Association For Surgical Education Research Articles

The Surgical Education Seminar Series: A novel, free resource from the Association for Surgical Education and the Society for Improving Medical Professional Learning

The Surgical Education Seminar Series: A novel, free resource from the Association for Surgical Education and the Society for Improving Medical Professional Learning

Survey Study of Clerkship Curriculum on Learner's Choice to Pursue Surgery: Positive Impact of Extracurricular Opportunities

Prior studies have focused on the role of the learning environment on students' decisions to pursue surgery, but few have analyzed the impact of the clerkship curriculum. This study assessed surgical clerkship curricula across United States (US) medical schools and their impact on students' likelihood of pursuing a surgical residency. A cross-sectional survey was developed to assess surgery clerkship characteristics. Questions included clerkship duration, number of offered and required surgical services, method of service assignment, and number of advanced clinical electives (e.g., fourth-year sub-internships) and additional surgical clinical opportunities (e.g., surgical elective rotations). Survey results were merged by the Association of American Medical Colleges with the percentages of students who matched into a surgical specialty. Linear regression models estimated the association of covariates with the percentage of students who (1) matched in surgical specialties, (2) were interested in surgery at medical school matriculation and ultimately matched into surgical residency (retention rate), and (3) were not interested in surgery at medical school matriculation but ultimately matched into surgical residency (recruitment rate). The survey was distributed to clerkship directors and coordinators at 66 medical schools through the Association for Surgical Education (ASE) from 5/1/2021 to 8/1/2021. All US medical schools in the ASE. A total of 21 medical schools responded (34.8% response rate). The overall retention rate was 36.4%, and the overall recruitment rate was 25.0%. Clerkships were 4 to 12 weeks. In 81% of programs, students submitted preferences and were assigned services. The percentage of students applying to surgical specialties was not associated with clerkship duration (p=0.79) or the number of required services (p=0.15), subspecialty services offered (p=0.33), or advanced clinical electives (p=0.24) but was associated with a program's having additional surgical clinical opportunities (p=0.02). Most of these factors were not associated with retention or recruitment rates. Offering more extracurricular surgical clinical opportunities was associated with having more students pursue surgical careers. Though limited by a relatively small sample size, our findings suggest that having shorter clerkships or limited subspecialty offerings may not have a significant influence on students' career choices.

Video Interviews and Surgical Applicants’ Ability to Assess Fit to Residency Programs

IntroductionDue to the COVID-19 pandemic, the recruitment cycle for the 2021 Match was performed virtually. This Association for Surgical Education (ASE)-sponsored survey set out to study applicants’ ability to assess the factors contributing to fit through video interviews. MethodsAn IRB-approved, online, anonymous survey was distributed to surgical applicants at a single academic institution and through the ASE clerkship director distribution list between the rank order list certification deadline and Match Day. Applicants used 5-point Likert-type scales to rate factors for importance to fit and their ease of assessment through video interviewing. A variety of recruitment activities were also rated by applicants for their perceived helpfulness in assessment of fit. ResultsOne hundred and eighty-three applicants responded to the survey. The three most important factors for applicant fit were how much the program cared, how satisfied residents seem with their program, and how well residents get along. Resident rapport, diversity of the patient population, and quality of the facilities were hardest to assess through video interviews. In general, diversity-related factors were more important to female and non-White applicants, but not more difficult to assess. Interview day and resident-only virtual panels were the most helpful recruitment activities, while virtual campus tours, faculty-only panels, and a program's social media were the least helpful. ConclusionsThis study provides valuable insight into the limitations of virtual recruitment for surgical applicants’ perception of fit. These findings and the recommendations herein should be taken into consideration by residency program leadership to ensure successful recruitment of diverse residency classes.

Analysis of gender representation, authorship inflation, and institutional affiliation in abstract acceptance: a 5-year study.

