Purpose: Previous data suggest that formal, structured preparation might improve knowledge and skills of senior medical students (SMSs) as they transition to surgical residency. However, subsequent impact on clinical performance has not been demonstrated.
Method: The authors developed a comprehensive course for SMSs entering surgical residencies and studied the impact of the course on the subsequent performance of 2010 graduates (n = 22) compared with matched peers (16 nonparticipant controls at authors' home institution and 24 nonparticipant peer controls at outside institutions; total n = 62). Through pre- and postcourse surveys, knowledge tests, and technical examinations, they measured confidence and skill acquisition in 32 specific, job-related tasks. They followed participants and matched peers into internship and collected performance evaluations from supervising senior residents to determine whether course graduates would display performance advantages in these same tasks. The authors used t tests for all comparisons, α = 0.05.
Results: Participants demonstrated marked improvement in task-specific confidence in all 32 tasks from course beginning to end, with improved scores on written and technical skill examinations. Further, course participants outperformed peers in all 32 tasks in July, with their performance advantage predictably dissipating into the third month of residency. There was a marked correlation between confidence and competence in all tasks.
Conclusions: Competency-based preparation for surgical internship resulted in objective gains in task-specific confidence and test performance at course conclusion, translating to improved performance and better patient care upon residency matriculation. These data emphasize the significant impact of formally preparing SMSs before graduation.
Dr. Antonoff is chief resident in general surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota.
Dr. Swanson is senior resident in general surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota.
Ms. Green is a medical student, Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota.
Dr. Mann is program director, Lankenau Surgical Residency Program, Department of Surgery, Lankenau Hospital, Wynnewood, Pennsylvania, and professor of surgery, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania.
Dr. Maddaus is program director, General Surgery Residency Program, and Garamella Lynch Jensen Professor of Surgery, Division of Thoracic and Foregut Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota.
Dr. D'Cunha is associate program director, General Surgery Residency Program, associate program director, Thoracic Surgery Training Program, and assistant professor of surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota.
Please see the end of this article for information about the authors.
Correspondence should be addressed to Dr. D'Cunha, 420 Delaware St, SE, Mayo Mail Code 207, Minneapolis, MN 55455; telephone: (612) 624-3277; fax: (612) 625-9657; e-mail: firstname.lastname@example.org.
First published online January 25, 2012