Journal of Surgical Education最新文献

{"title":"Shared EPA Expectations: Mapping Micro-Assessments to The Traditional Rotational Training Framework","authors":"Shannon Barter MD ,&nbsp;Elisabeth T. Tracy MD ,&nbsp;Kevin Shah MD ,&nbsp;Jacob Greenberg MD, Msc, Edu ,&nbsp;Kimberly Brown MD","doi":"10.1016/j.jsurg.2025.103826","DOIUrl":"10.1016/j.jsurg.2025.103826","url":null,"abstract":"<div><h3>Introduction</h3><div>In the transition to competency-based surgical training, Entrustable Professional Activities (EPAs) must demonstrate their efficacy as a formative assessment tool while working in a time-based, rotational framework. We seek to identify how the EPA clinical content areas fit into a traditional time-based general surgery training paradigm at a single institution to explore how to bolster EPA implementation.</div></div><div><h3>Methods</h3><div>The educational lead faculty for each resident rotation were asked how often the residents on that rotation would perform each of the EPAs in all phases of care within a 1-month block. Residents received rotation-specific surveys over a 6-month period on how often they performed the EPA functions in a month's rotation. The frequency of reported EPA exposure was then mapped to our clinical year-specific training schedule and intraclass correlation coefficients were calculated to determine attending and resident agreement.</div></div><div><h3>Results</h3><div>Twenty faculty completed the survey across our 4 hospital sites and 45 rotations. There were 91 resident responses over 6 months for 41 individual rotations. When averaged together, the most frequent EPA opportunity for each of the 5 clinical years of training was Consults (EPA 7). Trends in EPA opportunities were identified based on clinical year and phase. Overall, the interclass correlation coefficient (ICC) values were poor, suggesting a low level of agreement between faculty and residents. Our institution's rotation-specific EPA roadmap provides a projection of where the EPA clinical areas fit into this time-based training program.</div></div><div><h3>Conclusions</h3><div>A thorough survey-based review of the EPA content areas’ alignment with a single institution's rotation structure highlights areas of low frequency and agreement of EPA task performance. The results of this study will help to guide EPA implementation through the intentional creation of shared EPA expectations.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 3","pages":"Article 103826"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146014012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Imposter Phenomenon on Residents in Surgical Specialties:A Scoping Review","authors":"Andrew J. Gaetano BS ,&nbsp;Maya V. Roytman ,&nbsp;Eisa Razzak ,&nbsp;Maha L. Khan ,&nbsp;Elizabeth Huggins ,&nbsp;Mitchell J. Christiansen ,&nbsp;Mary K. Mulcahey MD","doi":"10.1016/j.jsurg.2025.103836","DOIUrl":"10.1016/j.jsurg.2025.103836","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to review the existing literature on imposter phenomenon (IP) among residents in surgical specialties to determine its prevalence, examine differences across demographics (e.g., gender, race, age, year in training), and explore its qualitative effects on mental health and wellbeing.</div></div><div><h3>Design</h3><div>This scoping review was conducted in accordance with the PRISMA-ScR checklist. Eligible sources included peer-reviewed articles, conference abstracts, and commentaries; systematic reviews were excluded. Literature searches were conducted in APA PsychINFO, Embase, the AAMC’s MedEdPortal, PubMed, and Web of Science Core Collection using keywords related to IP and surgical trainees. The literature search was performed in October 2024 and updated in May 2025. Screening and full-text review were performed independently and in duplicate using Covidence, with discrepancies resolved by consensus.</div></div><div><h3>Setting</h3><div>Various academic and clinical training environments within the U.S.</div></div><div><h3>Participants</h3><div>Study participants were surgical residents in U.S.-based training programs. Inclusion criteria required that studies report on either the prevalence or psychological effects of IP among surgical residents.</div></div><div><h3>Results</h3><div>Of the 3249 studies identified, 2346 titles and abstracts were screened, and 46 full-text articles reviewed. Fifteen studies met inclusion criteria. IP was highly prevalent among surgical residents, with women residents reporting higher rates. Identified associations included burnout (2 studies), anxiety (2), emotional exhaustion (1), lower self-compassion (1), and suicidal ideation (1). Several studies recommended strategies to mitigate IP, such as mentorship, coaching, inclusive environments, and education especially for high-risk groups such as women and underrepresented residents.