distributed to senior residents, faculty, and hospital administrators working within 3 residency programs. The opinions of a convenience sample of the general public were also assessed using a similar survey. Setting Keesler Medical Center, Keesler AFB, MS; the University of Texas Health Science of San Antonio, TX; and the University of Nebraska Medical Center, Omaha, NE. Participants A total of 169 responses were collected: 32 residents, 50 faculty, 20 administrators, and 67 general public. Results Faculty and residents agree that when attending staff grant more autonomy, residents' self-confidence and sense of ownership improve. Faculty felt that residents should have less autonomy than residents did (p < 0.001). When asked to reflect on the current level of autonomy at their institution, 47{\%} of residents felt that they had too little autonomy and 38{\%} of faculty agreed. No resident or faculty felt that residents had too much autonomy at their institution. The general public were more welcoming of resident participation than faculty (p = 0.002) and administrators (p = 0.02) predicted they would be. When the general public were asked regarding their opinions about resident participation with complex procedures, they were less welcoming than faculty, administrators, and residents thought (p < 0.001). The general public were less likely to think that resident involvement would improve their quality of care (p < 0.001). Conclusion Faculty and senior residents both endorse resident autonomy as important for resident development. The general public are more receptive to resident participation than anticipated. However, with increasing procedural complexity and resident independence, they were less inclined to have residents involved. The general public also had more concerns regarding quality of care provided by residents than the other groups had.",
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