Latest / Behind The Knife: The Surgery Podcast / Journal Review in Surgical Education: Gossip in Residency
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- BTK#7 CoSEF_Gossip_Final === [00:00:00] Hey Kate, I'm starting on the vascular surgery service next week. Can you tell me a little bit about that rotation? Hey, Joe, absolutely. It's a really busy but awesome rotation. Dana's the junior fellow and she's really supportive. I found that she was able to get me into the, or a ton. Zach is the senior fellow on service and he is, um, how do I say this? A little harder to work with. I think he can be a little condescending or short, especially when he is super stressed. So just try not to take it personally. Think this extremely common interaction is just feedback. Well, it's actually gossip and has potentially harmful ramifications. Throughout this podcast, we will explore gossip and its impacts within surgical residency. Hello everyone and welcome to another exciting Behind the Knife episode brought to you by the collaboration of Surgical Education Fellows, also known as cef. I'm Maya Hunt. I'm a general surgery resident and surgical education research fellow [00:01:00] at Indiana University, and currently obtaining my Master's of Health Professions education through the University of Illinois Chicago. I'm taking over as Coss behind the Knife Lead for the next year from the inimitable Josh Roch For today's episode, we have a few other co-hosts joining us. John, wanna go first? Absolutely. My name is John Woodward and I am a general surgery resident at the University at Buffalo in upstate New York. Currently, I'm in my second year of professional development time, obtaining my Master's of Health Professions education through M-G-H-I-H-P, and working with the Pediatric Surgery Research group in Buffalo. I'm also the research and innovations chair of cef. Hello. My name's Kate Sylvestri and I'm a general surgery resident at Columbia, and currently finishing my second and last year of professional development time as the surgical education fellow at Columbia. I've also been an active member of CSEP for the past two years, and I've been working closely with John as a member of the leadership team as the communications and [00:02:00] board liaison chair. For those of you wondering. What the heck is CS E? Well, we're a multi-institutional organization of surgical education research fellows working together to foster peer mentorship, networking, and scholarly collaboration. We meet every week to discuss ongoing research efforts by individuals or by smaller groups within CS e. We also collaborate with larger groups like the Association for Surgical Education and the American College of Surgeons. Simply put, whereby residents for residents, if you are a surgical education fellow or surgery resident, interested in education. You are interested in joining cef, email us at cef connect@gmail.com. That's C-O-S-E-F connect@gmail.com. You can also learn more about us at our fancy new website, cef.org. Okay. That was a great Josh impression. Thank you for that ad spot, John. [00:03:00] All right, onto our show today we are discussing a topic that I guarantee is gonna spark interest. The show is all about gossip and surgical education, what it is, what it means, and what we should do about it. With that, I'll introduce a familiar voice. One of our past SEF leaders and former SEF BTK podcast leads Dr. Joe Laier. Joe is a general surgery resident at the University of Buffalo. He spent two years out on research studying outcomes and trauma surgery while earning a master's in health professions education at the MGH Institute for Health Professions Education. His thesis work centered around gossip and surgical education. Thank you for joining us, Joe. Yeah. Thank you guys very much for having me. This work has been super interesting and I'm really excited to share it with BTK listeners today. Also, with us today is Dr. Bobby Ann Adair White. Dr. White earned her doctorate in education from the University of Mary Hard in Baylor, in Belton, Texas, and is currently faculty at the M-G-H-I-H-P. She's an expert in teens communication and [00:04:00] emotional intelligence, all of the important aspects of medicine that you won't find in textbooks. Well, at least that was the case until she wrote a textbook of her own Dr. White. We are thrilled that you are joining us today. Thank you so much for this kind introduction. They're always fun and embarrassing at the same time. And please call me ba. You got it. So Joe, let's start by asking why gossip? How did you settle on this as the topic of your master's thesis? I. Yeah, I know, right? Pretty interesting. So first off, I love thinking about human connection and interaction. In college I majored in, uh, psychology and was particularly captivated with the field of social psychology. When I started my master's, I was super excited to have BA as an advisor. I knew that our interests would easily overlap and we would come up with some really cool stuff. One of her previous mentees was working on a project related to gossip amongst Canadian OB GYN residents, and she floated that idea to me as some food for thought. I was immediately