E. S. Shipper1, S. Miller1, B. Hasty1, S. Merrell1, D. Lin1, J. Lau1 1Stanford University,Palo Alto, CA, USA
Introduction:
A challenge with developing an interest in surgery among preclinical medical students is capturing their interest prior to the clerkship experience while providing representative experiences that will allow them to make an informed decision prior to committing to a career in surgery. To address these challenges, our institution designed an intensive surgical immersion experience curriculum for pre-clinical medical students. Here, we evaluate the curriculum for its efficacy, and perform a needs assessment to direct future iterations of the curriculum.
Methods:
Our curriculum consisted of advanced skills training followed by high fidelity operative simulations taught by faculty. Students were then offered a voluntary online course evaluation survey. For this study, we compiled survey data from the last 4 years. Students reported on their confidence levels (on a scale of 1 to 5) before and after completing the course in performing the following surgical skills: knot-tying, basic suturing, advanced suturing, hand-sewn bowel anastomoses, laparoscopic surgical skills, and vascular anastomoses. They also reported how seriously they were considering a career in surgery, before and after completing the course. Lastly, students were asked to comment on suggestions to improve the course. The data were analyzed for basic descriptive statistics and compared using an unpaired, two-tailed t test.
Results:
Of the 72 learners who completed the course over the last 4 years, 41 learners (57.0%) responded to the course evaluation survey. The mean pre- confidence level, the mean post- confidence level, and the p value for each surgical skill are reported below:
Knot-tying (1.95, 3.91, <0.001)
Basic suturing (2.05, 3.68, <0.001)
Advanced suturing (1.59, 3.14, <0.001)
Hand-sewn bowel anastomoses (1.14, 2.50, <0.001)
Laparoscopic surgical skills (1.45, 2.68, <0.001)
Vascular anastomoses (1.09, 2.14, <0.001)
The mean level of interest in a career in surgery before the course was 3.56 (SD=1.16), after the course was 3.95 (SD=0.97) (p=0.10).
Results of the primary reason respondents reported taking the course are presented below:
40.9%: to achieve proficiency in surgical techniques prior to beginning clerkships. 22.7%: to pursue a known interest in a career in surgery as a preclinical medical student
18.2%: to gain exposure without necessarily gaining proficiency.
13.6%: to inform a decision about a career in surgery
4.6%: “other”
Conclusion:
Our intensive surgical immersion experience curriculum achieved its goals of increasing pre-clinical interest in surgery. Interestingly, our needs assessment showed that our learners identified the curriculum less as an opportunity to investigate an interest in surgery, and more as a way to achieve proficiency in basic surgical skills prior to beginning the surgery clerkship. Further study is needed to define the essential components of this resource-intensive surgical immersion program.