H. Hasan¹, M. Malinowski¹, M. Goldblatt¹, R. Treat¹, T. Carver¹, L. Olson¹, P. Redlich^{1  1}Medical College Of Wisconsin,Milwaukee, WI, USA

Introduction:  The transition from medical student to surgical intern is difficult, generating strong interest in preparing students through “boot camp” training and simulation in medical school. These boot camps increase students’ confidence, but the impact on performance at the start of residency requires further study. We studied basic surgical procedures in interns and compared the skills of those who had boot camp training as medical students to those without a boot camp course. 

Methods:  In our single institution study, twelve interns starting in multiple specialties completed a questionnaire regarding prior boot camp and skills training experiences as fourth-year medical students. During our June, 2016, Protected Block Curriculum, each intern was assessed for suturing (18 one-point items), knot tying (16 one-point items), overall performance (1 five-point item), and quality (1 five-point item) by three surgical faculty members using standardized evaluation forms published by the ACGME. Faculty raters were blinded to the interns’ responses about prior training. The primary outcome of our study is the impact of medical school boot camp on performance of surgical skills. Descriptive statistics are reported with medians (Mdn) and interquartile ranges (IQR). Secondary outcomes included association of various skills via Spearman rho correlations and inter-rater reliability using intraclass correlation coefficients (ICC). All analysis generated with IBM^® SPSS^® 23.0.

Results: Six out of 12 interns reported previous boot camp training during medical school. Interns in the boot camp group had higher suturing scores (Mdn (IQR)=15.0 (3.2)) than interns without boot camp (Mdn (IQR)=13.0 (5.2)), p<0.048. Knot tying scores trended higher in the boot camp group (Mdn (IQR)=12.0 (4.0) vs. 9.0 (5.3)), but the difference was not statistically significant (p<0.081). Overall performance and quality were similar in the two groups (p<0.34 and p<0.41), respectively. The number of boot camp days, the number of dedicated practice hours, and having “supervised instruction” as a student were not associated with improved scores in any variable. There was a strong association in scores for suturing, knot tying, overall performance and quality (range of Spearman rho=0.63-0.86, all p<0.001). The surgical faculty rated the interns in knot tying (ICC=0.51, p<0.001) and quality (ICC=0.40, p<0.003) in a consistent manner, and somewhat consistently in rating suturing (ICC=0.29, p<0.016) and overall performance (ICC=0.24, p<0.041).

Conclusion: Boot camp training during medical school may improve basic skills performance measured at the start of residency. Boot camp courses in medical schools should be strongly encouraged for students entering surgical specialties.