Teaching Of Surgical Skills Research Articles

Teaching experience, not surgical residency training, is the critical factor in optimizing student learning outcomes in performing ovariohysterectomy on a model.

To determine if surgical skills instructors' experience and qualifications influence students' learning of small animal ovariohysterectomy on a model (mOVH). Second-year veterinary students (n = 105). Students were randomized to three groups, taught by: (1) residency-trained surgeons with over 3 years' experience teaching mOVH, (2) general practitioners with over 3 years' experience teaching mOVH (GP >3), and (3) general practitioners with under 3 years' experience (GP <3). Students completed four 3-h laboratories where they performed mOVH under the supervision of one of the three types of instructors. Students were assessed performing mOVH using a validated 22-item rubric and completed a survey about their experience. GP <3 group students achieved lower total rubric scores than GP >3 group students (p = .021). Surgeon-taught students' scores did not differ from those taught by GP >3 (p = .685) or GP <3 (p = .052). GP <3 group students were more likely to require remediation than those taught by surgeons (p = .001); there were no differences between the other groups (surgeons vs. GP >3 p = .44; GP <3 vs. GP >3 p = .11). Students reported similar satisfaction with their instruction. Instructors with over 3 years' experience teaching mOVH had better student learning outcomes compared to instructors with under 3 years of experience. While mOVH teaching experience did influence learning, the instructor's completion of a surgical residency did not. The results of the study indicate a need for more extensive training for new surgical skills instructors and demonstrates that GPs with experience teaching surgical skills are suitable instructors for teaching ovariohysterectomy on a model. This study indicates a need for more extensive training for new surgical skills instructors and demonstrates that GPs with experience teaching surgical skills are suitable instructors for teaching ovariohysterectomy on a model.

363 Development and Validation of a Virtual Teaching Method for Minimally Invasive Surgery Skills

Abstract Aim Remote teaching of surgical skills has rapidly emerged as a promising alternative to the traditional face-to-face (F2F) format. This study sought to evaluate whether minimally invasive surgery (MIS) skills could be taught remotely using available technology with objective assessments of proficiency. Method In a pilot study, we compared face-to-face (F2F) and virtual training for novice MIS learners, evaluating proficiency through objective parameters. The pilot refined methods, and the subsequent course was the evaluation basis. Virtual training shifted from conventional to personalised teaching in the second round, introducing headphones for enhanced guidance. Optimisation achieved comparable online teaching quality to F2F. Evaluation tasks included peg transfer (MISTELS) and suturing (SUTT) on box trainers. Results Technical challenges in delivering a virtual MIS skills course were successfully addressed, particularly through the personalised approach in an isolated fashion in the second pilot course. Participants (n = 20) in the final course had similar baseline characteristics and were randomly allocated to F2F (n = 8) and virtual (n = 12) teaching groups. Participants in the virtual group demonstrated faster completion of the peg transfer task compared to the F2F group (11.25 minutes vs. 16.88 minutes; p = 0.015). However, no significant differences were observed in other MISTELS and SUTT performance measures or cognitive workload. parameters. Conclusions This study demonstrates that virtual teaching of MIS skills using a web-based streaming platform is feasible and effective, providing the foundation for scalable future programs. Online surgical skills teaching offers simultaneous access for learners in different regions and reduces costs and travel time.

A Surgical Skills Rotation for Mid-Level Residents.

The University of Iowa orthopaedic residency previously designed a month-long surgical skill rotation for postgraduate year (PGY)-1 residents. This successful initiative has become a model of interest for other teaching institutions. In addition to the intern year, an important phase in residency occurs during the transition from PGY2 to PGY3, when residents assume greater responsibility and autonomy in leading surgical procedures. To directly address this transition and assess residents' readiness, our residency program established a week-long PGY2 surgical skills rotation. This rotation serves as a training checkpoint and focuses on both training and evaluation of level-appropriate skills in joint arthroplasty, trauma, arthroscopy, and wire navigation. The primary objective of the PGY2 surgical skills rotation is to enhance orthopaedic residents' operative skills and experience by providing increased exposure and practice of requisite technical skills. Similar to the Orthopedic In-Training Examinations that assess residents' knowledge, this week-long program, aimed at assessing residents' proficiency in fundamental orthopaedic technical skills, occurs before their PGY3 year. Faculty-led training and assessment sessions in each area offer residents many opportunities for dedicated practice and improvement. Transferring these acquired skills from the laboratory to the operating room is essential for a training program. To confirm improvement, the final day of the surgical skills rotation was exclusively dedicated to structured performance evaluations, with a specific emphasis on establishing proficiency benchmarks. We herein describe the University of Iowa's PGY2 surgical skills rotation, providing insights into its development, implementation, and outcomes. By sharing our experience, we offer a framework for other academic departments seeking to optimize surgical skills education and ensure the successful transition of mid-level residents.

