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Hillemans V, Buyne O, de Blaauw I, Botden SM, Verhoeven BH, Joosten M. Self-assessment, and not continuous training, improves basic open suturing skills. MEDICAL EDUCATION ONLINE 2024; 29:2374101. [PMID: 38950187 PMCID: PMC11218580 DOI: 10.1080/10872981.2024.2374101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 06/25/2024] [Indexed: 07/03/2024]
Abstract
BACKGROUND To develop and maintain suturing skills, clinical exposure is important. When clinical exposure cannot be guaranteed, an adequate training schedule for suturing skills is required. This study evaluates the effect of continuous training, 'reflection before practice' and self-assessment on basic open suturing skills. METHODS Medical students performed four basic suturing tasks on a simulation set up before ('pre-test') and after their surgical rotation ('after-test'). Participants were divided in three groups; the 'clinical exposure group' (n = 44) had clinical exposure during their rotation only, the 'continuous training group' (n = 16) completed a suturing interval training during their rotation and the 'self-assessment group' (n = 16) also completed a suturing interval training, but with the use of reflection before practice and self-assessment. Parameters measured by a tracking system during the suturing tasks and a calculated 'composite score' were compared between groups and test-moments. RESULTS A significantly better composite score was found at the after-test compared to the pre-test for all groups for all basic suturing tasks (0.001 ≤ p ≤ 0.049). The self-assessment group scored better at the pre-test than the other two groups for all tasks, except for 'knot tying by hand' (0.004 ≤ p ≤ 0.063). However, this group did not score better at the after-test for all tasks, compared to the other two groups. This resulted in a smaller delta of time ('transcutaneous suture', p = 0.013), distance ('Donati suture' and 'intracutaneous suture', 0.005 ≤ p ≤ 0.009) or composite score (all tasks, except for knot tying by hand, 0.007 ≤ p ≤ 0.061) in the self-assessment group. CONCLUSION Reflection before practice and self-assessment during continuous training of basic open suturing tasks, may improve surgical skills at the start of the learning curve.
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Affiliation(s)
- Vera Hillemans
- Department of Surgery, Radboudumc, Nijmegen, The Netherlands
| | - Otmar Buyne
- Department of Surgery, Radboudumc, Nijmegen, The Netherlands
| | - Ivo de Blaauw
- Department of Pediatric Surgery, Radboudumc – Amalia Children’s hospital, Nijmegen, The Netherlands
| | | | - Bas H. Verhoeven
- Department of Surgery, Radboudumc, Nijmegen, The Netherlands
- Department of Pediatric Surgery, Radboudumc – Amalia Children’s hospital, Nijmegen, The Netherlands
| | - Maja Joosten
- Department of Surgery, Radboudumc, Nijmegen, The Netherlands
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Fu MZ, Islam R, DeMarzo J, Lichtbroun B, Tabakin AL, Park JH, Elsamra SE. The Boot Camp Model in Urology: Preparing PGY1 Urology Interns for Practice. Curr Urol Rep 2023; 24:553-559. [PMID: 37749358 DOI: 10.1007/s11934-023-01186-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to highlight literature regarding resident boot camps published across surgical specialties with a focus on urology. Herein, we discuss different boot camp iterations, their results, and the integration of simulation into their curriculum. We review program elements such as curriculum, course length, and efficacy as well as areas for continued investigation. RECENT FINDINGS The field of urology has grown in both the breadth of knowledge and the complexity of procedures. With urology now being an integrated surgical subspecialty, interns often start on the urology service despite limited experience navigating this unique specialty. The boot camp model is one method by which interns and junior residents participate in consolidated training programs to best prepare them for a patient-facing role and the day-to-day demands of residency. Urology programs, both in the USA and abroad, have begun integrating boot camps into their training programs with positive results. Urology boot camps can be a valuable part of training programs for interns to quickly establish medical knowledge, skills, and efficiency. Boot camps should be easily accessible, have sufficient support from institutions, and provide effective training through various methods such as didactics and simulation.
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Affiliation(s)
- Melinda Z Fu
- Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, Suite 4100, New Brunswick, NJ, 08901, USA
| | - Raeesa Islam
- Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, Suite 4100, New Brunswick, NJ, 08901, USA
| | - Joseph DeMarzo
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Benjamin Lichtbroun
- Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, Suite 4100, New Brunswick, NJ, 08901, USA
| | - Alexandra L Tabakin
- Division of Female Pelvic Medicine and Reconstructive Surgery, Donald and Barbara Zucker School of Medicine and Hofstra/Northwell, Great Neck, NY, USA
| | - Ji Hae Park
- Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, Suite 4100, New Brunswick, NJ, 08901, USA
| | - Sammy E Elsamra
- Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, Suite 4100, New Brunswick, NJ, 08901, USA.
