Feedback-Seeking Behavior and Practice Readiness for General Surgery

Abstract

Objective: To analyze the relationship between feedback-seeking behavior, operationalized as the number of trainee-requested evaluations, with ratings of surgical trainees' operative autonomy and performance.

Design: We analyzed operative assessment data using the System for Improving and Measuring Procedural Learning's smartphone-based assessment app called Society for Improving Medical Professional Learning (SIMPL) OR. Using cross-classified mixed effects models, we analyzed the association between trainee-requested SIMPL OR app evaluations and both trainee performance and autonomy ratings. Models included covariates for requested evaluations, PGY-year, month of the academic year, and patient-related case complexity. Random effects for program, procedure, rater, and trainee were also included to account for correlations among evaluations. Only ratings for procedures deemed Core to general surgery were included.

Setting: Operative assessment data using the SIMPL OR app requested by categorical U.S. general surgery residents between September 2015 to April 2021.

Participants: A total of 61 general surgery residency programs, encompassing 2190 categorical general surgery residents.

Results: A total of 58,104 SIMPL app operative assessments were analyzed. Autonomy scores were weakly but positively associated with number of trainee-requested evaluations (B = 0.002, p < 0.001). Trainee-requested evaluations were also statistically associated with operative performance scores ( B = 0.002, p < 0.001).

Conclusions: The propensity of a resident to seek feedback using the SIMPL app was weakly associated with higher operative autonomy ratings and higher operative performance ratings. While regular feedback is important for monitoring performance over time, more direct approaches related to the quality of feedback that trainees receive may be needed to better assess the relationships between feedback-seeking behavior and operative autonomy as well as performance.

Keywords: assessment; autonomy; general surgery residency, resident performance; surgical education; workplace-based assessment.