Journal of Surgical Education最新文献

{"title":"The Impact of Medical School Experiences in Global Surgery on Perceptions and Career Plans Among U.S. Medical Students","authors":"Lydia Kersh MS, MPH ,&nbsp;Paul Serrato MS ,&nbsp;Cassandra Anderson MD ,&nbsp;Vanitha Raguveer MD ,&nbsp;Connor Peck MD ,&nbsp;Syeda Akila Ally MD ,&nbsp;Isha Gondi BS ,&nbsp;Shivani Subhedar DO ,&nbsp;Allison Rollins MD ,&nbsp;Blake Hauser MD ,&nbsp;Anusha Jayaram MD ,&nbsp;Sarah Hill MD ,&nbsp;Bathsheba Wariso MD ,&nbsp;Shahyan Rehman MD ,&nbsp;Global Surgery Student Alliance,&nbsp;James Clune MD","doi":"10.1016/j.jsurg.2025.103441","DOIUrl":"10.1016/j.jsurg.2025.103441","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>There is a growing interest among medical students to learn about global surgery and how they can incorporate it into their further training in residency. This study addresses US-based medical student perceptions of global surgery, medical school experiences, and career plans.</div></div><div><h3>METHODS</h3><div>A cross-sectional survey study of US-based medical students was performed. Univariate and multivariable regression models were constructed to assess the impact of student experiences during medical school and mentor experiences on global surgery perceptions and career plans. Career plans for international surgical mission trips and for global surgery advocacy/research were further evaluated.</div></div><div><h3>RESULTS</h3><div>Of the 708 responses, 251 (34.6%) students indicated interest in global surgery. Global surgery curricular experiences during medical school were associated with increased odds of believing that global surgery topics should be included in medical school curricula (OR = 2.42, p = 0.021) and having career plans for global surgery research or advocacy (OR = 3.72, p = 0.002). Students with mentors with global surgery research experience were more likely to have career plans for global surgery research or advocacy (OR = 4.36, p = 0.019). Student participation in global health research was associated with lower odds of having career plans for international surgical mission trips (OR = 0.22, p &lt; 0.001).</div></div><div><h3>CONCLUSION</h3><div>Students with more experience in global surgery view it more favorably, and have greater odds of participating in global surgery in their future careers. There is a desire among the respondent medical students for more global surgery education and mentoring among medical institutions. Therefore, medical schools may benefit by offering more global surgery opportunities at their institutions.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 4","pages":"Article 103441"},"PeriodicalIF":2.6,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082866","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":"Serve Coffee, Hold Clamps, Do Not Complain: Student Perceptions and Experiences Regarding Surgery","authors":"Begum Pekbay MD ,&nbsp;Sjoerd M. Lagarde MD, PhD ,&nbsp;Claudia M. Keyzer-Dekker MD, PhD ,&nbsp;Frouke C. de Vries MSc ,&nbsp;Jeroen de Jonge MD, PhD ,&nbsp;Johanna M. Hendriks MD, PhD","doi":"10.1016/j.jsurg.2024.103394","DOIUrl":"10.1016/j.jsurg.2024.103394","url":null,"abstract":"<div><h3>Objective</h3><div>To explore medical students’ perceptions and experiences regarding the surgery clerkship and surgeons.</div></div><div><h3>Design</h3><div>Between November 2021 and February 2022, an anonymous prepost survey study was performed among 2 consecutive cohorts of medical students. The survey was taken 6 weeks prior to the surgery clerkship and repeated shortly after the surgery clerkship.</div></div><div><h3>Setting</h3><div>Single-center prepost survey study.</div></div><div><h3>Participants</h3><div>Medical students studying at Erasmus Medical Center entering a 6-week surgery education block directly followed by a ten-week surgery clerkship.</div></div><div><h3>Results</h3><div>The preclerkship response rate was 100% (n=145). One out of 5 students considered a surgical career (21%). Half of the students expected to be negatively treated (55%), mainly in terms of hierarchy and offensive language. The postclerkship response rate was 70% (n=101). Interest in a surgical career increased significantly from 21% to 50% (p&lt;0.001). Thirteen students (13%) reported being negatively treated during their surgery clerkship, mainly in terms of poor supervision of their learning process and nonconstructive feedback.</div></div><div><h3>Conclusions and Relevance</h3><div>Stereotypes of surgeons and the surgical clerkship are strongly prevalent among medical students. Half of the students enter the surgery clerkship with negative perceptions. Fortunately, the surgery clerkship debunked prejudices and increased interest in surgery. Poor supervision and feedback during the surgery clerkship were experienced as negative treatment, emphasizing the importance of cultivating a safe learning climate.