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Surgery 10/2009; 146(3):398-409. · 3.10 Impact Factor
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ABSTRACT: Major changes in surgical practice and myriad external mandates have affected residency education in surgery. The traditional surgery residency education and training model has come under scrutiny, and calls for major reform of this model have been made by a variety of stakeholders. The American Surgical Association appointed a Blue Ribbon Committee in 2002 to consider the recent changes in surgical practice and surgical education and propose solutions that would ensure a well-educated and well-trained surgical workforce for the future. This committee included representatives from the American Surgical Association, the American College of Surgeons, the American Board of Surgery, and the Residency Review Committee for Surgery. The committee made several far-reaching recommendations relating to residency education in surgery. After the Blue Ribbon Committee completed its task in 2004, representatives from the aforementioned four organizations, the Association of Program Directors in Surgery, and the Association for Surgical Education created a national consortium called the Surgical Council on Resident Education (SCORE). This consortium is pursuing efforts to reform residency education in surgery and implement several key recommendations of the Blue Ribbon Committee. The principal area of focus of SCORE is the development of a national curriculum for surgery residency education and training. Other activities of SCORE include the development of a Web site to support surgery residency education and pursuit of international collaboration. SCORE's efforts will be key to offering surgery residents the best educational experiences, preparing residents for future practice, and supporting delivery of surgical care of the highest quality. The authors examine the current state of residency education in surgery and explore efforts underway to reform this educational model.
Academic Medicine 01/2008; 82(12):1200-10. · 3.52 Impact Factor
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ABSTRACT: This study assessed the reliability of surgical resident self-assessment in comparison with faculty and standardized patient (SP) assessments during a structured educational module focused on perioperative management of a simulated adverse event.
Seven general surgery residents participated in this module. Residents were assessed during videotaped preoperative and postoperative SP encounters and when dissecting a tumor off of a standardized inanimate vena cava model in a simulated operating room.
Preoperative and postoperative assessments by SPs correlated significantly (P < .05) with faculty assessments (r = .75 and r = .79, respectively), but not resident self-assessments. Coefficient alpha was greater than .70 for all assessments except resident preoperative self-assessments.
Faculty and SP assessments can provide reliable data useful for formative feedback. Although resident self-assessment may be useful for the formative assessment of technical skills, results suggest that in the absence of training, residents are not reliable self-assessors of preoperative and postoperative interactions with SPs.
American journal of surgery 01/2008; 195(1):1-4. · 2.36 Impact Factor
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ABSTRACT: BACKGROUND: The American College of Surgeons (ACS) and the Accreditation Council for Graduate Medical Education (ACGME) are committed to promoting patient safety through education. In view of the critical role of residents in the delivery of safe patient care, the ACS and ACGME sponsored jointly a national consensus conference to initiate the development of a curriculum on patient safety that may be used across all surgical residency programs. CONCLUSIONS: National leaders in surgery with expertise in surgical care and surgical education, patient safety experts, medical educators, key stakeholders from national organizations, and surgical residents were invited to participate in the conference. Attendees considered patient safety issues within the context of the 6 core competencies defined by the ACGME and American Board of Medical Specialties (ABMS). Discussions resulted in the development of a curriculum matrix that includes listings of patient safety topics, teaching and learning strategies, and assessment methods. Guidelines for implementation and dissemination are also provided. The curriculum content underscores the need to create an organizational culture of safety and focuses on both individuals and systems. Individual residency programs may prioritize the curriculum content based on their specific needs. The ACS and ACGME will pursue development of educational modules to address the curriculum content, disseminate helpful information, and assist in implementation of new educational interventions. This effort has the potential to positively impact residency education in surgery, help surgical program directors address the core competencies, and enhance patient safety.
Surgery 05/2007; 141(4):427-41. · 3.10 Impact Factor
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ABSTRACT: This pilot project involved the development of a structured, experiential, educational module using a bench model technical skills simulation and standardized patients. It integrated teaching and assessment of clinical, technical, and interpersonal skills, as well as professionalism within the context of an adverse surgical event.
General surgery residents (postgraduate year [PGY] 2, 3) were asked to participate in the pre-, intra-, and postoperative management of a patient with a retroperitoneal sarcoma. Residents' performances during the module were assessed by standardized patients and faculty, and residents were provided feedback during debriefing sessions.
Resident performance during the module was appropriate for the level of training. Residents found this module to be a realistic, challenging, and beneficial learning experience.
Novel educational modules such as this one may serve as a useful addition to resident education in surgery residency programs, particularly in addressing patient safety and the core competencies. Reliability of the model may be enhanced by modifications of the module.
The American Journal of Surgery 12/2005; 190(5):687-90. · 2.78 Impact Factor
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Surgical Clinics of North America 01/2005; 84(6):1669-98, xii. · 2.14 Impact Factor
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Linda Barry, Patrice Gabler Blair,
Ellen M Cosgrove,
Richard L Cruess,
Sylvia R Cruess,
A Brent Eastman,
P Jeffrey Fabri,
Thomas D Kirksey,
Kathleen R Liscum,
Rosemary Morrison,
Ajit K Sachdeva,
David S Svahn,
Thomas R Russell,
Jamie Dickey,
Ross M Ungerleider,
Alden H Harken
Journal of the American College of Surgeons 12/2004; 199(5):736-40. · 4.55 Impact Factor
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ABSTRACT: To assess reactions by program directors (PDs) to a preview of a scenario from the Fundamentals of Surgery Curriculum (FSC), which is a case-based interactive curriculum developed by the American College of Surgeons's (ACS) Division of Education and designed to be delivered online to first-year (PGY-1) surgical residents.
After previewing a scenario, each PD completed a questionnaire requesting age and ratings of comfort using computers, the scenario's utility in addressing 9 educational goals (eg, provides a solid foundation for future learning), and 6 separate features of the scenario (eg, ease of use and feasibility). All ratings were based on a 1-9 scale. For items related to educational goals, ratings were anchored: 1-3 = poor/needs revision; 4-6 = adequate/as good as current methods; 7-9 = excellent/superior to current methods. Informal discussions were also conducted and comments were collected.
October 2007 ACS Clinical Congress.
In all, 31 PDs participated in the study.
Most PDs perceived that the scenario addressed 8 of the 9 educational goals in a manner superior to current methods [eg, provides a solid foundation for future learning (97%), challenges residents (90%), and delivers content consistent with current practices and/or evidence (90%)]. The mean ratings of all scenario features were 7 or greater on the 9-point scale.
Most PDs reacted very positively to a preview of FSC perceiving that it can address several important educational goals in a manner superior to existing methods. Comments from PDs suggest a high level of interest in incorporating FSC into their residency programs as well as participating in a coordinated multi-institutional evaluation project. The results provide baseline data concerning PD expectations of the utility of FSC that will help to guide and evaluate further developments and applications of this curriculum.
Journal of Surgical Education 65(6):470-5. · 1.38 Impact Factor
