Podium IIB -Faculty Development / Assessment
(S055) THE EVOLVING IDENTITY OF EDUCATIONAL SCHOLARSHIP IN ACADEMIC SURGERY: A QUALITATIVE STUDY OF FACULTY PERCEPTIONS
Nicole M Santucci, MD, MAEd, Ariana Naaseh, MD, MPHS, Sabrina Madrigal, BA, Julie M Clanahan, MD, MPHE, Paul E Wise, MD, Michael M Awad, MD, PhD, Jennifer Yu, MD, MPHS, Mary E Klingensmith, MD; Washington University in St. Louis School of Medicine
Purpose: Over the last two decades, efforts to improve wellness, diversity, and evaluation methods have significantly altered the landscape of general surgery residency training, coinciding with a rise in educational scholarship (ES). This study aimed to identity faculty perceptions of what defines ES, their motivations for pursuing it, and changes to the field overtime.
Methods: Participants for semi-structured interviews self-identified at the completion of a cross-sectional survey of surgical educator faculty previously completed by our group. Interviews were conducted to thematic saturation and transcripts were inductively coded and thematically analyzed.
Results: Eleven faculty (9 Female; 9 surgeons, 2 PhD educators) participated in interviews. Four major themes emerged (Figure 1). First, participants described ES as a broad and evolving field encompassing the study of simulation, ethics, curriculum design, feedback, and global surgery, among others. ES was distinguished from effective teaching, as it requires the involvement in methodologically rigorous research. Second, views on the necessity of formal education training in establishing credibility were influenced by training backgrounds. PhD educators expressed that formal training in education or education-research methodologies was essential to ES that was theoretically grounded. Clinician-educators emphasized that clinical experiential expertise in addition to formal education training was essential to ES, with increasing opportunities for such training. Third, despite external perception of being “hobbyist researchers” (P1), all faculty identified intrinsic value in pursuing ES and satisfaction in seeing learners succeed. Finally, educators noted culture shifts over the past two decades, driven by greater advocacy for ES and mentorship by senior faculty. Inclusion of PhD educators had further strengthened academic infrastructure for ES. Ongoing challenges included inadequate protected time, inconsistent promotion pathways, and limited funding. Many identified that the skills central to ES align with departmental leadership roles.
Conclusion: Surgical educators view ES as rigorous, clinically relevant, and meaningful work. While enthusiasm and intrinsic motivation drive engagement, inconsistent institutional structures and limited protected time hinder sustainability. Ongoing efforts to define, recognize, and reward ES will be essential to cultivate future leaders and sustain the positive momentum of ES as a viable career pathway.
Figure 1: Primary themes encompassing a conceptual model of Educational Scholarship in academic surgery
(S056) BRIDGING THE GAP: PREPARING JUNIOR SURGICAL FACULTY TO MANAGE COGNITIVE LOAD IN THE OPERATING ROOM
Tasha Posid, MA, PhD1, Kyle Elko1, Kimberly M Hendershot, MD2, Cali E Johson, MD, EdD3, Amanda B Cooper, MD4; 1The Ohio State University Wexner Medical Center, 2University of Alabama at Birmingham, 3University of Utah Health, 4Penn State College of Medicine
Introduction: New surgical faculty assume dual roles as clinicians and educators with limited formal preparation during training for managing cognitive demands in the operating room (OR). As they balance patient safety, case flow, and learner supervision, many experience cognitive overload that hinders performance and teaching effectiveness. Our aim was to examine how junior faculty navigate cognitive load in their new role, manage the need to teach learners across different stages of competency, and whether there is a need for faculty development in this area.
Methods: Semi-structured 1:1 interviews were conducted and recorded with junior surgical faculty via Zoom (<6 years out of training; n=14). Participants discussed their early faculty experiences, factors contributing to overload, and perceived training gaps in this domain. Transcripts underwent inductive thematic analysis.
Results: Several key themes emerged from thematic analysis (Figure 1).
Unprepared for Cognitive Complexity: Nearly all junior faculty (92%) described cognitive overload in the OR, particularly during complex cases or when supervising less experienced learners. Their own training emphasized technical proficiency over multitasking or team supervision.
Trial-and-Error Learning: Junior faculty described developing adaptive strategies to overcome this cognitive overload—mental checklists, structured debriefs, reliance on experienced teams—but acknowledged inefficiency and stress during this “self-taught” phase. 85% said they developed these strategies via experience / trial-and-error.
Adaptive Strategies: Informal systems such as mental checklists, post-case debriefs, and reliance on trusted team members helped reduce cognitive load and improve teaching focus.
Desire for Structured Training: All participants endorsed the need for formal instruction on cognitive load management, decision triage, and adaptive teaching strategies. Several noted that such training would have accelerated their professional growth and reduced early burnout.
Senior Faculty Modeling Expertise: Participants highlighted the value of observational learning and mentorship from experienced surgeons, noting that senior faculty model effective cognitive prioritization and calm/confidence under pressure.
