Journal of surgical education
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Where Has All the Complexity Gone? An Analysis of the Modern Surgical Resident Operative Experience.
The operative experience of today's general surgery (GS) residents are changing. The Surgical Council on Resident Education (SCORE) was founded to provide a standardized, competency-based curriculum. We set out to evaluate resident operative experience in core and advanced operations. ⋯ There has been an increase in core operative experience with a concurrent decrease in advanced operative experience of graduating GS residents. These findings highlight the continued narrowing of the operative experience for trainees, with increasing focus on GS and less on subspecialty domains. Ongoing efforts to look beyond operative volume to ensure competency of graduates will prove beneficial.
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Established primary goals of general surgery subinternships are improvement in patient care and medical knowledge. However, the secondary gains such as obtaining recommendation letters and forming relationships are apparent but poorly defined. We sought the opinion of general surgery program directors (PDs) on the secondary purposes of subinternships. Our aim is to aide mentors and students to optimize the subinternship experience relative to the residency application process. ⋯ Our study suggests subinternships significantly impact a student's application to general surgery residency, clarifying a secondary role for these rotations. Subinternships are important for PDs to assess a student for ranking at their program. All students should pursue a letter of recommendation from subinternship faculty, when possible, as they can heavily influence the interview selection process. Away rotations should only be recommended for those students who need to strengthen their application.
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The COVID-19 pandemic has disrupted graduate medical education, impacting Accreditation Council for Graduate Medical Education (ACGME)-mandated didactics. We aimed to study the utility of 2 methods of virtual learning: the daily National Surgery Resident Lecture Series (NSRLS), and weekly "SCORE School" educational webinars designed around the Surgical Council on Resident Education (SCORE) curriculum. ⋯ Virtual didactics aimed at surgical residents are feasible, well-attended (both live and recorded), and have high levels of viewer engagement. We have observed that careful coordination of timing and topics is ideal. The ability for asynchronous viewing is particularly important for attendance. As the COVID-19 pandemic continues to disrupt healthcare systems, training programs must continue to adapt to education via virtual platforms.
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Effective provider-patient communication has several benefits; however, few surgical residency programs have communication training and surgical residents have limited time for education. We developed a communication curriculum with limited didactics and emphasis on practice. Our objective was to evaluate whether this time-limited intervention led to changes in surgical resident communication skills. ⋯ The brief modules led to increased self-reported use of communication skills and were effective in improving resident communication in OSCEs. This may be a useful curricular model for both surgical and nonsurgical residency programs with limited availability for curricular time.
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In surgery residency programs, Accreditation Council for Graduate Medical Education mandated performance assessment can include assessment in the operating room to demonstrate that necessary quality and autonomy goals are achieved by the conclusion of training. For the past 3 years, our institution has used The Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) instrument to assess and track operative skills. Evaluation is accomplished in near real-time using a secure web-based platform for data management and analytics (Firefly). Simultaneous to access of the platform's case logging function, the O-SCORE instrument is delivered to faculty members for rapid completion, facilitating quality, and timeliness of feedback. We sought to demonstrate the platform's utility in detecting operative performance changes over time in response to focused educational interventions based on stored case log and O-SCORE data. ⋯ The data management platform proved to be an effective tool to track responses to supplemental training that was deemed necessary to close defined skills gaps in laparoscopic surgery. This could be seen both in individual and in aggregated data. We were gratified that at the conclusion of the supplemental training, O-SCORE results for the intervention group were not different than those seen in the non-intervention group.