R. Panni1, M. Laurel2, K. Nandagopal3, G. Cohen3, G. M. Walton3, A. Salles1 1Washington University,Surgery,St. Louis, MO, USA 2Washington University School Of Medicine,St. Louis, MO, USA 3Stanford University,Palo Alto, CA, USA
Introduction: Attrition continues to be a major problem in general surgery residencies with an estimated one out of five residents failing to complete training. While there are a number of reasons for this, here we examine one factor, pluralistic ignorance, and its relationship to risk of attrition among surgical residents. The difference between the perception of one's own experience compared to the experiences of those around them is termed pluralistic ignorance. For example, in academic contexts, it is common for people to think that those around them are faring better, whether that be with more success, better grades, or more happiness. This feeling is often more pronounced at times of transition. In this study, we hypothesized that those who experience greater degrees of pluralistic ignorance may be at greater risk for attrition.
Methods: Junior residents in a single general surgery residency program were surveyed on a voluntary basis for two consecutive years (2011-2012 and 2012-2013). As part of a larger study, residents were administered a questionnaire which included measures of pluralistic ignorance with items such as the number of time per week they made any mistakes, felt down, felt bothered by blaming themselves for things, were satisfied with their performance. The participants were then asked the same questions about a typical resident in their program. We measured risk of attrition with two items, how frequently they thought about leaving residency and how likely they think it is that they will complete their current residency. We examined the correlations among these measures to see whether pluralistic ignorance was related to risk of attrition.
Results:
36 residents participated in the survey (43% response rate). We found that higher degrees of pluralistic ignorance were associated with more frequent thoughts of leaving residency (rs = 0.55, p=0.0006). The less pluralistic ignorance residents experienced, the more likely they were to intend to complete their residency (rs = -0.62, p<0.0001). Thus, pluralistic ignorance was significantly associated with these two measures of risk of attrition. In regression analyses controlling for gender and post-graduate year, pluralistic ignorance was significantly predictive of the frequency of thoughts of leaving residency (B=0.75, t=3.35, p=0.002) and intention to complete residency (B=-0.76, t=-3.25, p=0.003).
Conclusion:
To our knowledge, pluralistic ignorance has not been examined in the context of surgical residencies. Our data suggest that this may be a predictor of risk of attrition. Perhaps more importantly, pluralistic ignorance is modifiable. At the institution where this study was performed, each post graduate year group routinely meets with a psychologist. Residents thus have an opportunity to discuss their various struggles together and realize that others are having similar experiences. Interventions such as this may reduce pluralistic ignorance and potentially decrease the risk of attrition.