</div></div><div><h3>Conclusion</h3><div>IP is highly prevalent among surgical residents and associated with adverse mental health outcomes. Targeted interventions such as mentorship, coaching, and culturally responsive support are needed to address the psychological burden of IP and promote wellbeing in surgical residents.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 3","pages":"Article 103836"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid Delivery of ATLS Maintains Learner Outcomes","authors":"Sam Mathai MD ,&nbsp;Robyn Wolverton MSN, RN, CEN, TCRN ,&nbsp;Renee Hildebrand BSN, RN, TCRN ,&nbsp;Whitney Jenson MD, MPH, FACS ,&nbsp;William Aaron Marshall MD, FACS ,&nbsp;Michael W. Cripps MD, MSCS, FACS ,&nbsp;Thomas J. Schroeppel MD, MS, FACS ,&nbsp;Kristy L. Hawley MD, MPH, FACS","doi":"10.1016/j.jsurg.2025.103852","DOIUrl":"10.1016/j.jsurg.2025.103852","url":null,"abstract":"<div><h3>Objective</h3><div>To compare learner outcomes and satisfaction between traditional in-person and hybrid Advanced Trauma Life Support (ATLS) 10th Edition course formats. We hypothesized that the hybrid model would maintain learner performance without compromising satisfaction.</div></div><div><h3>Design</h3><div>Retrospective cohort study comparing pre- and post-test scores and postcourse survey responses from ATLS participants at 2 sites between January 2021 and December 2024. Data were analyzed using 2-tailed t-tests.</div></div><div><h3>Setting</h3><div>Two Level I trauma centers and academic teaching hospitals offering ATLS courses—one using a traditional in-person format, and the other a hybrid format incorporating asynchronous online modules with a shortened in-person session.</div></div><div><h3>Participants</h3><div>A total of 649 learners were included (370 hybrid; 279 traditional). All completed both pre- and post-tests; 197 learners (63 hybrid; 134 traditional) completed postcourse surveys. Participants included physicians, resident physicians, advanced practice providers, and certified nurse anesthetists. Resident physicians were present only in the hybrid cohort.</div></div><div><h3>Results</h3><div>Learners in the hybrid group had lower pretest scores (median 78 vs. 80, p = 0.037) but higher post-test scores (median 90 vs. 85, p &lt; 0.001) compared to the traditional group. Survey responses showed no significant differences between cohorts in perceived competence, communication, or overall satisfaction.</div></div><div><h3>Conclusions</h3><div>Hybrid ATLS delivery was noninferior to traditional models when comparing post-test scores and learner satisfaction. These findings support the use of hybrid formats in trauma education and suggest potential benefits in scalability and accessibility. Further research is needed to assess long-term retention and cost-effectiveness.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 3","pages":"Article 103852"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Growing Momentum of Leadership Education in General Surgery Training: A Systematic Review","authors":"Baila Maqbool MD ,&nbsp;Arshia Jahangir ,&nbsp;Murtaza Hassan ,&nbsp;Muhammad Taha Nasim ,&nbsp;Shaikh Saif ur Rehman ,&nbsp;Muhammad Uzair","doi":"10.1016/j.jsurg.2025.103854","DOIUrl":"10.1016/j.jsurg.2025.103854","url":null,"abstract":"<div><h3>Introduction</h3><div>Leadership is a core competency in surgery, critical for guiding interprofessional teams in high-stakes environments such as the operating room and trauma bay. While competency frameworks mandate leadership development during residency, training opportunities remain variable and inconsistently evaluated. This systematic review summarizes published curricula on leadership training for general surgery and subspecialty residents.</div></div><div><h3>Methods</h3><div>A systematic search identified studies describing leadership development interventions for surgical trainees. Data were extracted on study characteristics, intervention design, delivery methods, curriculum content, and evaluation strategies. Outcomes were synthesized narratively with emphasis on effectiveness and educational approaches.</div></div><div><h3>Results</h3><div>Nineteen studies published between 1987 and 2024 were included. Most originated from the United States, with additional contributions from Australia and Canada. Interventions targeted a range of trainees from interns to fellows, with participant numbers ranging from 8 to 180. Curricula varied in duration, from single-day workshops to multi-year longitudinal programs. Delivery methods included lectures, case-based discussions, simulations, coaching, and hybrid models. Early curricula emphasized practice management and career preparation, whereas more recent initiatives focused on non-technical skills, resilience, diversity, and inclusivity. Most programs provided protected time, and about half mandated participation. Evaluation was predominantly via post-session surveys, though some incorporated validated tools such as the Internal Strength Scorecard, NOTSS, and structured video assessments. Participants consistently reported improved confidence, leadership behaviors, and team communication. Randomized studies demonstrated significant gains in leadership performance during simulated and real clinical settings.