Harvesting the 'SEAD': Long-Term Follow-Up of the Surgical Exploration and Discovery Program

Attitudes of Canadian medical students towards surgical training and perceived barriers to surgical careers: a multicentre survey

Background

Medical student interest in surgical specialties continues to decline. This study aims to characterize attitudes of Canadian medical students towards surgical training and perceived barriers to surgical careers.

Methods

An anonymous survey was custom designed and distributed to medical students at the University of Alberta and University of Calgary. Survey questions characterized student interest in surgical specialties, barriers to pursuing surgery, and influence of surgical education opportunities on career interest.

Results

Survey engagement was 26.7% in 2015 and 24.2% in 2021. General surgery had the highest rate of interest in both survey years (2015: 38.3%, 2021: 39.2%). The most frequently reported barrier was worry about the stress that surgical careers can put on personal relationships (2015: 70.9%, 2021: 73.8%, p= 0.50). Female respondents were significantly more likely to cite gender discrimination as a deterrent to surgical careers (F: 52.0%, M: 5.8%, p < 0.001).

Conclusions

Despite substantial interest, perception of work-life imbalance was the primary reported barrier to surgical careers. Further, female medical students' awareness of gender discrimination in surgery highlights the need for continued efforts to promote gender inclusivity within surgical disciplines to support early career women interested in surgery.

Transforming the "SEAD": Evaluation of a Virtual Surgical Exploration and Discovery Program and its Effects on Career Decision-Making

OBJECTIVE

The abrupt cessation of in-person education due to the COVID-19 pandemic has made it difficult for preclerkship students to explore a career in surgery. To supplement the lack of exposure, the Surgical Exploration and Discovery (SEAD) program was transitioned to an entirely virtual format. This study aims to describe the virtual SEAD program and evaluate its effectiveness as a career decision-making (CDM) intervention.

DESIGN

The week-long program was delivered on Microsoft Teams, featured 11 surgical specialties, and comprised four activities: live demonstrations, virtual operating room observerships, career talks, and technical skills workshops. The program was evaluated using the four levels of the Kirkpatrick model: (1) reactions, (2) knowledge, (3) CDM behaviors - assessed using the Career Decision-making Difficulties Questionnaire (CDDQ) - and (4) results. The latter was indirectly assessed using CDDQ scores from an in-person SEAD program, where lower CDDQ scores indicate less difficulty with CDM.

SETTING

Faculty of Medicine at the University of Ottawa in Ontario, Canada.

PARTICIPANTS

Forty pre-clerkship students (27 first and 13 second year students) at the University of Ottawa RESULTS: Level 1: 97.5% of participants rated the program as good or very good. Live demonstration and technical skills workshops were the highest rated activities. Level 2: participants' scores on knowledge-based questions about a surgical career significantly increased following the program (pre: 9/25 vs post: 15/25, p = 0.008). Level 3: overall mean CDDQ scores (±SD) decreased difficulties with significantly following the program (pre: 45.6 ± 10.5 vs post: 38.8 ± 10.9, p < 0.001), which indicates decreased CDM difficulties. Level 4: Except for one sub-category, the difference in mean CDDQ scores between the virtual and in-person programs were not significantly different.

CONCLUSION

The program received the positive reactions and significantly increased participants' knowledge. The change in CDDQ scores following the virtual program suggests it may reduce career decision-making difficulties in the short-term. In-person surgical exposure remains important; however, a hybrid model may be valuable in resource limited settings. WC: 300.

Impact of Early Exposure to Simulation Program on Undergraduate Medical Students' Interest in Urology

BACKGROUND

Urological education is as important as surgical training for undergraduates. However, students in undergraduate medical schools have less exposure to urology as their curriculum focuses more on clinical skills, particularly community-based healthcare for a super-aging society. This study aimed to evaluate whether urology-related hands-on training could increase the interest of undergraduate medical students in urology.

METHODS

A 1-day elective program in urological surgery at the University of Tsukuba, particularly in robotic, laparoscopic, and endoscopic surgeries, was offered to 85 fourth-year medical students from 2018 to 2020, prior to their clinical clerkship. The average age of the participants was 22 (range: 21-25) years. We used a scoring system that comprised 1-5 Likert-type items to assess training activity, interest in surgery, and interest in urology before and after the course.

RESULTS

Before attending the program, the average scores of interest in urology were 3.53 in 2018, 3.15 in 2019, and 3.00 in 2020. The scores in surgery increased after the program; however, this was not significantly different from scores prior to the program. However, the average interest scores in urology were significantly increased to 3.91 ± 0.63 (P < .05), 3.88 ± 0.58 (P < .01), and 4.00 ± 0.61 (P < 0.01) in 2018, 2019, and 2020, respectively. Total likely scores of this program in 2018, 2019, and 2020 were 4.59, 4.76, and 4.88, respectively, indicating a motivation to study surgery and urology during clinical clerkship.

CONCLUSIONS

Urological hands-on training facilitated interest in urology in medical students prior to their clinical clerkship.