J. Simon1, L. A. Bevilacqua1, D. Rutigliano1, S. Docimo1, J. Sorrento1, R. Verma1, A. Wackett2, L. Chandran3, M. Talamini1 1Stony Brook University Medical Center,Surgery,Stony Brook, NY, USA 2Stony Brook University Medical Center,Emergency Medicine,Stony Brook, NY, USA 3Stony Brook University Medical Center,Office Of The Dean,Stony Brook, NY, USA
Introduction: In recent years, boot camp courses for senior medical students have risen in popularity with the goal of improving preparation for residency. While studies have demonstrated increased student confidence after such boot camps, data is lacking on the impact of these courses on objective clinical skills. The American College of Surgeons (ACS) has developed a curriculum for use in such courses. This study aims to test the impact of a Surgical Boot Camp course using the ACS-based curriculum and objective, observer-based rating tools, on both subjective confidence and objective skills of fourth-year medical students.
Methods: Fourth-year medical students who had matched into surgical subspecialties were invited to participate in a two-week Surgical Boot Camp. Informed consent was obtained on the first day of the course. Prior to any teaching, students performed five tasks (patient handoff, suturing, knot tying, central line placement, and chest tube placement) which were scored using objective rating tools provided by the ACS. Students also completed two subjective confidence measures, the New General Self-Efficacy scale (NSGE) and a Task-Specific Confidence Scale (i.e., "How confident are you placing a central line"). Both measures used a 5-point likert scale. After two weeks of dedicated lectures, simulation, and cadaver-based anatomy review, students were scored on the same five tasks and repeated the confidence measures. To help avoid potential bias, each scorer graded a different skill at pre- and post-course testing, so that they were unaware of scores given by the previous assessor.
Results: Twelve students participated in the Boot Camp. Average age was 26.7 years; 25% of subjects were female. Subspecialties represented included general surgery (N=5) orthopedics (N=3), integrated plastics (N=2), urology (N=1), and neurosurgery (N=1). Scores on objective skills improved significantly in all five tasks at post-course testing (Table 1). Mean NSGE scores did not improve over the study period (4.49 vs. 4.46; p=0.866), however mean scores on task-specific confidence improved significantly (2.77 vs. 3.64; p<0.0010).
Conclusion: Implementation of a two-week, multimodal Surgical Boot Camp improved student performance on objectively-rated surgical skills and increased student confidence. Research is still lacking on whether, and for how long, these improvements persist into surgical residency. Future studies utilizing larger samples of students with matched controls are needed to confirm these findings and support the use of such boot camps in undergraduate medical education nationwide.
