Podium IIC - Faculty Development
(S042) EVALUATION OF THE JAPANESE SURGEONS AS EDUCATORS ADVANCED COURSE: IMPACT AND CHALLENGES IN SURGICAL EDUCATION IN JAPAN
Akihiro Suzuki, MD1, Masanori Isobe, MD2, Akihiko Oshita, MD3, Ken Imai, MD4, Hideki Takami, MD5, Saseem Poudel, MD6, Hisakazu Hoshi, MD7; 1St. Luke’s International Hospital, Gastroenterological Surgery, 2Gifu University, department of obstetrics and gynecology, 3Onomichi General Hospital, Surgery, 4Jichi University Saitama Medical Center, department of obstetrics and gynecology, 5Nagoya University, Department of Surgery, 6Hokkaido University, Department of Gastroenterological Surgery II, 7University of Iowa Hospitals and Clinics. Departmetn of Surgery
Background:
We developed the Japanese Surgeons as Educators Basic Course (JSAE-BC) in 2019 as a two-day workshop to provide foundational knowledge on adult learning principles, curriculum development, leadership, organizational change, and priority and time management for surgical educators. Due to high participant satisfaction and demand for more advanced content, we launched the two-day Japanese Surgeons as Educators Advanced Course (JSAE-AC) in 2023, with a focus on evaluation methodologies.
Objective:
To evaluate the effectiveness and relevance of the JSAE-AC as an educational program for surgical educators.
Methods:
Participation in JSAE-AC was limited to those who had completed JSAE-BC. We conducted named surveys before, immediately after, and three months post-course completion. Participants self-assessed their competency across twelve sessions and provided feedback on behavioral changes post-training, course evaluation, and suggested improvements.
Results:
From May 2023 to the present, we held four JSAE-AC sessions with a total of 112 participants (88 men, 24 women). Self-assessment scores improved across all twelve metrics. The highest-rated sessions included “Personal and Career Goals,” “Emotional Intelligence (EQ),” and “Surgeon Performance Evaluation.” On the other hand, the session on 'Surgical Resident Recruitment and Selection Methods' was relatively low in the evaluation, as it is not common in Japan to select surgical residents due to the shortage of candidates. Overall, participant satisfaction with the workshop was high, with 95% recommending it to colleagues. In a three-month post-completion survey of the first three cohorts (response rate: 77%), 76% reported implementing new educational initiatives at their institutions. Time constraints and lack of understanding by those around them were often cited as impediments to new initiatives.
Discussion:
The JSAE-AC was deemed highly valuable for Japanese surgeons. Given the lack of prior opportunities in Japan for formal training for surgical educators, the impact of the JSAE program is considerable. However, aspects such as “Resident Recruitment” require ongoing adjustments to accommodate cultural and systemic differences between Japan and the U.S.
(S043) EXPLORING FACULTY DEVELOPMENT AS EDUCATORS THROUGH PILOT IMPLEMENTATION OF THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION CLINICIAN EDUCATOR MILESTONES
Tawni M Johnston, MD1, Ting Sun, PhD1, Gabrielle M Moore, MD1, Kshama Jaiswal, MD, FACS1, Brigitte K Smith, MD, MHPE, FACS, FSVS2; 1University of Utah, 2University of Wisconsin
INTRODUCTION - Vice Chairs of Education (VCE) are responsible for ensuring faculty in their department deliver high quality education to the next generation of physicians, therefore an assessment tool for faculty educators is needed. The ACGME developed Clinician Educator Milestones (CEM) as a formative assessment tool for faculty educators, with significant interest generated during a CEM workshop at Surgical Education Week 2023. Competencies include: Universal Pillars, Educational Theory & Practice, Well-Being, Diversity, Equity & Inclusion, Administration. CEMs have yet to be widely implemented, so their feasibility and potential impact is unclear.
METHODS - Participants included VCEs and faculty from multiple departments at a single academic institution. Faculty performed a CEM self-assessment and VCEs used the CEM to assess faculty. Subsequently, faculty and VCEs were instructed to meet, using the CEM as a framework for discussion of faculty development. After implementation, surveys were sent to participants and analyzed using descriptive statistics.
RESULTS - 15 faculty and 6 VCEs from 6 distinct departments (Neurosurgery, Ophthalmology, Psychiatry, Physical Medicine & Rehab, Family Medicine, Neurology) participated (87% faculty and 100% VCE response rates). Most faculty (80%) and VCEs (100%) completed the CEM in < 30 minutes. 77% of faculty and 67% of VCEs found the CEM feasible (Figure 1). 54% of faculty and 50% of VCEs reported they identified strengths. 54% of faculty and 67% of VCEs reported they identified areas for improvement. Most faculty thought the CEM assisted VCEs in providing meaningful feedback (62%), whereas only 33% of VCEs agreed. Most participants reported the CEM helped them identify faculty development goals (69% of faculty, 83% of VCEs), a majority within the domains of Educational Theory & Practice (54%) and Administration (54%), while none related to Well-Being. Less than half of participants were satisfied with the tool (33% of VCEs, 46% of faculty).
