Confidence, Knowledge, and Skills at the Beginning of Residency: A Survey of Pathology Residents
Cindy M Hsieh, Norris J Nolan. George Washington University, Washington, DC
Background: In medical school, pathology is not a core clerkship. Elective experiences can be highly variable, which may lead new residents to feel underprepared for pathology residency. To assess this, we created a survey to document the pathology experiences residents had prior to starting pathology residency, and to determine how confident they were with various skills and knowledge.
Design: We designed an online survey utilizing SurveyMonkey software and e-mailed the link to all pathology residency program directors in the United States. We requested that interested program directors forward the survey link to their residents. Survey participation was anonymous and voluntary. Data was obtained on pathology electives, grossing experience, and frozen section experience. Likert scale questions assessed confidence level in knowledge and skills. For analysis, we considered an answer of very or extremely to be “confident” and an answer of slightly or not at all to be “not confident”.
Results: 170 pathology residents responded (32.5% first year, 24.8% second year, 22.9% third year, and 19.7% fourth year). Prior to starting residency, 15.7% were confident in their surgical pathology (SP) knowledge. 118 reported doing a SP elective in medical school, 21 did a non-specific Anatomic Pathology elective, which may have included time on SP, and 31 did not do either. Of the people who did a SP elective of at least four weeks (91), less than four weeks (27), or did not do a specific rotation (52), 21.1%, 7.6%, and 9.4% felt confident in their SP knowledge, and 64.4%, 37%, and 53.5% felt confident in their understanding of resident duties on SP. In regards to grossing small cases, 8.6% of people who never grossed, 9.8% who only observed, 36.2% who only grossed small cases, and 84% who grossed both small and large cases felt confident, while 8.7%, 1.7%, 2.1%, and 44% felt confident grossing large cases. Of those with no experience, who only observed, and who actually cut frozen sections, 11.4%, 10.2%, and 58.6% felt confident they could cut frozen sections.
Conclusions: Prior to beginning residency, most people are not confident in their SP knowledge and skill set, such as grossing and cutting frozen sections. The length of a SP elective appears to have a beneficial effect on confidence in SP knowledge when it is at least four weeks long. The effect of the elective length on the understanding of resident duties on the SP service is less clear. For improving confidence in specific skills, hands-on experience is beneficial, but observation alone is similar to having no experience at all.
Tuesday, March 5, 2013 9:30 AM
Poster Session III # 61, Tuesday Morning