Optimizing resident operative self-confidence through competency-based surgical education modules: are we there yet?
Introduction and hypothesis
Self-confidence is the belief in one’s ability to perform and can be enhanced by training. Surgical education should aim to optimize trainee confidence. We designed three procedure-specific competency-based modules to teach vaginal hysterectomy (VH), anterior (AR) and posterior repair (PR) to novice gynecology residents. We hypothesized each module would improve self-confidence and satisfaction during index procedure performance in the operating room.
This was an ancillary analysis of a larger randomized-controlled trial of gynecologic educational interventions. Residents at three Canadian universities were included if they had previously performed fewer than five index procedures independently. Intervention residents received educational modules; controls engaged in self-directed learning. All residents performed one or more of the three surgeries and filled out a validated Self-Confidence Scale and a Satisfaction Scale. Scores were compared between groups. Correlations were sought between self-confidence and various variables.
Forty-six residents at three Canadian universities were randomized (21 intervention, 25 control). Most residents had never performed the index procedure. Overall, self-confidence was significantly higher (p = 0.021) in the intervention group for VH, but not for AR and PR (p = 0.94 and p = 0.12, respectively). Compared with controls, self-confidence was also significantly higher in intervention residents who had never performed VH (p = 0.026) or PR (p = 0.027) and in first and second year intervention residents. There was a positive correlation between self-confidence and satisfaction.
Surgical modules improved self-confidence preferentially in the most junior residents and for more complicated procedures. The wide self-confidence ranges observed suggest that optimization should be an important goal for surgical educators.
KeywordsCompetency-based surgical education Gynecology Junior residents Self-confidence
Financial support from a Medical Education Research Grant (competitive), the Royal College of Physicians and Surgeons of Canada. The funding source did not have any role in any aspect of this research.
Compliance with ethical standards
Conflicts of interest
• R Geoffrion: Preceptor/proctor Boston Scientific Capio and Obtryx devices; Advisory Board Duchesnay.
• N Todd: Advisory board, Bayer Pharmaceuticals.
• Remaining authors claim no conflict of interest.
- 4.Driskell JE, Salas E. Stress and human performance. Mahwah: Lawrence Erlbaum Associates Inc.; 1996.Google Scholar
- 8.Bandura A. The exercise of control. New York: WH Freeman & Co; 1997.Google Scholar
- 14.Silva DR, Mazzo A, Jorge BM, Souza Júnior VD, Fumincelli L, Almeida RG. Intermittent urinary catheterization: the impact of training on a low-fidelity simulator on the selfi-confidence of patients and caregivers. Rehabil Nurs. 2015. https://doi.org/10.1002/rnj.226.