Our goals were to characterize associations of author number, author gender, and institutional affiliation on ratings and acceptances of abstracts submitted to one surgical education conference over 5 years. We retrospectively reviewed all abstracts submitted between 2017 and 2021 to the annual meeting of the Association for Surgical Education (ASE). Abstract data included average rater scores, acceptance status, author lists, and institutional affiliations. We cross-referenced last author affiliation with top-40 National Institutes of Health (NIH)-funded institutions and used a gender determination software to code first and last author genders. We analyzed 1,162 abstracts. Higher reviewer scores demonstrated positive, weak associations with more authors [r(1160) = 0.191, p < 0.001] and institutions [r(1160) = 0.182, p < 0.001]. Significantly higher scores were noted for abstracts with last authors affiliated with top-40 NIH-funded institutions [4.18 (SD 0.96) vs. 3.72 (SD 1.12), p < 0.001]. Women were first authors (51.8%) (n = 602) and last authors (35.4%) (n = 411) of the time. Abstracts were rated significantly higher with women rather than men as first authors [3.98 (SD 0.99) vs. 3.82 (SD 1.12), p = 0.011] or last [4.01 (SD 1.04) vs. 3.82 (SD 1.10), p = 0.005]. Across all years, abstracts were accepted more often as podium or plenary presentations when submitted by women first [n = 279, 59.7% (p = 0.002)] or last [n = 183, 38.4% (p = 0.095)] authors. Abstracts whose last authors were affiliated with top-40 NIH-funded institutions received significantly higher scores, possibly indicating increased tangible or intangible resources contributing to research efforts. Abstracts with women first and last authors scored higher and were more frequently invited for plenary and podium presentations.

Use of a Structured Observation Tool to Promote Medical Student Engagement in Trauma Resuscitations

We describe a novel approach to promoting medical student learning and engagement during trauma resuscitation with implementation of a structured observation and debriefing tool. In the context of a multifaceted quality improvement effort in our emergency room, we implemented a structured trauma observation tool (SOT) for medical students based on ATLS trauma guidelines. The SOT reflects the American College of Surgeons and Association for Surgical Education (ACS/ASE) trauma evaluation module for medical students. Two medical students from our quality improvement working group undertook a proof-of-concept study to determine whether the SOT facilitated accurate observations of trauma resuscitations and promoted educational debriefs with precepting providers. Results were encouraging, so the tool was implemented for elective use on surgical clerkships. Clerkship students who used the SOT were given the opportunity to share its impact on their experience. Institutional Review Board approval was obtained under Pro00109569. A large level 1 trauma center at an academic hospital in the southeastern United States. An interdisciplinary working group including surgeons, emergency medicine physicians, nurses, and students developed the observation tool. Two medical students from this team showed that the tool was effective at guiding observations and facilitating debriefs prior to its broader implementation on the general surgery clerkship. A total of 630 resuscitation tasks were observed during 15 trauma activations prior to implementation on the surgery clerkship. There was over 97% agreement between students observations and evaluating physicians self-reporting on which tasks were completed. Tasks on which there was disagreement were discussed to aid student learning. The tool was implemented for elective use on the surgery clerkship where students reported positive experiences. Early data suggest that this structured observation tool facilitates accurate trauma assessment observations and provides an opportunity for high-yield debriefs with the evaluating physician. This promotes student comprehension of ATLS principles. The SOT is being implemented as a pedagogic tool for students on the surgery clerkship to guide their observations, improve comprehension of decisions made in a hyperacute setting, and offer real time feedback as part of their learning in the trauma bay. The tool appears to be a valuable supplement which supports the ACS/ASE curriculum.

