title: Service versus education, what are we talking about?
abstract: OBJECTIVE
  To investigate the degree of variability in perception as related to the service versus education issue in general surgery residency education.
  
  
  METHODS
  A survey questionnaire was designed with 15 scenarios constructed by the author to represent an array of resident experiences with differing educational and noneducational value. After appropriate Institutional Review Board (IRB) approval, the survey was administered to a variety of medical student, resident, and faculty groups. Individual and intergroup variability was assessed.
  
  
  METHODS
  Large, university-affiliated teaching hospital.
  
  
  RESULTS
  A total of 137 questionnaires were returned from medical students, residents, and attending physicians encompassing several medical specialties and a broad range of clinical experience. In all, 7 of 15 scenarios resulted in statistically significant different response patterns across specialties and 8 of 15 scenarios across levels of experience. Individual responses spanned nearly all possible responses for most scenarios.
  
  
  CONCLUSIONS
  Considerable variability exists across individuals as well as groups in the interpretation of the types of experiences that represent service, education, or both in general surgery residency training. Arriving at a quantifiable balance in service versus education in general surgery resident education may never be possible given the variability in interpretation of the various activities residents perform. This must be kept in mind in both interpreting the results of the Accreditation Council for Graduate Medical Education (ACGME) survey and also when designing educational activities within a program.
authors.affiliation: Department of General Surgery, Greenville Hospital System, University of South Carolina School of Medicine Program, Greenville, South Carolina 29605, USA. dsmith3@ghs.org
authors.forename: Dane E
authors.initials: DE
authors.lastname: Smith
authors.forename: Brent
authors.initials: B
authors.lastname: Johnson
authors.forename: Yonge
authors.initials: Y
authors.lastname: Jones
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000592:standards / Q000639:trends; D004503:Education, Medical, Graduate / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D004504:Education, Medical, Undergraduate / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D005260:Female; D013502:General Surgery / Q000193:education*; D006784:Hospitals, Teaching; D006801:Humans; D007396:Internship and Residency / Q000592:standards / Q000639:trends; D008297:Male; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data; D013337:Students, Medical / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D017749:Total Quality Management; D014481:United States