Margaret A Reilly, Christina L Cui, Yue Jiang, Eric B Pillado, Ruojia Debbie Li, Joshua S Eng, Leanne E Grafmuller, Kathryn L DiLosa, Palma M Shaw, Yue-Yung Hu, Karl Y Bilimoria, Dawn M Coleman, Malachi G Sheahan
{"title":"A multimethod assessment of the vascular surgery program director experience in creating effective training environments.","authors":"Margaret A Reilly, Christina L Cui, Yue Jiang, Eric B Pillado, Ruojia Debbie Li, Joshua S Eng, Leanne E Grafmuller, Kathryn L DiLosa, Palma M Shaw, Yue-Yung Hu, Karl Y Bilimoria, Dawn M Coleman, Malachi G Sheahan","doi":"10.1016/j.jvs.2025.08.034","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Surgical training has received significant attention in recent years with efforts to improve trainee wellness. Vascular surgery training is subject to unique challenges, and vascular program directors (PDs) are tasked with providing learning environments that produce effective and competent surgeons. The aim of this study was to examine the experience of vascular surgery PDs in promoting effective learning environments for vascular trainees.</p><p><strong>Methods: </strong>Data were collected from confidential, voluntary surveys of vascular surgery residency PDs with multiple choice and free response questions as part of the Surgical Education Culture Optimization Through Targeted Interventions based on National Comparative Data (SECOND) trial. PDs were asked about their use of wellness interventions, resources available through their institution, and resources still required. PDs indicated the most rewarding and challenging aspects of their role. Program-level wellness data were aggregated from trainee responses to an annual survey of trainee wellness. Associations between program wellness metrics and the number of interventions used by PDs were assessed with Wilcoxon rank-sum tests. Qualitative data were analyzed with inductive reasoning to identify themes.</p><p><strong>Results: </strong>Of 33 PDs who participated in the survey (76.7% of programs enrolled in the Vascular SECOND trial), most PDs had opportunities to engage with other faculty (n = 27 [81.8%]), support from Graduate Medical Education (n = 27 [81.8%]), and administrative support from program coordinators (n = 26 [78.8%]). Many PDs reported a need for additional salary/stipend support to incentivize program leadership (n = 23 [69.7%]), funded protected effort to decrease clinical responsibilities (n = 18 [54.6%]), and discretionary educational funds (n = 13 [39.4%]). The trainee-related issues most frequently encountered by PDs were performance challenges (n = 15 [45.5%]) and interpersonal issues between trainees and ancillary staff (n = 9 [27.3%]). The most common institutional-level issues were incongruence between hospital administration goals and clinical priorities (n = 9 [27.3%]) and protected time for administrative responsibilities (n = 8 [24.2%]). There were no significant associations between trainee wellness and perception of program responsiveness or resources needed or available to PDs. Themes of the most rewarding aspects of the PD job were participating in trainee growth, training the next generation, and interpersonal relationships. Themes of most challenging aspects were generational differences, interpersonal challenges, lack of resources, and administrative tasks.</p><p><strong>Conclusions: </strong>Vascular surgery PDs assume a challenging role with unique responsibilities. Certain barriers and facilitators of wellness may be experienced by a majority of PDs, which allows for identification of potentially widely effective interventions. Ultimately, supporting PD efforts should focus on improving resources like funded protected efforts and reducing administrative burden.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Vascular Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jvs.2025.08.034","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Surgical training has received significant attention in recent years with efforts to improve trainee wellness. Vascular surgery training is subject to unique challenges, and vascular program directors (PDs) are tasked with providing learning environments that produce effective and competent surgeons. The aim of this study was to examine the experience of vascular surgery PDs in promoting effective learning environments for vascular trainees.
Methods: Data were collected from confidential, voluntary surveys of vascular surgery residency PDs with multiple choice and free response questions as part of the Surgical Education Culture Optimization Through Targeted Interventions based on National Comparative Data (SECOND) trial. PDs were asked about their use of wellness interventions, resources available through their institution, and resources still required. PDs indicated the most rewarding and challenging aspects of their role. Program-level wellness data were aggregated from trainee responses to an annual survey of trainee wellness. Associations between program wellness metrics and the number of interventions used by PDs were assessed with Wilcoxon rank-sum tests. Qualitative data were analyzed with inductive reasoning to identify themes.
Results: Of 33 PDs who participated in the survey (76.7% of programs enrolled in the Vascular SECOND trial), most PDs had opportunities to engage with other faculty (n = 27 [81.8%]), support from Graduate Medical Education (n = 27 [81.8%]), and administrative support from program coordinators (n = 26 [78.8%]). Many PDs reported a need for additional salary/stipend support to incentivize program leadership (n = 23 [69.7%]), funded protected effort to decrease clinical responsibilities (n = 18 [54.6%]), and discretionary educational funds (n = 13 [39.4%]). The trainee-related issues most frequently encountered by PDs were performance challenges (n = 15 [45.5%]) and interpersonal issues between trainees and ancillary staff (n = 9 [27.3%]). The most common institutional-level issues were incongruence between hospital administration goals and clinical priorities (n = 9 [27.3%]) and protected time for administrative responsibilities (n = 8 [24.2%]). There were no significant associations between trainee wellness and perception of program responsiveness or resources needed or available to PDs. Themes of the most rewarding aspects of the PD job were participating in trainee growth, training the next generation, and interpersonal relationships. Themes of most challenging aspects were generational differences, interpersonal challenges, lack of resources, and administrative tasks.
Conclusions: Vascular surgery PDs assume a challenging role with unique responsibilities. Certain barriers and facilitators of wellness may be experienced by a majority of PDs, which allows for identification of potentially widely effective interventions. Ultimately, supporting PD efforts should focus on improving resources like funded protected efforts and reducing administrative burden.
期刊介绍:
Journal of Vascular Surgery ® aims to be the premier international journal of medical, endovascular and surgical care of vascular diseases. It is dedicated to the science and art of vascular surgery and aims to improve the management of patients with vascular diseases by publishing relevant papers that report important medical advances, test new hypotheses, and address current controversies. To acheive this goal, the Journal will publish original clinical and laboratory studies, and reports and papers that comment on the social, economic, ethical, legal, and political factors, which relate to these aims. As the official publication of The Society for Vascular Surgery, the Journal will publish, after peer review, selected papers presented at the annual meeting of this organization and affiliated vascular societies, as well as original articles from members and non-members.