Development and Utilization of a Medical Student Surgery Podcast During COVID-19

BackgroundThe 2019 coronavirus disease (COVID-19) pandemic drastically reduced learning opportunities for medical students. We sought to determine the cost and success of implementation of a podcast for a surgical department in a large academic hospital.MethodsWe created a podcast series for Israeli medical students during the COVID-19 epidemic based on the Medical Student Core Curriculum of the American College of Surgeons / Association for Surgical Education. Episodes were available for free download or streaming on a designated website and popular podcast platforms. Podcast analytics were used to measure public listeners and uptake.ResultsTotal development time was 90 hours at an estimated cost of $7091 USD. A total of 10 episodes were released between March 21, 2020 and August 31, 2020. An average of 9 ± 1.26 h (range 2-6) was required to generate each episode, including 3.4 ± 1.26 h (2-6) for content review and 5.6 ± 2 h (4-10) for audio production. An average episode ran for 35.9 ± 4.3 min (28-42). Podcasts recorded a total of 5678 downloads, with an average of 228 and 336 downloads per episode in the first 30 and 90 days, respectively. The average daily downloads before the students returned to clinical rotations (March 21-April 30) was 48 ± 58.3 (7-283;) compared to 16 ± 7.4 after their return (1-38; P< 0.01). Estimated costs to produce a video-based education series would have been significantly more.ConclusionPodcasts can serve as a cost-effective and quickly produced instructional tool to supplement online learning. Further research is required to determine the efficacy of podcasts versus video-based education modules.

Implementation of the ACS/ASE simulation-based basic airway skills module in medical school curriculum: experience from Saudi Arabia

Background: Simulation-based basic airway management training may enhance the learner's competence and offer practitioners the opportunity to practice infrequently applied skills in cases with difficult airway management. Here, we aimed to examine the effectiveness of implementing the American College of Surgeons/ Association for Surgical Education (ACS/ASE) simulation-based Basic Airway Management module in the current medical school curriculum in PNU. Methods: This is a quasi-experimental study in which 44 students were enrolled in the training course; the instructors comprised six practicing physicians and technicians from the anesthesia and emergency departments. The students were divided among six groups for a 20-minutes hands-on training. Cognitive assessment and performance rating scale were conducted after the introduction of the module. An independent t-test was applied to analyze the pre- and post-test training scores for the cognitive assessment and performance rating scale. Statistical significance was set at p < 0.05. Results: There was a significant improvement in the post-training cognitive assessment scores, especially for basic maneuvers to establish the airway in a restrained and unrestrained driver, and in a patient with neck hematoma. A significant difference was also observed in pre- and post-training procedural steps, product characteristics, and global rating score. Conclusions: The ACS/ASE surgical skills curriculum for basic airway skills training is a feasible and effective approach for teaching basic airway management skills to medical students in PNU and other local universities.

Leaders by example: Best practices and advice on establishing a state-of-the art surgical simulation center that optimizes available resources

BackgroundThe role of simulation-based education continues to expand exponentially. To excel in this environment as a surgical simulation leader requires unique knowledge, skills, and abilities that are different from those used in traditional clinically-based education. MethodsLeaders in surgical simulation were invited to participate as discussants in a pre-conference course offered by the Association for Surgical Education. Highlights from their discussions were recorded. ResultsRecommendations were provided on topics such as building a simulation team, preparing for accreditation requirements, what to ask for during early stages of development, identifying tools and resources needed to meet educational goals, expanding surgical simulation programming, and building educational curricula. ConclusionThese recommendations provide new leaders in simulation with a unique combination of up-to-date best practices in simulation-based education, as well as valuable advice gained from lessons learned from the personal experiences of national leaders in the field of surgical simulation and education.

Resource Usage Implementing the Surgical Resident Prep Curriculum at a Single Institution

