title: A cadaveric procedural anatomy course enhances operative competence.
abstract: BACKGROUND
  Inadequate anatomy training has been cited as a major contributor to declines in surgical resident operative competence and confidence. We report the impact of a procedurally oriented general surgery cadaveric dissection course on trainee-operative confidence and competence.
  
  
  METHODS
  After obtaining institutional review board approval, postgraduate year 2 and 3 general surgery residents were prospectively enrolled into two cohorts: (1) an intervention group (n = 7) participating in an 8-wk procedurally oriented cadaver course and (2) controls (n = 7) given access to course materials without participation in cadaver dissection. At both the beginning and end of the study, we used two evaluation instruments: (1) an oral examination using standardized templates and (2) a questionnaire assessing operative confidence.
  
  
  RESULTS
  There were no intergroup differences in baseline characteristics, including number of operative procedures performed to date. Residents who took the anatomy course had significantly higher improvements in examination scores on common bile duct exploration (mean ± standard error, 33 ± 8% versus 10 ± 7%, P = 0.04), femoral endarterectomy (43 ± 5% versus 11 ± 7%, P = 0.003), fasciotomies (55 ± 10% versus 22 ± 9%, P = 0.04), inguinal hernia repair (20 ± 9% versus -14 ± 5%, P = 0.005), superior mesenteric artery embolectomy (38 ± 10% versus 2 ± 11%, P = 0.04), and in overall examination scores (31 ± 4% versus 8% ± 3%, P = 0.0006). In addition, they reported higher operative confidence on common bile duct exploration (P = 0.008) and superior mesenteric artery embolectomy (P = 0.02), and a trend toward higher overall operative confidence (P = 0.06).
  
  
  CONCLUSIONS
  In this study, we demonstrate that a procedurally oriented cadaver course covering a wide range of essential general surgery procedures resulted in significant improvements in self-reported operative confidence and competence as assessed by oral examination.
authors: Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts.
authors: Gaurav
authors: G
authors: Sharma
authors: Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts.
authors: Mario A
authors: MA
authors: Aycart
authors: Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts.
authors: Peter A
authors: PA
authors: Najjar
authors: Department of Radiology, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts.
authors: Trudy
authors: T
authors: van Houten
authors: Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts.
authors: Douglas S
authors: DS
authors: Smink
authors: Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts.
authors: Reza
authors: R
authors: Askari
authors: Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts. Electronic address: jgates@partners.org.
authors: Jonathan D
authors: JD
authors: Gates
mesh_terms: D000715:Anatomy / Q000193:education*; D002102:Cadaver; D002983:Clinical Competence; D013502:General Surgery / Q000193:education*; D006801:Humans; D011446:Prospective Studies
keywords: Anatomy; Cadaver; Oral examination; Surgical education