Do we know what we are talking about? Measuring resident and faculty surgical ethics competency

Abstract

Purpose

Educating residents on surgical ethics relies on interactions between residents and faculty about surgical cases. We performed an internal needs assessment designed to determine general surgery (GS) residents’ and faculty members’ knowledge base for addressing ethical dilemmas common in surgical cases.

Methods

GS residents and faculty members completed a 10-question multiple choice knowledge assessment. Participants rated their confidence with recognizing and managing ethical dilemmas using a Likert scale (1-very low confidence to 5-very high confidence). The GS residents also completed an oral boards style assessment using a surgical case with multiple ethical dimensions. Mann Whitney and Kruskal–Wallis tests were applied in analyses.

Results

34 residents and 82 faculty members completed the knowledge assessment. 34 residents and 19 faculty members completed the confidence assessment. 39 residents completed the oral boards assessment. Median faculty scores were statistically lower on the knowledge assessment compared to residents (5.0 [4.0, 6.0] vs. 6.0 [5.0, 7.0], p = 0.037). Senior resident median scores were higher compared to junior resident median scores p = 0.019. Compared to residents, faculty felt more comfortable recognizing (4.0 [3.0, 4.0] vs. 3.0 [3.0, 4.0], p = 0.003) and managing (4.0 [3.0, 4.0] vs. 3.0 [2.0, 3.0], p < 0.0001) ethical dilemmas common in surgical cases. Comfort level was greatest with dilemmas involving informed consent and lowest involving conflicts of interest. The resident median score on the oral board assessment was 65% [55, 75].

Conclusions

This needs assessment demonstrates a knowledge gap regarding clinical surgical ethics among residents and faculty members. These results will inform a novel curriculum focused on improving faculty and resident knowledge and confidence in managing surgical ethical dilemmas.