The Resident Prep Curriculum (RPC), published in 2014 and developed as a collaboration of the American College of Surgeons, Association of Program Directors in Surgery, and the Association for Surgical Education, was designed to improve the quality and consistency of medical student preparation for surgical residency. We aim to assess the feasibility of and resource usage for implementation of this curriculum at our institution. Our institution expanded upon a pre-existing 2-week surgical preparatory course, adding modules designed to meet the goals and objectives of the RPC. We performed an evaluation of the resources required for these additions, namely time, logistics and incremental cost. The course took place at the Perelman School of Medicine, which is a large, academic medical center affiliated with the Hospital of the University of Pennsylvania. Our course satisfied each of the six domains outlined in the RPC. In 2015, 22 students were enrolled in the course. It was run over a consecutive 4-week period in the spring of 2015, with 9 full and 9 half days. To meet the needs of the Curriculum, approximately 33 hours (38%) were spent in the classroom, 34 hours (39%) in a simulation center, and 20 hours (23%) in the anatomical laboratory. Seventy faculty-hours (from 5 disciplines) and 73 resident-hours (double-counting for cotaught modules) were required to support the course. Besides room availability, funding was required for certain aspects of the course such as cadavers, dedicated anatomy teaching, and the costs of supplies in the simulation center. There is also a cost associated with the use of the Penn Medicine Simulation Center. Taking these into account, the total cost of implementing the curriculum amounted to $30,627.10. The implementation of the RPC was feasible but relied heavily upon faculty/resident time. As a result of the success of this initiative, our medical school seeks to expand the idea across multiple specialties.

Association for Surgical Education: Highlights and Selected Abstracts From the 2014 Annual Meeting

The theme of the 34th annual meeting of the Association for Surgical Education held in Chicago, Illinois, from April 10 to 12, 2014, was global surgery. This year, a special call for abstracts on s...

Surgical subinternships: bridging the chiasm between medical school and residency: A position paper prepared by the Subcommittee for Surgery Subinternship and the Curriculum Committee of the Association for Surgical Education

BackgroundSurgery subinternship rotations are clinical rotations intended to provide senior medical students with experiential exposure and increased autonomy during the care of surgical patients in clinical settings. Due to the lack of guidelines from national surgical organizations, these rotations remain largely unstructured and unstandardized with wide variability in the goals and experiences they provide for medical students. MethodsThrough synthesis of the literature and by applying an iterative process among members of the subcommittee for surgery subinternship and the curriculum committee of the Association for Surgical Education (ASE) consensus recommendations were established. RecommendationsFive defined domains were identified as essential for establishing surgery subinternship rotations. These are: administrative structure, goals and objectives, curricular elements, instructional methods, and assessment tools. ConclusionsThese recommendations should serve as a blue print for establishing a structured, educationally sound, and rewarding clinical rotation for medical students. Applying these recommendations may also provide educators with opportunities for scholarships and academic advancement.

Statement on Surgical Preresidency Preparatory Courses

The following statement on surgical pre-residency preparatory courses has been approved by the American Board of Surgery, the American College of Surgeons, the Association of Program Directors in Surgery, and the Association for Surgical Education: The leadership of the surgical community is actively engaged in improving the preparation of incoming residents to assume responsibility and accountability for key elements of care and stewardship. To better prepare for this transition, it is essential that all matriculants to surgery residency successfully complete a preparatory course of blended learning that specifically addresses essential components of quality care and patient safety before the start of their training. A national multidimensional curriculum, along with objective assessment tools, has been developed to accelerate readiness, responsibility, and accountability during the transition from medical school to surgery residency. We strongly endorse this effort and encourage medical schools to adopt this or a similar program. We stand ready to assist medical schools and medical students in implementation of this important initiative.

Abstracts From the Proceedings of the 2013 Annual Meeting of the Association for Surgical Education (ASE)

Thirty of 89 submitted abstracts were selected for podium presentation at the 33rd annual meeting of the Association for Surgical Education (ASE), held in Orlando, Florida, from April 23 to 25, 201...

