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Surgical Trainees' Sense of Responsibility for Patient Outcomes: A Multi-institutional Appraisal.

Publication ,  Journal Article
Randle, RW; Ahle, SL; Elfenbein, DM; Hildreth, AN; Lee, CY; Greenberg, JA; Schenarts, PJ; Kempenich, JW
Published in: J Surg Res
November 2020

BACKGROUND: Surgeon educators express concern about trainees' sense of patient ownership. We aimed to compare resident and faculty perceptions on residents' sense of personal responsibility for patient outcomes and to correlate patient ownership with resident and residency characteristics. METHODS: An anonymous electronic questionnaire surveyed 373 residents and 390 faculty at seven academic surgery residencies across the United States. We modified an established psychological ownership scale to measure patient ownership among surgical trainees. RESULTS: Respondents included 123 residents and 136 faculty (response rate 33% and 35%, respectively). Overall, 78.0% of faculty agreed that residents took personal responsibility for patient outcomes, but only 26.4% thought residents felt a similar or higher degree of patient ownership compared with themselves. Faculty underestimated the proportion of residents that routinely checked on their patients when off-duty (36.8 versus 92.6%, P < 0.001). Higher means on the patient ownership scale correlated with female sex (5.9 versus. 5.5 for males, P = 0.009), advanced post graduate year level (5.3, 5.5, 5.7, 5.8, 6.1, for post graduate year 1-5, respectively, P = 0.02), and the sense that patient outcomes affected the resident respondent's mood (5.8 versus 4.8 for those whose mood was not affected, P < 0.001). In addition, trainees who perceived better resident camaraderie (P = 0.004), faculty mentorship (P < 0.001), and that their program provided appropriate autonomy (P = 0.03) felt greater responsibility for patient outcomes. CONCLUSIONS: Most faculty agree that residents assume personal responsibility for patient outcomes, but many still underestimate residents' sense of patient ownership. Certain modifiable aspects of residency culture including camaraderie, mentorship, and autonomy are associated with patient ownership among trainees.

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Published In

J Surg Res

DOI

EISSN

1095-8673

Publication Date

November 2020

Volume

255

Start / End Page

58 / 65

Location

United States

Related Subject Headings

  • United States
  • Trust
  • Treatment Outcome
  • Surveys and Questionnaires
  • Surgical Procedures, Operative
  • Surgery
  • Surgeons
  • Mentors
  • Male
  • Internship and Residency
 

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Randle, R. W., Ahle, S. L., Elfenbein, D. M., Hildreth, A. N., Lee, C. Y., Greenberg, J. A., … Kempenich, J. W. (2020). Surgical Trainees' Sense of Responsibility for Patient Outcomes: A Multi-institutional Appraisal. J Surg Res, 255, 58–65. https://doi.org/10.1016/j.jss.2020.05.035
Randle, Reese W., Samantha L. Ahle, Dawn M. Elfenbein, Amy N. Hildreth, Cortney Y. Lee, Jacob A. Greenberg, Paul J. Schenarts, and Jason W. Kempenich. “Surgical Trainees' Sense of Responsibility for Patient Outcomes: A Multi-institutional Appraisal.J Surg Res 255 (November 2020): 58–65. https://doi.org/10.1016/j.jss.2020.05.035.
Randle RW, Ahle SL, Elfenbein DM, Hildreth AN, Lee CY, Greenberg JA, et al. Surgical Trainees' Sense of Responsibility for Patient Outcomes: A Multi-institutional Appraisal. J Surg Res. 2020 Nov;255:58–65.
Randle, Reese W., et al. “Surgical Trainees' Sense of Responsibility for Patient Outcomes: A Multi-institutional Appraisal.J Surg Res, vol. 255, Nov. 2020, pp. 58–65. Pubmed, doi:10.1016/j.jss.2020.05.035.
Randle RW, Ahle SL, Elfenbein DM, Hildreth AN, Lee CY, Greenberg JA, Schenarts PJ, Kempenich JW. Surgical Trainees' Sense of Responsibility for Patient Outcomes: A Multi-institutional Appraisal. J Surg Res. 2020 Nov;255:58–65.
Journal cover image

Published In

J Surg Res

DOI

EISSN

1095-8673

Publication Date

November 2020

Volume

255

Start / End Page

58 / 65

Location

United States

Related Subject Headings

  • United States
  • Trust
  • Treatment Outcome
  • Surveys and Questionnaires
  • Surgical Procedures, Operative
  • Surgery
  • Surgeons
  • Mentors
  • Male
  • Internship and Residency