Residents' self-reported learning needs for intraoperative knowledge: are we missing the bar?

Background: The purpose of this study was to compare the intraoperative learning needs and educational resource use of junior and senior residents. Our goal was to gain a better understanding of the progression of learning needs in surgical training. Methods: Residents (n = 125) completed a previously validated, 27-item survey indicating the following: (1) the extent to which traditional learning resources are used when preparing for cases in the operating room, and (2) which intraoperative management topics in which they believed they were deficient despite preoperative preparation. Results: On a scale of 1 to 5, with 5 indicating frequent use, postgraduate year (PGY)-5 residents (n = 39) indicated surgical atlases (4.15; SD, .90) and surgical texts (4.15; SD, .90) were their most frequently used resources when preparing for a case in the operating room. In contrast, PGY-1 residents (n = 32) indicated anatomy atlases (3.97; SD, .93) and advice from colleagues (3.64; SD, .90) were their most frequently used resources when preparing for a case in the operating room. Despite the differences in how the PGY-5 group and the PGY-1 group prepared for a case, of 12 intraoperative management topics both groups believed they were the least prepared for instrument use/selection and suture selection. Conclusions: Today's residents represent a heterogeneous group of individuals with different learning needs based on level of experience, knowledge, and learning style. Our study highlights unexpected but critical learning needs for senior-level residents that can and should be readily addressed.