C. A. Green1, S. M. Wyles1, E. H. Kim1, P. S. O’Sullivan1, H. Chern1 1University Of California – San Francisco,Department Of Surgery,San Francisco, CA, USA
Introduction: Educators have developed preparatory courses for senior medical students (SMS) entering surgery aiming to improve the transition from medical school to residency. We chose to design a novel curriculum that can be embedded in a capstone course to enhance student’s readiness for surgical internship. The course emphasizes major intern competencies, ward management and technical skills, through interactive simulation and practice activities. This study aims to assess the feasibility and outcomes of this course.
Methods: A surgical curriculum was designed and executed based on competencies highlighted in our surgical intern milestones. Students participated in 8 (3-hour) sessions held over four weeks as an adjunct to the well-established intern preparatory course at our institution. Course activities involved interactive simulation cases and mock page encounters to emphasize post-operative patient care and management of the critically ill. Additional sessions included technical skills exercises reinforced with home video assignments. Students rated confidence on 13 management skills using a five-point Likert scale (5=high confidence). Confidence levels were then averaged to give an overall score. Faculty graded students’ technical performance using a global grading scale (1 to 10) for 5 different suturing exercises. Students completed all measures both on the first and last day of the course. Comparisons between pre- and post-course data were made using t-tests (a=0.05).
Results: 11 students entering 4 different types of surgical residencies enrolled in the 2014 course. Assessment of overall confidence in patient management improved from 2.41 to 3.89 (SD 0.49, 0.35; P<0.05). Additionally, student scores on fundamental suturing exercises significantly increased in all 5 tasks (P<0.05) (Figure 1).
Conclusion: We developed and incorporated a surgical component to the existing preparatory course at our institution. Our results illustrate the feasibility of an adjunctive specialty-specific curriculum for SMS entering surgical residencies. Students demonstrated increased confidence in ward management skills and increased technical scores in all measured exercises. The technical improvement is noteworthy because only 3 of the sessions were dedicated to these skills. The significant progress may be due to the additional implementation of the home video component. Investigation into subsequent performance benefits is warranted. This course serves as a specialty-specific model for schools with existing preparatory courses. Our described curriculum allows for consolidation efforts to maximize resources while still highlighting specific components to heighten participants’ readiness for surgical residency.
