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Residents’ Perceptions: Impact of Associate Providers on Surgical Training
*Ravinder Kang1, *Samuel T. Kunkel1, *Jesse A. Columbo1, *Austin Tang2, *Matthew J. Sabatino1, Kari M. Rosenkranz1
1Dartmouth Hitchcock Medical Center, Lebanon, NH;2The Dartmouth Institute, Hanover, NH

Objective: To understand the impact of Associate Providers (APs) on surgical training from the residents’ perspective. Design: We designed a survey to examine 4 domains of interaction between residents and APs (administrative, clinical, and procedural tasks, and overall impressions), in the operating room, inpatient wards, and clinics. We examined the internal reliability of the survey with Cronbach’s alpha. Setting: A single academic medical center. Participants: Residents from 7 surgical specialties. Intervention: N/A. Main Outcome Measure: Surgical residents’ perception of the impact of APs on administrative, clinical, and procedural tasks. Results: Fifty residents responded (77% participation rate). The majority felt APs reduced administrative tasks such as documentation (96%) and answering pages (88%; Figure 1A). Most (74%) reported less time spent counseling patients, and a third (32%) reported less time performing consults. Most residents (80%) felt there was no difference in the number of bedside procedures performed, and over half (54%) felt there was no impact on case volume. Overall, the majority (88%) felt APs made the workload lighter (Figure 1B). Cronbach’s alpha showed excellent reliability for administrative tasks (0.96), and good reliability for clinical tasks (0.76), procedural tasks (0.69), and overall impressions (0.66). Conclusions: Most surgical residents felt APs reduced their workload, with the greatest impact on administrative tasks. APs on surgical services have not resulted in a perceived decrease in clinical tasks or an increase in procedural volume.


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