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Baird R, Puligandla P, Lopushinsky S, Blackmore C, Krishnaswami S, Nwomeh B, Downard C, Ponsky T, Ghani MO, Lovvorn HN. Virtual curriculum delivery in the COVID-19 era: the pediatric surgery boot camp v2.0. Pediatr Surg Int 2022; 38:1385-1390. [PMID: 35809106 PMCID: PMC9455938 DOI: 10.1007/s00383-022-05156-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE We evaluated the impact of a virtual Pediatric Surgery Bootcamp curriculum on resource utilization, learner engagement, knowledge retention, and stakeholder satisfaction. METHODS A virtual curriculum was developed around Pediatric Surgery Milestones. GlobalCastMD delivered pre-recorded and live content over a single 10-h day with a concluding social hour. Metrics of learner engagement, faculty interaction, knowledge retention, and satisfaction were collected and analyzed during and after the course. RESULTS Of 56 PS residencies, 31 registered (55.4%; 8/8 Canadian and 23/48 US; p = 0.006), including 42 learners overall. The virtual BC budget was $15,500 (USD), 54% of the anticipated in-person course. Pre- and post-tests were administered, revealing significant knowledge improvement (48.6% [286/589] vs 66.9% [89/133] p < 0.0002). Learner surveys (n = 14) suggested the virtual BC facilitated fellowship transition (85%) and strengthened peer-group camaraderie (69%), but in-person events were still favored (77%). Program Directors (PD) were surveyed, and respondents (n = 22) also favored in-person events (61%). PDs not registering their learners (n = 7) perceived insufficient value-added and concern for excessive participants. CONCLUSIONS The virtual bootcamp format reduced overall expenses, interfered less with schedules, achieved more inclusive reach, and facilitated content archiving. Despite these advantages, learners and program directors still favored in-person education. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Robert Baird
- Department of Pediatric Surgery, BC Children’s Hospital University of British Colombia, Ambulatory Care Bldg, K0-134, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada
| | - Pramod Puligandla
- Department of Pediatric Surgery, Montreal Children’s Hospital, McGill University, Montreal, CA Canada
| | - Steven Lopushinsky
- Section of Pediatric Surgery, Alberta Children’s Hospital, University of Calgary, Calgary, CA Canada
| | - Christopher Blackmore
- Division of Pediatric General and Thoracic Surgery, IWK Health Centre, Dalhousie University, Halifax, NS Canada
| | - Sanjay Krishnaswami
- Division of Pediatric Surgery, Doernbecher Children’s Hospital, Oregon Health and Science University, Portland, OR USA
| | - Benedict Nwomeh
- Department of Pediatric Surgery, Nationwide Children’s Hospital, Ohio State University, Columbus, OH USA
| | - Cynthia Downard
- Division of Pediatric Surgery, Hiram C Polk, Jr, MD Department of Surgery, University of Louisville, Norton Children’s Hospital, Louisville, KY USA
| | - Todd Ponsky
- Division of Pediatric Surgery, Cincinnati Children’s Hospital, University of Cincinnati, Cincinnati, OH USA
| | - Muhammad O. Ghani
- Department of Pediatric Surgery, Monroe Carell, Jr. Children’s Hospital at Vanderbilt, Nashville, TN USA
| | - Harold N. Lovvorn
- Department of Pediatric Surgery, Monroe Carell, Jr. Children’s Hospital at Vanderbilt, Nashville, TN USA
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Zhang J, Zilundu PLM, Zhang W, Yu G, Li S, Zhou L, Guo G. The use of a surgical boot camp combining anatomical education and surgical simulation for internship preparedness among senior medical students. BMC MEDICAL EDUCATION 2022; 22:459. [PMID: 35705984 PMCID: PMC9202198 DOI: 10.1186/s12909-022-03536-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/08/2022] [Indexed: 05/06/2023]
Abstract
BACKGROUND Senior medical students feel unprepared for surgical procedures and care for surgery patients when they begin their internship. This study sought to introduce and evaluate a surgical boot camp training for senior medical students. METHODS A 44-h surgical boot camp program of lectures on clinical practice simulation, anatomical dissections, and simulated operation on cadavers was designed, implemented, and evaluated during the 2018 to 2019 academic year. A self-administered questionnaire was used to assess students' perceptions of the content, delivery, and self-confidence. The mini-Clinical Evaluation Exercise (mini-CEX) and the Operative Performance Rating System were used to assess skills essential to good clinical care and to facilitate feedback. RESULTS Over 93% of the students were satisfied with the surgical boot camp, training equipment, and learning materials provided. After six sessions of training, 85.3% reported gaining self-confidence and performed better in some surgical procedures such as major gastrectomy. The mini-CEX scores suggested significant improvement in the students' clinical skills, attitudes, and behaviors (P < 0.01). Ninety-eight percent of students felt that the anatomical knowledge taught met their needs. The scores of the Operative Performance Rating System suggested that the students' surgical skills such as instruments handling, incising, treatment of surrounding tissues (blood vessels, nerves), and smoothness of the whole operation had increased significantly following the surgical boot camp (All P < 0.01). CONCLUSION The surgical boot camp curriculum improved students' satisfaction and confidence in core clinical practice competencies. Therefore, medical schools the world over should continue to seek ways to bridge the gaps between pre-clinical, clinical, and internship training.