The Usefulness of YouTube Videos Related to Endoscopic Sinus Surgery for Surgical Residents

Abstract Objective The use of online teaching modalities to supplement surgical learning has increased recently, demonstrating promising results. Previous studies have analyzed the value and usefulness of YouTube as an educational source to learners, including teaching surgical skills to Otolaryngology–Head and Neck Surgery (OHNS) trainees. YouTube videos on endoscopic sinus surgery (ESS) still need to be explored as ESS remains a common, yet challenging surgery that OHNS residents encounter regularly. This study aimed to objectively evaluate the usefulness of YouTube videos on ESS for surgical education. Design YouTube was searched using the following keywords: “uncinectomy,” “maxillary antrostomy,” “anterior ethmoidectomy,” and “ethmoid bulla resection.” These represent the initial ESS steps residents learn. Each video was assessed for eligibility by two independent reviewers. Outcome Measures The LAParoscopic surgery Video Educational Guidelines (LAP-VEGaS) and ESS-specific criteria were used to assess educational quality. Video popularity index (VPI) was used to calculate video popularity. Results Of the 38 videos that met inclusion criteria, the average LAP-VEGaS score was 6.59 (± ) 3.23 standard deviation. Most videos were designated low quality. There was a weak positive correlation between whether a video included ESS-specific criteria and LAP-VEGaS score (r = 0.269, p = 0.102). There was a significant positive correlation between VPI and LAP-VEGaS scores (r = 0.497, p = 0.003). Conclusions Overall, the quality of included videos was poor. OHNS residents should not rely solely or primarily on YouTube videos to learn surgical skills relevant to ESS. To maximize potential of online teaching, high-quality videos should be used to compliment other methods of teaching.

Innovation in surgical trauma care education: assessment of a Panamerican Trauma Society online surgical skills course hosted by the Spanish Surgical Association.

Incorporating surgical skills education in trauma care is essential for young surgeons and surgical trainees. This study describes an innovative e-learning course for teaching trauma care surgical skills in an international cooperative setting. Furthermore, it aims to offer valuable insights on enhancing e-learning practices. The Panamerican Trauma Society and the Spanish Surgical Association have joined forces to launch an online course focusing on advanced trauma care surgical skills. This report provides an in-depth examination of the project and scrutinizes participant feedback through a post-course survey. The survey thoroughly evaluates their satisfaction level, the usefulness of the course content, and their view on its clinical relevance. Three hundred eighty-two surgeons from 16 countries completed an online course. Three hundred seventy-nine of them responded to the post-course survey. The mean age was 36, with 64% females and 36% males. The course consisted of 9.9h of academic content, including 5h of video lectures and 4.9h of live discussions. Ninety-seven percent of the participants were practicing general and acute care surgeons, and only 2% were exclusively dedicated to trauma surgery. Sixty-one percent of participants highly valued real-time interaction with faculty, and 95% believed their trauma surgical skills would improve. Additionally, 93% of the participants were satisfied or very satisfied with the e-learning experience. The use of video-based instructional materials has revolutionized surgical education. With online courses in trauma surgery, surgeons can now improve their skills and better prepare themselves to handle severe trauma cases. This innovative approach to surgical education has proven to be very effective and can potentially enhance patients' quality of care.

The Potential of Mental Simulation for Enhancing Self-efficacy and Managing Stress in Emergency Care: A Nurse Education Perspective

This theoretical article explores how mental simulation can enhance self-efficacy and stress management in emergency care, focusing on its application in nurse education. This article delves into the concept, functionality, and applications of mental simulation in nurse education, specifically addressing stress mitigation in emergency care. We offer an overview of relevant literature and research, including a specific focus on surgical skills education. The mechanisms of mental simulation, encompassing the simulation theory of action and dual code theory, are discussed, providing valuable insights into neural networks and image evocation processes. The article underscores the significant impact of stress on emergency care performance. It highlights the potential benefits of incorporating mental simulation as a stress-exposure training technique in the learning process. By adopting a Bandurian theoretical framework, the article proposes how mental simulation can contribute to the cultivation of self-efficacious nurses. Integrating mental simulation in nurse education has the potential to mitigate stress’s negative impact on emergency care. Nurses mentally rehearse and simulate scenarios, becoming familiar with demands and stressors. This practice can potentially refine skills, improve performance under pressure, and boost self-efficacy. Mental simulation replicates real-life situations, enhancing learning from a patient safety perspective. Mental simulation enhances self-efficacy and stress management in emergency care. Its integration into nurse education prepares nurses for high-stress situations. Further research should explore its diverse applications. Understanding mental simulation mechanisms can improve training programmes, potentially empowering nurses in delivering self-confident emergency care.

