Resident Race and Operative Experience in General Surgery Residency: A Mixed-Methods Study

IF 1.8 3区医学 Q2 SURGERY

Journal of Surgical Research Pub Date : 2024-10-28 DOI:10.1016/j.jss.2024.09.049

Nicole Panzica MD , Alexander R. Cortez MD , Chukwuma Eruchalu MD , Kenneth Lynch PhD , Andrea Gillis MD , Brenessa Lindeman MD, MEHP , Herbert Chen MD , Jessica Fazendin MD , Polina Zmijewski MD, MA

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引用次数: 0

Abstract

Introduction

Recent multi-institutional quantitative work has found that Black general surgery residents perform fewer operations during training. Further mixed-methods research exploring the reasons for this phenomenon is needed to address this inequity for residents who are underrepresented in medicine (URiM).

Material and methods

Data were collected through open response and Likert scale questions that were distributed electronically to residents at 21 accredited US general surgery programs within the US Resident Operative Experience Consortium. Questions focused on what barriers prevent residents from going to the operating room and potential solutions. Free text was analyzed by three qualitative reviewers.

Results

The online survey was completed by 96 general surgery residents representing a 12% overall response rate from the 21 US Resident Operative Experience Consortium programs. Eight (n = 8/13, 62%) of the URiM residents endorsed that they experienced barriers in obtaining case numbers compared to 13% of non-URiM residents (P < 0.05). A similar proportion of both groups agreed that their quality of training was affected by their race or ethnicity (n = 6/13, 46% versus n = 34/49, 41%; P = 0.77). Floor work and clinical tasks were the most common qualitative themes regarding operative barriers (75 responses). Racial bias (n = 22) was frequently referenced as a barrier specifically experienced by URiM residents. Suggestions to improve the operative experience of URiM residents included increasing mentorship at the attending level (n = 25) and setting objective standards for resident operating room participation (n = 30).

Conclusions

Nearly five times as many URiM residents reported experiencing barriers in obtaining case numbers compared to non-URiM residents. Qualitative analysis suggests that clear expectations for resident participation in cases and increasing mentorship at the attending level may be ways to achieve parity.

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普通外科住院医生的种族和手术经验：混合方法研究

导言最近的多机构定量研究发现，黑人普外科住院医师在培训期间进行的手术较少。材料与方法通过开放式回答和李克特量表问题收集数据，这些问题以电子方式分发给美国住院医师手术经验联盟（US Resident Operative Experience Consortium）中 21 个经认证的美国普外科项目的住院医师。问题主要涉及哪些障碍阻碍住院医师进入手术室以及潜在的解决方案。三位定性评审员对自由文本进行了分析。结果在线调查由96名普外科住院医师完成，占美国住院医师手术经验联盟21个项目总回复率的12%。8名（n = 8/13，62%）URiM住院医师表示他们在获取病例号时遇到了障碍，而非URiM住院医师的这一比例为13%（P <0.05）。两组住院医师中同意其培训质量受种族或民族影响的比例相近（n = 6/13，46%；n = 34/49，41%；P = 0.77）。地面工作和临床任务是有关手术障碍最常见的定性主题（75 个回答）。种族偏见（n = 22）是URiM住院医师经常遇到的障碍。改善URiM住院医师手术体验的建议包括增加主治医师层面的指导（n = 25）以及为住院医师参与手术室工作设定客观标准（n = 30）。定性分析表明，明确住院医师参与病例的期望值和加强主治医师层面的指导可能是实现均等的途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Research 医学-外科

CiteScore

3.90

自引率

4.50%

发文量

627

审稿时长

138 days

期刊介绍： The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories. The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.