CONCLUSIONS - A majority of participants found completion of the CEM was feasible, accessible, identified strengths and weaknesses, assisted in goal development, and took < 30 minutes. However, less than half were satisfied with the tool. The practicality of utilizing CEMs will need to be further evaluated through focus groups.
(S044) DEFINING GROWTH MINDSET LANGUAGE BEST PRACTICES IN THE OPERATING ROOM: LESSONS FROM LISTENING IN
Michael J Furey, DO, MSMED, Jamaica Westfall-Snyder, MD, Yasmeen Byrnes, MD, Matthew Factor, MD, Rebecca L Hoffman, MD, MSCE; Geisinger Surgery Institute
Introduction
Unlike other learning environments, the operating room(OR) is a unique space for surgical educators and trainees. Prior studies have sought to define the characteristics of an effective intraoperative educator, but none with the focus on growth mindset and its effect on learning motivation. Achievement motivation is a construct used to understand/describe motivation as both an individual trait and as a product of the learning environment. Growth mindset(GM) refers to the belief that intelligence/human potential can be improved with effort. A GM has been shown to have positive effects on achievement motivation. While in a previous study we defined a codebook for growth mindset language in written feedback, the aims of this study were to identify and characterize growth mindset language used by surgical faculty in the OR and to elucidate resident reaction to this in the context of achievement motivation.
Methods
Intraoperative general surgery faculty/resident conversations during randomly selected(attending blinded)cases at a large academic program were recorded and transcribed. Immediate post-operative interviews with residents were conducted with a focus on achievement motivation. An inductive thematic analysis was performed of all intraoperative statements which were preliminarily identified as using growth mindset language(GML). Because these themes happened to align with the previous codebook for written feedback, an elaborative coding approach was utilized. Resident responses corresponding to specific GML themes were identified.
Results
Thematic saturation was achieved on 8 OR transcripts/cases from 3 attending surgeons. In the language of the OR transcripts, 4 of 5 formerly identified themes were present: support/partnership language, process language, progress language, learning language. Effort language was absent. Definitions and subcodes are shown in the figure. Residents were able to independently identify the use of GML as motivators for learning(figure).
Discussion
In this study we have described GML utilization in the OR environment, provided concrete examples for faculty, and identify how residents derive motivation from GML. Unique opportunities for attendings in the OR include sharing of personal growth and/or struggles, recognition of trainees’ real-time growth, utilization of language reflecting shared responsibility and giving instructions with insight. This work has immediate applications for faculty development in an understudied environment.
(S045) EVALUATION OF EFFECTIVENESS OF ACGME FACULTY MILESTONES
Claire Wilson, MS, MD, Nadj Pierre, MD, Diane Shih-Della Penna, MD, Ebondo Mpinga, MD, Mohsen Shabahang, MD, PhD; Wellspan York Hospital
Background:
The Accreditation Council for Graduate Medical Education (ACGME) has introduced milestones for evaluating faculty competency as educators. While residents are assessed bi-annually using similar milestones, no literature specifically addresses these new clinician education milestones or faculty self-assessment. The milestones highlight five core competencies: Universal Pillars for Clinician Educators (UP), Educational Theory and Practice (ETP), Administration (A), Diversity Equity and Inclusion (DEI), and Well-Being (WB). Each competency has specific milestones indicating graduated levels of expertise.
Purpose:
This study investigates the concordance among resident assessments of faculty performance, administrative evaluations, and faculty self-assessments with the clinical milestones across the five competency areas defined by the ACGME.
Methods:
The Clinical Educator Milestone survey was administered to attending faculty for self-assessment based on key educational pillars. Administrators and residents also completed the surveys, with residents divided into junior (PGY2, PGY3) and senior (PGY4, PGY5) groups. The primary outcomes—educational pillars—were analyzed using the Least Significant Difference (LSD) test to identify statistically significant mean differences across groups, with significance set at p < 0.05.
Results:
Sixteen attending faculty, ten junior residents, nine senior residents, and three administrators completed the survey. A statistically significant difference in milestone scores was found between faculty and junior residents across all categories except programmatic evaluation (ETP), where junior residents rated attendings at 4.1 compared to the faculty's self-assessment of 3.6 (p = 0.44). Senior resident evaluations generally aligned with faculty self-assessments, except in commitment to professional responsibilities (UP), learner assessment (ETP), science of learning (ET), and change management (A). Statistically significant discordances between administration and faculty were limited to a few areas, including learning environment (ETP), leadership skills (A), change management (A), diversity, equity, and inclusion (DEI), and well-being.
