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Factors affecting the confidence of surgical trainees: a systematic review and thematic analysis

Published online by Cambridge University Press:  16 July 2025

Clare Perkins Open the ORCID record for Clare Perkins [Opens in a new window] ,
Matthew Steward ,
Matthew Allen ,
Madeleine Sian Dale Open the ORCID record for Madeleine Sian Dale [Opens in a new window]  and
Oliver McLaren
Clare Perkins*
Affiliation:
Department of Otolaryngology, Torbay and South Devon NHS Foundation Trust, Torquay, UK
Matthew Steward
Affiliation:
Department of Clinical and Biomedical Biosciences, University of Exeter, Exeter, UK
Matthew Allen
Affiliation:
Department of Trauma and Orthopaedics, University Hospitals Plymouth NHS Trust, Plymouth, UK
Madeleine Sian Dale
Affiliation:
Department of Otolaryngology, University Hospitals Plymouth NHS Trust, Plymouth, UK
Oliver McLaren
Affiliation:
Department of Otolaryngology, Torbay and South Devon NHS Foundation Trust, Torquay, UK Department of Otolaryngology, Royal Devon University Hospitals Foundation Trust, Exeter, UK
*
Corresponding author: Clare Perkins; Email: clare.perkins1@nhs.net
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Abstract

Objectives

Confidence among surgeons is required for complex decision-making and surgical ability. However, surgical trainees’ confidence is decreasing. This systematic review aims to explore factors that affect the confidence of surgical trainees.

Methods

A systematic review was performed following the PRISMA guidelines. Pubmed®, Embase™, Scopus, ClinicalTrials.gov and grey literature were searched for primary research on factors affecting surgical trainee confidence.

Results

Eleven studies were included. Key factors positively impacting trainee confidence were receiving regular positive feedback, working with a supportive trainer and having a calm working environment and effective team dynamic. The main factors negatively impacting trainee confidence were experiencing undermining behaviour from trainers and stressful, time-pressured environments. Female gender was also associated with reduced confidence. Greater confidence was associated with higher perceived performance.

Conclusion

This work assimilates the factors impacting surgical trainees’ confidence, which could guide training programmes to improve trainee self-confidence and therefore patient care.

Keywords

educationlearningself-conceptsurgeonsteaching

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 11 , November 2025 , pp. 1007 - 1014
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Clare Perkins takes responsibility for the integrity of the content of the paper

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