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A qualitative exploration of teaching assistant cases: opportunities and mediators

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Global Surgical Education - Journal of the Association for Surgical Education Aims and scope Submit manuscript

Abstract

Purpose

Teaching assistant (TA) cases are opportunities for supervised autonomy in surgical training. The express purpose or value of these cases is not well defined. This study is a qualitative exploration of the value of TA cases. The study also explores external factors that bear on resident participation in TA cases.

Methods

Semi-structured interviews with senior surgery residents (SSR), junior attending (JAS), and senior attending surgeons (SAS) from across the Unites States about the TA case experience were conducted. Participants were selected by purposive and snowball sampling. Audio recordings were de-identified, transcribed, and qualitative codes were inductively derived. The interviews were coded and analyzed for themes.

Results

Twenty-one interviews (5 SSRs, 6 JASs, 10 SASs) were analyzed. The emergent themes were the value of TA cases, including technical skills, cognitive skills, and autonomy; the barriers to performing TA cases, including feasibility and external pressures; and the modulators of participation in TA cases, including the resident–surgeon and patient–surgeon relationships. SSRs and JASs confirmed that TA cases were a valuable part of their training experience and fostered skills for operative independence. SASs highlighted that external pressures, preexisting patient relationships, and limited familiarity with individual residents hinder entrustment and are barriers to allowing resident participation in TA cases.

Conclusions

Interviews revealed value of TA case participation in surgical training. To increase the opportunities for TA case participation, structural barriers should be addressed and surgeons must be able to entrust operations to residents. Nurturing long-term resident–surgeon relationships should be prioritized.

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Abbreviations

ABS:

American Board of Surgery

JAS:

Junior attending surgeon

JSR:

Junior surgery resident

OR:

Operating room

SAS:

Senior attending surgeon

SSR:

Senior surgery resident

TA:

Teaching assistant

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Acknowledgements

The authors wish to thank Lindsay Demers, PhD for her review of the interview guides and Jeffrey Markuns, MD for his helpful comments and suggestions regarding the project.

Funding

Alaina Geary was supported by a T32 training Grant (GM86308). Hannah Buettner was supported by the Pancreatic Cancer Alliance.

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Authors and Affiliations

  1. Department of Surgery, Boston University Medical Center, Boston, MA, USA

    Alaina D. Geary, Priyanka V. Chugh & Luise I. Pernar

  2. Boston University School of Medicine, Boston, MA, USA

    Alaina D. Geary, Erin Kim & Luise I. Pernar

  3. Department of Surgery, University of Massachusetts Medical Center, Worcester, MA, USA

    Hannah Buettner

  4. Department of Surgery, Southern Illinois University, Springfield, IL, USA

    Hilary Sanfey

  5. Department of Surgery, NYU Langone School of Medicine, New York, NY, USA

    Loretto Glynn

Authors
  1. Alaina D. Geary
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  2. Erin Kim
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  4. Priyanka V. Chugh
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  5. Hilary Sanfey
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  6. Loretto Glynn
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  7. Luise I. Pernar
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Corresponding author

Correspondence to Luise I. Pernar.

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Geary, A.D., Kim, E., Buettner, H. et al. A qualitative exploration of teaching assistant cases: opportunities and mediators. Global Surg Educ 2, 23 (2023). https://doi.org/10.1007/s44186-023-00101-z

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  • DOI: https://doi.org/10.1007/s44186-023-00101-z

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