A novel critical skills curriculum for surgical interns incorporating simulation training improves readiness for acute inpatient care

J Surg Educ. 2009 Sep-Oct;66(5):248-54. doi: 10.1016/j.jsurg.2009.09.002.

Abstract

Introduction: Surgical interns encounter complex, acute care situations often managed with limited supervision. Furthermore, medical school training does not adequately prepare students for special surgical considerations. Using simulation training, we implemented a course aimed at improving surgical intern readiness for responding to unique, life-threatening issues encountered in daily surgical care.

Methods: Twenty University of Minnesota surgical interns participated in the 3-week course. The first session consisted of interactive didactics and simulation covering hypoxia, shock, and metabolic disturbances; the second session addressed cardiopulmonary emergencies, including ventricular assist device and pacemaker use. Electronic simulation scenarios comprised the third session, allowing learners to demonstrate learned/practiced skills. The outcomes were assessed objectively (pretest and posttest) and subjectively (standardized feedback evaluations).

Results: Fifteen learners completed the pretest and posttest. The mean absolute score increase was 14% with average relative score improvement of 43%. Twenty learners completed feedback evaluations using a standard 5-point Likert scale. Respondents scored the first 2 sessions on topic importance (5 = very important), giving the first session 4.90 (+/- 0.31) and the second session 4.45 (+/- 0.89). Respondents ranked their confidence in executing practiced skills on actual patients (5 = very confident) as 4.24 (+/- 0.71). There was uniform support for the value of the electronic simulation scenarios as enhanced learning tools.

Conclusions: We developed a course for surgical interns incorporating didactics and simulation. Learners demonstrated objective improvement in testing and reported that the course topics were highly important. After course completion, learners provided feedback indicating a high level of confidence in executing practiced skills, suggesting improved preparation for acute surgical care.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Clinical Competence
  • Computer Simulation
  • Computer-Assisted Instruction / methods*
  • Critical Care / methods*
  • Critical Illness / therapy
  • Curriculum*
  • Education, Medical, Graduate / methods*
  • Educational Measurement
  • Female
  • Humans
  • Internship and Residency*
  • Male
  • Patient Simulation*
  • Problem-Based Learning / methods
  • United States