</div></div><div><h3>Conclusion</h3><div>Leadership training for surgical residents has evolved from management-focused lectures to interactive, competency-driven curricula. While evidence shows consistent learner benefit, the literature remains limited by reliance on self-reported outcomes and heterogeneity in evaluation methods. Future efforts should prioritize rigorous assessment, longitudinal follow-up, and integration across surgical specialties. Embedding structured, evidence-based leadership training into residency is essential for preparing surgeons to lead interprofessional teams effectively and improve patient outcomes.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 3","pages":"Article 103854"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Usmle Step 2 CK the New Usmle Step 1 for Ophthalmology Residency Applications? A San Francisco Match Analysis","authors":"Rahel M. Imru BA ,&nbsp;Muhammad Ali MBBS ,&nbsp;Ahmed Sabit MS ,&nbsp;Laura K. Green MD ,&nbsp;Jules Winokur MD ,&nbsp;R. Michael Siatkowski MD, MBA ,&nbsp;Jeff H. Pettey MD, MBA ,&nbsp;Alice Lorch MD, MPH ,&nbsp;Fasika A. Woreta MD, MPH","doi":"10.1016/j.jsurg.2025.103851","DOIUrl":"10.1016/j.jsurg.2025.103851","url":null,"abstract":"<div><h3>Objective</h3><div>To assess trends in Step 2 CK score by ophthalmology residency match status, and to compare Step 2 CK scores by applicant sex and race and ethnicity.</div></div><div><h3>Design</h3><div>This is a retrospective cohort study from 2021 to 2023. Applicants were stratified by match status and mean Step 2 CK score was compared between matched and unmatched applicants. Step 2 CK scores were also compared by applicant sex, race/ethnicity, type of medical school, and Alpha Omega Alpha selection. Chi-Squared tests, Kruskal-Wallis tests, and multivariate logistic models were used to assess for association of (1) Step 2 CK score and matching into ophthalmology residency, and (2) applicant characteristics and achieving above the national cohort average (&gt;250) Step 2 CK score.</div></div><div><h3>Setting</h3><div>The data is extracted from the San Francisco Match (SF Match).</div></div><div><h3>Participants</h3><div>Applicants who registered for the SF Match and submitted their application to at least 1 ophthalmology residency program from 2021 through 2023 were included.</div></div><div><h3>Results</h3><div>Of 2367 total applicants in ophthalmology residency, 64.2% matched successfully. Overall mean Step 2 CK score was 255 for matched and 242 for unmatched applicants (p &lt; 0.001). For each 10-point increase in Step 2 CK score, odds of matching in ophthalmology increased by approximately 63% (p &lt; 0.001). White, Asian, and URiM applicants had mean scores of 252, 251, and 244, respectively (p &lt; 0.001). Identifying as Asian, URiM, and female, and attending an osteopathic school were associated with lower odds of achieving a high Step 2 CK score (OR = 0.70, p = 0.011; OR = 0.32, p &lt; 0.001; OR = 0.78, p = 0.042; OR = 0.31, p &lt; 0.001; respectively).</div></div><div><h3>Conclusions</h3><div>Higher Step 2 CK score was associated with higher odds of matching in ophthalmology. Non-White and female students had lower odds of achieving an above average score. Future studies are necessary to determine the barriers that exist which put these applicants at a disadvantage with this standardized exam.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 3","pages":"Article 103851"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Table of Contents & Bacode","authors":"","doi":"10.1016/S1931-7204(26)00032-2","DOIUrl":"10.1016/S1931-7204(26)00032-2","url":null,"abstract":"","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 3","pages":"Article 103899"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Undermining Confidence: Examining Trainees’ Perspectives on Confidence in General Surgery","authors":"Meghna Kurup MD ,&nbsp;Dawn Elfenbein MD, MPH, FACS ,&nbsp;Claire Wendland MD, PhD, FACOG","doi":"10.1016/j.jsurg.2025.103859","DOIUrl":"10.1016/j.jsurg.2025.103859","url":null,"abstract":"<div><h3>Objective</h3><div>General surgeons need confidence to operate in high-pressure settings, and so it is an important trait to cultivate in residency. Previous studies have characterized factors that influence trainee confidence without clearly defining what it is or how it may interact with gendered social norms. The study’s aim was to examine perspectives on confidence and define the relationship between confidence and gender among trainees in general surgery.</div></div><div><h3>Design</h3><div>This qualitative study utilized an anonymous online survey followed by semi-structured interviews to elicit participants’ perspectives. While our intent had been to correlate data from both methods, not all who participated in the survey completed an interview and vice versa. As the narrative data was better suited to the study’s objective, that is what we present here. Interview responses were analyzed using a grounded theory approach with iterative thematic coding and identification of illustrative data extracts. Surveys and interviews were completed between February and March 2023.