The anatomy of reputation: an Association for Surgical Education priority

0002-9610/$ see front matter 2014 http://dx.doi.org/10.1016/j.amjsurg.20 In preparation for this address, I thought, ‘‘What could I possibly say to such an impressive group of scholars?’’ I thought of this organization and what it has come to mean to me in terms of my own academic career. I thought of how much the Association for Surgical Education (ASE) has changed since I first came to a meeting as a clinical clerk. I thought of its evolution as an organization and how it has just wrapped up its first 3-year strategic plan, a strategic plan that set the direction for this organization’s past 3 presidents and Boards of Directors. As the ASE prepares for its second strategic plan and sets the direction for the next 3 to 5 years, I thought I would share with you my thoughts on reputation: why our reputation is so important, what constitutes our reputation, and how we can further develop and strengthen the ASE’s reputation in the context of the ASE’s upcoming strategic planning process. My address is entitled ‘‘The Anatomy of Reputation: An ASE Priority.’’ I have used an anatomic metaphor because I want us to dissect and really understand what reputation is. Why an ASE priority? Because the ASE’s reputation as ‘‘the go-to organization for all things surgical education and surgical education research’’ is a distinctive competitive advantage and one that we need to further leverage and capitalize on.

Abstracts from the Proceedings of the 2012 Annual Meeting of the Association for Surgical Education (ASE)

Twenty-six of 89 submitted abstracts were selected for podium presentation at the 32nd annual meeting of the Association for Surgical Education, held in San Diego, California. Based on popular themes, 10 abstracts were chosen for publication under the auspices of the Alliance for Clinical Education. These abstracts have been modified to succinct, self-contained works that can be understood by those who have not attended the meeting or are from non-surgical disciplines. The first 4 abstracts involve learning about and teaching nontechnical skills in the operating room. First is an ethnographic study exploring surgeons’ responses to intraoperative challenge. The second is an ASE Paper of Distinction, reporting a needs assessment for teaching conflict resolution in the operating room. The third abstract regards the theme of motivating learners in the operating room, and the final abstract in this group, another ASE Paper of Distinction, provides recommendations for training assessors of nontechnical skills. The concept of risk taking and risk management in surgery is explored in the fifth abstract. The next 3 abstracts involve facets of focused simulated-skills training. A novel simulation model for casting is presented, and the link between focused skills training and patient outcome is examined via meticulous video analysis of microsurgical technique. The efficacy of a large-scale, telesimulation program for teaching laparoscopic skills was demonstrated. The final 2 abstracts examine teaching methods on the surgery clerkship. A method for eliciting and exploring issues of professionalism is presented, and the rationale for multimedia slide design receives further support.

The Association for Surgical Education's Roadmap for Research on Surgical Simulation

The Association for Surgical Education's Roadmap for Research on Surgical Simulation

Abstracts from the Proceedings of the 2011 Annual Meeting of the Association for Surgical Education (ASE)

Twenty-four of 85 submitted abstracts were selected for podium presentation at the 31st annual meeting of the Association for Surgical Education, held in Boston, Massachusetts. Based on popular themes, 10 abstracts were chosen for publication under the auspices of the Alliance for Clinical Education. These abstracts have been modified to succinct, self-contained works that can be understood by those who have not attended the meeting or are from nonsurgical disciplines.

The Association for Surgical Education (ASE) 年次総会に参加して

The Association for Surgical Education (ASE) 年次総会に参加して

Abstracts From the Proceedings of the 2010 Annual Meeting of the Association for Surgical Education (ASE)

Eighteen of 72 submitted abstracts were selected for presentation at the 30th annual meeting of the Association for Surgical Education, held in San Antonio, Texas. Based on common themes, 9 abstrac...

Abstracts from the Proceedings of the 2009 Annual Meetings of the Association for Surgical Education

Thirty-seven abstracts were selected for presentation at the 27th annual meeting of the Association for Surgical Education, held March 2007, in Washington, D.C. Based on common themes eight abstracts were chosen for publication under the auspices of the Alliance for Clinical Education. These abstracts have been modified to be self-contained and understandable to those who have not attended the meeting or are from non-surgical disciplines. The first two abstracts use the method of Cognitive-Task-Analysis, which translates an expert's knowledge of a procedure or skill into a basic outline of sequential steps and decision points. This outline in turn can be used to teach novices attempting to learn a skill or to provide guidance to the expert attempting to teach this skill. The first abstract used this method to teach decision making during tendon repair, while the second used the method to identify omission of relevant steps while teaching colonoscopy. The next group of abstracts explored surgical skills. T...