Journal of surgical education
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Model for Team Training Using the Advanced Trauma Operative Management Course: Pilot Study Analysis.
Education and training of surgeons has traditionally focused on the development of individual knowledge, technical skills, and decision making. Team training with the surgeon's operating room staff has not been prioritized in existing educational paradigms, particularly in trauma surgery. We aimed to determine whether a pilot curriculum for surgical technicians and nurses, based on the American College of Surgeons' Advanced Trauma Operative Management (ATOM) course, would improve staff knowledge if conducted in a team-training environment. ⋯ Team training is critical to improving the knowledge base of surgical technicians and nurses in the trauma operative setting and may contribute to improved patient outcomes, decreased risk, and hospital cost savings.
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Residency program directors have increasingly expressed concern about the preparedness of some medical school graduates for residency training. The Association of American Medical Colleges recently defined 13 core entrustable professional activities (EPAs) for entering residency that residents should be able to perform without direct supervision on the first day of training. It is not known how students' perception of their competency with these activities compares with that of surgery program directors'. ⋯ A large gap exists between confidence in performance of the 13 core EPAs for entering residency without direct supervision for graduating medical students and surgery program directors. Both the groups identified several key areas for improvement that may be addressed by medical school curricular interventions or expanding surgical boot camps in hopes to improve resident performance and patient safety.
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Operative experience during residency lays the foundation for independent practice and additional specialty training following general surgery residency. The aim of this study was to examine operative experience of general surgery residents and detail the results of an intervention aimed at improving resident record keeping in the Accreditation Council for Graduate Medical Education (ACGME) case log system to better reflect their experience. ⋯ Based on our results, we found that weekly displays of cases improved resident record keeping in the ACGME case log system, especially by junior residents. We believe that the addition of first assistant column on M&M lists, periodic audits reviewed at conferences, and semiannual evaluations will help junior residents more accurately report their experience during training.
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Error management training is an approach that encourages exposure to errors during initial skill acquisition so that learners can be equipped with important error identification, management, and metacognitive skills. The purpose of this study was to determine how an error-focused training program affected performance, retention, and transfer of central venous catheter (CVC) placement skills when compared with traditional training methodologies. ⋯ These data indicate that incorporating error-based activities and discussions into training programs can be beneficial for skill retention and transfer.
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Comparative Study
Resident Surgeons Underrate Their Laparoscopic Skills and Comfort Level When Compared With the Rating by Attending Surgeons.
The development of operative skills during general surgery residency depends largely on the resident surgeons' (residents) ability to accurately self-assess and identify areas for improvement. We compared evaluations of laparoscopic skills and comfort level of residents from both the residents' and attending surgeons' (attendings') perspectives. ⋯ A gap exists between residents' and attendings' perception of residents' laparoscopic skills and comfort level in performing laparoscopic cholecystectomy. These findings call for improved communication between residents and attendings to ensure that graduates are adequately prepared to operate independently. In the context of changing methods of resident evaluations that call for explicitly defined competencies in surgery, it is essential that residents are able to accurately self-assess and be in general agreement with attendings on their level of laparoscopic skills and comfort level while performing a case.