Education of the modern surgical resident: novel approaches to learning in the era of the 80-hour workweek.
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.
Nguyen
Liz
L
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, Texas 77030, USA.
Brunicardi
F Charles
FC
Dibardino
Daniel J
DJ
Scott
Bradford G
BG
Awad
Samir S
SS
Bush
Ruth L
RL
Brandt
Mary L
ML
D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D018794:Problem-Based Learning; D013663:Teaching / Q000379:methods*; D016526:Workload