Enhancing resident perceptions of autonomy, education, and psychological safety: effects of implementing a senior resident-led team-based service model on a trauma and acute care surgery rotation

Purpose Team-based service models (TBSMs) may result in greater satisfaction and perceptions of teamwork among residents. However, the applications of TBSMs in general surgery (GS) residency are poorly understood. We evaluated the implementation of a TBSM on the educational and operative experiences of GS residents on a trauma and acute care surgery (TACS) rotation. Methods A survey study was conducted to examine the impact of piloting a senior resident-led TBSM, focused on the principles of resident autonomy, teamwork, and patient care continuity, on the TACS rotation at a high-volume (> 5000 TACS-related admissions annually), urban Level 1 adult trauma center. Within the TBSM, GS residents and advanced practice providers were redistributed to form clinical teams. All GS residents were surveyed 2 months prior to (“pre-implementation group”, PRE) and 10 months after the implementation of the TBSM (“post-implementation group”, POST). The survey questions were scored on a five-point Likert scale. The survey responses were compared using descriptive statistics and Fisher’s exact test. Results In total, 38 of 54 (70.4%) residents completed PRE surveys and 38 of 55 (69.1%) residents completed POST surveys. The residents reported significantly increased overall rotation satisfaction (23.5% PRE vs. 71.1% POST; p