The effect and durability of a pregraduation boot cAMP on the confidence of senior medical student entering surgical residencies.
OBJECTIVE
Medical school does not specifically prepare students for surgical internship. Preinternship courses are known to increase confidence in multiple key areas. We examined the immediate effect and durability of effect of a surgical pregraduation preparatory course or "boot camp" on provider confidence in technical and medical management skills.


METHODS
A 5-day boot camp was offered to senior medical students (SMS) entering surgical programs. SMS were anonymously surveyed before, after, and 6 months following the course. The same survey was given 6 months into internship to a control group of surgical interns who graduated from the same medical school but did not participate in boot camp before graduation. Data were compared between the time intervals and across cases and controls using the Wilcoxon rank-sum and signed-rank tests and the Student t test.


METHODS
A joint effort between the University of Pennsylvania School of Medicine, the Department of Surgery at the Hospital of the University of Pennsylvania, and the Penn Medicine Simulation Center in Philadelphia, PA.


METHODS
All senior medical students set to graduate from a single institution entering general surgery or surgery subspecialties were offered the course. Twenty-nine students participated in the course.


RESULTS
Post-boot camp confidence scores of SMS were significantly greater in all areas except placement of a peripheral intravenous catheter compared with pre-boot camp scores. Six months into internship, the SMS boot camp group felt more confident than controls in their ability to perform a cricothyroidotomy (median 2.5 vs 1.0, p = 0.04) and to insert a chest tube (median 3.3 vs 1.0, p = 0.05). Otherwise, there was no residual difference in confidence levels between the boot camp group and the controls.


CONCLUSIONS
Boot camps can improve self-confidence in young doctors in many areas of perioperative care before enrolling in surgical residency. The effect is most durable in high risk, infrequently performed technical tasks. Future studies are under design to examine the impact of boot camps on the "July Effect."
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. Okusanya@uphs.upenn.edu
Olugbenga T
OT
Okusanya
Zev N
ZN
Kornfield
Caroline E
CE
Reinke
Jon B
JB
Morris
Babak
B
Sarani
Noel N
NN
Williams
Rachel R
RR
Kelz
D000328:Adult; D001291:Attitude of Health Personnel; D002321:Career Choice; D002982:Clinical Clerkship / Q000458:organization & administration*; D002983:Clinical Competence; D003198:Computer Simulation; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods; D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D004521:Educational Measurement; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration; D008297:Male; D015143:Philadelphia; D018794:Problem-Based Learning; D016730:Program Development; D015397:Program Evaluation; D012649:Self Concept; D013337:Students, Medical / Q000523:psychology; D055815:Young Adult