Designing, implementing, and evaluating a basic surgical skills bootcamp: An effective approach to enhance competency in surgical residency training.

INTRODUCTION: Recent technological advances have facilitated the development of new educational methods, such as simulation-based learning, in specialized bootcamps to enhance the learning of surgical residents. This study aimed to design, implement, and evaluate a basic surgical skills bootcamp for residents in general surgery, orthopedics, neurosurgery, and gynecology based on the learning gap in the current educational program. METHODS: This intervention study focused on the design, implementation, and evaluation of a basic surgical skills bootcamp in a simulated operating room for first-year surgical residents in general surgery, orthopedics, neurosurgery, and gynecology. RESULTS: The study resulted in the creation of a comprehensive course plan and the execution of a 6-day training program. Evaluation of educational outcomes confirmed high learner satisfaction, improvement in Multiple Choice Questions (MCQ) exam scores, and acceptable scores in the Objective Structured Clinical Examination (OSCE). CONCLUSION: The findings of this study suggest that surgical bootcamps, when designed based on needs assessment and in line with scientific bootcamp design principles, play a crucial role in enhancing the satisfaction, knowledge, and skills of surgical residents.

The Surgical Skills and Technology Elective Program and Medical Student Career Choice.

INTRODUCTION: The Surgical Skills and Technology Elective Program (SSTEP) is a bootcamp for preclinical medical students that uses simulation learning methodology to provide exposure to procedural specialties and enhance surgical skills. Despite the widespread adoption of similar bootcamps, evidence is lacking regarding their impact on students' decision to pursue surgical/procedural careers. METHODS: This exploratory analysis consisted of a retrospective, cross-sectional assessment of SSTEP involving a survey examining engagement during clerkship rotations and career decision-making was sent to all SSTEP participants since the program's inception (n = 184). In addition, publicly available data through the Canadian Resident Matching Service (CaRMS) were used to compare match data between all SSTEP participants who have participated in the CaRMS match (n = 144) and students in corresponding years who did not participate in SSTEP (n = 351). RESULTS: Seventy-four SSTEP participants (40.2%) responded to the survey. Of the respondents, the majority agreed or strongly agreed that SSTEP influenced participants to engage in more procedural opportunities during clerkship (73%) and that they felt more confident performing procedural tasks during clerkship because of SSTEP (92%). Fifty percent of participants agreed that their anxiety decreased regarding clinical specialty decision. Thirty percent of participants indicated that SSTEP influenced them to pursue a procedural career. Examination of CaRMS data showed that 42% of SSTEP participants matched into direct-entry procedural specialties compared with 32% of non-SSTEP graduating medical students at our institution (P = 0.048). CONCLUSIONS: Our analysis supports the utility of preclerkship surgical bootcamps. By providing early exposure to procedural skills, SSTEP promoted engagement with procedural skills during clerkship. Participation in SSTEP influenced student career choice, which may have contributed to the increased match rate into procedural specialties for SSTEP participants.

The Next Surgical Skills and Technology Elective Program: The "Surgical Skills and Technology Elective Program" Decreases Cognitive Load During Suturing Tasks in Second Year Medical Students.

OBJECTIVE: The Surgical Skills and Technology Elective Program (SSTEP) is a one-week, simulation-based procedural skills bootcamp for preclinical medical students. Using cognitive load (CL) as a useful framework for understanding simulation in medical education, our aims were to (1) examine the ability of SSTEP to decrease medical students' CL during procedural skills training and (2) determine the impact of SSTEP on secondary learning. METHODS: In this prospective cohort study, twenty SSTEP participants and twenty controls were recruited. CL was assessed during a simple suturing task and a clinical vignette multitasking activity, where participants were required to suture and concurrently listen to a clinical vignette. CL was measured using the validated Subjective Rating of Mental Effort (SRME) and its impact on working memory was assessed using a knowledge test about the clinical vignette. RESULTS: Participants reported lower SRME scores while suturing following SSTEP, which persisted at 3 months (p = 0.002) and were significantly lower than controls (p = 0.031). Participants also reported lower SRME scores during the clinical vignette multitasking activity (p = 0.011), despite no improvement among controls (p = 0.63). Participants significantly outperformed controls on the clinical vignette knowledge test (p = 0.02). CONCLUSIONS: Surgical skills training through SSTEP was associated with lower reports of mental effort and increased performance on secondary learning tasks. Procedural skills bootcamps may better prepare students for the complex learning environments encountered during clinical clerkship.

Technical skill improvement with surgical preparatory courses: What advantages are reflected in residency?

INTRODUCTION: Sustainability of skill acquisition gained from graduating medical student (GMS) preparatory courses remains uncertain. GMS skills were assessed before (T1) and after a preparatory course (T2) and then again 2 (T3) and 4 (T4) months into residency and compared to surgical interns without such a course. METHODS: In April, GMS took the preparatory course. In July-August all interns participated in a basic skills curriculum. Learners completed four technical exercises pre/post each course. Three surgeons scored performances. GMS scores were compared across the 4 time points. Control interns were compared at T3 and T4. RESULTS: Thirty-two interns completed all pre/post course assessments (T3 and T4); seven of those were GMSs. GMS scores increased from 74.5%(T1) to 94.2%(T2) (p < 0.001), and were maintained into residency. Control interns also improved (65.8%(T3) to 91.8%(T4), p < 0.001). GMS-interns scored higher starting residency compared to control interns (T3, 89.08% vs 65.03%, p < 0.001). CONCLUSIONS: These findings support existing literature and demonstrate that students maintain their skills into residency. Preparatory courses provide a head start. Without such course, interns require a steep learning curve.

The Surgical Skills and Technology Elective Program (SSTEP): A comprehensive simulation-based surgical skills initiative for preclerkship medical students.

BACKGROUND: The Surgical Skills and Technology Elective Program (SSTEP) is a voluntary preclerkship surgical bootcamp that uses simulation learning to build procedural knowledge and technical skills before clerkship. METHODS: Eighteen second year students (n = 18) participated in simulation workshops over the course of 7 days to learn clerkship-level procedural skills. A manual was supplied with the program outline. Assessment of the participants involved: 1) a written exam 2) a single videotaped Objective Structured Assessment of Technical Skill (OSATS) station 3) an exit survey to document changes in career choices. RESULTS: Compared to the mean written pre-test score students scored significantly higher on the written post-test (35.83 ± 6.56 vs. 52.11 ± 5.95 out of 73) (p = 0.01). Technical skill on the OSATS station demonstrated improved performance and confidence following the program (10.10 vs. 17.94 out of 25) (p = 0.05). Most participants (72%) re-considered their choices of surgical electives. CONCLUSIONS: A preclerkship surgical skills program not only stimulates interest in surgery but can also improve surgical knowledge and technical skills prior to clerkship.