title: The usefulness of the surgical knowledge and skills acquired via the university curriculum for doctors' medical practice several years after graduation.
abstract: BACKGROUND
  Teaching surgery during university curriculum comprises transferring theoretical knowledge traditionally and simultaneously acquiring manual skills, i.e., suturing, stitch removal, limb immobilization, catheterization, and assisting operations. Observations of doctors several years after graduation led to the reflection that teachers' ideas about surgical knowledge and skills that are useful in daily practice frequently fail to meet the facts of the case. The objective of this study was to determine which part of the surgical knowledge and skills taught via the university surgical curriculum proved to be useful in the daily practice of young doctors.
  
  
  METHODS
  A custom-made questionnaire was designed and mailed to 200 randomly chosen doctors who had graduated from the medical faculty at the authors' university 5 to 6 years previously. The questionnaire comprised 9 items concerning the knowledge and skills that proved to be the most useful in participants' daily practice, regardless of their specialty.
  
  
  RESULTS
  A total of 64 completed questionnaires were returned (32% of 200 sent) and were the subject of analysis. The most useful knowledge in daily practice was that acquired from general surgery, followed by oncological and vascular surgery. The most useful was knowledge about the rational interpretation of clinical symptoms and signs acquired from examination of the patient, followed by arriving at an accurate diagnosis through logical analysis, and next developing "oncological sensitivity" to diagnosing neoplasms. The most effective teaching model was specialized outpatient clinic rounds, followed by training manual skills on a model and classical ward-round teaching. The most frequently learned (acquired) manual skills were removal of stitches, rectal examination, and examination of the abdomen. Of these skills, the most useful in daily practice appeared to be removal of stitches, catheterization of the urinary bladder, and wound suturing. Learning and practicing manual skills followed by classical ward-round teaching was considered "skill-/competency-oriented teaching" surgery by all respondents.
  
  
  CONCLUSIONS
  The results of this study show some discrepancy between the knowledge and skills taught during university surgical curriculum and their actual usefulness in the daily practice of graduates. Awareness of this should have an effect on modification of the curriculum and methods for undergraduate surgery teaching.
authors.affiliation: Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland. Electronic address: azyluk@hotmail.com.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Zyluk
authors.affiliation: Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Puchalski
authors.affiliation: Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Szlosser
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004501:Education, Medical / Q000592:standards*; D013502:General Surgery / Q000193:education*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017145:Models, Educational; D011044:Poland; D011795:Surveys and Questionnaires
keywords: Medical Knowledge; Practice-Based Learning and Improvement; Systems-Based Practice; competency-based training; curriculum assessment; surgery clerkship; surgical education