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Affiliation(s)
- Jifeng Zhang
- Department of Anatomy, Basic Medical College, Jinan University, Guangzhou, China
| | - Prince Last Mudenda Zilundu
- Department of Medical and Dental Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Department of Anatomy, Sun Yat-Sen School of Medicine, Sun Yat-Sen University, Shenzhen, China
| | - Wenbin Zhang
- Department of Surgery, The First Clinical Medical College, Jinan University, Guangzhou, China
| | - Guangyin Yu
- Department of Anatomy, Basic Medical College, Jinan University, Guangzhou, China
| | - Sumei Li
- Department of Anatomy, Basic Medical College, Jinan University, Guangzhou, China
| | - Lihua Zhou
- Department of Anatomy, Sun Yat-Sen School of Medicine, Sun Yat-Sen University, Shenzhen, China
| | - Guoqing Guo
- Department of Anatomy, Basic Medical College, Jinan University, Guangzhou, China.
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Farr DE, Zeh HJ, Abdelfattah KR. Virtual Boot Camps-An Emerging Solution to the Undergraduate Medical Education-Graduate Medical Education Transition. JAMA Surg 2021; 156:282-283. [PMID: 33404635 DOI: 10.1001/jamasurg.2020.6162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Deborah E Farr
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas
| | - Herbert J Zeh
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas
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Kassam AF, Singer KE, Winer LK, Browne D, Sussman JJ, Goodman MD, Makley AT. Acquisition and retention of surgical skills taught during intern surgical boot camp. Am J Surg 2020; 221:987-992. [PMID: 32981654 DOI: 10.1016/j.amjsurg.2020.09.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/11/2020] [Accepted: 09/11/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Surgical residencies have implemented boot-camps for early acquisition of basic technical skills for interns. However, educators worry that retention is poor. We hypothesized that a structured boot-camp curriculum would improve skills. METHODS Interns underwent eight boot-camp sessions at the beginning of residency. Interns completed pre-, post-boot-camp, and end-of-year skills assessments, as well as post-boot camp and end-of-year porcine procedure labs. Proficiency was measured on a 5-point scale and by completion time. RESULTS After boot-camp, interns improved all domains of knot-tying. Median time decreased for skin-closure (8.3 vs 9.9 min, p < 0.01), peg transfer (57 vs 87 s, p < 0.01), intracorporeal (178 vs 300 s, p < 0.01), and extracorporeal knot-tying (140 vs 259 s, p < 0.01). At the end-of-year assessment, interns exhibited retention of all skills and improved in knot-tying and central line skills. During the retention porcine lab, interns progressed basic but not complex skills. CONCLUSIONS An eight-week boot-camp effectively improved technical skills among surgery interns. Interns retained all skills and improved upon techniques frequently practiced during intern year.
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Affiliation(s)
- Al-Faraaz Kassam
- Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Kathleen E Singer
- Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Leah K Winer
- Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Deborah Browne
- Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Jeffrey J Sussman
- Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Michael D Goodman
- Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Amy T Makley
- Department of Surgery, University of Cincinnati, Cincinnati, OH, USA.
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McMillan R, Redlich PN, Treat R, Goldblatt MI, Carver T, Dodgion CM, Peschman JR, Davis CS, Alizadegan S, Grushka J, Olson L, Krausert T, Lewis B, Malinowski MJ. Incoming residents’ knot-tying and suturing skills: Are medical school boot camps sufficient? Am J Surg 2020; 220:616-619. [DOI: 10.1016/j.amjsurg.2020.01.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 01/13/2020] [Accepted: 01/18/2020] [Indexed: 10/25/2022]
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