Practical training for postgraduate year 1 surgery residents

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Abstract

Background: Surgical interns accept significant patient care responsibilities with minimal orientation. We have developed a multifaceted training program for incoming surgical interns in which learning in a simulated environment plays a key role. The purpose of this study was to evaluate resident perceptions of simulated clinical calls as an educational modality and to measure the effect on self-ratings of confidence.

Methods: A multidisciplinary team compiled 15 clinical scenarios. Simulated nurse-to-resident clinical call sessions were held on 3 separate days. Daily course evaluation surveys and identical precourse and postcourse confidence surveys were completed.

Results: The resident confidence measure increased significantly postcourse (6.73 versus 8.35, P <0.03). The evaluation survey score averaged 4.35 out of 5.

Conclusions: Simulated clinical call sessions were well received and resulted in a significant increase in resident confidence levels. Based on this modality’s apparent efficacy and ease of implementation, we offer it as a useful educational tool for incoming postgraduate year-1 surgical residents.

Section snippets

Methods

Eleven incoming surgical interns participated in the simulated clinical calls course and served as the study subjects. None of the subjects had previous surgical training, although 1 subject had 3 years of postgraduate clinical experience as a General Medical Officer in the United States Navy. The resident’s specialties are as follows: 4 categorical general surgery, 2 urology, 1 otolaryngology, 1 neurosurgery, 2 orthopedic surgery, and 1 preliminary general surgery.

Fifteen simulated

Results

All 11 subjects completed the course and surveys. The cumulative mean trainee confidence measure (n = 11) increased significantly (P <0.03) from a precourse value of 6.73 ± SD 1.23 to a postcourse value of 8.35 ± SD 0.84 (1 = no confidence, 10 = full confidence; Figure 1). Each of the 11 trainee’s mean confidence measure increased postcourse. The difference between individual postcourse and precourse mean confidence ratings ranged from 1.04 to 3.23 with an average difference of 2.02. In terms

Comments

One goal of this study was to measure the effect of simulated clinical calls sessions on resident’s (trainee’s) self-ratings of confidence. Our results show that interns’ confidence levels rose postcourse in all cases and the group’s mean confidence level rose significantly from 6.73 precourse to 8.35 postcourse (P <0.03).

These data suggest one outcome of the training course may be its effect on intern self-efficacy. Self-efficacy refers to the individual’s confidence in his or her ability to

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