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103394"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Table of Contents & Bacode","authors":"","doi":"10.1016/S1931-7204(25)00004-2","DOIUrl":"10.1016/S1931-7204(25)00004-2","url":null,"abstract":"","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103423"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147982","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":"Urology Resident Autonomy in the Veterans Affairs Healthcare System","authors":"Anh Thuy Nguyen ,&nbsp;Joseph B. Oliver ,&nbsp;Kunj Jain ,&nbsp;Janmejay Hingu ,&nbsp;Anastasia Kunac ,&nbsp;Hossein Sadeghi-Nejad ,&nbsp;Devashish Anjaria MD, FACS","doi":"10.1016/j.jsurg.2024.103370","DOIUrl":"10.1016/j.jsurg.2024.103370","url":null,"abstract":"<div><h3>Purpose</h3><div>Surgical resident autonomy in procedures has been eroding over time, due to multiple factors that include duty hour restrictions, focus on operating time, complication rate, and trust among supervising physicians. This study examines whether urology residents at the Veterans Affairs hospitals (VA) have experienced decreased surgical autonomy and contributing factors.</div></div><div><h3>Methods</h3><div>The national VA Surgical Quality Improvement Program (VASQIP) was queried for the most common urologic procedures between 2004 to 2019 with resident involvement. The most frequent surgeries were transurethral resection of prostate (TURP); transurethral resection of small, medium, or large tumor (TURBT); photo vaporization of prostate, scrotal surgery, and ureteral stent placement. The cases were stratified by resident involvement: attending as primary (AP), attending and resident (AR), resident as primary (RP).</div></div><div><h3>Results</h3><div>93,756 urology cases were selected from 2004 to 2019. The above procedures accounted for 76.5% of all urologic cases. The percentage of RP cases decreased from 44.4% of cases in 2004 to 25.1% in 2019. Reduction in RP cases was seen in all of the 7 examined urology cases. Cases with resident involvement had patients with more medical comorbidities. Mean operative times were not significantly different. The 30-day composite complications and 30-day return to operating room were greatest for AR. Postoperative morbidity and all-cause mortality were not significantly different.</div></div><div><h3>Conclusions</h3><div>Urology resident autonomy has decreased within the VA healthcare system over the past 15 years. Mean operative times and postoperative complications are not significantly different in cases with residents as primary surgeon.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103370"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Many Faces of Good Operating Room Supervision: Supervisors’ and Residents’ Perspectives After Operating Together","authors":"Bart Lambert MD ,&nbsp;Martine C. Keuning MD ,&nbsp;Paul C. Jutte MD, PhD ,&nbsp;Agnes D. Diemers MD, PhD ,&nbsp;Patrick Nieboer MD, PhD ,&nbsp;Mike Huiskes PhD","doi":"10.1016/j.jsurg.2024.103396","DOIUrl":"10.1016/j.jsurg.2024.103396","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Effective operating room (OR) learning requires surgical and surgical-educational skills. Current insights into educational skills of surgical educators are derived from general perceptions of supervisors and residents via survey and interview studies. This study aims to provide insight into what educators and residents perceive as good OR supervision behavior based on actual day-to-day collaboration. Additionally, it seeks to explore the underlying goals of good OR supervision and to identify relations between good OR supervision behavior and underlying goals</div></div><div><h3>DESIGN</h3><div>16 supervisor-resident dyads performing a procedure were video recorded. Directly after the procedure educators and residents independently identified 3 moments of what they perceived as good supervision. During subsequent video-stimulated interviews, they elaborated on why they selected those moments. Thereafter, a qualitative thematic analysis was performed.</div></div><div><h3>SETTING</h3><div>Four common surgical procedures performed by a resident under supervision of a general or orthopedic surgeon in 6 different teaching hospitals in the Netherlands.</div></div><div><h3>PARTICIPANTS</h3><div>16 unique supervisor-resident dyads were included in a convenient sample.</div></div><div><h3>RESULTS</h3><div>Analysis yielded 13 different codes identifying supervisor behaviors and 6 underlying goals of good OR supervision. Which strategy surgical educators use to achieve one of the underlying goals is situation-dependent.</div></div><div><h3>CONCLUSIONS</h3><div>Good supervision is situated and needs to be updated as procedures progress. There is no one-on-one relation between types of good supervision behavior and the underlying goals. As such, a fixed template for effective OR supervision does not exist.