Development of the Cognitive Load Inventory for Surgical Skills: preliminary validity evidence

PurposeThe operating room requires simultaneous processing of considerable information. Trainee learning and performance in this environment are restricted by working memory. Cognitive learning theory, which describes three types of cognitive load (CL), suggests that learning is maximized when intrinsic load (IL) is matched to experience, extraneous load (EL) is minimized, and germane load (GL) is optimized with schemas. The ability to measure CL is critical to maximize learning. The Cognitive Load Inventory for Colonoscopy (CLIC) measures the three types of CL during colonoscopy training. We adapted the CLIC for surgical skills education and aimed to gather validity evidence for this tool.MethodsWe initially developed a 21-item, 5-point Likert instrument, the Cognitive Load Inventory for Surgical Skills (CLISS), through a multi-step process. To support content validity, we revised CLIC content to reflect surgical skills, obtaining feedback from CLIC creators to ensure adjustments adequately retained IL, EL, and GL concepts. To examine the response process, we conducted cognitive interviews with surgical residents to assess wording and clarity and issued the survey in different settings (simulation exercises, operating room cases), relative to different tasks, and with different respondents (residents, fellows, faculty). To assess internal structure, we examined internal consistency using Cronbach's alpha and conducted confirmatory factor analysis (CFA) to confirm that relationships among the items were as hypothesized. We evaluated adequacy of the 3-factor model with three model fit indices, including Bentler’s Comparative Fit Index (CFI), the Tucker–Lewis Index (TLI), and root mean square error of approximation (RMSEA). A sensitivity analysis was performed eliminating items with factor loading estimates that (1) are less than 0.40, (2) are not statistically significant, or (3) load onto 2 or more factors.ResultsThe CLISS was distributed in 7 clinical and simulated procedural settings to 138 participants and yielded 100 responses (72% response rate). Of the respondents, 99 (99%) completed the entire CLISS. No respondents raised content questions. Each item garnered a range of responses. All 3 types of cognitive load had a Cronbach’s alpha above 0.7. However, several individual items were found not to correlate with other items within that load. CFA revealed a range of loadings for each factor. Model fit indices were outside the conventional cut-offs (CFI = 0.627, TLI = 0.579, RMSEA = 0.124), suggesting consensus that the initial 3-factor, 21-item model was not a good fit. Sensitivity analysis yielded a revised 11-item tool, which demonstrated improved Cronbach’s alpha for IL and GL and improved model indices (CFI = 0.940, TLI = 0.920, RMSEA = 0.076). An additional item was removed to further support content validity.ConclusionsThe CLISS can be a practical tool for administration in the skills lab and clinical settings, particularly if administered immediately after the session or requested individually. While promising, further study is needed to establish additional validity evidence for the CLISS.

Simulating aortic root replacement for a surgical wet laboratory in a resource-limited setting: an economical innovation.

Traditional cardiac surgery residency programs rely mainly on teaching surgical skills in the operating room. The increasing complexity of cardiac surgical operations on high-risk patients and the time constraints placed on residents in this surgical discipline negatively impact the learning opportunities for those residents. Simulation models, though efficient, are very expensive. In Third World Countries, they are unavailable for trainees due to financial constraints. We have introduced an innovative and cost-effective way of simulating aortic root replacement in a wet laboratory by applying a hand-made valve conduit or 'pencil conduit' to a bovine heart. It is reproducible, easy to assemble, cost-effective and simple to use. It can help develop and enhance the surgical skills of residents and junior surgeons for this advanced operation, which requires a meticulous surgical technique performed within a limited time frame.

Undergraduate teaching of surgical skills in the UK: systematic review.

