Technical skills acquisition in surgery-bound senior medical students: an evaluation of student assertiveness.
OBJECTIVE
To prepare students pursuing surgical careers, we devised a senior subinternship curriculum supplement that focused on the acquisition of technical skills required of surgical residents. We hypothesized that more assertive students, those that accomplished more of the curriculum, would perform better on a technical skills Objective Structured Clinical Examination (OSCE).


METHODS
Senior medical students rotating on their first general surgery subinternship were administered a 6-station OSCE on the first day of their subinternship and again during the final week of the month-long rotation. A self-directed, 38-task "scavenger hunt" representing common intern level clinical skills, procedures, and patient care activities was provided to each student.


METHODS
The study was performed at Jefferson Medical College, a large, private medical school in Philadelphia, PA.


METHODS
Forty-nine senior students completed surgical subinternships between July 2009 and September 2010, and participated both in the pre-/post-OSCEs and the scavenger hunt.


RESULTS
Students performed significantly better on the post-rotation OSCE than on the pre-rotation OSCE; 70.2% ± 8.1% vs. 60.4% ± 12.0%, p < 0.0001. Assertiveness scores from the "scavenger hunt" did not correlate with final OSCE scores (r = -0.328, p = 0.25), and were negatively correlated with the change between pre- and post-OSCE scores (r = -0.573, p < 0.04). Individual student assertiveness scores were determined by the number of tasks completed over the course of the rotation.


CONCLUSIONS
As surgical education becomes more streamlined with evolving work hour restrictions, medical school education is playing an increasingly pivotal role in preparing students for internship. In our study, individual assertiveness in completing structured self-directed learning tasks did not directly predict the acquisition of proficiency in technical skills. We feel assertiveness is overshadowed by other factors that may carry more weight in terms of technical skills acquisition. Further studies are required to delineate these factors and ultimately enhance technical skills acquisition during medical school.
Department of Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
Vanessa A
VA
Talbott
Joshua A
JA
Marks
Adam S
AS
Bodzin
Jason A
JA
Comeau
Pinckney J
PJ
Maxwell
Gerald A
GA
Isenberg
Niels D
ND
Martin
D001242:Assertiveness; D002321:Career Choice; D002983:Clinical Competence; D015331:Cohort Studies; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D013502:General Surgery / Q000193:education*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D015143:Philadelphia; D013337:Students, Medical / Q000523:psychology*; D013997:Time Factors; D055815:Young Adult