Resident Designed Intern Orientation to Address the New ACGME Common Program Requirements for Resident Supervision

• Published in: Journal of surgical education 2013-05, Vol.70 (3), p.350-356
• Main Authors: Rialon, Kristy L., MD, Barfield, Michael E., MD, Elfenbein, Dawn M., MD, Lunsford, Keri E., MD, Tracy, Elisabeth T., MD, Migaly, John, MD
• Format: Article
• Language: English
• Subjects: Accreditation; ACGME competencies; Adult; Clinical Competence; competency assessment; Education, Medical, Graduate - methods; Educational Measurement; Female; General Surgery - education; Humans; intern orientation; Internship and Residency; Male; Patient Care; Practice-Based Learning and Improvement; supervision; Surgery; System-Based Practice; United States
• ISSN: 1931-7204; 1878-7452
• DOI: 10.1016/j.jsurg.2012.11.015

Objective To design an orientation for surgical interns to meet the new Accreditation Council for Graduate Medical Education Common Program Requirements regarding supervision, to test patient-management competencies, and to assess confidence on skills and tasks pre-orientation and post-orientation. Design Twenty-seven incoming surgical interns participated in a two-day orientation to clinical duties. Activities included a pre-test, lectures, simulation, oral examination, intern shadowing, and a post-test. Incoming interns were surveyed before and after orientation and two months later for confidence in patient-management and surgical intern skills. Paired t -tests were used to determine if confidence improved pre-orientation and post-orientation, and two months following orientation. Setting The study took place at an academic training hospital. Participants All ( n = 27) postgraduate year-1 (PGY-1) surgical residents at our institution, which included the categorical and nondesignated preliminary general surgery, urology, orthopedic surgery, otolaryngology, and neurosurgery programs. Results All interns passed the oral and written examinations, and were deemed able to be indirectly supervised, with direct supervision immediately available. They reported increased confidence in all areas of patient management addressed during orientation, and this confidence was retained after two months. In surgical and floor-related tasks and skills, interns reported no increase in confidence directly following orientation. However, after two months, they reported a significant increase in confidence, particularly in those tasks that are performed often. Conclusions New requirements for resident supervision require creative ways of verifying resident competency in basic skills. This type of orientation is an effective way to address the new requirements of supervision and teach interns the tasks and skills that are necessary for internship.