• Aaron M Williams, Monita Karmakar, Julie Thompson-Burdine, Niki Matusko, Sunjong Ji, Neil Kamdar, Kristian Seiler, Rebecca M Minter, and Gurjit Sandhu.
• Department of Surgery, Michigan Medicine, Ann Arbor, Michigan.
• Ann. Surg. 2022 Feb 1; 275 (2): e366e374e366-e374.

BackgroundIntraoperative resident autonomy has been compromised secondary to expectations for increased supervision without defined parameters for safe progressive independence, diffusion of training experience, and more to learn with less time. Surgical residents who are insufficiently entrusted during training attain less autonomy, confidence, and even clinical competency, potentially affecting future patient outcomes.ObjectiveTo determine if OpTrust, an educational intervention for increasing intraoperative faculty entrustment and resident entrustability, negatively impacts patient outcomes after general surgery procedures.MethodsSurgical faculty and residents received OpTrust training and instruction to promote intraoperative faculty entrustment and resident entrustability. A post-intervention OpTrust cohort was compared to historical and pre-intervention OpTrust cohorts. Multivariable logistic and negative binomial regression was used to evaluate the impact of the OpTrust intervention and time on patient outcomes.SettingSingle tertiary academic center.ParticipantsGeneral surgery faculty and residents.Main Outcomes And MeasuresThirty-day postoperative outcomes, including mortality, any complication, reoperation, readmission, and length of stay.ResultsA total of 8890 surgical procedures were included. After risk adjustment, overall patient outcomes were similar. Multivariable regression estimating the effect of the OpTrust intervention and time revealed similar patient outcomes with no increased risk (P > 0.05) of mortality {odds ratio (OR), 2.23 [95% confidence interval (CI), 0.87-5.6]}, any complication [OR, 0.98 (95% CI, 0.76-1.3)], reoperation [OR, 0.65 (95% CI, 0.42-1.0)], readmission [OR, 0.82 (95% CI, 0.57-1.2)], and length of stay [OR, 0.99 (95% CI, 0.86-1.1)] compared to the historic and pre-intervention OpTrust cohorts.ConclusionsOpTrust, an educational intervention to increase faculty entrustment and resident entrustability, does not compromise postoperative patient outcomes. Integrating faculty and resident development to further enhance entrustment and entrustability through OpTrust may help facilitate increased resident autonomy within the safety net of surgical training without negatively impacting clinical outcomes.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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