Resident Perspectives on Effective Surgical Training: Incivility, Confidence, and Mindset

J Surg Educ. 2020 Sep-Oct;77(5):1088-1096. doi: 10.1016/j.jsurg.2020.04.002. Epub 2020 Jun 13.


Objective: Ample evidence exists that one's internal state (e.g., mindset, emotion) impacts one's performance. Both the military and sports organizations have focused on optimizing internal states of their service members and athletes, respectively, to improve performance and wellbeing. The internal states of surgical residents and the factors that influence their internal states have not yet been examined. Our goal is to better understand whether certain internal states are beneficial for resident operative performance, and how to optimize these during surgical training.

Design: A 17-question survey, containing both open-ended and multiple-choice questions, was distributed to all (n = 134) surgical residents at the University of Wisconsin. In open-ended questions, recurring themes were identified utilizing content analysis. Recurring themes stated by 25% or more of the respondents are reported.

Setting: Department of Surgery at the University of Wisconsin-Madison.

Participants: Surgical residents at the University of Wisconsin.

Results: The survey response rate varied between n = 47 (35%) and n = 32 (24%), as not all respondents answered all questions. (1) Effective surgical educators were identified to demonstrate humanism and focus on teaching. (2) Nearly all residents affirmed that certain mindsets help them excel in the OR, including positive and confident mindsets. (3) Nearly all residents affirmed that faculty and senior residents influence their mindsets. (4) Constructive resident mindsets were promoted by positive faculty behaviors and personal preparation, while negative faculty behaviors were identified to stifle constructive mindsets. (5) Factors contributing to favorable OR performance included personal preparation and positive OR environments. (6) Factors contributing to poor OR performance included inadequate preparation and negative interactions with faculty.

Conclusions: Residents near unanimously believe that certain mindsets help them excel, and that faculty impact their mindsets. As teachers, we must strive to better understand how to foster constructive mindsets in residents to optimize learning, performance, and wellbeing.

Keywords: Burnout; Confidence; Incivility; Mindset; Surgical education; Teaching approaches.

MeSH terms

  • Faculty, Medical
  • Humans
  • Incivility*
  • Internship and Residency*
  • Learning
  • Surveys and Questionnaires
  • Universities