E. Eguia1, P. J. Sweigert1, G. Abood1, A. J. Baldea1, A. Kabaker1, L. M. Knab1 1Loyola University Medical Center,Surgery,Maywood, ILLINOIS, USA
Introduction:
The first day of surgical intern year brings unique challenges when the calendar change marks a transition from student to physician. Many medical schools and surgical programs have implemented a "boot camp" to assist surgical interns with this transition and help them contend with a deluge of new responsibilities and expectations. While prior studies have focused on improved technical skills following bootcamps, little has been documented on what is perceived as critical intern skills needed to begin intern year. This study aims to determine what faculty, residents, and medical students identify as the most critical topics for a surgical boot camp curriculum. We hypothesize that faculty and residents will have differing priorities compared to medical students.
Methods:
A 45 question survey was developed through an iterative review with multiple surgical colleagues in conjunction with the ACS/APDS/ASE resident prep curricular modules. The questions were grouped into three broad categories, which included technical skills, practical knowledge, and clinical knowledge. A 5-point Likert scale scoring system was used. The survey was distributed online to the surgery faculty, general surgery residents including preliminary interns, and those medical students matched into surgical residencies. Data were analyzed by a chi-squared test for proportions and continuous variables were compared using t-test or ANOVA tests, when appropriate.
Results:
There was a total of 62 participants, 19 (31%) were attending surgeons, 28 (45%) were general surgery residents, and 15 (24%) were fourth-year medical students (MS4). The response rate for attendings was 45%, residents was 72%, MS4 was 43%. Practical knowledge was the most important skill by all participants, followed by clinical knowledge and technical skills (mean score 4.4 vs. 3.9 vs. 3.2, p <.001). The practical knowledge skill mean scores were highest for MS4, followed by attending surgeons and residents (4.5 vs. 4.3 vs. 4.4, p = 0.72). The top five most important practical knowledge skills to have according to all participants included: how to communicate with senior residents/attendings/nurses, how to use the electronic medical record, how to perform effective handoffs, and how to write orders. The top five practical knowledge skills which the attendings felt were more important compared to the trainees included: how to prepare patients for surgery, returning pages, death certification, disclosing adverse advents, and impact of communication breakdowns.
Conclusion:
Previous studies on bootcamp curricula have emphasized technical skills for incoming interns, with less importance placed on practical/communication skills. Our study demonstrates that there is general agreement among attendings, residents, and medical students about which critical skills should be acquired during bootcamp. Interestingly, practical skills mostly pertaining to communication, were often ranked as most important compared to technical skills. This study has implications for prioritizing the curricular components of an often tightly scheduled surgical bootcamp. Future studies using multi-institutional data will elucidate if effective communication skills taught in surgical boot camp will improve patient outcomes.