Conclusions:
The ACGME Clinical Educator Milestone Survey revealed greater discordance between junior residents and faculty than any other group, with residents consistently rating attendings higher than faculty rated themselves. Concordance between resident and faculty evaluations increases with advancing training levels. This phenomenon supports the validity of these clinical milestones as an assessment tool.
(S046) ENGAGING ACADEMIC SURGEONS IN SURGICAL EDUCATION: A QUALITATIVE STUDY
Sloan Senofsky, BA, Young-Ji Seo, MD, Saad Mallick, MD, Justin P Wagner, MD, Formosa Chen, MD, Areti Tillou, MD, James X Wu, MD; UCLA David Geffen School of Medicine
Background: Education is a main pillar of academic surgery, but engagement remains variable among academic surgeons. Our aim was to determine factors that promote or inhibit faculty engagement in surgical education, including a previous education incentive program.
Methods: Semi-structured interviews were conducted with surgical faculty from a single academic institution from Aug to Oct 2024, by interviewer outside the department. Anonymized interview transcripts were separately coded by 4 study authors. Faculty were asked about engagement in education, participation in education incentive program (2022-2023), and completion of Entrustable Professional Activities (EPA) assessments beginning in 2023. Interviews were conducted until thematic saturation was achieved.
Results: Study cohort comprised of 22 academic surgeons. Twelve (54.5%) participated in the education incentive program, 8 (36.4%) were aware of the program but did not participate, and 2 (9.1%) were unaware of the program. Eight (36.4%) had completed EPA assessments and 14 (63.6%) had not. Among the 12 faculty that participated in education incentive program, only 5 have completed an EPA assessment (41.6%). All faculty perceived teaching as integral to their job: “it’s like asking a fish what water is – we’re always swimming through it.” Faculty also derive fulfillment and meaning from education but feel that “the system doesn’t place a high value on education.” The financial incentives did not promote engagement in education, and past participants in an incentive program report that it did not change their behavior. Overwhelmingly, time constraints were cited as the main barrier to engagement in education: “every time I block off an hour for teaching, it takes away from clinical activities.” Another major barrier was perceived lack of learner engagement: “if [trainees] are disengaged, no amount of money will make me want to teach them.”
Conclusion: Programmatic efforts to promote engagement in surgical education should focus on protecting additional time for educational activities and demonstrate the department's commitment to the educational mission. In this qualitative study, financial incentives did not enhance the desire to teach nor provide faculty with a sense of recognition. Past participation in education incentive program did not lead to increased uptake of EPA assessment.
(S047) MINDSET, COGNITIVE LOAD, AND GOAL ORIENTATION IN RESIDENT OPERATIVE EXPERIENCE
Michael J Furey, DO, MSMED, Jamaica Westfall-Snyder, MD, Yasmeen Byrnes, MD, Matthew Factor, MD, Rebecca L Hoffman, MD; Geisinger Surgery Institute
Introduction
Goal orientation(GO)is a motivational construct used to understand/describe motivation as both an individual trait and as a product of the learning environment. GO is classified as either mastery oriented, the desire to achieve for pure knowledge/skill acquisition, or performance oriented, related to showing competence or avoiding the appearance of incompetence. Growth mindset(GM) refers to the belief that intelligence/human potential can be improved with effort. When understood together, GM and GO are a continuum, where mindset is the positive, tangible and discernable manifestation of GO theory. Cognitive load(CL)is the amount of mental effort required to process information. The aim of this study was to learn about what factors in the OR impact resident motivation for learning.
Methods
Immediate post-operative interviews were conducted with general surgery residents over the course of 2 months at a large academic institution to determine intraoperative teaching elements contributing to a motivation for learning. Interviews were recorded, transcribed and coded using an inductive thematic analysis.
Results
Major themes emerging when residents were questioned about intraoperative factors which promoted a desire for learning included elements related to mastery or performance orientation, decreasing cognitive load, or faculty demeanor. Within these themes, subthemes were elucidated(figure). These were defined as follows: intraoperative methods are the teaching skills and styles faculty utilize in the OR, fostering trust refers to ways faculty build trust between themselves and their trainees, and statements where residents identified faculty behaviors promoting autonomy were coded as such. Statements relating to cognitive load in the OR were further classified as being related to resident mastery goal orientation or faculty demeanor as it relates to intraoperative methods.
Discussion
In this study we demonstrate how both residents and faculty can work together to maximize motivation for learning via a mastery approach. This is evident by residents’ recognition of preparedness leading to a decreased cognitive load and facultys’ efforts to create a predictable and trusting environment and promote autonomy largely through the utilization of growth oriented language. There is great potential for faculty and resident development to positively impact a resident’s learning experience in the OR to become more mastery oriented.
