Preoperative Learning Goals Set by Surgical Residents and Faculty

Background The operating room (OR) remains the main teaching venue for surgical trainees. The OR is considered a pure-discovery learning environment; the downsides of this can be putatively overcome when faculty and trainee arrive at a shared understanding of learning. This study aimed to better understand preoperative learning goals to identify areas of commonalities and potential barrier to intraoperative teaching. Methods Brief, structured preoperative interviews were conducted outside the OR with the resident and faculty member who were scheduled to operate together. Answers were analyzed and grouped using grounded theory. Results Twenty-seven resident-faculty pairs were interviewed. Nine residents (33.3%) were junior (PGY 1 and 2) and 18 (66.7%) were senior (PGY 3 through 5). Learning goal categories that emerged from the response analysis were anatomy, basic and advanced surgical skills, general and specific procedural tasks, technical autonomy, and pre-, intra-, and postoperative considerations. Residents articulated fewer learning goals than faculty (1.5 versus 2.4; P = 0.024). The most frequently identified learning goal by both groups was one classifiable under general procedural tasks; the greatest divergence was seen regarding perioperative considerations, which were identified frequently by faculty members but rarely by residents. Conclusions Faculty articulate significantly more learning goals for the residents they will operate with than residents articulate for themselves. Our data suggest that residents and faculty align on some learning goals for the OR but residents tend to be more limited, focusing predominantly on technical aspects of the operation. Faculty members tend to hold a broader view of the learning potential of the OR. These discrepancies may present barriers to effective intraoperative teaching.