Association for Surgical Education
Implementation of a Web- and simulation-based curriculum to ease the transition from medical school to surgical internship

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Abstract

Background

Starting a surgical internship is a stressful experience. We developed a web and simulation-based curriculum to ease this transition.

Methods

We created an educational website containing a curriculum of commonly encountered on call situations. After match day in 2003, we contacted all of our new surgical interns. We performed a confidence assessment using a Likert-scale questionnaire, and the trainees were given access to the curriculum. In June 2003, we performed human patient simulator sessions. The participants were asked to provide feedback regarding the simulator experience. During the first week of residency, they were again asked to answer the confidence questionnaire.

Results

Sixteen residents (94%) used the web curriculum, and 17 (100%) participated in the simulations. Eleven (65%) filled out both questionnaires. The confidence score improved from 5.4 to 6.7 (P < .0001).

Conclusions

A web and simulation-based curriculum for incoming house staff is feasible. Studies are underway to validate this novel method and to expand its use for surgical education.

Section snippets

Website and content development

We created a dynamic database-driven website using an open-source content management system [12]. We integrated a password-protected online curriculum that provided a general introduction to the residency program and 6 content sections on postoperative complications, including arrhythmias, hemorrhage, myocardial infarction, pulmonary edema, pulmonary embolism, and sepsis. The sections also contained external links to other resources available online.

In March 2003, all PGY I that had matched to

Results

Sixteen residents (94%) used the web curriculum for a total of 89 sessions (5.2 sessions per user, range 2 to 11). The users viewed an average of 8.6 web pages (range 1 to 59) per online sessions. The most popular content section was the page on myocardial infarction with 30 hits and an average viewing time of 203 seconds (Table 1).

Fifteen residents (88%) submitted confidence data before and 12 residents (71%) after completion of the curriculum. Eleven PGY I (65%) filled out both questionnaires

Comments

The recent changes in academic medicine have had a major impact on surgical education. Primarily economic factors have resulted in higher patient turnover and an increased clinical workload for faculty members. Concerns about patient safety as outlined in Kohn et al’s report [13] have triggered a paradigm shift for surgical residency programs and resulted in significantly shortened resident work hours. Even though these changes were implemented with good intention, they have caused a decrease

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