Perception does not equal reality for resident vascular trauma skills

Mark W. Bowyer*, Stacy A. Shackelford, Evan Garofalo, Kristy Pugh, Colin F. MacKenzie

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background Experience with the management of vascular trauma by senior surgical residents is increasingly limited. When queried about their understanding of anatomy and ability to perform specific vascular exposures, residents express a moderately high level of confidence. We hypothesized that this perception does not equal reality. Methods A total of 42 senior surgical residents participating in an ongoing validation study of the Advanced Surgical Skills for Exposures in Trauma course were asked to self-assess their baseline (precourse) confidence of their understanding of the anatomy required to perform and their ability to perform exposure and control of the axillary, brachial, and femoral arteries, as well as lower extremity fasciotomy using a 5-point Likert scale. Residents then performed the four procedures on a fresh cadaver model and were scored in real time by experts using a global assessment of anatomic knowledge and readiness to perform." The Student t-test was used with α set at P < 0.05. Results Residents consistently rated their understanding of anatomy and their ability to perform the procedures significantly higher than expert evaluator ultimately scored them. Evaluators also deemed that residents would be unable to perform without help 65%-86% of the time. Conclusions Senior residents are ill-prepared to perform the procedures studied and have an unwarranted confidence in their knowledge and abilities. Perception clearly does not equal reality in preparing these trainees to perform as advertized. The low global scores for anatomy and performance should be a wake-up call for surgical educators prompting curricular reform and evaluation.

Original languageEnglish
Pages (from-to)280-288
Number of pages9
JournalJournal of Surgical Research
Issue number2
StatePublished - 1 Oct 2015
Externally publishedYes


  • Anatomical knowledge
  • Self-assessment
  • Surgical education
  • Surgical skills
  • Trauma
  • Vascular exposure


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