CanMEDS scholars: A national survey on urology residents' attitudes towards research during training

Abstract

Introduction: Participation in scholarly activity is an important tenet of residency training and is firmly entrenched in Canada since the introduction of CanMEDS roles by the Royal College of Physicians and Surgeons. As Canadian residency programs transition to competency-based training, it will remain important to understand how to best implement and encourage scholarly pursuits among resident trainees. The objective of this study was to understand the experiences, attitudes, and barriers that surgical residents face when pursuing research during their training.

Methods: An anonymous, cross-sectional, self-report questionnaire was administered to chief residents of all English-speaking urology programs in Canada in 2015. Questions were open- and close-ended, including an agreement score based on a five-point Likert scale. Questions addressed residents' involvement in and attitudes towards research, as well as their perceptions of the utility of research involvement during training. The residents were also asked about the support they received and potential areas to improve the attainment of this competency. Descriptive and correlative statistics were used to analyze the responses.

Results: There was a 100% overall response rate to the questionnaire. This study revealed that Canadian urology residents have a high rate of participation in scholarly work, with the vast majority (94%) publishing at least one manuscript with a mean of four papers. Despite this, there appeared to be significant variation in the respondent's experiences, including protected time for research. Furthermore, many residents appeared unconvinced of the importance of research involvement, with only 51% agreement that participation was important to their overall training. As well, a significant number of residents reported largely external, rather than internal, motivations for research participation, such as attaining a preferred fellowship (66% agreement). While the majority of respondents felt (66% agreement) that the scholar role was important in residency training, it would appear that significant barriers, including time and mentorship, limited the effectiveness of research participation to gain those competencies.

Conclusions: The results of this self-report survey outline the significant differences in attitudes and experience towards mandatory research as a component of scholarship in Canadian urology training programs. As postgraduate medical education evolves, particularly with the uptake of competency-based medical education, programs and residents will need to address the motives and barriers to better foster academic pursuits during urology training.

Fig. 1

Number of hours, on average, currently spent on research per month. Overall, the median time spent on research was four hours per month. As one might expect, time spent on research appeared to correlate with likeliness of academic practice.

Fig. 2

Breakdown of fellowship inclinations among residents. Twenty-six of 35 residents responded; the rest, presumably, did not plan on doing a fellowship.

Fig. 3

Number of publications reported by urology residents in their final year. These include all papers published or submitted with the resident’s name. The vast majority (94%) of chief residents had published, with an average of two first authorships and four total publications each. Most had participated in retrospective chart reviews and case reports/series (91% and 57%, respectively).

Fig. 4

Resident attitudes toward research. Thirty-five chief residents responded to a series of statements using a five-point Likert scale. In general, it appears that residents appear unconvinced of the importance of research and are extrinsically motivated to participate. They do, however, identify a paucity of allocated research time as a reversible barrier to scholarly pursuits.