We don't really know our residents as well as we think. Trait characteristic recognition by faculty in autonomy needs more attention. But does it matter?

Autonomy in the operating room is considered by the general surgery resident to be essential in their evolution from trainee to surgeon and has been considered the essential cornerstone to residency training in general surgery.1 Operative autonomy in general surgery residency programs is decreasing in frequency.2 Barriers around resident autonomy in practice and operatively are number one in institutional factors cited by program stakeholders affecting burnout and wellness.3 What is this entity of Autonomy? The take home point of this study and those related by this group is that resident autonomy in operations is a complex endeavor that is based on the perceived relationship between the faculty and the trainee.5 That this perception can be mismatched may contribute to the lack of progression in autonomy and thus technical/clinical decision making and case progression. Leadership, motivation, emotional intelligence, cognitive load are but a few factors that make up any effective learning relationship.