A Survey Assessment of Psychological Safety in Colon and Rectal Surgery Residents and Comparison to General Surgery Residents

Abstract

OBJECTIVE

Psychological safety (PS) is the shared belief that the team is safe for interpersonal risk-taking. Although some research has been conducted regarding PS in healthcare settings, there is minimal research in surgical training programs. Our objective was to study PS levels in colorectal surgery (CRS) residents.

DESIGN

Our survey was adapted from Amy Edmonson's psychological safety scale and the Maslach Burnout Inventory for the surgical work environment. Questions regarding interactions with attending surgeons (AS) and program directors (PD) and regarding burnout were asked. Each question was scored on a 1-9 Likert Scale. Total PS scores for questions targeting AS or PD ranged from 3 (low) to 126 (high) and the overall PS score ranged from 6 (low) to 252 (high). Burnout scores ranged from 0 (low) to 32 (high). Descriptive statistics including medians and interquartile ranges (IQR) are used to present the data.

SETTING

The survey was distributed to CRS residents in-person at the 2023 Colorectal Career Course in November, 2023.

PARTICIPANTS

Of the 87 CRS residents in attendance, 50 completed the survey (57%).

RESULTS

CRS residents had overall high psychological safety overall (median score 228, IQR 198-247) with 92% of CRS residents having PS scores in the top third of the range. CRS residents had low burnout scores (median score 6, IQR 3-11) with 80% having burnout scores in the lowest third of the range.

CONCLUSION

CRS residents generally have high PS levels and low burnout levels. This high level of PS could stem from the consistency of working with the same attendings, the shared interest in 1 subspecialty, and/or more frequent high-quality feedback. Further research to determine the mediators of high PS in surgical residency and CRS can be used to foster PS in other healthcare fields.