Pedro Pablo Gomez1, Ross E Willis2, Breanne L Schiffer3, Aimee K Gardner4, Daniel J Scott4. 1. Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas. Electronic address: gomezpp@uthscsa.edu. 2. Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas. 3. School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas. 4. Department of Surgery, University of Texas Southwestern, Dallas, Texas.
Abstract
PURPOSE: The purpose of this study was to perform external validation, examine educational effectiveness, and confirm construct validity of a previously developed "intermediate-level, proficiency-based knot-tying and suturing curriculum" in preparing residents to achieve proficiency in more advanced open surgical techniques. METHODS: A total of 47 postgraduate year-1 (PGY-1) surgery residents completed 6 intermediate-level knot-tying and suturing exercises. Baseline trainee performance was compared with intermediate and senior (PGY-3 and PGY-4) residents (n = 12) and expert faculty (n = 4). RESULTS: PGY-1 overall proficiency increased from 21.1% at baseline to 92.1% during posttest for all 6 exercises combined (p < 0.001). When compared with the PGY-3 and PGY-4 residents, at baseline intermediate and senior residents scored higher on half of the exercises. However, during posttesting PGY-1 residents not only matched, but also surpassed PGY-3 and PGY-4 residents' performance in 3 of 6 exercises. Significant differences on all 6 exercises were also found during pretesting when comparing interns against faculty, demonstrating construct validity. However, upon completion of the curriculum, PGY-1 residents' posttest scores were equivalent, if not significantly better than expert faculty performance. CONCLUSION: We obtained similar results as those previously reported, showing external validation. Additionally, we demonstrated that first-year surgical residents could achieve performance levels that match or exceed those of senior residents and experienced surgeons on these exercises with 4 weeks of training.
PURPOSE: The purpose of this study was to perform external validation, examine educational effectiveness, and confirm construct validity of a previously developed "intermediate-level, proficiency-based knot-tying and suturing curriculum" in preparing residents to achieve proficiency in more advanced open surgical techniques. METHODS: A total of 47 postgraduate year-1 (PGY-1) surgery residents completed 6 intermediate-level knot-tying and suturing exercises. Baseline trainee performance was compared with intermediate and senior (PGY-3 and PGY-4) residents (n = 12) and expert faculty (n = 4). RESULTS: PGY-1 overall proficiency increased from 21.1% at baseline to 92.1% during posttest for all 6 exercises combined (p < 0.001). When compared with the PGY-3 and PGY-4 residents, at baseline intermediate and senior residents scored higher on half of the exercises. However, during posttesting PGY-1 residents not only matched, but also surpassed PGY-3 and PGY-4 residents' performance in 3 of 6 exercises. Significant differences on all 6 exercises were also found during pretesting when comparing interns against faculty, demonstrating construct validity. However, upon completion of the curriculum, PGY-1 residents' posttest scores were equivalent, if not significantly better than expert faculty performance. CONCLUSION: We obtained similar results as those previously reported, showing external validation. Additionally, we demonstrated that first-year surgical residents could achieve performance levels that match or exceed those of senior residents and experienced surgeons on these exercises with 4 weeks of training.
Keywords:
Patient Care; Practice-Based Learning and Improvement; Systems-Based Practice; curriculum development and implementation; open knot-tying and suturing skills; proficiency-based skills training; simulation-based surgical training
Authors: Madeline Lemke; Hillary Lia; Alexander Gabinet-Equihua; Guy Sheahan; Andrea Winthrop; Stephen Mann; Gabor Fichtinger; Boris Zevin Journal: Surg Endosc Date: 2019-07-08 Impact factor: 4.584