hooked. Well, there's something biologic to this, [00:05:00] right? Gossip is just innately interesting. Who doesn't find some enjoyment in hearing the tea about others? Well, that's just it, Kate, just like we are physiologically programmed to enjoy eating sugar, we are socially programmed to enjoy gossip. And I will admit I am no different. Yeah, Joe, you make a really great point. We live in such a social world and knowledge about others is not only interesting, but really powerful. We need that information to move forward. I mean, knowledge is power after all. So that does make sense. Okay, so is all gossip true? And I guess, does the truth even matter? Like how far down this rabbit hole should we go? Hard questions Maya, but I'd say that the truth is a construct, perhaps now more than ever in the United States. But what you're getting at with your question actually requires us to take a big step back and first ask how do we define gossip? And that's where we started with this project. Even before you get into that, Joe, let me say that our questions around gossip and its [00:06:00] impacts were really big questions and they weren't amenable to quantitative techniques such as a survey when you don't even know kind of the basics about a construct. It's important to start with a qualitative approach. It makes a lot of sense, which is what we decided to do here. We had to start somewhere, and after diving into the social science literature, the academic definition of gossip is. Evaluative talk about an absent third party in essence, talking about someone in a judgmental manner without them being present. That makes sense with what I see in the resident room. Someone comes in after doing a case with an attending and says something to the effect of, Ugh, I hate operating with them. They never let residents do anything in their cases. I think they're just not confident. That's gossip. Right? Definitely. And we heard about similar instances of gossip from our study participants. That kind of gossip can be really damaging to a surgeon's reputation. Whether it's true or not, it sticks with you. Absolutely, but this [00:07:00] academic definition of gossip is very surface level, and we wanted to understand more of the nuances around it. So we approach this work by designing a semi-structured qualitative interview guide using the attribution model of gossip as a framework, the attribution model of gossip. Can you break that down a bit? I'm gonna guess not many people listening are familiar with it. You might be the only one, John, but Okay. For everybody who's not familiar, basically this model states that when gossip occurs, the person sending the gossip and the person receiving it engage in a back and forth style. Volley. Which attributes of both the gossip sender and the recipient influence how the conversation gets interpreted. There's more to it, but we'll come back to that after piloting this interview guide, I tapped EF for help because I needed residents to interview. I invited any COF member to join the initiative, and our ask was simply to recruit full residents from their program to participate in an interview and later help with the qualitative analysis and the eventual paper. So [00:08:00] nine of my best cof friends jumped on the opportunity. Riley from UCSF Kate, which I'm glad you're here now for this conversation. Kate Ananya from Stanford. Rebecca from LSU. Julie from Wash U. Sarah from Mayo, Andrea from Utah. Connie from OHSU, and Steven from Duke. With their recruitment. I interviewed a total of 36 residents with good distribution by PGY level and gender. Honestly, Joe participant recruitment can be such a struggle sometimes, but this was hands down the easiest project to recruit for. During my two years of research, people were genuinely excited to take part in this. Okay. I've been kicking myself for the last two years that I didn't help out with this project because it's just such a juicy topic. Ba, what did y'all ask? Great question, Maya, and there's always a next time, but we decided to begin each interview by asking participants for their definition of gossip. We wanted to first better understand if surgeons had a different definition entirely, what were their perceptions? So what do you guys think? How would you define gossip? [00:09:00] I mean, I guess I'm a little biased now since I've read your paper, but before residency, I always thought gossip was just talking negatively about someone when they weren't part of the conversation. Maya, that is my exact experience. Before reading this paper, gossip to me was focused on negative discussion of someone not present in the road. Kate, what do you think? Yeah, I'm on board with. Both of you guys, I mean, before this paper I used to think of gossip as talking behind somebody's back, usually to spread rumors or things that were totally untrue. That's pretty interesting. So you three were aligned with the majority of the residents that I spoke with who generally agreed that gossip involved talking about someone who wasn't physically present and like most of you all. Believed that gossip was a negative entity, however, some did not, and provided compelling stories that qualify as Gossip for Good. Hmm, gossip