Residents' perspectives of the value of a simulation curriculum in a general surgery residency program: a multimethod study of stakeholder feedback.
BACKGROUND
Simulation has altered surgical curricula throughout residency programs. The purpose of this multimethod study was to explore residents' perceptions of simulation within surgical residency as relevant stakeholder feedback and program evaluation of the surgery simulation curriculum.


METHODS
Focus groups were held with a sample of surgery residents (n = 25) at a university-affiliated program. Residents participated in focus groups based on level of training and completed questionnaires regarding simulation curricula. Groups were facilitated by nonsurgeon faculty. Residents were asked: "What is the role of simulation in surgical education?" An interdisciplinary team recorded narrative data and performed content analyses. Quantitative data from questionnaires were summarized using descriptive statistics and frequencies.


RESULTS
Major themes from the qualitative data included: concerns regarding simulation in surgical education (28%), exposure to situations and technical skills in a low-stress learning environment (24%), pressure by external agencies (19%), an educational tool (17%), and quality assurance for patient care (12%). Laparoscopy and cadaver lab were the most prevalent simulation training during residency, in addition to trauma simulations, central lines/chest tubes/IV access, and stapling lab. In response to the statement: "ACGME should require a simulation curriculum in surgery residency," 52.1% responded favorably and 47.8% responded nonfavorably.


CONCLUSIONS
Residents acknowledge the value of simulation in patient safety, quality, and exposure to procedures before clinical experience, but remain divided on efficacy and requirement of simulation within curricula. The greater challenge to residency programs may be strategic implementation of simulation curricula within the right training context.
Department of Internal Medicine, Texas A&M Health Science Center, College of Medicine, Temple, TX, USA. hwehbejanek@swmail.sw.org
Hania
H
Wehbe-Janek
Colleen Y
CY
Colbert
Cara
C
Govednik-Horny
Bobbie Ann A
BA
White
Scott
S
Thomas
Mohsen
M
Shabahang
D000328:Adult; D002102:Cadaver; D003198:Computer Simulation / Q000592:standards*; D003194:Computer-Assisted Instruction / Q000592:standards*; D003479:Curriculum / Q000592:standards*; D004521:Educational Measurement; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D007721:Knowledge of Results, Psychological; D010535:Laparoscopy / Q000193:education; D008297:Male; D012649:Self Concept; D011795:Surveys and Questionnaires