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103396"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Perceived Impact of Global Surgery Engagement on Career Advancement among US Medical Students","authors":"Paul Serrato MS ,&nbsp;Rafat Solaiman BA ,&nbsp;Hiba Vohra MS ,&nbsp;Katherine Hu BS ,&nbsp;Amiti Jain BS ,&nbsp;Yasmin Alamdeen BS ,&nbsp;Bani Medegan Fagla BS ,&nbsp;Connor Peck MD, MPH ,&nbsp;Sarah Hill MD, MPH ,&nbsp;Bathsheba Wariso MD, MPH, MHS ,&nbsp;Shahyan Rehman MD ,&nbsp;Shivani Subhedar DO, MS ,&nbsp;Lydia Kersh MS ,&nbsp;Cassandra Anderson MD ,&nbsp;James Clune MD ,&nbsp;Global Surgery Student Alliance","doi":"10.1016/j.jsurg.2024.103404","DOIUrl":"10.1016/j.jsurg.2024.103404","url":null,"abstract":"<div><h3>Introduction</h3><div>There is growing interest among medical institutions to formalize global surgery training. Understanding medical students’ perceptions of how global surgery engagement can enhance career advancement is essential for providing appropriate guidance and support for individuals with aspirations in academic global surgery.</div></div><div><h3>Methods</h3><div>A cross-sectional survey study of US-based medical students from 38 participating schools was performed. Univariate and multivariate logistic regression models were constructed to assess motivations and the perceived impact of global surgery engagement on career advancement. The primary outcomes of interest were whether students perceived global surgery participation as beneficial for residency applications and for becoming a better surgeon.</div></div><div><h3>Results</h3><div>Of the 708 responses, 251 (35.5%) students indicated interest in global surgery. The most common top-ranked motivations for participating in global surgery were feeling a “responsibility to help those who are less privileged or underserved” (32.8%), “finding global health academically interesting” (19.3%), “having a moral commitment to global surgery as a component of health equity” (16.7%). Regardless of global surgery interest, most students believed global surgery engagement would make students better surgeons (83.1%) and better residency applicants (70.5%). On multivariate analysis, having global surgery in the medical school curriculum was associated with increased odds of perceiving the benefit of global surgery engagement for residency applications (aOR: 3.04, p = 0.042). Student membership in a global surgery interest group was associated with increased odds of perceiving the benefit of global surgery engagement for becoming a better surgeon (aOR: 2.17, p = 0.028).</div></div><div><h3>Conclusion</h3><div>Students with curricular and extracurricular involvement in global surgery during medical school tend to perceive the career benefits of global surgery engagement. Medical institutions should consider how participants will regard their professional growth when developing global surgery programs for trainees.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103404"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911373","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":"Virtual Impressions: An Examination of OBGYN Programs’ Online Presence in the Match Process","authors":"Kaitlyn Rewis MD, MA ,&nbsp;Nuong Truong MD ,&nbsp;Ann Lal MD ,&nbsp;Nicole Sprawka MD ,&nbsp;Layan Alrahmani MD","doi":"10.1016/j.jsurg.2024.103389","DOIUrl":"10.1016/j.jsurg.2024.103389","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>The COVID pandemic led to the transition of residency applications to a virtual format and the expansion of residency programs' virtual presence.</div></div><div><h3>OBJECTIVE</h3><div>The objective is to understand what information Obstetrics and Gynecology Residency interviewees prioritize and how influential program websites and social media platforms are.</div></div><div><h3>STUDY DESIGN</h3><div>Electronic surveys were sent to fourth-year medical students and OBGYN residents and were available for 6 weeks in spring 2023. All responses were anonymous and voluntary.</div></div><div><h3>RESULTS</h3><div>There were 198 survey respondents. From our cohort, fourth-year medical students, PGY-1, and PGY-2 residents had virtual interviews (71.2%) while PGY-3 and PGY-4 residents had in-person interviews (28.8%). Both virtual and in-person interviewees reported that the most important residency website information they were interested in included current resident profiles, rotation schedule, application cycle information, postresidency employment or match, and salary and benefits. Virtual interviewees were more interested in current resident profiles, salary and benefits, and video tours. Program websites and social media platforms were used by most, with virtual applicants accessing social media platforms more than in-person applicants (p &lt; 0.001). Of those that interviewed virtually, when compared to those who interviewed in-person, there were more interest in resident profiles, salary and benefits, and video tours. Websites and social media were influential for all respondents, most significantly for virtual applicants (p &lt; 0.001).