Trainee Poster Session II: DEI, Recruitment, and Assessment
Introduction
The Women in Surgery at Emory Residencies (WISER) Podcast was started by medical students and surgical residents at Emory University in 2018 to highlight women surgeons and mentor the next generation. Our goal is to provide innovative mentorship and learning opportunities by establishing a widely accessible platform for women students and residents interested in surgery.
Methods
The WISER podcast is published in 5 different seasons on https://wiserpodcast.com. We have produced 42 podcast episodes where medical students and residents have interviewed 38 women surgeons in various surgical fields. We analyzed data from our podcast platforms to determine listener demographics and performed a cross-sectional, single-institution survey in September 2023 to better understand the experiences of WISER listeners.
Results
According to Spotify data, the WISER podcast has had 932 all-time streams, 320 listeners, and 98 followers. 78% of listeners are female. 43.2% of listeners are aged 23-27, and 33.3% are aged 28-34. The results of our survey indicate that a majority of listeners are medical students planning to become surgeons. All respondents strongly agreed or agreed that they have learned more about surgical careers, received helpful career advice, and become more interested in surgical specialties by listening to WISER. 80% of respondents strongly agreed or agreed that WISER has influenced their career or medical specialty. Respondents indicated that WISER could improve by including more podcasts from medical student and resident perspectives.
Conclusion
WISER is effective in reaching its target demographic of women at the start of their surgical careers. Importantly, a majority of listeners view WISER as a helpful way to learn about surgical careers and receive career advice, demonstrating the WISER podcast model is an effective and innovative educational tool. From our survey, we have identified areas of improvement for WISER.
Background & Hypothesis: Financial burdens significantly impact patient care, affecting medication compliance, clinical outcomes, and patient quality of life. Despite this, providers rarely initiate cost-communications with patients. This abstract presents a quantitative analysis of surgical resident comfort levels and engagement with cost-related health literacy.
Methods: A cross-sectional Likert scale survey, taken from Fischer et al. (2020), was administered to surgical residents at a large academic institution following a lecture on health-related price transparency. The survey assessed residents' comfort and current practices in managing treatment costs, knowledge of cost-related topics, and barriers to discussing financial burdens with patients. Demographic data, including gender and level of surgical education, and level of burnout (using the 2 item Maslach Burnout Inventory) were also collected. Spearman’s correlation was used for associations.
Results: Analysis of survey results (n = 20) revealed that while most residents (80%) are motivated to help patients save money, none had discussed anticipated costs with a patient prior to starting therapy, and most feel as if they cannot help even if financial stresses are brought up (90%). Additional barriers include limited time for cost discussions (80%), lack of price transparency (80%), and unawareness of available financial resources (50%). Interestingly, 70% of residents had adjusted treatment plans in the past year to alleviate patient financial burden, mainly by switching to cheaper medications. Residents experiencing higher burnout reported lower motivation to help patients (-.45) and a more pronounced sense of not being able to help (0.61). Knowledge of public and private insurance mechanisms was positively correlated with asking patients about financial distress (0.60 and 0.58 respectively). Additionally, feedback on the faculty lecture indicated improved understanding of out-of-pocket costs for treatments. No significant differences in comfort or knowledge were observed based on gender or training level.
Conclusions: While residents are motivated to contribute to the financial stability of their patients, they require additional support to engage in much needed cost conversations with patients. Our results support integration of cost literacy topics into surgical education to better equip future providers to address patients’ financial concerns and therefore enhance the quality of care.
Background:
The Japanese Association for Surgical Education (JASE) was established in 2014 to promote the quality of surgical education in Japan. Its annual meeting plays a role as a platform for surgical educators to exchange their experiences and research findings. The aim of this study was to identify the needs among the participants in the annual meetings to determine the future direction of the association.
Methods:
An online survey was sent to all participants in the annual meetings from 2014 to 2022. The survey included questions about their backgrounds, challenges in the educational roles and research, motivations to attend the meeting, satisfaction and value of the meeting, and expectations for the JASE.
Results:
The response rate was 34.5% (107/310). Respondents represented 12 surgical specialties or surgery-related disciplines, with gastroenterological surgery being the most common. Among the respondents, 77.6% (83/107) were surgical educators, and they reported the lack of time for teaching and incentives for educational responsibilities as major challenges. Twenty-six surgical educators have conducted surgical education research; the main barriers for surgical education research were insufficient knowledge about research methodologies, and budget and time constraints. Most respondents (92%) rated the annual meeting as satisfactory, and they valued it for providing fundamental knowledge and skills in surgical education, and increasing and maintaining motivation as educators. The participants’ primary expectation for the JASE and its annual meeting was to share the latest topics in the field of surgical education.
Conclusions:
The survey demonstrated that the JASE and its annual meetings contributed to the enhancement of the participants’ knowledge and motivation, whereas it highlighted the unmet needs among Japanese surgical educators. This data is valuable to determine the future direction of the JASE.
