title: Education of the modern surgical resident: novel approaches to learning in the era of the 80-hour workweek.
abstract: BACKGROUND
  Implementation of the 80-hour work week has resulted in limitations on the hours available for resident education, creating a need for innovative approaches to teach surgical residents successfully. Herein we report the methods and results of an innovative didactic learning program at a large academic surgical residency program.
  
  
  METHODS
  Between 2004 and 2005, based on known principles of adult education and innovative learning techniques, a didactic learning program was instituted in a major academic surgery program. The course work consisted of a structured reading program using Schwartz's Textbook of Surgery, with weekly testing and problem-based learning (PBL) groups led by surgical faculty. The residents' progress was assessed by American Board of Surgery In-Training Examination (ABSITE) training scores before and after program implementation. A resident survey was also conducted to assess residents' attitudes toward the new program. Results were reported as a mean, and categoric variables were compared using a paired Student's t-test.
  
  
  RESULTS
  During the academic year of the structured reading program, the mean ABSITE score improved by 10% (P=0.02) from the previous year. The postgraduate year 4 class had the largest change, with a score increase of 17% over the previous year's performance (P=0.02). Survey results demonstrated that 64% of the responders agreed that the small-group PBL was preferable for achieving educational goals. Furthermore, 89% of residents responded that the PBL groups improved interaction between residents and faculty members.
  
  
  CONCLUSIONS
  An innovative formal learning program based on a major surgical textbook with weekly testing and small group sessions can significantly improve surgical training in the modern era of work-hour restrictions. Furthermore, surgical trainees find this format to be innovative and useful for improving didactic teaching.
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, Texas 77030, USA.
authors.forename: Liz
authors.initials: L
authors.lastname: Nguyen
authors.forename: F Charles
authors.initials: FC
authors.lastname: Brunicardi
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Dibardino
authors.forename: Bradford G
authors.initials: BG
authors.lastname: Scott
authors.forename: Samir S
authors.initials: SS
authors.lastname: Awad
authors.forename: Ruth L
authors.initials: RL
authors.lastname: Bush
authors.forename: Mary L
authors.initials: ML
authors.lastname: Brandt
mesh_terms: D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D018794:Problem-Based Learning; D013663:Teaching / Q000379:methods*; D016526:Workload