title: Defining quality in surgical training: perceptions of the profession.
abstract: BACKGROUND
  To improve surgical training standards, it is necessary to first define the elements of high-quality training and methods for measuring them.
  
  
  METHODS
  Semistructured interviews were conducted with attending (n = 10) and resident (n = 10) general surgeons. An interview topic guide was used to elicit end users' opinions on indicators of training quality and methods to measure them. Interviews were recorded, transcribed verbatim, and coded using a framework to identify emergent themes. Sampling ceased once thematic saturation was achieved.
  
  
  RESULTS
  Key surgical training quality indicators include continuity (80% of participants) and relationship (95%) between trainee and trainer, level of supervision (85%), and an optimal volume (95%) and mix (90%) of operative cases. All surgeons felt that trainee logbook analysis and feedback was essential. The majority (85%) felt that training analysis should be freely available to create accountability for hospitals and attending surgeons (70%) and encourage competition (70%) to drive up standards. Only 30% felt that all attending surgeons should offer training.
  
  
  CONCLUSIONS
  Surgical training quality needs to be robustly assessed. Transparency in training outcomes will create competition and raise standards of surgical education.
authors.affiliation: Division of Surgery, Department of Surgery & Cancer, Imperial College London, St Mary's Hospital, Academic Surgical Unit, 10th Floor QEQM, South Wharf Road, London, W2 1NY, UK. Electronic address: pritam.singh@imperial.ac.uk.
authors.forename: Pritam
authors.initials: P
authors.lastname: Singh
authors.affiliation: Division of Surgery, Department of Surgery & Cancer, Imperial College London, St Mary's Hospital, Academic Surgical Unit, 10th Floor QEQM, South Wharf Road, London, W2 1NY, UK; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Aggarwal
authors.affiliation: Division of Surgery, Department of Surgery & Cancer, Imperial College London, St Mary's Hospital, Academic Surgical Unit, 10th Floor QEQM, South Wharf Road, London, W2 1NY, UK.
authors.forename: Philip H
authors.initials: PH
authors.lastname: Pucher
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Duisberg
authors.affiliation: Division of Surgery, Department of Surgery & Cancer, Imperial College London, St Mary's Hospital, Academic Surgical Unit, 10th Floor QEQM, South Wharf Road, London, W2 1NY, UK.
authors.forename: Sonal
authors.initials: S
authors.lastname: Arora
authors.affiliation: Division of Surgery, Department of Surgery & Cancer, Imperial College London, St Mary's Hospital, Academic Surgical Unit, 10th Floor QEQM, South Wharf Road, London, W2 1NY, UK.
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
mesh_terms: D002321:Career Choice; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000592:standards*; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008297:Male; D019984:Quality Indicators, Health Care; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Curriculum; Quality; Residency; Surgery; Training