Enhancing Perceptions of Social Support and Belonging in Surgery Residency Programs

Objective

To evaluate perceptions of social support, belongingness, and program culture among general surgery trainees.

Design

Cross-sectional quantitative study using a program assessment survey with Likert scale questions (1-5). Questions evaluated trainee perceptions of organizational culture (4 dimensions—Authoritarian, Empowering, Self-Directed, and Relational; 29 items), social support (5 items), belongingness (7 items), frequency of social interactions (1 item), satisfaction with socializing (2 items) and ease of access to support (6 items).

Setting

Four academic general surgery programs in the United States.

Participants

General surgery trainees.

Results

Overall response rate was 67% (63/94). Respondents were 46% (29) women, 72% White (45), and 61.9% (39) junior residents (PGY 1-3). Trainees shared similar perceptions of level of social support (mean 4.29, SD 0.75, p = 0.08), access to support, and sense of belonging (mean 4.27, SD 0.76, p = 0.17) across programs. Majority reported either daily (34, 41.7%) or weekly (19, 33.3%) social interactions. Increased social interaction frequency was associated with higher perceptions of social support (p = 0.04), with anything beyond 2 interactions per month outside of work associated with the highest levels of perceived social support. Trainees’ sense of belonging was strongly correlated with perceptions of social support (r = 0.89, p < 0.001). Both social support and sense of belonging were positively correlated with a program culture predominant in Self-Directed and Relational dimensions (social support: r = 0.531 and 0.366, belonging: r = 0.531 and 0.313, all p < 0.05 respectively) and negatively correlated with a program culture predominant in Authoritarian and Empowering dimensions (social support: r = −0.323 and −0.282, belonging: r = −0.387 and −0.366, all p < 0.05, respectively).

Conclusions

Resident perceptions of social support and belongingness are interrelated and may be maximized by increasing frequency of social interactions and fostering program cultures higher in Self-Directed and Relational dimensions. Programs should make efforts to cultivate and encourage activities outside of work to optimize trainee inclusivity and support.