Resident and attending assessments of operative involvement: Do we agree?

- Resident involvement in a series of intraoperative tasks is evaluated.
- Resident self-perceptions correspond well with attending surgeon evaluations.
- Resident involvement correlates with operative variables and attending experience.
- Resident agreement with attending surgeons improves with the same variables.

BackgroundGeneral surgery residents' (GSRs') operative experience likely improves with increased involvement. We explored GSRs and attending surgeons' (ASs') perceptions of GSRs' operative roles.MethodsGSRs and ASs completed surveys postoperatively regarding responsibility for several operative tasks (incision opening, dissection of minor and major structures, major suturing, and incision closure). Analyses used chi-square test (P < .05) and Spearman's rank correlation (ρ).ResultsA total of 151 pairs of surveys were collected. Interpair agreement on GSRs involvement varied for each category (ρ range: .30 to .67), and GSRs underestimated their involvement for every step. GSRs frequently performed the majority of each task (range: 86% to 97%). Decreasing operational complexity, acute operations, and junior ASs (<5 years in practice) were each associated with increased agreement and GSRs involvement in operative tasks.ConclusionsGSRs involvement was extensive, and agreement with ASs was high overall. Some discrepancies remain in several categories based on operational complexity, acuity, and ASs experience.