for Good. So would that just look like residents saying good things about each other behind their backs? [00:10:00] Yeah, exactly right, Maya. So as an example, you know, I frequently pump the tires, so to speak, of many of the interns in front of my attendings saying things like this intern has been doing a really great job on the floor, and I'd like to have them join me for this tracheostomy leader today, if that's okay with you. As a way to sort of promote them and provide a fun experience, and that is gossip. It's a evaluative talk. So you've offered an assessment of their performance and it's about a person who is not present. I think one study participant also gave a similar example. Something like telling a resident that a new attending was really great to work with and they would have a great experience on service with them. Gossip can be used to build people up as well. Yeah, guys. I mean, I know gossip usually gets a bad rap, but honestly I'm always talking about my co-residents behind their back, but in the best way. I'm constantly bragging about how great they are. So I guess you can just call me a gossip queen. Yeah, Kate. Honestly, same. I see it as cheerleading from the sidelines when I do that, but I never really [00:11:00] considered it gossip. What about negative gossip? What other stories do people share? Spill the tea, Joe. See, I told you everybody's just innately interested in gossip. So after asking first their definitions of gossip, we provided the academic definition to establish consistency. We asked about recent gossip that they have both heard and shared, as well as the impact of this gossip, like if relationships were affected or how a resident was viewed differently. We use these data to construct a process model for how gossip occurs in a surgical residency program. And I wanna pause to shout out Dr. Irene Yu, our former co-resident at Buffalo. Who illustrated the model that we published in this paper. She is now a colorectal surgery fellow in Baylor, and she actually illustrated the BTK AB Site Companion. So many thanks to her. So it's a really cool model, but it does seem a little bit complicated. If I may, Joe, let me take a stab at walking our listeners through this model. I would love that. Also we've included [00:12:00] the figure of the model in the show notes, so you can visually see how this breaks down. So it looks like it begins with a gossip target doing something such as exhibiting lazy behavior at work. Yep. You got it. Then the gossip sender perceives this event and shares it with the gossip recipient at a particular time and place. Say like sign out. And I'm noticing that the Center has some particular intention to sharing this gossip. Correct. Sometimes the gossip sender may be blowing off some steam or trying to make meaning out of a situation such as understanding where a communication breakdown occurred or if they misperceived something, they may also have more malicious motives, such as spreading negative gossip about someone in order to negatively impact the reputation. Rude. Okay. And then there's a reverse arrow pointing from the gossip recipient to the gossip sender, and this is getting to that conversational volume back and forth, you mentioned earlier. Is that right? Yes. We found that the person receiving the gossip does, in some cases, had the power to resist gossip [00:13:00] by saying something like, you know what, let's not go there. It can also do the opposite and seek out gossip or go actively fishing for it. Then there are four arrows coming off of the gossip recipient that each represent choices, things that the recipient can do with this information, so to speak, so they can tell the gossip target what they heard. They could change the perception of the gossip target. They could perpetuate this gossip by becoming the gossip center themselves and spreading it to other people. But it also looks like they can seek resolutions. That one seems like a good outcome of gossip. Yeah, yeah. Perhaps an ideal outcome. Let's say someone was unhappy on a specific rotation and not performing well. Someone observes this and shares the gossip with another resident. Maybe the person who receives the gossip decides to grab the ear of the program director and say, Hey, this resident isn't looking or doing so well. I'm wondering if there's an aspect of the rotation that can be changed to improve conditions. Let's talk. So we heard about gossip like that. That's really much more action [00:14:00] oriented gossip that people tried to use for a good reason. And I'll also add, there's another potentially positive thing that gossip recipients can do with information. I. Another scenario might be a resident is struggling and contemplating quitting. One resident hears this and shares it with someone else. The gossip recipient here may be a good friend of the gossip target, the person who said that they wanna quit. Then they can choose to feed this gossip back to the target and provide some support. So, hey, I heard that you're really struggling on this rotation. I'm worried about you, and I want you to know I'm here for you. Let's chat after work or go get coffee this weekend. We've heard plenty of stories like