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1. Reimagining general surgery resident selection: Collaborative innovation through design thinking

Author

Tejas S. Sathe, MD, Joseph C. L'Huillier, MD, Rebecca Moreci, MD, Sarah Lund, MD, Riley Brian, MD, Caitlin Silvestri, MD, Connie Gan, MD, Colleen McDermott, MD MPH, Angie Atkinson, MD, Sergio M. Navarro, MD, Justine Broecker, MD, John M. Woodward, MD, Tawni Johnston, MD, Nicholas Laconi, MD, Jonathan Williams, MD, and Steven Thornton, MD

Subjects
Resident selection, Design thinking, Surgical education, Collaboration, Academic Surgery, Surgery, RD1-811
Abstract

Introduction: The process by which surgery residency programs select applicants is complex, opaque, and susceptible to bias. Despite attempts by program directors and educational researchers to address these issues, residents have limited ability to affect change within the process at present. Here, we present the results of a design thinking brainstorm to improve resident selection and propose this technique as a framework for surgical residents to creatively solve problems and generate actionable changes. Methods: Members of the Collaboration of Surgical Education Fellows (CoSEF) used the design thinking framework to brainstorm ways to improve the resident selection process. Members participated in one virtual focus group focused on identifying pain points and developing divergent solutions to those pain points. Pain points and solutions were subsequently organized into themes. Finally, members participated in a second virtual focus group to design prototypes to test the proposed solutions. Results: Sixteen CoSEF members participated in one or both focus groups. Participants identified twelve pain points and 57 potential solutions. Pain points and solutions were grouped into the three themes of transparency, fairness, and applicant experience. Members subsequently developed five prototype ideas that could be rapidly developed and tested to improve resident selection. Conclusions: The design thinking framework can help surgical residents come up with creative ideas to improve pain points within surgical training. Furthermore, this framework can supplement existing quantitative and qualitative methods within surgical education research. Future work will be needed to implement the prototypes devised during our sessions and turn them into complete interventions. Key message: In this paper, we demonstrate the results of a resident-led design thinking brainstorm on improving resident selection in which our team identified twelve pain points in resident selection, ideated 57 solutions, and developed five prototypes for further testing. In addition to sharing our results, we believe design thinking can be a useful framework for creative problem solving within surgical education.

Published
2024
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2. Medical student attitudes and actions that encourage teaching on surgery clerkships

Author

Chanta’l Babcock, Tawni Johnston, Sarah Nguyen, Candace J. Chow, Brigitte K. Smith, Boyd F. Richards, and Hilary C. McCrary

Subjects
Male, medicine.medical_specialty, Students, Medical, 020205 medical informatics, Attitude of Health Personnel, media_common.quotation_subject, education, Exploratory research, 02 engineering and technology, Humility, 03 medical and health sciences, 0302 clinical medicine, ComputingMilieux_COMPUTERSANDEDUCATION, 0202 electrical engineering, electronic engineering, information engineering, medicine, Humans, 030212 general & internal medicine, media_common, Teamwork, business.industry, Learning environment, Teaching, Clinical Clerkship, General Medicine, Focus group, Self Concept, Surgery, General Surgery, Female, Thematic analysis, Faculty development, business, Theme (narrative)
Abstract

Introduction Surgical faculty and residents are responsible for the clinical education of medical students during their core surgical clerkship, sub-internships, and clinical electives. Much attention has been paid to faculty development in teaching, as well as residents-as-teachers programs, to enhance student learning in the surgical environment. This focus to “train the trainers” has not addressed what medical students can do to take ownership of and improve their own learning, as partners in educational interactions. The purpose of this exploratory study was to investigate how medical students’ attitudes and actions can enhance clinical teaching interactions during surgical rotations. Methods Previously collected data from a multiple case study that explored the learning environment at a single academic medical center was analyzed to understand the roles that students play in their learning. The data includes transcriptions from semi-structured interviews with four 4th year mediacl students, three general surgery residents, and four surgery attendings, and focus groups with two sets of 3rd year medical students. Two authors employed thematic analysis to code the data. Results Findings were organized into five themes: eagerness, humility, confidence, team player, and adaptability. Each attitudinal theme was associated with specific actions that students adopted to encourage teaching behaviors from resident and faculty surgeons during their surgery rotations. Participants discussed the importance of students “seek[ing] out opportunities” for learning (eagerness) and being “willing to be wrong” (humility). Student expressions of confidence in their knowledge and skills were marked by following “steps that I know,” which signaled to teachers that they could be entrusted to participate in patient care. Students categorized as team players “follow[ed] up on information without specifically being told.” Finally, students categorized as adaptable responded to “immediate feedback” by making “adjustments.” Conclusions Medical students are important stakeholders and contributors to teaching interactions and are likely to impact their own learning experience through the adoption of key attitudes and associated actions.

Published
2020

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