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. 2020 Oct;220(4):893-898.
doi: 10.1016/j.amjsurg.2020.03.022. Epub 2020 Mar 29.

Residents' method for gaining operative autonomy

Ingrid Woelfel  1 , Brentley Q Smith  2 , David Strosberg  3 , Michael Villarreal  3 , Alan Harzman  3 , Ritu Salani  2 , Amalia Cochran  3 , Xiaodong Phoenix Chen  3
Affiliations

Residents' method for gaining operative autonomy

Ingrid Woelfel et al. Am J Surg. 2020 Oct.

Abstract

Introduction: The goal of this study was to explore the resident construct for their perceived successful method of actions that lead to OR autonomy during residency and the strategies they employed.

Methods: We conducted focus group interviews with residents from the General Surgery (GS) and Obstetrics & Gynecology (OBGYN) departments at a single academic institution across all clinical postgraduate years (PGY) using convenience sampling. Audio recordings of each interview were transcribed, analyzed and emergent themes were identified using a framework method.

Results: A total of 38 residents participated. A 3-stage resident method to gain operative autonomy emerged. This progresses from building rapport, developing mutual entrustment, and finally to obtaining autonomy. We identified 4 common strategies used by residents to construct this method: smart communication, attention to attending preferences, helpful allies and visible attributes.

Conclusion: Our findings provide insight into resident strategies to achieve progressive autonomy in the OR helping programs improve resident's learning efficiency.

Keywords: Autonomy; Entrustability; Surgical residency.

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Conflict of interest statement

Declaration of competing interest The authors report no proprietary or commercial interest in any product mentioned or concept discussed in the article. RS sits on advisory boards for Astra Zeneca, Clovis, Tesaro, Ethicon, Genentech and Genmab. RS also is on the speaker’s bureau for Genentech.

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