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Improved Strategies for Teaching Surgical Skills to Medical Students: Simulation and Beyond
a curriculum to optimize surgical skills and to increase operating room (OR)
opportunities for medical students.
Background: Simulation-based strategies for teaching surgical skills are evolving.
Using an innovative task trainer, we compared one-on-one deliberate practice to
video-based self-guidance in the performance of two-handed knot tying and
subcuticular suturing during the OBGYN clerkship.
Methods: A randomized prospective trial compared two groups of third year medical
students in the same clerkship rotations. Group A received one-on-one
deliberate practice undergoing three sessions with an instructor and Group B
received unlimited access to video-based self-guided practice over six weeks.
At the end of the clerkship, surgical performance was assessed using the
validated checklist. Self-reported data regarding OR experience was collected
using a specifically designed phone application.
Results: Fifty-nine students participated in the study. Group A demonstrated a
statistically significant improvement in two-handed knot tying and subcuticular
suturing in pre-post assessments (knot-tying +4.34, p<0.001; suturing +19.4,
p<0.001). Group B demonstrated a statistically significant improvement
(knot-tying +6.03, p<0.001; suturing +22.3, p<0.001). No significant
differences were found between groups in overall knot-tying (p=0.13), suturing
(p=0.14), hours practiced (p=0.90), or number of OR cases (p=0.49).
Discussions: The use
of simulation significantly improved surgical skills for all students from
baseline. No differences were found between one-on-one deliberate practice and
video-based self-guided practice. Both instructional strategies provided equal
efficacy in teaching surgical skills and optimizing surgical performance for
students during the OBGYN clerkship.
CREOG & APGO Annual Meeting, 2018, Student, Resident, Faculty, Clerkship Director, Patient Care, GME, Simulation, Independent Study, General Ob-Gyn,