Design: Survey study.
Setting: REDCap survey study.
Patients or Participants: All post-graduate year four (PGY-4) and five (PGY-5) Ob/Gyn residents in Canada and a random representative cohort of PGY-4 Ob/Gyn residents in the U.S. during the 2022-2023 academic year.
Interventions: A survey was distributed electronically to all 16 Ob/Gyn residency programs in Canada and 74 randomly selected Ob/Gyn programs in the U.S. via program coordinators.
Measurements and Main Results: Demographic information, self-reported gynecologic case numbers and resident self-efficacy rating in independent performance of 11 common gynecologic surgeries were collected.
127 individuals responded to the survey, including 69 (54%) U.S. PGY4-s, 30 (24%) Canadian PGY-4s and 28 (22%) Canadian PGY-5s. There were no major differences in demographics across groups. U.S. PGY-4s self-reported higher numbers of abdominal, laparoscopic and robotic-assisted hysterectomies than the combined Canadian cohort. Highest self-efficacy was reported for laparoscopic salpingo-oophorectomy and salpingectomy for all 3 groups. Lowest self-efficacy was reported for laparoscopic and robotic-assisted myomectomies, vaginal hysterectomies (any type) and endometriosis excision across all 3 groups. Notably, Canadian PGY-5s reported higher self-efficacy with total laparoscopic hysterectomy (TLH) compared with U.S. PGY-4s (p=0.031), whereas U.S. PGY-4s reported higher self-efficacy with robotic-assisted TLH (RA-TLH) than both Canadian PGY-4s and PGY-5s (p<0.001).
Conclusion: Differences in reported self-efficacy for TLH and RA-TLH may reflect less availability of robotics in Canadian residency programs and the need to learn both laparoscopic and robotic approaches in U.S. programs. Generally, U.S. and Canadian residents reported high self-efficacy for minor laparoscopic procedures, with self-efficacy scores decreasing with increasing case complexity. Given the similarities between reported self-efficacy for both 4-year and 5-year residency programs, further research is needed to elucidate how best to optimize surgical education and build confidence in the setting of the ongoing surgical “volume problem”.
Lin, E*1, Warshafsky, C2, Su, J3, Chen, I3, Warner, K4, Fajardo, O5, Pruszynski, J1, Kho, KA1. 1Obstetrics & Gynecology, UT Southwestern Medical Center, Dallas, TX; 2Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada; 3Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada; 4Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI; 5Minimally Invasive Gynecologic Surgery, University of Wisconsin, Madison, WI
