Early, intermediate, and late effects of a surgical skills "boot camp" on an objective structured assessment of technical skills: a randomized controlled study.
BACKGROUND
Surgical interns enter residency with variable technical abilities and many feel unprepared to perform necessary procedures. We hypothesized that interns exposed to a preinternship intensive surgical skills curriculum would demonstrate improved competency over unexposed colleagues on a test of surgical skills and that this effect would persist throughout internship.


METHODS
We designed a 3-day intensive skills "boot camp" with simulation-based training on 10 topics. Interns were randomized to an intervention group (boot camp) or a control group (no boot camp). All interns completed a survey including demographic information, previous experience, and comfort with basic surgical skills. Both groups completed a clinical skills assessment focused on 4 topics: chest tube insertion, central line placement, wound closure, and the Fundamentals of Laparoscopic Surgery peg transfer task. We assessed both groups immediately (month 0), early postcurriculum (month 1), and late postcurriculum (month 6).


RESULTS
Fifteen participants were in the intervention group and 13 were in the control group. Before boot camp, mean comfort levels were similar for the groups. All participants had minimal prior experience. Competency for chest tube insertion and central line placement were considerably higher for the boot camp group at months 0 and 1, although much of this difference disappeared by month 6. There was no substantial difference between the 2 groups in the Fundamentals of Laparoscopic Surgery peg transfer and wound closure skills.


CONCLUSIONS
A surgical skills boot camp accelerates the learning curve for interns in basic surgical skills as measured by a technical skills examination for some skills, although these improvements diminished over time. This can augment traditional training and translate into fewer patient errors.
Department of Surgery, Stanford University Medical Center, 780 Welch Road, Stanford, CA 94024, USA.
Richard J
RJ
Parent
Timothy A
TA
Plerhoples
Eliza E
EE
Long
Danielle M
DM
Zimmer
Mediget
M
Teshome
Catherine J
CJ
Mohr
Daphne P
DP
Ly
Tina
T
Hernandez-Boussard
Myriam J
MJ
Curet
Sanjeev
S
Dutta
D000328:Adult; D000818:Animals; D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008348:Manikins; D013647:Task Performance and Analysis