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Purpose <p>Patient feedback is increasingly recognized as a valuable component of resident assessment, offering unique insights into communication, professionalism, and patient-centered care not always observed by attending surgeons. However, concerns remain about potential biases in patient perceptions, particularly regarding race, ethnicity, and gender, which could disadvantage residents from underrepresented groups. This study aims to examine whether patient assessments of surgical residents differ by race, underrepresented in medicine (URiM) status, and gender to inform equitable use of patient feedback in assessing resident progress.</p> Methods <p>Surgical inpatients who underwent elective gastrointestinal and oncologic surgery evaluated the quality of surgical resident care using a modified Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS). The top-box method, which quantifies the frequency of the highest possible rating for each question, was used to analyze patient satisfaction with surgical resident care in a manner consistent with S-CAHPS reporting guidelines. Patient assessments of senior and intern residents were stratified by resident race and underrepresented in medicine (URiM) status and compared both across and within gender.</p> Results <p>A total of 324 patients completed 267 assessments of senior residents and 256 assessments of intern residents. There were no significant demographic differences between patients evaluating White vs. non-White residents at either the senior or intern level (age, gender, or education level). Patient recognition rate of White vs. non-White residents did not differ at either the senior (White 85.1% vs. non-White 84.8%, <i>p</i>-value = 1.0) or intern level (White 80.1% vs. non-White 88.8%, <i>p</i>-value = 0.085), even after accounting for gender. Top-box S-CAHPS scores across all 8 domains did not significantly differ between assessments of White and non-White residents for both senior (<i>p</i> &gt; 0.10) and intern (<i>p</i> &gt; 0.36) residents, including when further stratified by gender. Similar results were observed when examining resident assessment by URiM status, where patient recognition rate did not differ at either the senior (non-URiM 84.5% vs. URiM 90.3%, <i>p</i>-value = 0.545) or intern level (non-URiM 83.0% vs. URiM 80.8%, <i>p</i>-value = 0.982), even after accounting for gender. While there were no differences between the proportion of URiM compared to non-URiM senior assessments that received top-box scores in 7 individual S-CAHPS items, a difference was observed in the item related to pain treatment. Specifically, 91.5% (214/229) of assessments of non-URiM seniors had the top-box score whereas 71.4% (20/28) of assessments of URiM seniors had the top-box score (<i>p</i> = 0.004). However, patient-reported pain scores did not significantly differ between these groups, and this difference was not observed after further stratification by gender. Top-box S-CAHPS scores across all 8 domains did not significantly differ between non-URiM and URiM resident assessments of intern (<i>p</i> &gt; 0.19) residents.</p> Conclusions <p>Assessments of surgical residents based on race and URiM status were overall similar, suggesting that structured patient feedback can provide a relatively equitable form of assessment. These findings support the use of patient feedback as a valuable complement to traditional assessments, offering unique insights into resident development without reinforcing known training disparities.</p> Graphical abstract <p></p>

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Patient evaluation of white versus non-white surgical senior and intern residents

  • 期刊论文

  • 发表日期：

    2026年1月13日

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  • Tiffany R. Bellomo,
  • Shaghayegh Sabbaghan Kermani,
  • Camila Marmolejo Muriel,
  • Erick Herrera Castaneda,
  • Arian Mansur,
  • Claire C. Ferguson,
  • Chase Marso,
  • Roy Phitayakorn,
  • Sophia K. McKinley

摘要

Purpose

Patient feedback is increasingly recognized as a valuable component of resident assessment, offering unique insights into communication, professionalism, and patient-centered care not always observed by attending surgeons. However, concerns remain about potential biases in patient perceptions, particularly regarding race, ethnicity, and gender, which could disadvantage residents from underrepresented groups. This study aims to examine whether patient assessments of surgical residents differ by race, underrepresented in medicine (URiM) status, and gender to inform equitable use of patient feedback in assessing resident progress.

Methods

Surgical inpatients who underwent elective gastrointestinal and oncologic surgery evaluated the quality of surgical resident care using a modified Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS). The top-box method, which quantifies the frequency of the highest possible rating for each question, was used to analyze patient satisfaction with surgical resident care in a manner consistent with S-CAHPS reporting guidelines. Patient assessments of senior and intern residents were stratified by resident race and underrepresented in medicine (URiM) status and compared both across and within gender.

Results

A total of 324 patients completed 267 assessments of senior residents and 256 assessments of intern residents. There were no significant demographic differences between patients evaluating White vs. non-White residents at either the senior or intern level (age, gender, or education level). Patient recognition rate of White vs. non-White residents did not differ at either the senior (White 85.1% vs. non-White 84.8%, p-value = 1.0) or intern level (White 80.1% vs. non-White 88.8%, p-value = 0.085), even after accounting for gender. Top-box S-CAHPS scores across all 8 domains did not significantly differ between assessments of White and non-White residents for both senior (p > 0.10) and intern (p > 0.36) residents, including when further stratified by gender. Similar results were observed when examining resident assessment by URiM status, where patient recognition rate did not differ at either the senior (non-URiM 84.5% vs. URiM 90.3%, p-value = 0.545) or intern level (non-URiM 83.0% vs. URiM 80.8%, p-value = 0.982), even after accounting for gender. While there were no differences between the proportion of URiM compared to non-URiM senior assessments that received top-box scores in 7 individual S-CAHPS items, a difference was observed in the item related to pain treatment. Specifically, 91.5% (214/229) of assessments of non-URiM seniors had the top-box score whereas 71.4% (20/28) of assessments of URiM seniors had the top-box score (p = 0.004). However, patient-reported pain scores did not significantly differ between these groups, and this difference was not observed after further stratification by gender. Top-box S-CAHPS scores across all 8 domains did not significantly differ between non-URiM and URiM resident assessments of intern (p > 0.19) residents.

Conclusions

Assessments of surgical residents based on race and URiM status were overall similar, suggesting that structured patient feedback can provide a relatively equitable form of assessment. These findings support the use of patient feedback as a valuable complement to traditional assessments, offering unique insights into resident development without reinforcing known training disparities.

Graphical abstract