Progression of operational autonomy in Swedish surgery and urology residents
Victor Schagerlöf, Alexander Tejera, Martin Bäckström, Hanne Pedersen, Magnus Anderberg, Mikael Ekelund, Christopher Mathieu, Britt-Marie Johansson, Kristine HagelsteenAbstract
Introduction
Progress toward operative autonomy is an important step in residency. This process is largely unexplored in Swedish residents. The aim was to analyse self-reported progression of operational autonomy in Swedish surgical and urology residents, and to explore a possible correlation with personality traits.
Methods
Applicants for positions at surgical departments at seven hospitals were invited to participate. A neutralized Big Five Personality Inventory was conducted. Questionnaires with background information and operative experience were carried out on recruitment, after one and three years. Descriptive statistics, Cochran’s Q test, McNemar’s test and Spearman’s rho correlation were used.
Results
Of 50 participants, 46 received employment, and 41 were still in a residency program after three years. A total of 28 participants had complete data for all tests and questionnaires. Descriptive statistics showed progression of autonomy in basic surgical procedures. Four individuals had noticeably higher or lower numbers compared to peers. Female gender and higher levels of neuroticism correlated with lower levels of autonomy (P < 0.05). No difference in autonomy was found between hospital types. Specialization correlated with levels of autonomy in the respective fields (P < 0.01).
Discussion
Residents at non-university hospitals are given opportunities to perform independent laparoscopic surgery more frequently than in university hospitals. Resident’s self-assessed operational autonomy did not significantly differ after three years of training. Our results indicate that high levels of neuroticism may affect operational autonomy progression. Discussion within the Swedish surgical society is called for to determine what levels of operative autonomy is expected at different stages of residency.