Surgical residents as medical student mentors

doi:10.1016/j.amjsurg.2006.07.011

The American Journal of Surgery

Volume 193, Issue 1, January 2007, Pages 90-93

Presented in abstract form at the 2006 Annual Meeting of the Association of Surgical Education, Tucson, AZ, April 24–27, 2006

https://doi.org/10.1016/j.amjsurg.2006.07.011 Get rights and content

Abstract

Background

Medical students’ decreasing interest in surgery may be caused by the inadequate availability of role models. We believe that surgical residents show the qualities of outstanding surgical mentors and are in a key position to influence students’ career choices.

Methods

In 2004–2005, 117 medical students at Mount Sinai School of Medicine completed their third-year surgery clerkship. They were asked to complete an anonymous survey regarding a career in surgery and surgical mentors.

Results

A total of 107 students (91%) completed the survey. Seventy-nine percent were influenced positively toward a surgical career after the clerkship. A higher fraction of these students identified a mentor or role model than the students who did not increase their interest in surgery (95% vs 52%). Residents scored higher than attendings in 12 of 14 qualities describing outstanding clinical mentors (P < .001).

Conclusions

Role models are crucial in bolstering medical students’ interest in surgical careers. Residents are identified as having qualities that are essential to being an outstanding mentor and residents may play a role in influencing students’ career choices.

Section snippets

Methods

During the academic year of 2004–2005, 117 medical students completed their third-year surgery clerkships at the Mount Sinai School of Medicine in New York, NY. On completion of the rotation, the students were asked to complete an anonymous written survey regarding their interest in a surgical career and their ability to identify a surgical mentor during the clerkship (Fig. 1). These surveys were collected prospectively as each rotation of students completed their experience with the surgery

Results

A total of 117 students finished the surgical clerkship during the study period. A total of 107 (91%) of the students completed the survey. There were 45 men (42%) and 62 women (58%). Twenty-seven percent of students were interested in surgery or a surgical subspecialty. Twenty-one percent were interested in medicine or a medical subspecialty. Twenty-four percent were interested in other specialties and 28% were undecided.

Forty students (37%) had a positive view of surgery as a specialty before

Comments

The surgery clerkship positively influenced students’ perceptions of surgical careers. Although the reasons likely are multifactorial, we found that identifying appropriate mentors likely had a significant impact. Role models have been noted to be key in student recruitment into surgery and recent editorials have called for increased attention to surgical mentoring [4], [5], [6], [9]. Faculty traditionally have been identified as the main players in this role. However, we found that residents

Conclusions

Role models are crucial in bolstering medical students’ interest in surgical careers. As shown in this study, students identify residents with many of the qualities essential to an outstanding mentor. Efforts should be made to foster the student-resident mentoring relationship as an adjunct to the efforts made by attending surgeons.

