(1100) A Grounded Theory Investigation into the Otolaryngology Resident Learning Experience

Introduction: Otolaryngologic residency operative education is a unique process that teaches technical and reasoning skills during high-stakes situations. However, there has yet to be a consensus on what qualities of an individual or environment create a positive surgical learning experience.

Methods: Purposive sampling was used to select a heterogeneous cohort from our institution’s otolaryngology department between March and December 2023. Interviewees were categorized as “Trainee” (resident) or “Attending” and “Junior” (1-3 years’ experience) or “Senior” (4 or more years). A trained interviewer conducted semi-structured interviews until thematic saturation was reached. Constant comparative analysis using coding, memoing, and categorization was conducted using grounded theory methodology.

Results: In total, 23 participants completed interviews, averaging 42 minutes. An average of 32 distinct codes were created per interview. Advanced coding and theoretical integration revealed four themes as essential to the creation of a positive teaching experience: “Showing investment in the learner,” “Communication,” “Understanding/Addressing learner needs,” and “Control of learning environment.” “Investment” and “Understanding/Addressing Needs” represent the ability and desire of the teacher to assess and advance learner progress during surgery. “Communication” refers to the ability to convey information clearly and succinctly. “Control of environment” reflects the ability of the teacher/surgeon to navigate the multiple factors of an operating environment to create a safe and effective learning experience within the context of a surgical operation.

Conclusions: This study suggests that positive otolaryngologic surgical learning experiences consist of four thematic elements. Conscious attention to these elements by a teacher or learner may assist in creating a more effective surgical learning environment. Further research is needed to understand the nuance of learner and teacher experience and how best to optimize and operationalize these concepts in diverse surgical educational settings.