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- Title
A Novel Paradigm for Surgical Skills Training and Assessment of Competency.
- Authors
Bowyer, Mark W.; Andreatta, Pamela B.; Armstrong, John H.; Remick, Kyle N.; Elster, Eric A.
- Abstract
<bold>Importance: </bold>Sustainment of comprehensive procedural skills in trauma surgery is a particular problem for surgeons in rural, global, and combat settings. Trauma care often requires open surgical procedures for low-frequency/high-risk injuries at a time when open surgical experience is declining in general and trauma surgery training.<bold>Objective: </bold>To determine whether general surgeons participating in a 2-day standardized trauma skills course demonstrate measurable improvement in accuracy and independent performance of specific trauma skills.<bold>Design, Setting, and Participants: </bold>General surgeons in active surgical practice were enrolled from a simulation center with anatomic laboratory from October 2019 to October 2020. Differences in pretraining/training and posttraining performance outcomes were examined using (1) pretraining/posttraining surveys, (2) pretraining/posttraining knowledge assessment, and (3) training/posttraining faculty assessment. Analysis took place in November 2020.<bold>Interventions: </bold>A 2-day standardized, immersive, cadaver-based skills course, developed with best practices in instructional design, that teaches and assesses 24 trauma surgical procedures was used.<bold>Main Outcomes and Measures: </bold>Trauma surgery capability, as measured by confidence, knowledge, abilities, and independent performance of specific trauma surgical procedures; 3-month posttraining skill transfer.<bold>Results: </bold>The study cohort included 65 active-duty general surgeons, of which 16 (25%) were women and 49 (75%) were men. The mean (SD) age was 38.5 (4.2) years. Before and during training, 1 of 65 participants (1%) were able to accurately perform all 24 procedures without guidance. After course training, 64 participants (99%) met the benchmark performance requirements for the 24 trauma procedures, and 51 (78%) were able to perform them without guidance. Procedural confidence and knowledge increased significantly from before to after the course. At 3 months after training, 37 participants (56%) reported skill transfer to trauma or other procedures.<bold>Conclusions and Relevance: </bold>In this study, direct measurement of procedural performance following standardized training demonstrated significant improvement in skill performance in a broad array of trauma procedures. This model may be useful for assessment of procedural competence in other specialties.
- Subjects
OPERATIVE surgery; CURRICULUM; CONTINUING medical education; EDUCATIONAL tests &; measurements; CLINICAL competence; TRAUMATOLOGY; DEAD
- Publication
JAMA Surgery, 2021, Vol 156, Issue 12, p1103
- ISSN
2168-6254
- Publication type
journal article
- DOI
10.1001/jamasurg.2021.4412