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Creation and Implementation of an Online Tool for Feedback on Resident Teaching: A Pilot Study
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There are few assessments of the competence and growth of surgical residents as educators. We developed and piloted an observation-based feedback tool (FT) to provide residents direct feedback during a specific teaching session, as perceived by medical students (MS). We hypothesized that residents’ performance would improve with frequent, low stakes, observation-based feedback.
This prospective study took place at an academic general surgery program.
Focus groups of MS, surgical residents, and faculty informed FT development. MS completed the FT regarding resident teaching.
The FT utilized 5 slider-bar ratings (0 to 100) about the teaching encounter and a checklist of 16 desirable teaching behaviors. QR codes and weekly email links were distributed for 12 months (6 clerkship blocks) to promote use. Residents were sent their results after each block. A survey after each block assessed motivation for use and gathered feedback on the FT. Descriptive statistics were used for analysis (medians, IQRs). Primary measures of performance were median of the slider-bar scores and the number of teaching behaviors.
The FT was used 111 times; 37 of 46 residents were rated by up to 65 MS. The median rating on the slider-bars was 100 and the median number of desirable teaching behaviors was 12; there were no differences based on gender or PGY level. 10 residents had 5 or more FT observations during the year. Four residents had evaluations completed in 4 or more blocks and 19 residents had evaluations completed in at least 2 blocks. Over time, 13 residents had consistent slider-bar scores, 1 resident had higher scores, and 5 residents had lower scores (defined as a more than 5-point change from initial rating). Frequency of use of the FT decreased over time (38, 32, 9, 21, 7, 5 uses per block). The post-use survey was completed by 24 MS and 19 residents. Most common reasons for usage were interest in improving surgical learning environment, giving positive feedback (MS), and improving teaching skills (residents). Most common reasons for lack of usage from residents were “I did not think I taught enough to ask for feedback,” “I forgot it existed,” and “I did not know it existed.”
The FT did not lead to any meaningful improvement in resident scores over the course of the year. This may be due to overall high scores, suggesting that the components of the FT may require reevaluation. Additionally, decreased utilization of the instrument over time made it challenging to assess change in performance of specific residents, likely due to lack of awareness of the FT despite frequent reminders. Successful implementation of observation-based teaching assessments may require better integration with residency or clerkship objectives.
The Role of Gender-Concordant Mentorship in Women Premedical Students’ Perception and Pursuit of Surgical Careers
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Evaluate the impact of a 6-month structured mentorship program between women premedical student mentees paired with women medical students and surgical residents on mentees’ interests and perceptions of surgical careers.
Prospective qualitative and quantitative study.
This study took place at the Boston University School of Medicine, a single institution tertiary care hospital.
Self-identified women premedical students at Boston University were eligible for inclusion in this program (n=90). Participants were recruited and grouped with self-identified women medical student (n=52) and resident (n=19) mentors. Participants were provided with a monthly curriculum to guide discussions. Mentees completed pre- and postprogram surveys with 5-point Likert scale questions regarding interest and exposure to surgery, role models and mentorship, and effect of COVID-19 on their career interests. Pre- and postprogram responses were compared using a Wilcoxon rank sum test.
Of the 90 mentees, 63 (70%) completed preprogram surveys, and 53 (59%) completed postprogram surveys. Survey respondents indicated statistically significant increased exposure to positive role models (preprogram mean 3.15, postprogram mean 4.06, p=0.0003), increased exposure to women role models (preprogram 2.30, postprogram 3.79, p<0.0001), increased access to dedicated mentors (preprogram 2.11, postprogram 3.75, p<0.0001), and increased availability of support persons to answer their questions and concerns about careers in surgery (preprogram 3.03, postprogram 3.85, p=0.001). There was also a statistically significant increase in the reported effect that exposure to gender-concordant role models in surgery had on participants’ decisions to consider a surgical career (preprogram 3.58, postprogram 4.23, p=0.001).
This 6-month structured mentorship program for undergraduate premedical students increased mentees’ exposure to positive women role models and mentors, and increased mentee's interest in pursuing a surgical career. This emphasizes the need for structured gender-concordant mentorship programs early in women's careers to encourage pursuit of surgical careers in an otherwise men-dominated field.
Mentoring on Orthopedic Surgery Clinical Rotations: A Survey of Mentor Effectiveness on Student Mentees Compared to an Unmentored Control Group
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Mentorship is an important aspect of medical education in providing students guidance and connections to new opportunities, ultimately leading to increased productivity and career satisfaction. The purpose of this study was to design and implement a formal mentoring program between medical students participating in their orthopedic surgery rotation and orthopedic residents to determine if this relationship improved students’ experiences during their rotation compared to students who were not mentored.
