P. Kandagatla1, R. Rinaldi1, Z. Al Adas1, E. Field1, C. Steffes1, H. Abdallah1, L. Kabbani1 1Henry Ford Health System,Detroit, MI, USA
Introduction: During a surgical clerkship, medical students rotate through various specialties. There is little research on the effect of this diversity of rotations on students. Some programs allow students to select their rotations while others assign them in an attempt to provide a similar experience to everyone. The purpose of this study is to assess the effect of taking core rotations compared to specialty rotations on students’ technical and academic development.
Methods: Students going through a surgical clerkship at our institution were given a suturing workshop at the beginning of their clerkship. A questionnaire was also given to students to record any prior interest in surgery or previous hands-on experience. Immediately after the workshop, they were asked to perform a simple and a complex suturing task. The tasks were repeated again at the end of the 2-month clerkship and a post clerkship questionnaire filled out. These tasks were videotaped, the times to completion were recorded, and the proficiency scored by a blinded attending surgeon. The times and scores were analyzed to assess for any improvement. The students were then divided into two groups depending on the number of core surgical rotations they rotated through. Groups were compared using uni-variate and multi-variate analyses and the variables compared included objective scores, time to complete tasks, and exam scores.
Results: Thirty-eight students were included in the study. By the end of the rotation there was a decrease in the average time to perform the simple task (5.1 vs 4.1 min, p<0.01) and the complex task (7.9 vs 6.3 min, p<0.01). There was also an increase in proficiency of the simple task (14.2 vs 16.4, p=0.035) and the complex task (12.9 vs 16.5, p<0.01). Using multi-variate analysis, we found that reported hours in the operating room per week and previous hands-on experience affected proficiency of the simple suturing task.
Sixteen students had predominantly core surgical rotations. When compared to the 22 students with more subspecialty rotations, there was no difference in terms of age, hours logged in the operating room per week, amount of practice, previous interest in surgery, and previous hands-on experience. There was a difference in gender (more males in the core surgical rotations, 50% vs 87.5%, p=0.02). There was no significant difference in the completion times (p=0.964, 0.821), the proficiency scores (p=0.057, 0.198), the shelf exam scores (p=0.572), and oral exam pass rates (p=0.885) between the two groups.
Conclusion: After completion of a general surgery clerkship most students’ technical skills improved. This was not affected by the type of rotations (core vs subspecialty) they were assigned. In this small study, it appears that neither their surgical skills development nor their knowledge is associated by their choice of rotation.