Playing the Surgical Technologist Role by Surgery Residents Improves Their Technical and Nontechnical Skills.

BACKGROUND: The present study was designed to implement and evaluate an interprofessional surgical technologist-to-surgical resident training program for junior general surgery residents aimed at enhancing their operating room skills. This program would be incorporated into the general surgery educational curriculum. MATERIAL AND METHODS: Under the guidance and supervision of a surgical technologist, first-year and second-year general surgery residents performed the perioperative and intraoperative tasks that are the responsibilities of the surgical technologist for 16 inguinal/umbilical hernia and 15 laparoscopic appendectomy/cholecystectomy operations performed by attending surgeons assisted by other surgical residents from June 01, 2017 until December 31, 2017. A pretraining and post-training survey comprised 25 ranked questions (using a four-point Likert scale), and four Yes/No questions were administered to volunteer general surgery residents. RESULTS: Paired t-test analysis showed that playing the role of the surgical technologist by the junior surgery residents significantly improved (P < 0.0001) their assessment of operating room technical skills (knowledge and skills to prepare for the case and maintain a sterile field, understanding of the operative steps, knowledge of surgical instruments and their handling) as well as their nontechnical skills (situational awareness, understanding the importance of collaboration, teamwork, and communication). The answers to the binary Yes/No questions showed that all participating residents expect to use the experience gained from this training, would recommend this training session to a colleague, and support including this training session in their educational curriculum. CONCLUSIONS: The findings of this study suggest a significant educational benefit of incorporating interprofessional, surgical technologist-to-surgical resident training into the educational curriculum of the junior general surgery residents.

Design and pilot test of an implicit bias mitigation curriculum for clinicians.

Introduction: Clinician implicit racial bias (IB) may lead to lower quality care and adverse health outcomes for Black patients. Educational efforts to train clinicians to mitigate IB vary widely and have insufficient evidence of impact. We developed and pilot-tested an evidence-based clinician IB curriculum, "REACHing Equity." Methods: To assess acceptability and feasibility, we conducted an uncontrolled one-arm pilot trial with post-intervention assessments. REACHing Equity is designed for clinicians to: (1) acquire knowledge about IB and its impact on healthcare, (2) increase awareness of one's own capacity for IB, and (3) develop skills to mitigate IB in the clinical encounter. We delivered REACHing Equity virtually in three facilitated, interactive sessions over 7-9 weeks. Participants were health care providers who completed baseline and end-of-study evaluation surveys. Results: Of approximately 1,592 clinicians invited, 37 participated, of whom 29 self-identified as women and 24 as non-Hispanic White. Attendance averaged 90% per session; 78% attended all 3 sessions. Response rate for evaluation surveys was 67%. Most respondents agreed or strongly agreed that the curriculum objectives were met, and that REACHing Equity equipped them to mitigate the impact of implicit bias in clinical care. Participants consistently reported higher self-efficacy for mitigating IB after compared to before completing the curriculum. Conclusions: Despite apparent barriers to clinician participation, we demonstrated feasibility and acceptability of the REACHing Equity intervention. Further research is needed to develop objective measures of uptake and clinician skill, test the impact of REACHing Equity on clinically relevant outcomes, and refine the curriculum for uptake and dissemination.ClinicalTrials.gov ID: NCT03415308.