</div></div><div><h3>Setting</h3><div>The study was conducted at a single academic medical center.</div></div><div><h3>Participants</h3><div>Participants were recruited through purposive sampling of all general surgery residents and 3rd or 4th year medical students who had completed general surgery clerkships.</div></div><div><h3>Results</h3><div>Of 27 participants (20 medical students – 8 planning to pursue surgical residency – and 7 general surgery residents) interviewed, 19 identified as female and 8 as male. Nineteen participants were White. Three themes emerged from interviews: (1) definitions of confidence are variable, not exclusively positive, and associated with certain gendered behaviors; (2) women and non-White trainees disproportionately incur social costs to enacting confidence; and (3) gender stereotypes continue to undermine trainee confidence.</div></div><div><h3>Conclusions</h3><div>Perceptions of confidence are manifold and difficult to unravel from cultural attitudes. As such, we advise against using <em>perceived</em> confidence as a metric in trainee evaluation and instead encourage open dialogue among trainees and faculty about the impact of intersectional identities on confidence.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 3","pages":"Article 103859"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Case Complexity Impact EPA Entrustment? Analysis Across PGY Levels and Phases of Care","authors":"Martin Paul Jones BS ,&nbsp;Julia Adriana Kasmirski MD ,&nbsp;Zhixing Song MD ,&nbsp;M. Chandler McLeod PhD, MS ,&nbsp;Andrea Gillis MD, MSPH ,&nbsp;Jessica Fazendin MD ,&nbsp;Britney Corey MD, MACM ,&nbsp;Brenessa Lindeman MD, MEHP","doi":"10.1016/j.jsurg.2025.103857","DOIUrl":"10.1016/j.jsurg.2025.103857","url":null,"abstract":"<div><h3>Background</h3><div>The American Board of Surgery will require Entrustable Professional Activity (EPA) assessments for general surgery certification beginning in 2028. Though many studies have examined EPA implementation, a gap exists in understanding the relationship between procedural complexity and entrustment scores, and the influence of phase of care (POC) and postgraduate year (PGY) level.</div></div><div><h3>Study Design</h3><div>De-identified EPA data from one institution were analyzed using linear and ordinal mixed models. Residents were grouped as juniors (PGY1-2) and seniors (PGY3-5). Interactions of case complexity with PGY and POC were examined to assess influence on entrustment.</div></div><div><h3>Results</h3><div>A total of 1413 EPA assessments were analyzed. A linear mixed-effects model demonstrated a significant interaction between PGY group and case complexity (p &lt; 0.01). Scores were significantly higher in nonoperative phases (β = 0.60, 95% Confidence Interval [95% CI]: 0.52-0.68, p &lt; 0.001), and PGY3-5 residents received higher ratings across all complexities: +1.02 (95% CI: 0.83-1.21) for straightforward, +0.77 (95% CI: 0.48-1.06) for moderate, and +0.87 (95% CI: 0.51-1.24) for complex cases. For junior residents, scores did not differ significantly between straightforward and moderate cases (β = −0.01, p = 0.87) but declined significantly in complex cases (β = −0.23, 95% CI: –0.42 to −0.03, p = 0.02). The PGY × complexity interaction resulted in a greater drop in mES for senior residents, as compared to junior residents, when moving from straightforward to moderate cases (β = −0.25, 95% CI: –0.41 to −0.09, p &lt; 0.01). While senior residents also experienced a significant decline from straightforward to complex cases, this decrease was not significantly different from that experienced by junior residents (β = −0.14, 95% CI: −0.36-0.07, p = 0.20).</div></div><div><h3>Conclusions</h3><div>Entrustment scores decrease with increasing procedural complexity and increase with PGY level and nonoperative phases of care. The effect of complexity differed by training levels: junior resident scores remained stable from straightforward to moderate cases and declined only in complex procedures, while senior resident scores declined significantly at both the moderate and complex threshold. These findings underscore the importance of interpreting EPA data in the context of both case complexity and trainee experience.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 3","pages":"Article 103857"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence of Skill Transferability From Training in Virtual Reality Robotic Surgery Simulators to Nonvirtual Environments: A Systematic Review","authors":"Krishnamurti MA Sarmento Jr PhD ,&nbsp;Walter B Vidal Filho PhD ,&nbsp;Hugo NA França MD ,&nbsp;Luca C Rocha MD ,&nbsp;Maria L Sampaio MD ,&nbsp;Andre LL Sampaio PhD","doi":"10.1016/j.jsurg.2025.103833","DOIUrl":"10.1016/j.jsurg.2025.103833","url":null,"abstract":"<div><h3>Objectives</h3><div>Synthesize evidence on (1) transfer of skills acquired with virtual reality robotic surgery simulators (VR-RSS) to nonvirtual settings, (2) equivalence or noninferiority versus nonvirtual training, and (3) downstream clinical outcomes.