Association for Surgical EducationAcquiring basic surgical skills: Is a faculty mentor really needed?
Section snippets
Study population and group assignment
First- and second-year (R1 and R2) surgical residents, both preliminary and categorical, were recruited to participate in the study during a dedicated rotation in which residents have time protected for laboratory-based technical skills training. Study procedures were performed over the course of 12 months at the University of Washington Institute for Surgical and Interventional Simulation. Participation in basic skills training and subsequent task performance were required by the residency
Results
Forty-five surgical residents participated in the study. Confounding factors were not significantly different between groups (Table 1). Prior surgical experience was homogenous among residents and was not suitable for inclusion as a covariate in the statistical model. Most residents had performed a significant number of skin closures and few had performed a bowel anastomosis. Inter-rater reliability of skin closure esthetic quality composite scores was acceptable (Cronbach α = .8). Significant
Comments
This study was designed to help elucidate the effect of 8 hours of expert-directed basic technical skills instruction as a function of differential transfer of learned skills to more complex tasks. Other studies of transfer of training after isolated partial-task simulation have shown the following: (1) correlation between performance on a laboratory model and operating room performance for saphenofemoral dissection; (2) equivalence between cadaver-based training and low-fidelity bench models
Conclusions
The addition of an expert mentor to a day-long basic technical skills training laboratory did not result in objective improvements in the performance of 2 more complex tasks. Indeed, outcomes for skin closure and bowel anastomosis were similar among residents who had acquired 14 basic skills by self-directed practice when compared with those who acquired those skills under faculty-directed supervision. In this context, we must question the utility of using valuable faculty time. Other contexts
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None of the authors has received financial support or has a conflict of interest related to this study to disclose.
University of Washington Human Subjects Approval # 06-1593-E/A 01.