G. Kwakye1, X. Chen1, J. Havens1, J. Irani1, D. S. Smink1 1Brigham And Women’s Hospital,Department Of Surgery,Boston, MA, USA
Introduction: Traditionally, surgical training utilized an apprenticeship-model but has more recently moved to a service-based model, with groups of residents working with groups of attending surgeons. We developed an apprenticeship rotation to encourage more one-on-one interaction between residents and faculty. We hypothesized that the apprenticeship-model would be effective for teaching non-technical skills (NTS) and core competencies.
Methods: Surgery chief residents from two consecutive classes at a single institution identified a preceptor to work with over a dedicated one-month rotation. Emphasis was placed on acquiring the 4 non-technical ACGME core competencies- Interpersonal Skills and Communication (ISC), Practice-based Learning and Improvement (PBLI), Professionalism (Prof), and Systems-based Practice (SBP). Participants were surveyed anonymously afterwards about their rotation.
Results: 100% (13/13) residents and 67% (8/12) faculty completed the survey. 84.6% of residents and 87.5% of faculty would recommend the rotation to others. Both groups felt that technical skills (TS) and NTS improved. However, there was a trend for faculty to find the rotation more useful at teaching NTS than TS (NTS: mean 4.63, median 5.0; TS: mean 3.63, median 4.0; p<0.06). Residents reported improvement in all 4 non-technical competencies, particularly PBLI, Prof, and ICS. 85% felt the skills obtained were relevant to their intended career or fellowship training.
Conclusion: The apprenticeship-model is an effective means of teaching residents both TS and NTS essential for independent practice. Faculty and residents, however, differ on the area of greatest impact, with faculty reporting greater improvement in non-technical competencies. Consideration should be given to introducing this program into surgical curricula nation-wide and expansion to other residents.