S. Kavuturu1, R. Stanulis1, R. Stanulis1 1Michigan State University, Surgery, Lansing, MI, USA
Introduction: There is little empirical data about how surgical residents experience their learning environment (Grover, 2020). We examined the relationship between elements of the learning environment and professional fulfillment. 73 residents from four different residencies (65% response rate), PGY1-5 participated in a survey that included the Stanford Professional Fulfillment Index and subscales of the John Hopkins Learning Environment Scale. Residents also responded to four qualitative questions (ex: In what ways is your current health care system helping you reach your goals of who you want to be as a surgeon?).
Methods: Through a series of ANOVA, results revealed significance among the variables of learning environment and loss of empathy. The learning environment subscales included meaningful engagement, connection to a community of peers, and faculty relationships as role models (F(3, 70) = 4.34, p < .01). A significant number of residents also reported a lack of fulfillment, including negative emotions and in particular a loss of empathy with patients and peers (F(3, 69) = 3.07, p = .03).
Results:
Overall, the results indicate that 70 of the 73 residents experience a suboptimal learning environment. To learn about differences between residency programs, post-hoc tests were conducted which revealed that the Juniper Residents– pseudonym- (M = 4.25, SD = .46) experienced a better learning environment than the Birch Residents – pseudonym- (M = 3.74, SD = .72), p = .01. For loss of empathy, residents from Juniper (M = 1.96, SD = .59) reported a less severe loss of empathy than those in Birch (M = 2.62, SD = .92), p = .02.
Qualitative data analysis reinforced results of the quantitative data. The Juniper Residency themes: Caring about the whole person, caring about education, and caring about preparing residents for the future beyond residency. Examples: “They
support me educationally and as a person outside the hospital” and that “seeing how [an attending] interacted with the family was an inspiring moment and is something I wish to emulate.” In contrast, the Birch residents responded“My seniors berated and screamed at me,” “Attendings ask ‘gotcha’ questions instead of educating” and “You feel as though you are being held to a standard of perfection which you can never attain, and seniors are too emotionally spent to invest time in your learning.”
Conclusion: Residents in four different programs experienced a suboptimal learning environment that affected their empathy with patients and each other. Findings suggest that meaningful educational experiences are important for residents’ professional fulfillment, learning, and desire to remain in the profession. Feeling valued as a trainee was vital for these residents’ growth. Feeling valued at work is linked to better work outcomes (Yang, Jiang & Pu, 2021), critical for high quality patient care. This study brings up significant results that are actionable. Next steps involve faculty development in one of the residency contexts.