Third- and fourth-year medical students rotating in orthopedic surgery and PGY2-PGY5 orthopedic residents at one institution were eligible to participate in a voluntary mentoring program between the months of July and February during 2016 to 2019. Students were either randomly paired with a resident mentor (experimental group) or not (unmentored control group). Anonymous surveys were distributed to participants at weeks 1 and 4 of their rotation. There were no minimum number of meetings required between mentors and mentees.
Twenty-seven students (18 mentored, 9 unmentored) and 12 residents completed surveys during week 1. Fifteen students (11 mentored, 4 unmentored) and 8 residents completed surveys during week 4. While both mentored and unmentored students experienced an increase in enjoyment, satisfaction, and level of comfort at week 4 compared to week 1, the unmentored group demonstrated a greater overall increase. However, from the perspective of the residents, excitement for the mentoring program and the perceived value of mentoring decreased and 1 (12.5%) resident felt that it detracted from their clinical responsibilities.
While formal mentoring enhanced the experience of medical students on orthopedic surgery rotations, it did not substantially improve medical student perceptions when compared to students who did not receive formal mentoring. The greater satisfaction and enjoyment observed in the unmentored group may be explained by informal mentoring that naturally occurs among students and residents with similar interests and goals.
The Big Sibling program: Impact of a medical student-resident mentorship program during the surgery clerkship
2023, American Journal of Surgery
We created a Big Sibling mentorship program for medical students and studied the program effects.
Between July 2019 to December 2020, students completing their surgery clerkship were paired with a Big Sibling surgical research resident. Participation in and perceptions of the program were assessed by survey.
81 medical students and 25 residents participated with a 79% and 95% survey response rate, respectively. The most valuable topics discussed included ward skills, personal development and career advising. Students who interacted >2 times with their Big Sibling were more likely to perceive the operating room as a positive learning environment, view attendings as role models, and receive mentoring and feedback from residents and attendings (p = 0.03, 0.02, 0.01 respectively). 78% of residents thought the program was a positive experience and no residents found it burdensome.
The Big Siblings program enhances the surgery clerkship learning environment. Students who engaged with their Big Sibling had a more positive view of the clerkship and the mentorship provided by residents and attendings.
Qualities of excellent resident and attending teachers recognized by medical students: A qualitative analysis of nominations for surgical clerkship teaching awards
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Effective teaching positively impacts student experience during the surgical clerkship. We sought to better understand how medical students characterize excellent surgical educators and how these characteristics may differ between residents and attendings.
289 nominations by third-year medical students for a surgical resident and attending teaching award were examined for thematic content using conventional content analysis.
Six major themes emerged: inclusion of students, prioritizing student education, facilitating procedural involvement, utilizing effective educational methods, providing mentorship, and role modeling. Residents were more frequently commended for the first three themes, while residents and attendings were recognized equally for the latter three.
In identifying excellent surgical educators, students emphasized the educators’ roles in fostering a positive learning environment where student education is prioritized. Residents were recognized more often than attendings for a broader set of qualities valued by students. Residents as teachers training should be structured to develop these qualities.
Medical Student Career Choice: Who Is the Influencer?
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While many factors influence medical student career choice, interactions with attending and resident physicians during clinical rotations are particularly important. To evaluate the influence of attending and resident physicians on medical students’ career choices, particularly for those pursuing surgical careers, we quantified their respective influence in the context of other known influences.
Rising fourth-year medical students and new graduates were given an IRB-exempt, 14-item online survey. Descriptive statistics were performed on the demographic information. Chi-square analysis was used, as were Kruskal-Wallis and Mann-Whitney analyses on the Likert responses (α = 0.05).
Survey response was 24%. Students pursuing general surgery rated residents greater than or equal to attendings on 7 of 8 key mentoring characteristics. Of students choosing a different specialty than the one they intended to pursue upon entering medical school, the influence of residents was cited by 100% of the students pursuing general surgery, compared to 59% of the entire cohort. Identification of a role model and perceived personality fit were significantly more important than other factors (P < 0.0001). Students pursuing general surgery rated the importance of identifying a role model and perceived personality fit greater than their peers.
Residents have greater influences on medical students’ career choice compared to attendings. Students pursuing a surgical specialty, particularly general surgery, considered the influence of role models and perceived personality fit to be the most important factors in their specialty decision. These findings provide valuable insights to improve student experiences and career recruitment in surgical specialties, particularly general surgery.

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Association for Surgical EducationSurgical residents as medical student mentors

Abstract

Background

Methods

Results

Conclusions

Section snippets

Methods

Results

Comments

Conclusions

Curr Surg

Surgery

Surgery

Am J Surg

Surgery

J Am Coll Surg

Association for Surgical Education
Surgical residents as medical student mentors