title: Long-term impact of a preclinical endovascular skills course on medical student career choices.
abstract: OBJECTIVE
  Surging interest in the 0 + 5 integrated vascular surgery (VS) residency and successful recruitment of the top students in medical school requires early exposure to the field. We sought to determine the impact of a high-fidelity simulation-based preclinical endovascular skills course on medical student performance and ultimate career specialty choices.
  
  
  METHODS
  Fifty-two preclinical medical students enrolled in an 8-week VS elective course from 2007 to 2009. Students completed a baseline and postcourse survey and performed a renal angioplasty/stent procedure on an endovascular simulator (pretest). A curriculum consisting of didactic teaching covering peripheral vascular disease and weekly mentored simulator sessions concluded with a final graded procedure (posttest). Long-term follow-up surveys 1 to 3 years after course completion were administered to determine ultimate career paths of participants as well as motivating factors for career choice.
  
  
  RESULTS
  Objective and subjective performance measured on the simulator and through structured global assessment scales improved in all students from pre- to posttest, particularly with regard to technical skill and overall procedural competency (P < .001). Prior to enrolling in the course, 9% of the students expressed high interest in VS, and after completing the course, this response nearly tripled in terms of seriously considering VS as a career option (P = .03). Overall interest postcourse in VS and procedural-based surgical specialties was nearly 90%. In long-term follow-up, 25% were still strongly considering integrated VS residencies, with other top career choices including surgical subspecialties (64%), radiology (10%), and cardiology (6%). Most respondents indicated major reasons for continued interest in VS were the ability to practice endovascular procedures on the simulator (92%) and mentorship from VS faculty (70%).
  
  
  CONCLUSIONS
  Basic endovascular skills can be efficiently introduced through a simulation-based curriculum and lead to improved novice performance. Early exposure of preclinical medical students provides an effective teaching and recruitment tool for procedural-based fields, particularly surgical subspecialties. Mentored exposure to endovascular procedures on the simulator positively impacts long-term medical student attitudes toward vascular surgery and ultimate career choices.
authors: Division of Vascular Surgery, Stanford University Medical Center, 300 Pasteur Dr., Ste. H3600, Stanford, CA 94305, USA. jtlee@stanford.edu
authors: Jason T
authors: JT
authors: Lee
authors: Ji H
authors: JH
authors: Son
authors: Venita
authors: V
authors: Chandra
authors: Emily
authors: E
authors: Lilo
authors: Ronald L
authors: RL
authors: Dalman
mesh_terms: D000328:Adult; D017130:Angioplasty / Q000193:education* / Q000295:instrumentation; D002140:California; D002321:Career Choice; D002983:Clinical Competence; D003198:Computer Simulation; D003194:Computer-Assisted Instruction; D003479:Curriculum; D004504:Education, Medical, Undergraduate; D005260:Female; D006801:Humans; D008297:Male; D008611:Mentors; D009042:Motivation; D009048:Motor Skills; D012078:Renal Artery Obstruction / Q000628:therapy*; D015607:Stents; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D013997:Time Factors