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A crucial part of surgical residents' training occurs in the operating room; but operative teaching has not been well researched. The purpose of this study was to describe how surgical residents perceived intraoperative teaching by staff surgeons.


Using qualitative methods, a purposive sample of 45 junior and senior residents from a variety of subspecialties participated in one of ten focus groups conducted at a single tertiary care centre. A seven-item facilitator guide was used to elicit participants' experiences and perceptions about how they were taught in the operating room. Focus groups were audio taped for transcription and entered verbatim into NVivo software, and notes were taken by a research assistant. Qualitative content analysis included generating a thematic coding scheme, which assisted in identifying emerging concepts and linkages in the data. Methodology used to guarantee study integrity and validity included maintaining an audit trail, triangulation, reaching conceptual saturation of the data, and member checking.


Two overlapping domains emerged: teaching techniques and managing the teaching environment. Within these domains, the residents valued their teachers providing constructive criticism, assigning increasing responsibility, and being aware of resident learning needs. Residents thought that consistently providing little feedback or instruction and developing a negative learning atmosphere were negative teacher attributes. Surprisingly, residents did not cite sharing up-to-date knowledge as a teaching virtue.


Good teachers are those who employ techniques and provide an environment that engages the residents. This comprehensive qualitative study details those techniques and behaviours that exemplify good teaching by surgeons in the operating room as perceived by surgical residents across a multitude of specialties.

Hamilton, Canada