Conclusions: Junior faculty face substantial cognitive demands in the OR with little formal preparation. Intentional training in cognitive load management and instructional strategies could accelerate professional growth, improve teaching, and mitigate burnout. Integrating cognitive load principles into faculty development represents a critical next step in surgical education.
(S057) RESIDENT PERCEPTIONS OF ENTRUSTABLE PROFESSIONAL ACTIVITIES AND FACULTY ENGAGEMENT
Daniela D Muñoz Wilson, MA1, Lauren McLeod, BS1, M Chandler McLeod, PhD, MS1, Andrew Jones, PhD2, George Sarosi, MD3, Karen Brasel, MD2, Carol Barry, PhD2, Rebecca M Minter, MD4, Erin M White, MD, , MBS, MHS1, Brenessa Lindeman, MD, MEHP1; 1University of Alabama at Birmingham Heersink School of Medicine, 2American Board of Surgery, 3University of Florida College of Medicine, 4University of Wisconsin School of Medicine and Public Health
Introduction: Surgical educators recognize the importance of consistent faculty feedback, yet variability in learners’ perceptions make it difficult to identify targets for intervention. We hypothesize perception of faculty feedback is improved through Entrustable Professional Activities (EPAs).
Methods: In January 2025, trainees completed an optional survey post-ABSITE. Trainees reported percentage of faculty that consistently give feedback. Those who responded at the extremes (0-25% or 76-100%) were grouped and termed as low percentage (LP) and high percentage (HP). Additional items queried include feedback and EPA frequency and characteristics. Overall feedback and EPA satisfaction were reported on 1-10 numeric scales. Demographics included self-reported gender, race, ethnicity, PGY-level, and underrepresented in medicine (URiM) status. Outcomes were compared using bivariate analysis.
Results: Of 10,404 examinees, 57% (n=5,963) responded about faculty engagement. Of these, 17% (n=1,008) and 18% (n=1,098) were in respective LP and HP groups. The LP group had more Female (62%, n=599) and PGY1-3 trainees (76%, n=761)(p<0.001, for all), with no differences in race, ethnicity, or URiM status compared to HP group.
Most HP trainees (83%, n=911) received feedback every day or 2-3 days compared to 13% (n=128) of LP trainees (p<0.001). Higher faculty percentage was moderately correlated with increased feedback frequency (rho=0.56) and weakly correlated with EPA frequency (rho=0.21). HP trainees (54%, n=553) received EPAs at least once a week or more often compared to 23% (n=219) of LP trainees (p<0.001). Only 11% (n=114) of HP trainees reported not receiving an EPA compared to 29% (n=274) of LP trainees. Most HP trainees (64%, n=660) agreed frequency of EPAs met expectations compared to 9% (n=81) of LP trainees (p<0.001). Most HP trainees (62%, n=653) reported >50% of EPAs were accompanied by verbal feedback.
Overall feedback and EPA satisfaction were moderately correlated (rho=0.53). Mean feedback satisfaction was significantly higher for HP trainees (8.9+/-1.1) than LP trainees (4.36+/-1.9)(p<0.001). Similarly, EPA satisfaction was higher for HP than LP trainees (8.24+/-2.0 vs. 4.07+/-2.31, p<0.001).
Conclusion: Trainees who report a high percentage of faculty engaged in feedback endorse more frequent feedback, including EPAs, and EPAs accompanied by verbal feedback. These data suggest EPAs are an avenue for faculty to improve feedback to trainees.
(S058) FACDEV SPRINKLES: BECAUSE GREAT TEACHING DESERVES A LITTLE SUGAR
Granville Lloyd, Daniel Wood, Kristy Hawley, Michael Cripps, Zachary Asher, Nicole Christian, Aimee Gardner; University of Colorado School of Medicine
Background
Faculty development interventions typically rely upon one-time lectures or seminars. Leaders in faculty development, however, have urged the community to incorporate interventions that are more longitudinal, interwoven, pragmatic, group-focused, and delivered in existing workspaces. We explored the impact of interweaving bite-sized faculty development into existing venues in which faculty gather over the course of a year.
Methods
Faculty completed a faculty development needs assessment centered on topics aligning with the international Academy of Medical Educators professional standards framework along a 1 (no need) to 5 (high need) Likert-type scale. These data informed unique curricula in which each division dedicated 15 minutes of a monthly faculty meeting for one year to watch an institutionally developed “FacDev in 5” video on a relevant education topic, followed by facilitated group discussion. Faculty rated the quality of each video monthly (1=poor; 5=excellent) and rated perceived improvements in teaching skills and the culture for teaching and learning within the division after the intervention.
Results
Forty-six of 59 faculty across four surgery divisions completed the pre-intervention survey. Across all divisions, the highest areas of reported need were assisting the struggling learner (mean=3.93), delivering feedback (mean=3.82), coaching (mean=3.78), debriefing a clinical encounter (mean=3.69), and integrating teaching responsibilities with clinical demands (mean=3.59). There were significant differences in need ratings across the divisions. Specifically, the topics of cultivating professionalism (p<0.05), implementing reflective practice (p<0.01), integrating novel instructional methods (p<0.05), and promoting autonomy in the clinical environment (p<0.05) were rated significantly differently across divisions, warranting unique curricula for each. Monthly evaluations of the video series were favorable across all divisions and significant improvements in the culture for teaching and learning were reported.