Students must be proficient in surgical skills according to General Medical Council and Royal College of Surgeons of England guidelines. If these skills are not appropriately taught, there is a risk of an incoming junior workforce with inadequate surgical skills. This paper aimed to review the literature relating to undergraduate teaching of surgical skills in the UK and summarize future suggested training methods. The databases MEDLINE, Embase and SCOPUS were searched, and the existing literature relating to methodology of undergraduate teaching of surgical skills in the UK over the past 10 years was summarized. The Medical Education Research Quality Instrument was used to assess research quality. A total of 19 papers were included. Cross-sectional evaluations and survey-based studies highlight a clear deficit in surgical skills teaching in the UK. Medical students are currently unable to fulfil their own learning needs and meet requirements set out by the General Medical Council. This lack of surgical teaching appears to negatively affect student desire to pursue a surgical career. The three main themes for improvement are extracurricular surgical skills days, near-peer teaching and simulation. Each method appeared to improve learning, although no studies utilized medium- to long-term follow-up to demonstrate efficacy and there lacks a clear consensus as to the 'standard' of undergraduate surgical skill education. There was also potential for selection bias and response shift bias in many of the studies assessing pre- and postintervention confidence and opinions. There is a concerning lack of surgical skills teaching that has resulted in medical students and junior doctors not having the necessary surgical skills as per General Medical Council guidance and students feel that their own learning needs are not met. This failure to address the learning deficit may be responsible for the fall in surgical competition ratios. While surgical skills teaching must be improved urgently, more robust evidence is required to evaluate the optimal ways of approaching this issue.

920 Regular Formal Surgical Skills Training for Undergraduates - an Easy Way to Increase Enthusiasm for Postgraduate Surgical Training?

Abstract Aim Despite the publication of a clearly defined surgical curriculum by the Royal College of Surgeons of England, the availability of surgical training opportunities at medical school remains highly variable [1]. While one-off training days can increase students’ surgical skills confidence, we wanted to explore the effect of a regular skills course on students’ skills confidence, and the effect this had on their willingness to attend theatre lists and purse surgical training after graduation. Method We designed a 6-session training program covering the Basic Surgical Skills curriculum produced by the RCS. It also included robotic surgery simulation. The course was run twice due to high demand for places. Core trainees were recruited to help supervise the course. The course was sponsored by both ASiT and Medtronic and was free for attendees. Results The course received excellent feedback. Free text sections highlighted how regular skills training allowed for consolidating learning. Attendees were significantly more likely to feel confident in performing all the techniques covered after the course (Chi Squared, p &amp;lt; 0.05). 16/17 attendees (94.1%) candidates agreed that the course filled a gap in what teaching is provided by the medical school, and all attendees felt more confident attending theatre lists after attending the course. Of note, most students agreed the course had increased their inclination towards a surgical career (12/17 70.2%.). Conclusions The course highlights the importance of regular surgical skills teaching. It also highlights an important knock-on effect of making students more confident attending lists, and more likely to pursue surgical careers.

1295 To What Extent Would an Augmented Reality Surgical Skills Mobile App Effectively Supplement Surgical Skills Training for UK Medical Students and Foundation Doctors?

Abstract Aim Augmented Reality (AR) has been identified as having high potential to provide early, focused and satisfactory surgical skills education for UK surgical trainees. AR overlays digital information onto the physical world, providing an interactive experience. Mobile applications are effective, low-cost methods of delivering technology-enhanced learning (TEL). This study aimed to determine the viability and efficacy of augmented reality (AR) mobile applications for immersive simulation training for surgical trainees in the UK. Method A systematic search using pre-determined terms and criteria was used to identify and screen relevant literature on seven major databases, including EMBASE, MEDLINE, CENTRAL and JBI. Further search of citations, dissertations, and theses (ProQuest) were also conducted. Identified publications were further screened using pre-defined criteria. Results 34 unique publications were identified in total, from database searches (n = 31) and review of reference lists (n = 3). Following detailed review of abstracts, 14 publications were omitted from ongoing analysis. All remaining publications (n = 20) discuss TEL. Five positive themes emerged: widespread acceptance, improved surgical accuracy, reduced time wasted, telementoring and real-life scenario replication. 2 barriers of AR identified were the lack of tactile feedback, and accessibility, particularly AR implementation. Conclusions As a digital technology, AR has the potential to supplement and enhance surgical training. Current literature suggests wide acceptance, skill improvement and time efficiency of digital compared to traditional training and educational methods. However, little research exists specifically evaluating the efficacy of AR mobile applications in delivering surgical skills to early surgical trainees. More research is therefore needed to inform appropriate adoption of this emerging technology.

