Abstract
Introduction
The balance between teaching and operative efficiency (i.e., continuing operative
case progression) is difficult for even the most experienced master surgeon educators.
The purpose of this study was to explore influencing factors behind attending surgeons’
decisions to break the balance between operative efficiency and teaching in the operating
room.
Methods
Semistructured interviews were conducted with surgeons across the United States via
Web-based video conferencing. The interviews were audio-recorded and transcribed.
Qualitative analysis using the framework method was utilized, and emergent themes
were identified.
Results
Twenty-three attending surgeons from 8 academic institutions and 11 surgical specialties
completed interviews (14 men and 9 women). Attending surgeons consider a variety of
factors associated with their dual roles (surgeon versus teacher) when balancing operative efficiency and providing appropriate independence
for residents with oversight to promote autonomy. These were divided into surgeon-role-related
factors (patient safety, financial factors, scheduling factors, preservation of faculty
reputation for efficiency, and mode of operation) as well as teacher-role-related
factors (preparation, level, and technical skill of the resident). These factors then
informed attending surgeons’ determinations about how the case was progressing, which
prompted them to intervene and reduce resident autonomy or allow the resident to continue.
Conclusions
Surgeons consider numerous factors when deciding how to balance resident teaching
and autonomy while preserving operative efficiency. These findings provide helpful
insights for surgical departments to consider inclusion in faculty-development programs,
resident education, and systematic improvements.
Keywords
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Article info
Publication history
Published online: November 16, 2022
Accepted:
October 17,
2022
Received in revised form:
August 20,
2022
Received:
February 25,
2022
Identification
Copyright
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