Conclusion
Meeting faculty in existing workspaces, rather than adding more demands to their already-full calendars, may be a fruitful approach for faculty development efforts. Our results reveal positive outcomes for interweaving bite-sized faculty development into existing spaces for busy clinician educators.
(S059) EQUITY IN EVALUATION: ASSESSING GENDER DIFFERENCES AMONGST ACGME MILESTONES 1.0 RATINGS (2014-2022)
Briana Griffin, MS, Briana Osei, MS, Carisa Cooney, MPH, Damon Cooney, MD; Johns Hopkins University School of Medicine
Background: Gender representation within plastic surgery residency programs has become more balanced in recent years. While these improvements are notable, previous studies on various surgical specialties, including plastic, general, vascular, and thoracic surgeries, have shown a difference in how men and women residents are evaluated and scored. These findings show gender-based disparities appear early in training and disappear by the end, but may be influenced by implicit bias and could result in significant long-term negative effects on residents’ overall training progress. We conducted our current study using the Accreditation Council for Graduate Medical Education (ACGME) Plastic Surgery Milestones 1.0 data to identify gender-based rating differences amongst plastic surgery residents from 2014-2022.
Methods: After IRB approval, we analyzed de-identified ACGME Milestones 1.0 data for Plastic Surgery Integrated programs from 2014–2022. Independent tracks and incomplete evaluations were excluded. Variables included resident gender, postgraduate year (PGY 1–6), milestone domain, and mid- or end-year evaluation period. We calculated mean milestone levels by gender and year, as well as growth slopes (PGY 1–6) to assess competency progression over time. Comparisons were made using t-tests and linear regression. Assessments from residents lacking self-reported gender data (n≈ 50,000) were excluded from the comparative analyses. Milestones were categorized as either Medical Knowledge (n=14), Patient Care (n=14), or Non-Patient Care (n=8).
Results: Of 1,885 integrated residents, a total of 410,690 milestone assessments were analyzed. Among these, 1,600 residents (706 female, 894 male) had self-reported gender data, representing 402,552 Milestones 1.0 assessments. We found no significant differences between Milestones scores for men and women across all Milestones and PGYS. The mean slope differences for men and women demonstrated almost identical growth trajectories and mean differences at the end of training were not significant.
Conclusion: Our analysis of national ACGME Milestones 1.0 data for all integrated plastic surgery training programs demonstrate equitable scoring of men and women across all Milestones and PGYs.
(S060) A MIXED-METHODS STUDY OF END-OF-ROTATION EVALUATIONS OF GENERAL SURGERY FACULTY BY RESIDENTS
Souma Kundu, MD, MPH1, David Rosas, MD, MBA2, Stephanie Seale, MD1, Cara Liebert, MD1, Lauren Paton, MD3; 1Stanford University, 2University of California Davis, 3Carolinas Medical Center
Introduction:
The purpose of end-of-rotation evaluations is to provide faculty with feedback on the effectiveness of their teaching with the goal of affirming certain behaviors and providing constructive comments. However, there are several challenges with giving constructive upward feedback including time demands, psychological safety, and fear of repercussion. We examined the quality of End-of-Rotation (EOR) resident evaluations of faculty through a mixed-methods approach.
Methods:
De-identified EOR evaluations of 29 faculty at a single institution were obtained, consisting of Likert scale-based ratings and narrative comments. Focused interviews were conducted with 10 residents (PGY1-5) using a standardized interview guide. Qualitative analysis was performed with deductive analysis of narrative comments and inductive analysis of semi-structured interviews. Narrative comments were coded for “specificity”, “constructiveness”, and/or “actionability” as well as based on a framework adapted from the Nationwide Children's Hospital Faculty Clinical Teaching Milestones.
Results:
169 individual faculty evaluations were analyzed. 52% of comments were specific; 0.02% were actionable, and 0.03% were constructive. The most frequently mentioned Teaching Milestones were Learning Climate, Promoting Skill and Knowledge, and Promoting Autonomy (respectively, 51%, 40%, 21%). The vast majority (87%) of evaluations gave the highest rating (i.e. 4) for all Likert-scale questions; less than 1% of evaluations received a 1 or 2. Of the ten interview participants, all ten stated the greatest barrier to providing feedback was length of the evaluation due to perceived redundancy in questions and time needed to read Likert-scale anchor descriptions. 70% described decision fatigue and a lack of meaningful distinction between descriptions of ratings along the 4-point Likert scale. A minority of residents (30%) expressed concern of repercussion or anonymity preventing them from providing specific feedback. 30% also stated they do not submit evaluations that would be primarily constructive or low ratings.
Conclusion:
This study finds while most written feedback from residents is specific, they contain minimally constructive or actionable comments for faculty. The Likert-based questions demonstrate minimal discrimination between faculty and skew heavily positive. This aligns with what is reported by interviewees – residents avoid evaluating low performers in part due to fear of repercussion and challenges with the current survey instrument.