Skills coaches as part of the educational team: A randomized controlled trial of teaching of a basic surgical skill in the laboratory setting

Department of Surgery, University of Rochester, Rochester, NY, USA.
American journal of surgery (Impact Factor: 2.29). 01/2010; 199(1):94-8. DOI: 10.1016/j.amjsurg.2009.08.016
Source: PubMed


The aim of this study was to compare the laboratory teaching of a basic technical skill by a nonphysician skills coach and a faculty surgeon.
Medical students were randomized to instruction of skin suturing in the skills laboratory by a faculty surgeon or by a nonphysician skills coach. Testing of performance occurred at 3 time points. Other faculty surgeons, blinded to identities and training groups, rated performance.
Forty-nine students participated. Baseline fourth-year student mean scores showed no significant difference between training groups. Third-year and fourth-year student performance showed no difference between training groups on postintervention testing. Delayed testing also showed no difference in third-year student scores.
Training by either a nonsurgeon skills coach or a faculty surgeon resulted in no difference in performance on a basic surgical skill. This was true for students with and without prior experience and was also true after subsequent clinical experiences. Nonphysician coaches may ease the teaching burden of surgical faculty members while providing similar quality of instruction for trainees.

10 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: In the last 2 decades, surgical education has experienced a transformative paradigm shift from the purely service-based Halstedian system to a curriculum-driven model based on educational theory. With the advent of minimally invasive surgery and its educational challenges, fostered by the simultaneously occurring rapid advances of computer technology and graphics and further promoted by rising concerns about patient safety, simulation and skills training has become a well-established tool in the arsenal of the surgical educator. Although most training institutions now have access to skills laboratories and simulation centers, running and integrating these facilities into the surgical curriculum remains a challenge. This article outlines general principles that are relevant for training facilities of all sizes and covers aspects from the initial phase of planning and establishing the center until its ultimately successful integration into the surgical education program.
    Surgical Clinics of North America 06/2010; 90(3):491-504. DOI:10.1016/j.suc.2010.02.003 · 1.88 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The Consortium of American College of Surgeons-Accredited Education Institutes was created to explore new opportunities in simulation-based surgical education and training beyond the scope of individual accredited institutes. During the Third Annual Meeting of the Consortium of American College of Surgeons-Accredited Education Institutes Consortium, 4 work groups addressed the validation and transfer of surgical skills, the use of nonsurgeons as faculty, the use of simulation to screen and select surgery residents, and long-term follow-up of learners. The key elements from the deliberations and conclusions are summarized in this manuscript.
    Surgery 02/2011; 149(6):735-44. DOI:10.1016/j.surg.2010.11.010 · 3.38 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The American College of Surgeons/Association of Program Directors in Surgery Phase 1 Curriculum (ACS/APDS) includes evaluation of basic surgical skills for junior residents. It is unclear if basic surgical skills evaluation is incorporated into residency curricula or used for resident advancement decisions. Our aim was to identify the perceptions of general surgery program directors (PDs) on the importance of basic surgical skills training and evaluation. Thirty PDS were invited to participate in a telephone interview. PDs were chosen for diversity of program location and size and asked to comment on their use and perceptions of basic surgical skills curricula, and evaluation. Twenty-two interviews were conducted with 23 of the total 30 invited PDs who agreed to participate. The mean number of residents graduating annually was 6 (range 2 to 12) per program. Ten of 22 (45%) PDs used the ACS/APDS curriculum, and 5 (23%) PDs were unaware of its existence. Only 4 programs (18%) perform formal basic surgical skills evaluation with mandatory remediation. No PD would either prevent residents with demonstrable poor basic surgical skills from going to the operating room or use poor basic surgical skills as a reason to deny promotion. One institution required evidence of satisfactory central line placement skills for credentialing. Obstacles to implementation of basic surgical skills included a lack of time, resources, and validated tests. Sixteen (73%) PDs saw some value in skills evaluation generally, but only 41% saw basic surgical skills evaluation as important for junior residents. Implementation of a summative evaluation of skills will require considerable resources for PDs. This study suggests that scarce resources might be more usefully directed toward evaluation of operative skills of senior residents.
    Journal of the American College of Surgeons 03/2011; 212(3):406-12. DOI:10.1016/j.jamcollsurg.2010.12.012 · 5.12 Impact Factor
Show more

Similar Publications