Background
To date, there is not much known about both the educational and operative experiences of orthopaedic resident trainees in sub-Saharan Africa. The main objective of the study was to survey and analyze the educational landscape of orthopaedic residency programs in sub-Saharan Africa and the U.S. in terms of the main learning resources being used, curriculum structure, and assessment modalities.
Methods
Two sets of electronic surveys, one for program directors (PDs), and one for residents, were designed with feedback from residents in Tanzania as well as attendings in the U.S. These surveys were distributed to orthopaedic residency programs across sub-Saharan Africa (n=50) and the U.S. (n=201) via e-mail with use of the Global Orthopaedic Residency Database (GORD). PD responses (n=39) and resident responses (n=94) from sub-Saharan Africa as well as PD responses from the U.S (n=12) were summarized using statistical software.
Results
Responses revealed that 26% of orthopaedic residents in sub-Saharan Africa use online resources as their primary learning resource, with 74% using textbooks, program-provided lectures/didactics, or resident group discussions. 47% of residents also reported a case volume of >5 per day on average and 48.6% reported not having formal mentorship in their program. 64.9% of residents also reported having assessments every few months to a year. Notably, 59.4% of PDs in sub-Saharan Africa reported not having the ability to provide internet access to appropriate full-text journals and electronic medical reference resources despite 90.6% of PDs stating a dissertation requirement for residency completion. 100% of PDs from programs in the U.S. reported providing internet access to these texts, with 60% stating a dissertation requirement.
Conclusions
The results of this study demonstrate the lack of access to electronic educational materials and formal mentorship in orthopaedic residency training across sub-Saharan Africa. Additionally, these results provide an initial insight into the overall layout of orthopaedic training in sub-Saharan Africa. This data can inform future gap analysis work to enhance equity in global surgery education.
Objective: Prior research has demonstrated lower reported procedural confidence levels among female medical students and surgical residents. This study compares self-reported confidence of male- and female-identifying medical students when performing common procedures during the surgery clerkship.
Design: After completing the surgery clerkship, a 29-question survey was administered to assess medical students' experience simulating and performing 36 common surgical procedures at a large academic institution. Utilizing 5-point Likert scales, we assessed student confidence in performing these procedures. Data collection occurred September 2021-August 2023. Statistical analysis included Chi-square, Fisher's exact, and student t-tests.
Results: A total of 81 responses were collected (response rate of 33%; 81/247). Median age was 26 [IQR: 24.5-26] and 69% (56/81) of students were female. The frequency of simulation across all 36 skills was not significantly different by gender, and only one skill (driving camera) was performed on the rotation by males more frequently than females (p=0.026). Despite this, males reported feeling more confident with laparoscopic instrument usage (p=0.024) and drain flushing/stripping (p=0.023) than females. Additionally, when asked about anticipated confidence performing the skill as an intern, males reported higher confidence for more advanced, high-complexity procedures such as vascular anastomosis (p=0.033), arterial blood gas (ABG) draw (p=0.014), arterial line placement (p=0.028), performing CPR (p=0.04), drain flushing/stripping (p=0.029), and intraosseous line placement (p=0.0047). Finally, males reported higher confidence at all points during the clerkship: before the orientation session (p=0.024), after orientation (p=0.019), and at the end of the clerkship (p=0.014). There was no difference by gender in interest in surgery before the clerkship nor change in interest in surgery as a result.
Conclusion: In this cohort, male medical students had significantly higher confidence across multiple skills than female students throughout the entire clerkship, despite similar experience simulating and performing the skills. This suggests that further work is needed to identify root causes of this difference to reduce any potential inequities or biases across genders in surgical skill education.
Background:
Research on students’ choice of surgery as a career have focused on perspectives of mentorship, exposure, surgeon lifestyle and culture. Research has not focused on medical students’ perceptions of surgery in their own words.
Hypothesis or research question:
What do medical students find appealing and unappealing about surgery that educators could address when teaching medical students?
Methods:
An interview study was approved as exempt by the institutional review board of the University of Pittsburgh. 10 first-year, 5 second-year, 7 third-year, and 6 fourth-year medical students were interviewed about their likes and dislikes about surgery and surgery experiences. 15 participants identified as female and 13 as male. 10 identified as White, 10 as Asian, 2 as Black, 1 as Hispanic, and 5 as mixed race. Qualitative analyses of participants’ answers were conducted according to qualitative research guidelines. Theme reliability and validity were assessed until the researchers agreed on all theme identification for all transcripts.
Results:
18 themes of what motivated and dissuaded participants about surgery recurred across the transcripts. Many were motivated by working with their hands, fascination with anatomy and technology, and surgical problem-solving. They were dissuaded by surgical lifestyle, culture, and short relationships with patients. Friendly surgeons and staff who welcomed them, preparatory activities, the surgical team’s collaboration, and one-on-one interactions with surgeons were influential.
Conclusions:
Medical students can be intrigued by physical, collaborative, and intellectual activities of surgery and concerned about the environment of surgery. Surgeon educators can find valuable information for teaching in the words of their students.