TY - JOUR
T1 - Utility of a Standardized Fourth-Year Medical Student Surgical Preparatory Curriculum
T2 - Program Director Perceptions
AU - Stewart, Melissa K.
AU - Henry, Rebecca C.
AU - Ehrenfeld, Jesse M.
AU - Terhune, Kyla P.
N1 - Funding Information:
Surgical internship requires competence and confidence from the start, so as to not compromise patient care. Each July, given that medical school educational experiences and exposure differ, interns matriculate to residency with variable preparedness, knowledge and technical skill. 1 To offset the differential readiness, supervision of clinical activities would be preferred; however, research reveals direct oversight of intern day-to-day activities is often limited. 2 In an effort to minimize the readiness differential and ease the transition, a national surgical preresidency preparatory curriculum was developed with the intention to accelerate readiness, responsibility and accountability of interns. Curriculum development was supported by the American College of Surgeons (ACS), the Association of Program Directors in Surgery (APDS) ,and the Association for Surgical Education (ASE). 3 The modular preparatory curriculum, termed “Resident Prep Curriculum” (RPC), 4 outlined specific goals and objectives that are explicitly tied to the Accreditation Council on Graduate Medical Education's (ACGME) first-year resident supervision requirements. 5 A special communication regarding the novel and national initiative was jointly published at end-of-year 2014 in a multitude of wide reaching surgical journals, inclusive of the Journal of Surgical Education, Annals of Surgery, American Surgeon, World Journal of Surgery, American Journal of Surgery, Surgery, Journal of the ACS, and the Journal of the American Medical Association Surgery. 3,6-12 The curriculum was piloted in 39 US medical schools in 2014 and 55 institutions in 2015. 4 In 2016, the curriculum was endorsed for global use. Despite increasing use and evolving endorsement, outcomes of the implementation of the RPC remain unknown. That is, to date, no studies have analyzed these efforts. As an initial means for evaluation of the RPC, we sought to garner the perceptions of program directors (PDs) as an outcome surrogate.
Publisher Copyright:
© 2018
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Objective: Each July, surgical interns arrive to residency with variable skills, knowledge, and clinical experience. To standardize and improve intern preparation, the American College of Surgeons (ACS), Association of Program Directors in Surgery, and Association for Surgical Education developed a pilot Resident Prep Curriculum (RPC). To date, no studies have analyzed these efforts. We aimed to discern program director (PD) perceptions of RPC participants as an initial means of analysis. Design: A 17-question PD survey was designed to assess variable preparedness and performance between RPC participants and nonparticipants. PDs reporting matriculation of a RPC participant were first asked to globally compare the participant to nonparticipants. Using a 5-point Likert scale, PDs were then asked to compare participants to nonparticipants in 7 distinct categories, which were based on course objectives that parallel the Accreditation Council for Graduate Medical Education competencies. Descriptive statistics and tests of significance were performed to evaluate the responses. Participants: The survey was sent via electronic mail to 245 accredited general surgery residency PDs. Results: A total of 103 (42.0%) PDs responded. Of the respondents, 27 (26.2%) reported matriculation of a RPC participant. When assessing efficiency in intern responsibilities, 26.9% of PDs noted participant advantage, and when gauging comfort in intern-role, 25.9% of PDs reported participant benefit. Across the 7 queried course objectives, there was a statistically significant improvement in the technical skill domain (p = 0.007) and a nonsignificant trend toward improvement in several of the other 6 domains: interpersonal skills (p = 0.055), medical knowledge (p = 0.067), patient care (p = 0.081), systems-based practice (p = 0.085), problem-based learning (p = 0.106), and professionalism (p = 0.357). Conclusions: PD perceptions revealed global advantage to RPC participation Furthermore, 1/4 of the time and specific competency performance showed substantial improved performance in technical skills. Survey timing and washout may bias this study, and the results should be compared to learner and senior resident perceptions, where observations may be more granular.
AB - Objective: Each July, surgical interns arrive to residency with variable skills, knowledge, and clinical experience. To standardize and improve intern preparation, the American College of Surgeons (ACS), Association of Program Directors in Surgery, and Association for Surgical Education developed a pilot Resident Prep Curriculum (RPC). To date, no studies have analyzed these efforts. We aimed to discern program director (PD) perceptions of RPC participants as an initial means of analysis. Design: A 17-question PD survey was designed to assess variable preparedness and performance between RPC participants and nonparticipants. PDs reporting matriculation of a RPC participant were first asked to globally compare the participant to nonparticipants. Using a 5-point Likert scale, PDs were then asked to compare participants to nonparticipants in 7 distinct categories, which were based on course objectives that parallel the Accreditation Council for Graduate Medical Education competencies. Descriptive statistics and tests of significance were performed to evaluate the responses. Participants: The survey was sent via electronic mail to 245 accredited general surgery residency PDs. Results: A total of 103 (42.0%) PDs responded. Of the respondents, 27 (26.2%) reported matriculation of a RPC participant. When assessing efficiency in intern responsibilities, 26.9% of PDs noted participant advantage, and when gauging comfort in intern-role, 25.9% of PDs reported participant benefit. Across the 7 queried course objectives, there was a statistically significant improvement in the technical skill domain (p = 0.007) and a nonsignificant trend toward improvement in several of the other 6 domains: interpersonal skills (p = 0.055), medical knowledge (p = 0.067), patient care (p = 0.081), systems-based practice (p = 0.085), problem-based learning (p = 0.106), and professionalism (p = 0.357). Conclusions: PD perceptions revealed global advantage to RPC participation Furthermore, 1/4 of the time and specific competency performance showed substantial improved performance in technical skills. Survey timing and washout may bias this study, and the results should be compared to learner and senior resident perceptions, where observations may be more granular.
KW - Medical Knowledge
KW - Patient Care
KW - education
KW - intern
KW - medical student
KW - residency
KW - resident prep curriculum
KW - resident preparatory course
KW - surgery
UR - http://www.scopus.com/inward/record.url?scp=85039870066&partnerID=8YFLogxK
U2 - 10.1016/j.jsurg.2017.09.004
DO - 10.1016/j.jsurg.2017.09.004
M3 - Article
C2 - 29306578
AN - SCOPUS:85039870066
SN - 1931-7204
VL - 75
SP - 639
EP - 643
JO - Journal of Surgical Education
JF - Journal of Surgical Education
IS - 3
ER -