Beyond the White Coat: A Multispecialty Needs Assessment of Residents’ Teaching Perceptions, Competency, and Learning Needs

Background: Residents contribute substantially to clinical teaching; however, many lack formal preparation for their role as educators. Despite rising expectations within competency frameworks, evidence from multicultural, rapidly evolving training environments remains limited. This study aimed to assess residents' perceptions of their educator role, evaluate self-reported teaching competency and involvement, and identify learning needs to inform the development of a context-sensitive Residents-as-Teachers program. Methods: A cross-sectional needs assessment survey was conducted among all 322 medical and surgical residents in a large academic health system between May and July 2025. A validated, locally adapted questionnaire assessed perceptions, teaching involvement, and learning needs. Data were analysed using descriptive statistics, bivariate analyses, and multivariable linear regression to identify independent predictors of positive perceptions of the educator role. Results: A total of 291 residents participated (response rate 90.4%), representing 18 specialties across medical and surgical disciplines. Residents reported spending a mean of 35.8% of their training time engaged in teaching activities. Overall perceptions of the educator role were positive (mean total score 49.99/60), while self-reported teaching competency was moderate. A consistent interprofessional teaching gap was identified, with nurses ranked least frequently taught by over 80% of residents and receiving the lowest competency rating. Residents expressed strong interest in structured teaching-skills training, preferring interactive instructor-led formats over online self-paced learning. In multivariable regression, interest in a future educator role (p <0.001) and competency in teaching medical students (p =0.038) were the strongest independent predictors of positive educator perceptions. Conclusion: These preliminary findings indicate that residents play a substantial yet underprepared role in clinical teaching. Results suggest that structured, contextually responsive Residents-as-Teachers programs prioritizing motivation, teaching competency, and interprofessional education may help address identified gaps and support the development of future clinician-educators. Longitudinal and implementation-focused research is needed to evaluate whether such programs improve observed teaching performance and learner outcomes in diverse postgraduate training environments.