The SECOND Trial

Surgical Education
Culture Optimization
through targeted interventions based on
National comparative Data
(SECOND) Trial

Well-being continues to be a pressing issue in surgical training. In the Flexibility in duty-hour Requirements for Surgical Trainees (FIRST) Trial, we found that 22% of U.S. general surgery residents weekly burnout symptoms, and that numerous aspects of the learning environment, not just duty hours, drive poor well-being. Currently, programs have no data about their performance on these issues compared to others in the country. More importantly, programs lack readily available strategies to make improvements. The SECOND Trial will begin with a national mixed-methods analysis to examine a variety of programs with respect to the learning environment and resident wellness. Lessons learned from these programs will be incorporated into a multidimensional Wellness Toolkit. The SECOND Trial will be a prospective, pragmatic cluster-randomized trial in which programs will be given a confidential program-specific report of their performance data compared to other programs in the country, then randomized control vs. receiving the Wellness Toolkit with implementation support to determine how best to improve the learning environment and resident well-being.