this too, Joe. That is a heartwarming example of the good that can occur through gossip. However, through personal experience and reading your paper, although I'm glad we started with the positives, I think there's also important aspects to explore with the less positive things that can occur through gossip. One of the negative outcomes that we found was that it alters the gossip recipient's [00:15:00] perception of the gossip target. This is one way that gossip can impact reputations. One of our themes was centered around this and is well described by this quote. Once you establish a reputation with the faculty, it sticks. It's really hard to shake. There are some specific examples of residents who didn't get off on the right foot when they started as interns, but really turned things around, but they still got treated a little bit differently. Related to that, as we have all seen, the gossip recipient can perpetuate the gossip by continuing to share it with others. While this may feel fun or facilitate bonding, people generally feel guilty afterward. I would bet that we've all shared some gossip about someone else without really appreciating that the post gossips guilt is a real thing. Very similar to what you talked about earlier, Joe, one of my co-residents specifically in my class was apparently contemplating leaving residency and I was in the mid-level room [00:16:00] working and I heard another resident say something to somebody else about it. Initially I started to participate in that sort of back and forth volleying conversation, but later decided to text that person directly and we ended up having a really great heart to heart later that day. Gossip truly for good, and I wanna highlight that you've put the entire model in one box and noted that everything we just discussed perceiving a behavior, gossip sender and recipient back and forth, and what the recipient does with the information. All of that occurs within a program's particular culture. And that may just be the most important point to make out of all of this. Culture influences gossip and culture can be changed, but it's hard. When we completed the formal thematic analysis, we highlighted several important concepts that bore out in our data. We constructed seven themes, but for the sake of time, I'll highlight just three here. First, gossip flourishes in environments that lack transparency, and among those experiencing [00:17:00] burnout, when decisions are made without explanation to those directly impacted, gossip inevitably occurs, especially when people feel overworked. As one resident told me, quote, I was on a team with a co-resident who got pulled out of a clinical rotation. No one got an explanation. Of course we're all a little bit peeved because it sucks to have your schedules changed last minute, especially getting cold to cover the worst rotations, losing days off, and in some cases almost violating duty hours. Almost instantaneously, people identified this resident and people were making up whatever stories about their absence that made sense. I would hope that these stories are coming from a place of wanting to determine what happened in order to better support that resident. And I understand a program wanting to protect that resident's privacy. That's incredibly important. But I can totally see how an already overworked resident whose schedule is changed and receives little to no information on why, could make up stories to make it easier to blame someone rather than just. [00:18:00] Accepting that sometimes things happen that's a lot harder to accept. I have definitely seen and felt how transparency impacts gossip. One positive example of transparency in contrast to your quote Joe, uh, happened when I was an intern, we were still in the CO era and I remember showing up to round on trauma. You know, you get in early, you caffeinate get prepared for rounds. Caffeinate again, uh, and halfway through rounds the admin chief stops our whole team in the hall and tells us that the night intern at another hospital is out with COVID and unfortunately, really symptomatic. Additionally, that night team had attempted to work without an intern for one night, and it was apparently a disaster. So. They asked if I could leave the trauma team, uh, now and cover for the night intern at the other hospital until they return in an unknown number of days because I knew the reason for it, and there was strong transparency. Well, I wouldn't say I was excited to switch to transition to cover [00:19:00] nights. I was more than happy to do it and to help out the team and my sick co-resident. I don't remember hearing any gossip about why we were shifting around or trying to assign blame, and I attribute that to everybody on the trauma team knowing who was out and why, which enabled us to rally and get the work done. And nobody caffeinate quite like you, John, so I'm sure that was a struggle. Totally agree with John both about the caffeinating and also about how transparency changes the game when it comes to gossip. I was in New York City during COVID and during the Omicron wave we had 14 of our 35 residents out sick at the same time. I was one of the few who hadn't gotten COVID lucky or unlucky, depending