Computer-based training initiatives for education in surgical decision making

Abstract

PurposeTo determine how computer-based training (CBT) can be integrated into a general surgical residency education program for training and assessing decision-making skills in surgery. MethodsBecause of the emphasis on the American Board of Surgery In-training Exam (ABSITE) and Qualifying Exam preparation, traditional paper-and-pencil multiple choice quiz format testing predominates within most surgical programs. However, decision skills also require training and assessment for residents. Established methods of oral examinations for practice testing require a significant commitment of faculty time. Various CBT programs, with the necessary interactivity, are currently available for supplementing a residency’s education curriculum in the arena of decision making. Moreover, multimedia capability allows integration of new image technologies into training in decision making. One residency program is exploring new CBT systems to aid curriculum development and education in its subspecialty section curricula. ResultsThe divisions of cardiothoracic and vascular surgery have 2 concurrent and parallel CBT modules in place for service residents at the start of the 1998–1999 academic year. Both modules have flexibility that allows function as either testing or teaching modules. Either module can run when faculty are not available, requiring only a Windows-compatible computer. More important, both modules contain the requisite interactivity and branch-based decision trees that potentially model a certifying examination. The same decision branching also supports weighted scoring, allowing for emphasis and recording of certain responses. Each module also can integrate sophisticated multimedia, allowing exposure to medical imaging information. The enhanced and engaging feedback capabilities have generated high levels of resident acceptance. ConclusionsComputer-based training modules offer a promising new direction in decision-making-skill curriculum development for surgical education. It also allows integration of multimedia in creating tools for assessment and training of new image-intensive modalities in residency programs.