Abstract
Objective
This study sought to evaluate the self-reported and program director–reported comfort
of graduating Canadian obstetrics and gynaecology residents in independently performing
various surgical skills.
Methods
A Web-based survey was distributed to four cohorts of graduating obstetrics and gynaecology
residents across Canada (2014-2017). Residents were asked to indicate their comfort
level with independently performing 34 core surgical procedures by using a five-point
Likert-type scale. A similar survey was sent to program directors. Comfort scores
for residents and program directors were compared using quantitative and qualitative
methods as appropriate (Canadian Task Force Classification II-3).
Results
Resident and program director survey response rates were 168 of 320 (52.5%) and 20
of 48 (41.7%), respectively. Residents were “comfortable” or “very comfortable” performing
7 of 13 (54%) gynaecology and 4 of 6 (67%) obstetrics List A procedures independently.
Program directors reported that residents were “comfortable” or “very comfortable”
performing 10 of 13 (77%) gynaecology and 4 of 6 (67%) obstetrics List A procedures.
Compared with program directors, residents reported lower comfort with certain minimally
invasive and obstetrics List A procedures (P < 0.05). Differences in comfort when performing several List A procedures were related
to training program size and plans to pursue fellowship. Qualitative analysis revealed
several major and minor themes supporting the dichotomy between residents’ lack of
comfort and program directors’ expectation of comfort.
Conclusion
Graduating residents were not comfortable performing many core surgical procedures
independently. Additionally, program directors believed that trainees were more comfortable
than they reported, and comfort varied according to program size and future fellowship
plans. The new competency-based curriculum is an opportunity to address this gap.
Résumé
Objectif
Cette étude visait à évaluer l'aise des résidents finissants en obstétrique et en
gynécologie du Canada à pratiquer seuls diverses interventions chirurgicales, selon
eux-mêmes et selon leur directeur de programme.
Méthodologie
Un sondage en ligne a été distribué à quatre cohortes canadiennes de résidents finissants
en obstétrique et en gynécologie (2014-2017). Les résidents devaient indiquer leur
degré d'aise à pratiquer seuls 34 interventions chirurgicales de base sur une échelle
de Likert en cinq points. Un sondage semblable a été envoyé aux directeurs de programme.
Nous avons comparé les degrés d'aise indiqués par les résidents et les directeurs
de programme au moyen d'une méthode quantitative ou qualitative selon le cas (classification
II-3 du Groupe d'étude canadien).
Résultats
Le taux de réponse des résidents et des directeurs de programme était de 168 sur 320
(52,5 %) et de 20 sur 48 (41,7 %), respectivement. Les résidents se sentaient « à
l'aise » ou « très à l'aise » de pratiquer seuls 7 des 13 interventions gynécologiques
(54 %) et 4 des 6 interventions obstétricales (67 %) de la liste A. Les directeurs
de programme jugeaient que les résidents étaient « à l'aise » ou « très à l'aise »
de pratiquer 10 des 13 interventions gynécologiques (77 %) et 4 des 6 interventions
obstétricales (67 %) de cette même liste. Comparativement aux degrés indiqués par
les directeurs de programme, les résidents ont indiqué être moins à l'aise de pratiquer
certaines interventions obstétricales et à effraction minimale de la liste A (P < 0,05). Les différences dans l'aise à pratiquer plusieurs interventions de cette
liste ont été associées à la taille des groupes de formation et à l'intention d'effectuer
un stage postdoctoral. L'analyse qualitative a révélé plusieurs thèmes majeurs et
mineurs expliquant la dichotomie entre le manque d'aise des résidents et les attentes
des directeurs de programme à cet égard.
Conclusion
Les résidents finissants n'étaient pas à l'aise de pratiquer seuls un bon nombre d'interventions.
De plus, les directeurs de programme croyaient que les résidents étaient plus à l'aise
qu'ils ne l'étaient réellement, et le degré d'aise variait selon la taille des groupes
et l'intention d'effectuer un stage postdoctoral. Le nouveau programme d'apprentissage
par compétences est une occasion de combler cette lacune.
Key Words
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Article info
Publication history
Published online: May 30, 2019
Footnotes
Competing interests: The authors declare that they have no competing interests.
Each author has indicated that they meet the journal's requirements for authorship.
Identification
Copyright
© 2019 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
