title: The significant impact of a competency-based preparatory course for senior medical students entering surgical residency.
abstract: OBJECTIVE
  Previous data suggest that formal, structured preparation might improve knowledge and skills of senior medical students (SMSs) as they transition to surgical residency. However, subsequent impact on clinical performance has not been demonstrated.
  
  
  METHODS
  The authors developed a comprehensive course for SMSs entering surgical residencies and studied the impact of the course on the subsequent performance of 2010 graduates (n = 22) compared with matched peers (16 nonparticipant controls at authors' home institution and 24 nonparticipant peer controls at outside institutions; total n = 62). Through pre- and postcourse surveys, knowledge tests, and technical examinations, they measured confidence and skill acquisition in 32 specific, job-related tasks. They followed participants and matched peers into internship and collected performance evaluations from supervising senior residents to determine whether course graduates would display performance advantages in these same tasks. The authors used t tests for all comparisons, α = 0.05.
  
  
  RESULTS
  Participants demonstrated marked improvement in task-specific confidence in all 32 tasks from course beginning to end, with improved scores on written and technical skill examinations. Further, course participants outperformed peers in all 32 tasks in July, with their performance advantage predictably dissipating into the third month of residency. There was a marked correlation between confidence and competence in all tasks.
  
  
  CONCLUSIONS
  Competency-based preparation for surgical internship resulted in objective gains in task-specific confidence and test performance at course conclusion, translating to improved performance and better patient care upon residency matriculation. These data emphasize the significant impact of formally preparing SMSs before graduation.
authors.affiliation: Department of Surgery, University of Minnesota Medical School, Minneapolis, USA.
authors.forename: Mara B
authors.initials: MB
authors.lastname: Antonoff
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Swanson
authors.forename: Courtney A
authors.initials: CA
authors.lastname: Green
authors.forename: Barry D
authors.initials: BD
authors.lastname: Mann
authors.forename: Michael A
authors.initials: MA
authors.lastname: Maddaus
authors.forename: Jonathan
authors.initials: J
authors.lastname: D'Cunha
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004521:Educational Measurement; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D016555:Matched-Pair Analysis; D008910:Minnesota; D013043:Specialties, Surgical / Q000193:education*