</div></div><div><h3>Design</h3><div>PRISMA-conformant systematic review with a prospectively registered protocol. Risk of bias was appraised with RoB 2 (RCTs) and ROBINS-I (nonrandomized studies); certainty of evidence used GRADE with an imprecision adaptation (decision-threshold confidence intervals and scaled optimal information size).</div></div><div><h3>Setting</h3><div>Searches of major bibliographic databases and grey sources through September 2025; studies conducted in academic skills labs, simulation centers, or clinical environments, with nonvirtual outcome assessments (bench/animal/cadaveric tasks, simulated or live operations, or patient outcomes).</div></div><div><h3>Participants</h3><div>Medical students, surgical residents, or practicing surgeons trained on commercially available VR-RSS devices and evaluated on nonvirtual tasks or clinical endpoints.</div></div><div><h3>Results</h3><div>Twenty-five studies met criteria (13 randomized, 5 nonrandomized comparatives, 7 single-group pre/post). Across designs, VR-RSS training improved proximal nonvirtual performance—faster task completion, fewer errors, and higher GEARS/OSATS/GOALS scores. Two randomized trials found no important difference versus control; these null results were internally coherent and did not contradict the overall direction of benefit. Evidence for translation to live operative performance or patient-level outcomes was limited and heterogeneous. Risk of bias varied—generally lower in recent randomized trials—while imprecision was pervasive due to small samples, absent confidence intervals, and undefined minimally important differences. Overall certainty was low–moderate for educational outcomes and low for clinical endpoints.</div></div><div><h3>Conclusions</h3><div>VR-RSS improves proximal nonvirtual technical performance and merits integration within structured curricula. Claims of equivalence to nonvirtual training and of patient-level benefit remain provisional. Preregistered, adequately powered trials with blinded, standardized nonvirtual endpoints and explicit decision thresholds are needed to establish educational and clinical value.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 3","pages":"Article 103833"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145929180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Attending Feedback Styles in General Surgery: A Residency-Wide Survey and Needs Assessment","authors":"Spencer Wilhelm MD ,&nbsp;John T. Nida MD ,&nbsp;Felicia Ivascu MD ,&nbsp;Ngan Nguyen PhD ,&nbsp;Nathan M. Novotny MD","doi":"10.1016/j.jsurg.2025.103835","DOIUrl":"10.1016/j.jsurg.2025.103835","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the intraoperative feedback styles of general surgery attendings using a resident-facing assessment tool grounded in the “debriefing with good judgment” framework, and to evaluate associations between feedback style and faculty characteristics.</div></div><div><h3>Design</h3><div>Cross-sectional survey study employing a needs assessment approach and incorporating structured resident education on feedback theory prior to survey administration.</div></div><div><h3>Setting</h3><div>A general surgery residency program at a university affiliated teaching hospital.</div></div><div><h3>Participants</h3><div>Forty General surgery residents (PGY1-6) were surveyed for perceived intraoperative feedback styles of individual attending surgeons.</div></div><div><h3>Results</h3><div>About 80% of residents (33/41) completed evaluations of 42 attendings. Most attendings (95.3%) were perceived to use more than 1 feedback style. While 51.9% of total feedback interactions were categorized as effective (good judgment), 85.7% of attendings delivered ≥25% ineffective feedback (judgmental or nonjudgmental). Male attendings were significantly more likely to deliver effective feedback compared to female attendings (U = 0.5, p &lt; 0.001), and thoracic surgeons were less likely to provide effective feedback (OR = 0.55, p = 0.033). Faculty with ≥20 years of clinical experience were significantly more likely to deliver effective feedback (OR = 1.50, p = 0.037). No gender-based differences were found among residents in their perception of feedback.</div></div><div><h3>Conclusion</h3><div>Intraoperative feedback was frequently ineffective, with differences by attending gender, subspecialty, and seniority. These patterns indicate that feedback delivery may be a modifiable, teachable skill shaped by experience and context, emphasizing faculty development and sustained engagement as critical avenues to strengthen the culture and quality of surgical education.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 3","pages":"Article 103835"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}