on how you look at that situation. But for about four to six weeks, our schedules were constantly shifting. It was tough, but at least I and my co-residents really understood why we were being asked to make all of those changes. And I also knew that the folks who were out sick weren't just taking a vacation or [00:20:00] getting a break. They were also really going through it and super sick. So honestly, the gossip that was happening about residents who were out really wasn't negative at all. It was mostly us just checking in, making sure that they were doing okay, and that someone was around to help them get whatever they needed when they were isolating. Yeah, Kate, you won't be surprised that one of my favorite themes is related to mindfulness and emotional intelligence, which was remaining mindful of gossip's potential impact and how it can improve culture. Appreciating the complexity of situations and assessing the potential impact on others as a gossip sender and recipient. Can absolutely mitigate negative effects. So one participant specifically talked about how every story has two sides, and when they're both hearing and sharing gossip, they try to keep in mind how the individual that's being talked about would respond to the situation and would they feel comfortable in this conversation, and then they try to react accordingly, which covers both self-awareness and self-management. [00:21:00] Appreciating the complexity is hard for a lot of people though. We're taught so many heuristics in medical school and ways of seeing the world in black and white when it's really all shades of gray. I do really like the thoughtfulness behind the intent of listening when hearing gossip though, specifically to determine how to navigate that conversation. Absolutely. But it can be hard to know what to do. Say a medical student is in the OR with their attending and chief resident and they hear a conversation where they're discussing the intern on service in a not so kind way. The student feels uncomfortable listening to this, but doesn't feel like they can say anything to stop it. So what do they do? Ugh, ba. This is such a hard one. You know, I'm not really sure. In my experience, I've definitely heard my senior residents talking about one of my co-interns in front of me and just not really knowing what to say or how to speak up about it. Kate, I think this is all too common and it happens to interns, it happens to junior residents, and it happens to senior residents. I remember being [00:22:00] in a similar situation to that medical student and it is really tough to speak up to others, particularly when they're higher up on the hierarchy. Yeah, and these points guys are related to one of my favorite themes of this work. Gossiping across a hierarchy may force those lower on the hierarchy into uncomfortable situations. Some residents described exactly what you guys are talking about, feeling unable to stand up to gossip from those in positions of power, specifically attendings. Another quote from the paper quote, there's such a power dynamic between attending staff fellows, residents. If I were in another setting, I would've said, that's not professional, but it doesn't really feel like you can say that in surgery to your attending end quote. Furthermore, sharing gossip about a superior's performance may influence power dynamics. I like this quote a lot too. It'll be me and a medical student and an attending would ask me about the junior residents, how they're [00:23:00] doing. It was well intentioned, but if I were the medical student, I'd feel kind of awkward if I were the intern. I don't know that I would want the medical student knowing my deficiencies necessarily. End quote. Oof. Yeah, it would definitely make me wonder how I would be talked about if I went there for residency and whether this was just part of surgical culture really. So if gossip can be both positive and negative and can't get rid of it, is there a way to make gossip less harmful in programs? Well, you're not the only one who asked that insightful question, Maya. So this article is published in surgery and prior to acceptance, the reviewers challenged us to make a list of tips that programs can use to mitigate the negative impacts of gossip. Because you're right, I maintain that you can't take gossip out of any place where people work together. So, okay, here they are. First, commit to transparency whenever possible. As we discussed, uncertainty breeds gossip. [00:24:00] If someone needs to miss work, people are gonna gossip about potential reasons why, which may be factually incorrect. Consider asking the person who must miss work if it would be okay with them to share the reason for their absence with their coworkers. People may be much more willing to help if they know that someone is at a relative's funeral or what have you. And this will also remove an opportunity to gossip because the truth has been provided. Yes, and again, the resident in question should reserve the right to decide whether they share reasons for their schedule change. Totally agree with UBA about letting the residents decide if and how much they wanna share. I think that's such an important point, especially for