Qualitative Insights into Resident Perceptions of Teaching Excellence and Educational Curricula

Abstract

Objective: The objective of this study was to understand the resident perspective on what makes an excellent surgical educator and to identify gaps in a single-institution-developed "Residents as Teachers" curriculum (RaTC) following the completion of the RaTC by residents at the institution.

Design: A longitudinal 8-hour RaTC was developed and administered in 1-hour sessions over 2 years. Content included interactive clinical and technical skills teaching, feedback, evaluation and assessment, and interpersonal skills. Residents who had completed the RaTC were invited to participate in interviews exploring their perceptions of the RaTC and their own clinical teaching experiences. Interview comments were coded and analyzed for thematic content.

Setting: This study took place at the University of Nebraska Medical Center (Omaha, NE). The RaTC was delivered between 2021-2023 and interviews were held in June of 2023.

Participants: The eligible cohort for this study included all general surgery residents in our general surgery program who had completed the full RaTC (PGY2 and above).

Results: Seven subjects participated in interviews. Subjects reported that the RaTC helped enhance their skills as surgical educators and that teaching is an important part of their job. Thematic analysis identified 3 areas in which subjects commented on both facilitators and barriers to educating in the clinical environment: educator behaviors and teaching methodologies, learner attitudes and behaviors, and systemic factors. Residents felt uncomfortable teaching procedural tasks, giving constructive criticism, and finding time to teach throughout the day.

Conclusions: The RaTC was well received by our participants, who reported that it helped improve their ability to teach. However, they often felt uncomfortable implementing these skills in real-life scenarios with learners. Our curricula will be revised, and other training programs could design curricula to provide more time to practice these skills in particular in a low-stakes setting, which may help residents feel more confident utilizing them while teaching.

Keywords: Curricular design; Curriculum assessment; Medical student education; Residents as teachers.