The Surgical Education Culture Optimization Through Targeted Interventions Based on National Comparative Data - "The SECOND Trial"

2018-11-18 20:06:25 | BioPortfolio


Due to a number of factors, including power differentials and adverse events, residents are susceptible to mistreatment (i.e., discrimination, harassment, and abuse) and toxic outcomes (i.e., burnout, attrition, and suicide). Our subsequent work following the FIRST Trial identified considerable variation in program-level rates of resident-reported burnout, severe stress, gender discrimination, racial discrimination, sexual harassment, and verbal abuse. To investigate these issues, the SECOND Trial will include a national mixed-methods analysis of and a pragmatic randomized trial to improve resident program culture and wellness.


The prospective, pragmatic randomized trial will include approximately 262 surgical residency programs across the United States. Participating programs will be randomized to the intervention or usual care arm. The intervention arm (vs. usual care) will receive program-specific cultural outcomes reports and a Surgical Culture Toolkit at the start of the trial as well as participate in Coaching Calls and In-Person Meetings to help facilitate and support intervention uptake throughout the trial period.

To assess the individual efficacy of the reports in regards to decreasing rates of mistreatment and toxic outcomes, the reports will be given to programs approximately 2 months to 6 months prior to toolkit dissemination. Prior to toolkit dissemination, programs will have the opportunity to fully review the report, form internal teams to address the issues, and mobilize necessary resources in preparation of receiving the toolkit. A comprehensive list of all activities performed after report dissemination will be kept at a program level. Toolkit dissemination to intervention programs will occur within 6 months of report dissemination. Coaching Calls and In-Person Meetings will be held at a variety of time points during the trial. The usual care arm will continue to perform their normal quality improvement activities.

Subsequently, the investigators will compare multiple postoperative outcomes between the two study arms using data collected from an annual resident survey.

Study Design


Surgical Residency Workplace Culture


Resource allocation to improve general surgery residency program culture


Not yet recruiting


Northwestern University

Results (where available)

View Results


Published on BioPortfolio: 2018-11-18T20:06:25-0500

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Medical and Biotech [MESH] Definitions

Societal or individual decisions about the equitable distribution of available resources.

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