administrative chiefs or program leadership, to recognize this and help residents think through it, particularly when there's gonna be an extended absence that puts a lot of strain on the team that they leave behind. The reality is when there's a lack of transparency, especially in a high stress environment like surgical residency, gossip [00:25:00] just tends to fill that gap. And if a resident wants to have some control over that potential narrative that's gonna be talked about, that should absolutely be their choice. You know, I'll give an example from my own experience. During my second year, I had to take an unexpected leave for about a month from residency. My stepdad was hospitalized and later diagnosed with cancer. I knew that I had every right to keep that private and take the time that I needed, but I also knew that my absence would place a real burden on my co-residents. And I had been on the other side of that before and I felt it was important to share why I was stepping away. I wasn't around, so of course people were talking, but it didn't feel like harmful gossip. The narrative wasn't about speculating why I was gone. It was about making sure that my family and I were okay and that we had what we needed and that I would take enough time that I needed. And honestly, I thought that that made all the difference for both myself and my co-residents. Yeah. Thanks for sharing that, Kate. I know when you were going through [00:26:00] that, you had told all of us in in CEF too, and you know, our, our hearts and thoughts went out to you and your family as well. I completely agree. You know, with your, with your story and, and your experience, leadership should know that people tend to gossip, especially about schedule changes that impact them. So the second way to mitigate negative gossip is to broadly work against burnout. Oh, good. A quick and easy fix. Thank you, John. I know, right. But it is important to work on. Easier said than done. But environments filled with negativity and insurmountable workloads also breed gossip, particularly negative gossip. And finally, the most powerful suggestion is just talking about gossip and its potential impacts. Making people aware, making them mindful of gossip and what it can do to people can really start to change the culture. So what you're saying, Joe, is that we need to have you come give grand rounds at all of these programs to get leadership and residents thinking more intentionally about gossip and how much it really impacts [00:27:00] culture. Grand Rounds gossip toward 2026. I mean, I'd go, I'd be into it. I'm, I'm game, let's do it. But that's not where the journey stopped, right, Joe? Absolutely not. This was just the tip of the iceberg. We showed what I already knew as a surgery resident attendings are intimately involved in gossip two, we had to get their perspective. In the subsequent study, we followed a similar methodology, but asked attending surgeons for their perspective. I'll again, thank our awesome SEF team, including Sarah at Mayo. Connie at OHSU. Rebecca at LSU Kate again. Well, what can I say? People at Columbia just love to gossip, I guess, and we appreciate that Kate. Riley at UCSF, Jorge at Wash U, and Josh at UTMB. In total, I interviewed 18 attendings and to cut to the chase. Most attendings did not believe that they engaged in gossip about residents, but as we dug deeper into their stories, I realized that it certainly felt like they [00:28:00] engaged in gossip. They masked it as providing feedback to residents via other attendings or the program, but despite attempts to keep it objective, they inherently infuse their own interpretation. One participant said this, the difference between giving factual information and gossip, maybe something as subtle as resident X came to rounds and didn't appear to know the information that was pertinent to his patient presentations. Another way of saying this is Resident X appeared lazy to me. So now that becomes slanderous to a certain degree because they're basically saying that the lack of preparation was due to being lazy. They weren't saying that the lack of preparation was due to organizational issues, knowledge-based issues, this issue, that issue. What we tend to do is attribute to personality characteristics, laziness, dishonesty. These are very heavy accusations about people's personality. End quote. This is bringing back memories from med [00:29:00] school, one on one rotation. I spoke up at the end of a grand rounds that had included some racist imagery in it. I don't think it was intentionally done for that purpose, but regardless, I basically cautioned that attending in the most professional and kindest way possible from using those images in the future, especially without acknowledging their context. Within 20 minutes, I had gotten pulled into the clerkship director's office after they were getting calls from faculty that a medical student was chastising a beloved faculty member. Once they had the full story, it was clear that I hadn't done anything wrong, but boy did the gossip fly about that one Amongst faculty residents and throughout our med school. Lots of people that I didn't know were attributing their own perceptions of my