Outcomes of a proficiency-based skills curriculum at the beginning of the fourth year for senior medical students entering surgery

Thomas J. Wade, Karly Lorbeer, Michael M. Awad, Julie Woodhouse, Angela Declue, L. Michael Brunt

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Introduction We hypothesized that a proficiency-based curriculum administered early in the fourth year to senior medical students (MS4) would achieve outcomes comparable to a similar program administered during surgical internship. Methods MS4 (n = 18) entering any surgical specialty enrolled in a proficiency-based skills curriculum at the beginning of the fourth year that included suturing/knot-tying, on-call problems, laparoscopic, and other skills (urinary catheter, sterile prep/drape, IV placement, informed consent, electrosurgical use). Assessment was at 4-12 weeks after training by a modified Objective Structured Assessment of Technical Skills (OSATS). Suturing and knot tying tasks were assessed by time and OSATS technical proficiency (TP) scores (1 [novice], 3 [proficient], 5 [expert]). Outcomes were compared with PGY-1 residents who received similar training at the beginning of internship and assessment 4-12 weeks later. Data are presented as mean values ± standard deviation; statistical significance was assessed by Student's t test. Results Fifteen of 18 MS4 (83%) reached proficiency on all 15 tasks, and 2 others were proficient on all but 1 laparoscopic task. Compared with PGY-1s, MS4 were significantly faster for 3 of 5 suturing and tying tasks and total task time (547 ± 63 vs 637 ± 127 s; P <.05). Mean TP scores were similar for both groups (MS4, 3.4 ± 0.5 vs PGY-1, 3.1 ±.57; P = NS). MS4 OSATS scores were higher for IV placement, informed consent, and urinary catheter placement, but lower for prep and drape and for management of on-call problems. Conclusion MS4 who participate in a proficiency-based curriculum taught early in the fourth year are able to meet proficiency targets in a high percentage of cases. This approach should better prepare MS4 for surgical internship.

Original languageEnglish
Pages (from-to)962-971
Number of pages10
JournalSurgery (United States)
Volume158
Issue number4
DOIs
StatePublished - Oct 1 2015

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