Association of intraoperative entrustment with clinical competency amongst general surgery residents

Am J Surg. 2020 Feb;219(2):245-252. doi: 10.1016/j.amjsurg.2019.12.012. Epub 2019 Dec 13.

Abstract

Background: Lack of transparency and meaningful assessment in surgical residency has led to inconsistent intraoperative entrustment and highly variable trainee competence at graduation. The relationship between faculty entrustment and resident entrustability on clinical competency remains unclear. We sought to evaluate the dynamic between entrustment/entrustability and clinical competency in general surgery residency.

Methods: Intraoperative observations were conducted across a 22-month period at an academic tertiary center. Entrustment/entrustability were measured using OpTrust. Clinical competencies were appraised via ACGME Milestones and Objective Structured Assessment of Technical Skill (OSATS) scores. Mixed effects linear regression was used to investigate the relationship among overall ACGME Milestone scores, OSATS domain scores, and overall OpTrust scores.

Results: Overall OpTrust scores significantly correlated with overall Milestone scores and multiple OSATS score domains.

Conclusions: OpTrust demonstrated a positive association between ACGME general surgery Milestones and OSATS scores. Overall, OpTrust may help optimize intraoperative faculty entrustment and resident entrustability, facilitating surgical trainee success during residency.

Keywords: Competency; Entrustment; Milestones; OSATS; OpTrust; Surgical education.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Academic Medical Centers
  • Adult
  • Clinical Competence*
  • Cohort Studies
  • Education, Medical, Graduate / organization & administration*
  • Female
  • General Surgery / education*
  • Humans
  • Internship and Residency / organization & administration
  • Interprofessional Relations
  • Intraoperative Care
  • Male
  • Middle Aged
  • Operating Rooms / organization & administration
  • Professional Autonomy*
  • Retrospective Studies
  • Trust / psychology
  • United States