Undergraduate pediatric surgery objectives: goal and reality.

Abstract

Educational objectives can be used both in the standardization of curricula and in their evaluation. Surveys of subspecialty objectives can clarify educational priorities and identify areas of proficiency and deficiency.
Fifty-one third-year and 56 fourth-year medical students were surveyed on their perceived mastery level of 60 pediatric surgery cognitive objectives. The same objectives were also used to survey 34 pediatric surgeons and 126 practicing family physicians. Physicians' expected and students' self-reported proficiency was scored for each objective from 0 (not required/unaware of condition) to 3 (confident with diagnosis and management of condition). Information regarding pediatric surgery instruction was also obtained from the undergraduate deans of 12 Canadian medical schools. Data were analyzed using descriptive methods and one-way analysis of variance (ANOVA) and were compared with existing objectives listings in the subspecialty.
Students' familiarity scores increased significantly from third-year to fourth-year (P < .05), and approximated in fourth year the expected proficiency levels. Family physicians' and pediatric surgeons' expectations were remarkably similar. Eleven items were identified by both physician groups as nonessential (mean score < 1.5), whereas 29 were perceived as essential (score > 2.0). The fourth-year students' perceived knowledge of all but 3 of these 29 objectives was adequate. Comparison of the data with previous objectives listings showed similar expected competencies. Deans' data showed varied but mostly limited exposure to pediatric surgery in the undergraduate curriculum.
The current study has allowed a revision of undergraduate objectives in pediatric surgery based on broad stakeholder input. It has also clarified both the expected and the perceived student mastery of these objectives, and identified areas of specific stress required. The results can be used toward establishing a unified, reliable, undergraduate curriculum for pediatric general surgery.