High vs. low entrustment behaviors in the operating room

Background: Operative experience with an appropriate degree of supervised autonomy is critical to resident training. Progressively greater intraoperative entrustment has been associated with gradually higher levels of resident autonomy. This study attempts to identify consistently observed intraoperative behaviors that are linked with higher resident entrustment. Methods: This qualitative study analyzed observational notes recorded by trained raters who provided entrustment scores for 204 surgical cases at Michigan Medicine from 2015 to 2017. Notes were coded in NVivo12. Thematic analysis was used to identify themes and patterns within the data. Results: The analysis generated 144 codes. Codes were clustered into 10 themes. These themes manifested differently in intraoperative behaviors strongly associated with high entrustment versus low entrustment. Conclusion: This study demonstrates key differences in intraoperative behaviors exhibited by residents and faculty in high and low entrustment interactions. Awareness of behaviors that enhance entrustment can help faculty augment resident learning and enable higher resident operative autonomy. (C) 2020 Elsevier Inc. All rights reserved.

Automated summary

This study analyzed the importance of operative experience with appropriate degree of supervised autonomy in resident training, aiming to identify consistently observed intraoperative behaviors that are linked with higher resident entrustment. Results showed key differences in intraoperative behaviors exhibited by residents and faculty in high and low entrustment interactions.