</div></div><div><h3>CONCLUSIONS</h3><div>The recent shift to virtual OBGYN interviews has placed emphasis on residency programs' virtual presence. Our findings suggest that programs must be vigilant in providing a comprehensive view of their program in order to remain relevant and competitive.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103389"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911377","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":"Have Degree, Will Travel? Geography and Orthopaedic Surgery Residency Match","authors":"Elizabeth Cinquegrani BS ,&nbsp;Drake Giese BS ,&nbsp;Jefferson Driscoll BS ,&nbsp;Ajiel Basmayor BS ,&nbsp;Michael Perry BS ,&nbsp;Adam Thiessen MD","doi":"10.1016/j.jsurg.2024.103352","DOIUrl":"10.1016/j.jsurg.2024.103352","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>The paucity of objective data on the residency application is challenging to Orthopedic Surgery residency programs when selecting candidates to interview and to rank. Qualifying or quantifying the effect of geography on match results will help programs screen and rank candidates more effectively. The aim of this study is to describe the geographic background of current Orthopedic Surgery residents in the United States relative to their current residency program. We hypothesize there is a significant relationship between residents’ geographic background and the location of their residency programs.</div></div><div><h3>METHODS</h3><div>Geographic background information of current Orthopedic Surgery residents in the United States was obtained from public websites of Orthopedic Surgery residency programs. Information included region and city of each resident's residency program, hometown (HT), undergraduate (UG) school, and medical school (MS). The relationships between residents’ program region and city and their geographic background was analyzed. Cramer's V values were calculated to describe the strength of association between program region and HT, UG, and MS regions. Distance of program from HT, UG city, and MS city was calculated using the Haversine distance formula.</div></div><div><h3>RESULTS</h3><div>3718 US orthopedic residents were included. 47.2% of residents matched in the same region as their HT. 40.7% matched in the same region as their UG institution, and 49.6% matched in the same region as their MS. Of residents with data for HT, UG, and MS regions, 36.6% are in a program outside of the region of their HT, UG school, and MS. There was a statistically significant relationship between program region and HT, UG, and MS regions (p &lt; 0.0001) with the strongest relationship seen with medical school region.</div><div>The average distance of residency program from HT was 1175 km, from UG city was 1041 km, and from MS city was 894 km. Of residents with data for HT, UG, and MS cities, only 0.61% had all 3 in the same city as their residency program, and 13.3% had HT, UG city, and MS city within 100 km of their residency city.</div></div><div><h3>CONCLUSION</h3><div>The association between the geographic history of Orthopedic Surgery residents and their residency program location is complex. Most residents are in residency in a location with which they have some history, but many live a considerable distance from their hometowns and the cities in which they have previously studied. This information may be helpful to residency programs as they weigh the importance of geography with other factors when considering their rank lists.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103352"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916751","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":"Leadership in General Surgery Residency: The Impact as Seen by Former Program Directors","authors":"Shelley Jain MD ,&nbsp;Christie Buonpane MD ,&nbsp;Ryan Shabahang ,&nbsp;Rahul Kashyap MD ,&nbsp;Mohsen Shabahang MD, PhD","doi":"10.1016/j.jsurg.2024.103322","DOIUrl":"10.1016/j.jsurg.2024.103322","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>The position of general surgery residency program director (GSPD) has been well defined by governing bodies as an important educational role. Its impact on the individuals themselves has not been studied extensively. We aimed to examine the individual and professional impact of the role of GSPDs as seen by former program directors of general surgery residency programs.