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Performance Improvement With Implementation of a Surgical Skills Curriculum

OBJECTIVE: To assess the efficacy of an intern surgical skills curriculum involving a boot camp for core open and laparoscopic skills, self-guided practice with positive and negative incentives, and semiannual performance evaluations. DESIGN: Longitudinal cohort study. SETTING: Academic tertiary car...

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Autores principales: Loftus, Tyler J., Filiberto, Amanda C., Upchurch, Gilbert R., Hall, David J., Mira, Juan C., Taylor, Janice, Shaw, Christiana M., Tan, Sanda A., Sarosi, George A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Association of Program Directors in Surgery. Published by Elsevier Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462643/
https://www.ncbi.nlm.nih.gov/pubmed/32888847
http://dx.doi.org/10.1016/j.jsurg.2020.08.030
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author Loftus, Tyler J.
Filiberto, Amanda C.
Upchurch, Gilbert R.
Hall, David J.
Mira, Juan C.
Taylor, Janice
Shaw, Christiana M.
Tan, Sanda A.
Sarosi, George A.
author_facet Loftus, Tyler J.
Filiberto, Amanda C.
Upchurch, Gilbert R.
Hall, David J.
Mira, Juan C.
Taylor, Janice
Shaw, Christiana M.
Tan, Sanda A.
Sarosi, George A.
author_sort Loftus, Tyler J.
collection PubMed
description OBJECTIVE: To assess the efficacy of an intern surgical skills curriculum involving a boot camp for core open and laparoscopic skills, self-guided practice with positive and negative incentives, and semiannual performance evaluations. DESIGN: Longitudinal cohort study. SETTING: Academic tertiary care center. PARTICIPANTS: Intervention group (n = 15): residents who completed the intern surgical skills curriculum and had performance evaluations in fall of intern year, spring of intern year, and fall of second year. Control group (n = 8): second-year residents who were 1 year ahead of the intervention group in the same residency program, did not participate in the curriculum, and had performance evaluations in fall of second year. RESULTS: In fall of second year of residency, the intervention group had better performance (presented as median values with interquartile ranges) than the control group on one-hand ties (left hand: 9.1 [6.3-10.1] vs 14.6 [13.5-15.4] seconds, p = 0.007; right hand: 8.7 [8.5-9.6] vs 11.5 [9.9-16.8] seconds, p = 0.039). The intervention group also had better performance on all open suturing skills, including mattress suturing (vertical: 33.4 [30.0-40.0] vs 55.8 [50.0-67.6] seconds, p = 0.001; horizontal: 28.7 [27.3-39.9] vs 52.7 [40.7-57.8] seconds, p = 0.003), and a water-filled glove clamp, divide, and ligate task (28.0 [25.0-31.0] vs 59.1 [53.0-93.0] seconds, p < 0.001). Finally, the intervention group had better performance on all laparoscopic skills, including peg transfer (66.0 [59.0-82.0] vs 95.2 [87.5-101.5] seconds, p = 0.018), circle cut (82.0 [69.0-124.0] seconds vs 191.8 [155.5-231.5] seconds, p = 0.002), and intracorporeal suturing (195.0 [117.0-200.0] seconds vs 359.5 [269.0-450.0] seconds, p = 0.002). CONCLUSIONS: Implementation of a comprehensive surgical skills curriculum was associated with improved performance on core open and laparoscopic skills. Further research is needed to understand and optimize motivational factors for deliberate practice and surgical skill acquisition.
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spelling pubmed-74626432020-09-02 Performance Improvement With Implementation of a Surgical Skills Curriculum Loftus, Tyler J. Filiberto, Amanda C. Upchurch, Gilbert R. Hall, David J. Mira, Juan C. Taylor, Janice Shaw, Christiana M. Tan, Sanda A. Sarosi, George A. J Surg Educ Original Reports OBJECTIVE: To assess the efficacy of an intern surgical skills curriculum involving a boot camp for core open and laparoscopic skills, self-guided practice with positive and negative incentives, and semiannual performance evaluations. DESIGN: Longitudinal cohort study. SETTING: Academic tertiary care center. PARTICIPANTS: Intervention group (n = 15): residents who completed the intern surgical skills curriculum and had performance evaluations in fall of intern year, spring of intern year, and fall of second year. Control group (n = 8): second-year residents who were 1 year ahead of the intervention group in the same residency program, did not participate in the curriculum, and had performance evaluations in fall of second year. RESULTS: In fall of second year of residency, the intervention group had better performance (presented as median values with interquartile ranges) than the control group on one-hand ties (left hand: 9.1 [6.3-10.1] vs 14.6 [13.5-15.4] seconds, p = 0.007; right hand: 8.7 [8.5-9.6] vs 11.5 [9.9-16.8] seconds, p = 0.039). The intervention group also had better performance on all open suturing skills, including mattress suturing (vertical: 33.4 [30.0-40.0] vs 55.8 [50.0-67.6] seconds, p = 0.001; horizontal: 28.7 [27.3-39.9] vs 52.7 [40.7-57.8] seconds, p = 0.003), and a water-filled glove clamp, divide, and ligate task (28.0 [25.0-31.0] vs 59.1 [53.0-93.0] seconds, p < 0.001). Finally, the intervention group had better performance on all laparoscopic skills, including peg transfer (66.0 [59.0-82.0] vs 95.2 [87.5-101.5] seconds, p = 0.018), circle cut (82.0 [69.0-124.0] seconds vs 191.8 [155.5-231.5] seconds, p = 0.002), and intracorporeal suturing (195.0 [117.0-200.0] seconds vs 359.5 [269.0-450.0] seconds, p = 0.002). CONCLUSIONS: Implementation of a comprehensive surgical skills curriculum was associated with improved performance on core open and laparoscopic skills. Further research is needed to understand and optimize motivational factors for deliberate practice and surgical skill acquisition. Association of Program Directors in Surgery. Published by Elsevier Inc. 2021 2020-09-01 /pmc/articles/PMC7462643/ /pubmed/32888847 http://dx.doi.org/10.1016/j.jsurg.2020.08.030 Text en © 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Reports
Loftus, Tyler J.
Filiberto, Amanda C.
Upchurch, Gilbert R.
Hall, David J.
Mira, Juan C.
Taylor, Janice
Shaw, Christiana M.
Tan, Sanda A.
Sarosi, George A.
Performance Improvement With Implementation of a Surgical Skills Curriculum
title Performance Improvement With Implementation of a Surgical Skills Curriculum
title_full Performance Improvement With Implementation of a Surgical Skills Curriculum
title_fullStr Performance Improvement With Implementation of a Surgical Skills Curriculum
title_full_unstemmed Performance Improvement With Implementation of a Surgical Skills Curriculum
title_short Performance Improvement With Implementation of a Surgical Skills Curriculum
title_sort performance improvement with implementation of a surgical skills curriculum
topic Original Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462643/
https://www.ncbi.nlm.nih.gov/pubmed/32888847
http://dx.doi.org/10.1016/j.jsurg.2020.08.030
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