TY - JOUR
T1 - Accelerated Skills Preparation and Assessment for Senior Medical Students Entering Surgical Internship
AU - Brunt, L. Michael
AU - Halpin, Valerie J.
AU - Klingensmith, Mary E.
AU - Tiemann, Debra
AU - Matthews, Brent D.
AU - Spitler, Jennifer A.
AU - Pierce, Richard A.
N1 - Funding Information:
Supported in part by a grant from the Washington University School of Medicine Innovations in Medical Student Education program and by the Washington University Institute for Minimally Invasive Surgery. Supported in part by an educational grant from Stryker Endoscopy and equipment support from Ethicon Endosurgery and Ethicon, Inc.
Funding Information:
A skills course for senior medical students matching in a surgical specialty entitled “Accelerated Skills Preparation for Surgical Internship” was implemented in the spring of 2006. The course curriculum was developed based on perceived needs for students entering internship and with a focus on development of basic surgical skills and management of acute patient problems. The course was given as a once-weekly 2- to 3-hour session for a period of 7 weeks. Each session consisted of a short lecture, followed by hands-on skills instruction and practice. Students were also expected to spend additional time, outside the formal instruction setting, practicing and refining the skills they were taught. The once-weekly format of this program allowed students to enroll while continuing to take their regularly scheduled elective rotations. Funding for the course was obtained with a grant from the Washington University School of Medicine Innovations in Medical Student Education program and was supplemented by grant support from industry.
Funding Information:
A barrier to the implementation of skills courses of this nature is the time required of faculty and the expense of the core materials and support personnel. Funding for the initiation of this course was obtained form a grant program for medical student education from the Washington University School of Medicine and was supplemented by industry funding for some supplies and equipment. Substantial faculty time was invested in developing the course structure and teaching the different skills sessions. Resident instructors were also invaluable in providing focused instruction for various skills stations and to provide feedback to students individually and in small groups. Development of this course was also greatly facilitated by the existence in our general surgery training program of a comprehensive surgical skills curriculum for surgical residents developed by our Program Director (MEK) and an experienced surgical education nurse coordinator (DT). Now that a skills laboratory program has been mandated for all surgical training programs, it is time for medical schools and departments of surgery to collaborate to provide the necessary personnel and equipment support to extend skills training to senior medical students planning a surgical career.
PY - 2008/5
Y1 - 2008/5
N2 - Background: Skills training plays an increasing role in residency training. Few medical schools have skills courses for senior students entering surgical residency. Methods: A skills course for 4th-year medical students matched in a surgical specialty was conducted in 2006 and 2007 during 7 weekly 3-hour sessions. Topics included suturing, knot tying, procedural skills (eg, chest tube insertion), laparoscopic skills, use of energy devices, and on-call management problems. Materials for outside practice were provided. Pre- and postcourse assessment of suturing skills was performed; laparoscopic skills were assessed postcourse using the Society of American Gastrointestinal and Endoscopic Surgeons' Fundamentals of Laparoscopic Surgery program. Students' perceived preparedness for internship was assessed by survey (1 to 5 Likert scale). Data are mean ± SD and statistical analyses were performed. Results: Thirty-one 4th-year students were enrolled. Pre- versus postcourse surveys of 45 domains related to acute patient management and technical and procedural skills indicated an improved perception of preparedness for internship overall (mean pre versus post) for 28 questions (p < 0.05). Students rated course relevance as "highly useful" (4.8 ± 0.5) and their ability to complete skills as "markedly improved" (4.5 ± 0.6). Suturing and knot-tying skills showed substantial time improvement pre- versus postcourse for 4 of 5 tasks: simple interrupted suturing (283 ± 73 versus 243 ± 52 seconds), subcuticular suturing (385 ± 132 versus 274 ± 80 seconds), 1-handed knot tying (73 ± 33 versus 58 ± 22 seconds), and tying in a restricted space (54 ± 18 versus 44 ± 16 seconds) (p < 0.02). Only 2-handed knot tying did not change substantially (65 ± 24 versus 59 ± 24 seconds). Of 13 students who took the Fundamentals of Laparoscopic Surgery skills test, 5 passed all 5 components and 3 passed 4 of 5 components. Conclusions: Skills instruction for senior students entering surgical internship results in a higher perception of preparedness and improved skills performance. Medical schools should consider integrating skills courses into the 4th-year curriculum to better prepare students for surgical residency.
AB - Background: Skills training plays an increasing role in residency training. Few medical schools have skills courses for senior students entering surgical residency. Methods: A skills course for 4th-year medical students matched in a surgical specialty was conducted in 2006 and 2007 during 7 weekly 3-hour sessions. Topics included suturing, knot tying, procedural skills (eg, chest tube insertion), laparoscopic skills, use of energy devices, and on-call management problems. Materials for outside practice were provided. Pre- and postcourse assessment of suturing skills was performed; laparoscopic skills were assessed postcourse using the Society of American Gastrointestinal and Endoscopic Surgeons' Fundamentals of Laparoscopic Surgery program. Students' perceived preparedness for internship was assessed by survey (1 to 5 Likert scale). Data are mean ± SD and statistical analyses were performed. Results: Thirty-one 4th-year students were enrolled. Pre- versus postcourse surveys of 45 domains related to acute patient management and technical and procedural skills indicated an improved perception of preparedness for internship overall (mean pre versus post) for 28 questions (p < 0.05). Students rated course relevance as "highly useful" (4.8 ± 0.5) and their ability to complete skills as "markedly improved" (4.5 ± 0.6). Suturing and knot-tying skills showed substantial time improvement pre- versus postcourse for 4 of 5 tasks: simple interrupted suturing (283 ± 73 versus 243 ± 52 seconds), subcuticular suturing (385 ± 132 versus 274 ± 80 seconds), 1-handed knot tying (73 ± 33 versus 58 ± 22 seconds), and tying in a restricted space (54 ± 18 versus 44 ± 16 seconds) (p < 0.02). Only 2-handed knot tying did not change substantially (65 ± 24 versus 59 ± 24 seconds). Of 13 students who took the Fundamentals of Laparoscopic Surgery skills test, 5 passed all 5 components and 3 passed 4 of 5 components. Conclusions: Skills instruction for senior students entering surgical internship results in a higher perception of preparedness and improved skills performance. Medical schools should consider integrating skills courses into the 4th-year curriculum to better prepare students for surgical residency.
UR - http://www.scopus.com/inward/record.url?scp=43049124372&partnerID=8YFLogxK
U2 - 10.1016/j.jamcollsurg.2007.12.018
DO - 10.1016/j.jamcollsurg.2007.12.018
M3 - Article
C2 - 18471719
AN - SCOPUS:43049124372
SN - 1072-7515
VL - 206
SP - 897
EP - 904
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 5
ER -