</div></div><div><h3>DESIGN</h3><div>This Institutional Review Board (IRB) exempt study conducted semi structured virtual interviews from May– September 2023 with former GSPDs. The research team consisted of 5 members who transcribed the interviews, coded the responses, and conducted a thematic analysis in an iterative consensus process. Final themes and subthemes were generated and representative quotes were selected.</div></div><div><h3>SETTING</h3><div>This study was conducted virtually at Wellspan York Hospital in York, Pennsylvania, a level-1 trauma center and community teaching hospital.</div></div><div><h3>PARTICIPANTS</h3><div>A total of 19 former GSPDs were recruited via purposeful sampling and snowballing. All 19 participants completed the study interview.</div></div><div><h3>RESULTS</h3><div>GSPD responses were found to have 5 recurring themes and several subthemes. The themes included 1) Development as a leader, 2) Relationship building, 3) Proficiencies needed as a program director, 4) Transactional aspects, 5) Transformational aspects.</div></div><div><h3>CONCLUSION</h3><div>Leading a general surgery residency program is an extremely impactful position that develops pivotal leadership skills, requires many proficiencies, relies on relationship building, and has aspects that are transactional and transformational. Holding the position of program director creates both personal fulfillment while 1 holds the position and has a positive professional impact in the subsequent stages of their career as a surgical educator.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103322"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916754","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 the Relationships Amongst Psychological Safety, the Learning Environment, and Well-Being in Surgical Faculty and Trainees","authors":"Alyssa A. Pradarelli MD ,&nbsp;Julie Evans MS ,&nbsp;Niki Matusko MS ,&nbsp;Norah N. Naughton MD ,&nbsp;Roy Phitayakorn MD, MHPE ,&nbsp;John T. Mullen MD ,&nbsp;Lily Chang MD ,&nbsp;Melissa Johnson MD ,&nbsp;Thavam Thambi-Pillai MD ,&nbsp;Jon Ryckman MD ,&nbsp;Melissa Alvarez-Downing MD ,&nbsp;Sebastiano Cassaro MD ,&nbsp;Felicia Ivascu MD ,&nbsp;David T. Hughes MD ,&nbsp;Gurjit Sandhu PhD","doi":"10.1016/j.jsurg.2024.103375","DOIUrl":"10.1016/j.jsurg.2024.103375","url":null,"abstract":"<div><h3>Objective</h3><div>Learning environments affect the well-being of surgical faculty and trainees. Psychological safety (PS) has been linked with learning behaviors and aspects of well-being within medicine; however, given the unique challenges inherent to the surgical learning environment, there is a need to more closely examine these concepts for surgical faculty and trainees. The objective of this study is to examine the relationships between learning environment and PS, as well as PS and well-being with surgery.</div></div><div><h3>Design</h3><div>Multi-institutional, cross-sectional survey study. The electronic survey included assessments of PS, professional fulfillment, and the learning environment. Exploratory and confirmatory factor analyses were performed to identify learning environment constructs. Index construct scores were generated. Multivariable multivariate regression analyses were used to examine the relationships between constructs in the learning environment and PS as well as PS and well-being.</div></div><div><h3>Setting &amp; Participants</h3><div>The electronic survey was distributed to surgical faculty, fellows, and residents at 8 institutions across the United States.</div></div><div><h3>Results</h3><div>For faculty, higher levels of professional interactions and rapport/climate within the learning environment were significantly associated with higher levels of PS (β = 0.39, p &lt; 0.01; β = 0.34, p &lt; 0.01, respectively). Higher levels of PS were significantly associated with lower levels of interpersonal disengagement (β = -0.16, p = 0.04). For trainees, higher levels of disrespect/retaliation and personal performance worry within the learning environment were significantly associated with lower levels of PS (β = -0.45, p &lt; 0.001; β = -0.11, p = 0.048, respectively). Higher levels of PS were significantly associated with higher levels of professional fulfillment (β = 0.24, p = 0.01) and lower levels of work exhaustion (β = -0.27, p &lt; 0.01) and interpersonal disengagement (β = -0.36, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>This study identified factors within the learning environment that were positively and negatively associated with psychological safety for surgical faculty and trainees. In addition, it identified a direct relationship between psychological safety and elements of well-being and burnout.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 2","pages":"Article 103375"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883937","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}