Preparing to Operate: A Multinational Analysis of Practices and Perceptions of Surgical Residents.

Introduction: Operative preparation among surgical residents is a critical aspect of surgical training, requiring a balance of technical and non-technical skill development. Structured residency programmes have introduced both opportunities and challenges for residents, including navigating diverse educational resources and addressing barriers to effective preparation. This study aimed to examine operative preparation among surgical residents, focusing on their attitudes, motivations, barriers and strategies to assess the efficacy of residency programmes.

Methods: A cross-sectional survey, designed by surgeons and surgical residents, gathered data from 201 surgical residents across various specialties and countries. The survey investigated demographics, practices, influences and experiences regarding residency programmes.

Results: The study revealed a positive correlation between time spent preparing and perceived preparedness, with residents spending more time preparing as they progressed in their residency. Barriers to preparation included limited time and energy as well as having a minimal role in the surgery. Motivations were centred around personal growth, as well as safety and complication avoidance. Common preparation techniques included reviewing imaging (88.6%), watching surgical videos (83.6%) and reviewing medical records (82.1%). Activities such as reviewing articles and mental rehearsal were utilised less but were strongly correlated with preparedness. Only 31% received formal training on preoperative preparation.

Conclusions: Surgical residency programmes need to address the diverse learning preferences of residents and provide a more structured approach to preparation. There is a need to optimise barriers and motivators to preoperative preparation and align expectations between tutors and residents to enhance the preparedness of surgical residents for the operating room.