title: Chief resident case experience and autonomy are associated with resident confidence and future practice plans.
abstract: OBJECTIVE
  To measure oral and maxillofacial surgery (OMS) chief resident case experience, including autonomy, and discover the role of this experience in developing resident confidence and determining the scope of practice on completion of training.
  
  
  METHODS
  A cross-sectional study was conducted using an online questionnaire made available to residents near the completion of their final year of training in United States OMS training programs. Predictors were the case numbers and autonomy level. Outcomes were the anticipated frequency of practice, confidence to meet the standard of care, and changes in anticipated practice scope. Each was measured in 10 domains within the scope of OMS.
  
  
  RESULTS
  Eighty-four residents (44%) completed the 116-item questionnaire. All respondents were "very confident" in their ability to meet the standard of care in mandibular trauma and dentoalveolar surgery. Autonomy was associated with the confidence to meet the standard of care in midface trauma, temporomandibular joint, orthognathic, cosmetic, pathology, reconstructive, and craniofacial surgery. Associations were noted between primary surgeon cases and confidence in midface trauma, temporomandibular joint, orthognathic, cosmetic, and craniofacial surgery. Case numbers were associated with an anticipated frequency of practice within the domains of midface trauma, temporomandibular joint, cosmetic, and pathology surgery.
  
  
  CONCLUSIONS
  Results of this study suggest an association between a resident's surgical case experience (overall exposure and autonomy) and that resident's future plans for practice and confidence to meet the standard of care in this specialty. OMS training curricula should evolve to incorporate an evaluation of competence and an appropriate transfer of responsibility and experience to residents, thus maximizing confidence and future practice opportunities.
authors.affiliation: Division of Oral and Maxillofacial Surgery, Mayo Clinic, Rochester, MN 55905, USA. fillmore.william@mayo.edu
authors.forename: W Jonathan
authors.initials: WJ
authors.lastname: Fillmore
authors.forename: Tyson J
authors.initials: TJ
authors.lastname: Teeples
authors.forename: Stephen
authors.initials: S
authors.lastname: Cha
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Viozzi
authors.forename: Kevin
authors.initials: K
authors.lastname: Arce
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003758:Dental Implantation, Endosseous / Q000592:standards; D004955:Esthetics, Dental; D005147:Facial Bones / Q000293:injuries; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008338:Mandibular Injuries / Q000601:surgery; D008446:Maxillofacial Injuries / Q000601:surgery; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000592:standards; D056948:Orthognathic Surgical Procedures / Q000592:standards; D010347:Patient Care Planning; D017009:Professional Autonomy; D011364:Professional Practice; D019651:Plastic Surgery Procedures / Q000592:standards; D012649:Self Concept; D059039:Standard of Care; D013515:Surgery, Oral / Q000193:education*; D011795:Surveys and Questionnaires; D013705:Temporomandibular Joint Disorders / Q000601:surgery