Bridging the gap: The intersection of entrustability and perceived autonomy for surgical residents in the OR

Gurjit Sandhu, Julie Thompson-Burdine, Niki Matusko, Danielle C. Sutzko, Vahagn C. Nikolian, Anna Boniakowski, Patrick E. Georgoff, Kaustubh A. Prabhu, Rebecca M. Minter

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background: Faculty entrustment decisions affect resident entrustability behaviors and surgical autonomy. The relationship between entrustability and autonomy is not well understood. This pilot study explores that relationship. Methods: 108 case observations were completed. Entrustment behaviors were rated using OpTrust. Residents completed a Zwisch self-assessment to measure surgical autonomy. Resident perceived autonomy was collected for 67 cases used for this pilot study. Results: Full entrustability was observed in 5 of the 108 observed cases. Residents in our study did not report full autonomy. Spearman's rank correlation coefficient identified that resident entrustability was positively correlated with perceived resident autonomy (ρ = 0.66, p < 0.05). Ordinal logistic regression assessed the relationship between resident entrustability and autonomy. The relationship persisted while controlling for PGY level, gender, and case complexity (OR = 8.42, SEM = 4.54, p < 0.000). Conclusions: Resident entrustability is positively associated with perceived autonomy, yet full entrustability is not translating to the perception of full autonomy for residents.

Original languageEnglish (US)
Pages (from-to)276-280
Number of pages5
JournalAmerican journal of surgery
Issue number2
StatePublished - Feb 2019
Externally publishedYes


  • Autonomy
  • Entrustability
  • Entrustment
  • OpTrust
  • Surgical education

ASJC Scopus subject areas

  • Surgery


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