title: Identifying areas of weakness in thoracic surgery residency training: a comparison of the perceptions of residents and program directors.
abstract: OBJECTIVE
  To identify core thoracic surgery procedures that require increased emphasis during thoracic surgery residency for residents to achieve operative independence and to compare the perspectives of residents and program directors in this regard.
  
  
  METHODS
  A modified Delphi process was used to create a survey that was distributed electronically to all Canadian thoracic surgery residents (12) and program directors (8) addressing the residents' ability to perform 19 core thoracic surgery procedures independently after the completion of residency. Residents were also questioned about the adequacy of their operative exposure to these 19 procedures during their residency training. A descriptive summary including calculations of frequencies and proportions was conducted. The perceptions of the 2 groups were then compared using the Fisher exact test employing a Bonferroni correction. The relationship between residents' operative exposure and their perceived operative ability was explored in the same fashion.
  
  
  RESULTS
  The response rate was 100% for residents and program directors. No statistical differences were found between residents' and program directors' perceptions of residents' ability to perform the 19 core procedures independently. Both groups identified lung transplantation, first rib resection, and extrapleural pneumonectomy as procedures for which residents were not adequately prepared to perform independently. Residents' subjective ratings of operative exposure were in good agreement with their reported operative ability for 13 of 19 procedures.
  
  
  CONCLUSIONS
  This study provides new insight into the perceptions of thoracic surgery residents and their program directors regarding operative ability. This study points to good agreement between residents and program directors regarding residents' surgical capabilities. This study provides information regarding potential weaknesses in thoracic surgery training, which may warrant an examination of the curricula of existing programs as well as a reconsideration of what the scope of practice of a general thoracic surgeon should entail.
authors.affiliation: Division of Thoracic Surgery, University of Calgary, Calgary, Alberta, Canada. Electronic address: janetpatriciaedwards@gmail.com.
authors.forename: Janet P
authors.initials: JP
authors.lastname: Edwards
authors.affiliation: Division of General Surgery, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Adam
authors.initials: A
authors.lastname: Schofield
authors.affiliation: Department of Surgery, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Elizabeth Oddone
authors.initials: EO
authors.lastname: Paolucci
authors.affiliation: Division of Thoracic Surgery, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Colin
authors.initials: C
authors.lastname: Schieman
authors.affiliation: Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kelly
authors.affiliation: Division of Thoracic Surgery, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Ramin
authors.initials: R
authors.lastname: Servatyari
authors.affiliation: Division of General Surgery, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Elijah
authors.initials: E
authors.lastname: Dixon
authors.affiliation: Division of General Surgery, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Chad G
authors.initials: CG
authors.lastname: Ball
authors.affiliation: Division of Thoracic Surgery, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Sean C
authors.initials: SC
authors.lastname: Grondin
mesh_terms: D000288:Administrative Personnel; D001291:Attitude of Health Personnel; D002170:Canada; D003625:Data Collection; D015397:Program Evaluation / Q000379:methods; D013903:Thoracic Surgery / Q000193:education*; D019616:Thoracic Surgical Procedures / Q000592:standards
keywords: Medical Knowledge; Practice-Based Learning and Improvement; Professionalism; operative ability; surgical education; thoracic surgery