personality characteristics onto a single event in which I just wanted the few black residents in the audience to know that somebody would call it out. I could only imagine the discomfort they must have been feeling and fear that it would just be. Allowed and that they probably couldn't say anything or feel comfortable enough to do so. And since nobody else was calling it out, I decided to, knowing that I had [00:30:00] some protection as a medical student, but I really did not anticipate the backlash that I'd. Oh wow. Was the backlash from residents or attendings? Mostly from the residents. Actually, my faculty evals weren't affected, which may have been 'cause they were already submitted, but I definitely got some retaliatory evaluations from residents on that rotation. That's so interesting. Maya. We did find that attendings had different preferences than residents surrounding gossip, particularly regarding wanting to be free of bias. They don't wanna hear others' reflections until they have a chance to form their own opinion. One participant said, I actually prefer not to have too much information about residents coming on service because I wanna formulate my own opinions of things and not be biased. So I actually don't go soliciting that sort of feedback really at all. Well BA based on that, should I be doing the same thing for our peers? Should I avoid asking other residents who are gonna be joining my service so that I can formulate my own opinions [00:31:00] beforehand? Sometimes for me asking about a junior resident joining the service is, in some instances good for patient safety. What can I trust them to do independently? Things like that. Yeah, great comment, Kate. Hard to answer since I don't really know. Maybe a future project would look into something like that. I, I guess I would say if you do gossip to elicit information about other residents joining your service, I would say you should at least do it thoughtfully, you know, such as to determine where your teaching efforts will be the best served. Last thing about attendings, they acknowledge that gossip is hard to regulate, but there were a few, uh, really inspiring attendings who talked about ways to step up and say something when they hear something, especially in front of, or nurses, techs and other trainees. One attending told me, quote, I tell my nurse, scrub tech and circulator, they do not talk about trainees in my or. I think that's completely inappropriate. I think the idea that you would regulate gossip is impossible, but [00:32:00] I think that there needs to be some safeguards. Gossip could hurt trainees and they're not in a position to stand up for themselves. End quote. Ugh. Love that. Protecting those lower on the hierarchy by setting boundaries about what can be discussed in the or. Definitely gonna be taking that for my future. Me too. I thought that was a really great kind of practical tip. So to wrap this up, gossip happens. It happens every day and we are never going to get rid of it. It's innate to any environment where people work together. So let's start understanding it. It's impacts and work to recognize it in our own words and the words of others. Well said. So what's next? Your Grand Rounds tour? I think I could sell tickets for at least half the price of Taylor Swift, but I think. You know, in all seriousness, the first phase of this project was really establishing some baseline understanding of gossip in searchable education, and now we need to quantify it. We have the tools to construct a survey about gossip. So how often are trainees sharing gossip? How often do they hear it? [00:33:00] How often is the gossip about attendings versus residents? How often are residents choosing to seek resolutions or solutions to situations uncovered through gossip versus just propagating it? We're always looking for new partners who would like to send the survey out to their residents or attendings or who have any other new ideas for collaboration, especially related to gossip. So reach out if you're interested. Well, you know, you can always reach out to Columbia Joe, as always, pedaling collaboration and research. How dare you. Well, thank you Joe and BA for chatting with us about your work. Thank you so much for your time. It has been such a joy to work with you all. Well, that just wraps up today's discussion on gossip. My favorite topic. If you like this conversation and wanna stay in the loop on everything CEF does or even find us for future collaborations, follow us on X at Surge Ed Fellows and Blue Sky Social at cef, or check out our website cef.org. And if you wanna dive deeper into what we [00:34:00] discussed, you can find both journal articles behind this episode linked in the show notes below. Thank you for listening to The Behind the Knife podcast, and as always, go forth and dominate the day. The day post stuff is the coolest group. How do I make up noise? That's gonna be the hardest part of the whole podcast. I thought I had it and then I just was the planning document thing. It's another tab. Oh man. Who's the boomer now, Joe? The future of surgical education. As long as it's not on another tab. Do you need. Joe's learned about tabs. Do you guys wanna get started?