A Novel Critical Skills Curriculum for Surgical Interns Incorporating Simulation Training Improves Readiness for Acute Inpatient Care

• Published in: Journal of surgical education 2009-09, Vol.66 (5), p.248-254
• Main Authors: Antonoff, Mara B., MD, Shelstad, Ryan C., MD, Schmitz, Connie, PhD, Chipman, Jeffrey, MD, D'Cunha, Jonathan, MD
• Format: Article
• Language: English
• Subjects: Adult; Clinical Competence; Computer Simulation; Computer-Assisted Instruction - methods; Critical Care - methods; Critical Illness - therapy; Curriculum; education; Education, Medical, Graduate - methods; Educational Measurement; Female; Humans; internship; Internship and Residency; Interpersonal and Communication Skills; Male; Medical Knowledge; Patient Care; Patient Simulation; Practice-Based Learning and Improvement; Problem-Based Learning - methods; Surgery; United States
• ISSN: 1931-7204; 1878-7452
• DOI: 10.1016/j.jsurg.2009.09.002

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.