Defining quality in surgical training: perceptions of the profession

Abstract

BACKGROUND: To improve surgical training standards, it is necessary to first define the elements of high-quality training and methods for measuring them. METHODS: Semistructured interviews were conducted with attending (n 5 10) and resident (n 5 10) general surgeons.Aninterviewtopic guidewasused toelicitend users’ opinionsonindicators oftraining quality and methods to measure them. Interviews were recorded, transcribed verbatim,and coded using a framework to identify emergent themes. Sampling ceased once thematic saturation was achieved. RESULTS: Key surgical training quality indicators include continuity (80% of participants) and relationship (95%) between trainee and trainer, level of supervision (85%), and an optimal volume (95%) and mix (90%) of operative cases. All surgeons felt that trainee logbook analysis and feedback was essential. The majority (85%) felt that training analysis should be freely available to create accountability for hospitals and attending surgeons (70%) and encourage competition (70%) to drive up standards. Only 30% felt that all attending surgeons should offer training. CONCLUSIONS: Surgical training quality needs to be robustly assessed. Transparency in training outcomes will create competition and raise standards of surgical education.