title: The rationale for combining an online audiovisual curriculum with simulation to better educate general surgery trainees.
abstract: BACKGROUND
  Surgery interns' training has historically been weighted toward patient care, operative observation, and sleeping when possible. With more protected free time and less clinical time, real educational hours for trainees in 2013 are precious.
  
  
  METHODS
  We created a 20-session (3 hours each) simulation curriculum (with pre- and post-tests) and a 24/7 online audiovisual (AV) curriculum for surgery interns. Friday morning simulation sessions emphasize operative skills and judgment. AV clips (using operating room, whiteboard, and simulation center videos) take learners through 20 different general surgery operations with follow-up quizzes. We report our early experience with this novel setup.
  
  
  RESULTS
  Thirty-two surgical interns (2012-2013) attended simulation sessions on 20 separate subjects (hernia, breast, hepatobiliary, endocrine, etc). Post-test scores improved (P < .05) and trainees enjoyed using surgical skills for 3 hours each Friday morning (mean, >4.5; Likert scale, 1-5). The AV curriculum feedback is similar (mean, >4.3) and usage is available 24/7 preparing learners for both operating room and simulation sessions. Most simulation sessions utilize low-fidelity models to keep costs <$50 per session. Scores on our semiannual Surgical Olympics (mean score of 49.6 in July vs 82.9 in January; P < .05) improved significantly, suggesting that interns are improving their surgical skills and knowledge.
  
  
  CONCLUSIONS
  Residents enjoy and learn from the step-by-step, in-house, AV curriculum and both appreciate and thrive on the 'hands-on' simulation sessions mimicking operations they see in real operating rooms. The cost of these programs is not prohibitive and the programs offer simulated repetitions for duty-hour-regulated trainees.
authors.affiliation: Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Yazan N
authors.initials: YN
authors.lastname: AlJamal
authors.affiliation: Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Shahzad M
authors.initials: SM
authors.lastname: Ali
authors.affiliation: Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Raaj K
authors.initials: RK
authors.lastname: Ruparel
authors.affiliation: Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Rushin D
authors.initials: RD
authors.lastname: Brahmbhatt
authors.affiliation: Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Siddhant
authors.initials: S
authors.lastname: Yadav
authors.affiliation: Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN. Electronic address: farley.david@mayo.edu.
authors.forename: David R
authors.initials: DR
authors.lastname: Farley
mesh_terms: D001296:Audiovisual Aids; D002983:Clinical Competence; D003198:Computer Simulation; D003194:Computer-Assisted Instruction / Q000379:methods*; D003479:Curriculum; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D017145:Models, Educational; D005791:Patient Care; D013514:Surgical Procedures, Operative / Q000193:education*