Assessing Surgical Training and Deliberate Practice Methods in Dermatology Residency: A Survey of Dermatology Program Directors.

Abstract

Resident surgical education and technical skills may be enhanced with deliberate practice-based learning. Deliberate practice methods, such as simulation-based training and formal skills-based assessments, allow for trainees to repeatedly practice a defined task with expert supervision and feedback. The authors sought to characterize how surgical skills are taught and assessed in dermatology residency, with an emphasis on whether deliberate practice methods are incorporated in the surgical curriculum. A survey was administered to program directors at 117 Accreditation Council for Graduate Medical Education-approved dermatology residency programs during 2013 to 2014. A total of 42 responses (36%) were collected. Over half of programs (57%) devote 10 to 30 hours each year to surgical didactics. Sixty-nine percent of programs use simulation models, and 62% of programs use formal assessment-guided feedback in evaluating surgical skills. Residents most commonly assume the role of primary surgeon in excisional surgery (100%) and less commonly in graft and flap reconstruction (52% and 52%, respectively). Twenty-nine percent of residents are the primary surgeons in Mohs micrographic surgery. Dermatology residency programs are incorporating deliberate practice-based tenets in the surgical curriculum. These results provide a benchmark for programs to assess and improve the quality of dermatologic surgery training.