C.E. McDermott1, M. Feinman2, J. Woodward6, X. Luo7, J. Shearer4, A. Bernard5, L. Lambert1 1University Of Utah, Department Of Surgery, Salt Lake City, UT, USA 2Sinai Hospital of Baltimore, Department Of Surgery, Baltimore, MD, USA 4Stanford University, Department Of Surgery, Palo Alto, CA, USA 5Stanford University, Department Of Ophthalmology, Palo Alto, CA, USA 6University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Department Of Surgery, Buffalo, NY, USA 7Tulane University School Of Medicine, Department Of Surgery, New Orleans, LA, USA
Introduction: In recent years patients have become increasingly complex, with a larger documentation burden required of trainees. Over this time, there has been little increase in the trainee workforce. There is evidence that having more time to spend with patients can decrease burnout, and increase patient satisfaction; however, there is a cultural onus on trainees to work more efficiently. Very little is known about how a desire for efficiency affects the surgical trainee learning environment, and we aim to evaluate resident and faculty perceptions of this in the present study.
Methods: A survey was developed in Qualtrics assessing perceptions of the role efficiency plays in the learning environment through 4-point Likert-style questions. We also assessed estimates for time allotment for different tasks in patients of various complexity. Survey distribution occurred via the Collaboration for Surgical Education Research Fellows (CoSEF) network, a task force of the Association for Surgical Education. An unpaired T-test was used to compare task time estimates, and Likert item analysis was performed via Fisher’s Exact Test. All analyses were performed in STATA.
Results: 48 respondents from community and academic programs in 7 of the 9 ERAS regions completed the survey. Time estimates for evaluating, admitting, and discharging patients of various complexities were similar between residents and faculty (p>0.29 for all cases). As the medical and social complexity of patients increased, time estimates increased significantly (p<0.05). Faculty and residents rated “efficiency” as a similarly valuable junior resident quality (8.2 vs 8.46, p=0.786) when compared to 14 other qualities. Faculty and residents differed in their perspectives on the effect that efficiency has on patient satisfaction and wellness. A full comparison between resident and faculty attitudes is depicted in Table 1.
Conclusion: Our data demonstrated that the time expectation for patient care tasks increases as the medical and social complexity of the patient increases. Efficiency was valued as moderately important by both residents and faculty. Despite congruence between groups on time estimates for patient care tasks and the value of efficiency, there are discrepancies in how the pressure to work efficiently is perceived, as well as how it affects patient satisfaction and wellness. Broader study to explore these differences, including potential interviews and qualitative analysis, may provide further insight.