Measuring hand movement for suturing skill assessment: A simulation-based study

BackgroundTo maximize patient safety, surgical skills education is increasingly adopting simulation-based curricula for formative skills assessment and training. However, many standardized assessment tools rely on human raters for performance assessment, which is resource-intensive and subjective. Simulators that provide automated and objective metrics from sensor data can address this limitation. We present an instrumented bench suturing simulator, patterned after the clock face radial suturing model from the Fundamentals of Vascular Surgery, for automated and objective assessment of open suturing skills. MethodsFor this study, 97 participants (35 attending surgeons, 32 residents, and 30 novices) were recruited at national vascular conferences. Automated hand motion metrics, especially focusing on rotational motion analysis, were developed from the inertial measurement unit attached to participants’ hands, and the proposed suite of metrics was used to differentiate between the skill levels of the 3 groups. ResultsAttendings’ and residents’ performances were found to be significantly different from novices for all metrics. Moreover, most of our novel metrics could successfully distinguish between finer skill differences between attending and resident groups. In contrast, traditional operative skill metrics, such as time and path length, were unable to distinguish attendings from residents. ConclusionThis study provides evidence for the effectiveness of rotational motion analysis in assessing suturing skills. The suite of inertial measurement unit-based hand motion metrics introduced in this study allows for the incorporation of hand movement data for suturing skill assessment.

A Simple Curriculum for Teaching Transfixion Stitches Using a Low-Fidelity Model and Following Gagne's Instructional Design [ID: 1377582

INTRODUCTION: Surgical training is often carried out through observation and practice in the clinical setting. Gagne's model of instructional design is an organized method of teaching motor skills. The purpose of the study is to evaluate the feasibility and effectiveness of using Gange's model to improve surgical knowledge on transfixation stitches used during hysterectomy on a low-fidelity pelvic model trainer. METHODS: A simple teaching curriculum for transfixation stitches was developed following Gange's model. A thought-provoking clinical vignette was presented and followed by clear learning objectives. Prerequisite knowledge was tested using a quiz. Stimulus material included relevant anatomy, instruments used in a hysterectomy, and steps of an abdominal hysterectomy. Learning guidance was provided in the form of diagrams and videos of various transfixation stitches. Learners practiced on low-fidelity pelvic models with supervision by faculty members. At the end, learners repeated the knowledge test and provided feedback. Comparisons were made between pretest and posttest scores using Fisher exact test and chi-square test as appropriate for nominal variables, and Mann-Whitney test for continuous variables. RESULTS: The simulation was performed by 18 participants (n=18). There was significant improvement in test scores after completing the simulation (59.6±21.8% versus 89.3±9.7%, P&lt;.0001). Additionally, the number of transfixation stitches each learner was familiar with increased significantly after the simulation (0 interquartile range [IQR] [0–1] versus 4 IQR [2–4], P&lt;.0001). CONCLUSION: These findings suggest that using Gagne's model of instructional design on a low-fidelity pelvic model trainer in a low-stress environment can help improve surgical skill education. Our experience demonstrates that simulation training can be organized without much time or resource and help build lasting surgical skills.

The role of virtual reality in hepato-pancreato-biliary surgical education: A systematic review

Background: Virtual reality (VR) is a technology that can be used as a tool to create 3-dimensional graphics for surgical education, including anatomy and surgical skills teaching. Hepato-pancreato-biliary (HPB) surgery requires specialized surgical skill training and is characterized by cases of complex anatomical variations, which might be difficult to appreciate and conceptualize for trainees in their early stages of education. We performed this systematic review to summarize evidence on real-world VR implementation in surgical education for HPB surgical trainees and to understand the effects of VR on HPB trainees.

Development and Evaluation of Virtual Teaching of Surgical Skills: A Feasibility Study

Background: The COVID-19 pandemic has created unprecedented challenges to health service delivery around the world, with an adverse impact on doctors-in-training. However, creating an opportunity to utilise and apply digital tools to replace most, if not all, face-to-face teaching. The aim of this study was to ascertain the feasibility and effectiveness of virtual training of basic surgical skills using the Kirkpatrick model of curriculum evaluation.

The medical kitchen: developing clinical skills through transdisciplinary simulation

It is ethically impermissible for medical students to perform invasive procedures on patients before being competent to do so safely [1,2]. Simulation offers obvious benefits, yet established simulation approaches can over-focus on technical tasks and overlook the need for simultaneous communication with patients and colleagues. Transdisciplinary Simulation (TS) addresses these issues by creating a safe, ‘low stakes’ learning environment based on an apparently unrelated field which in fact offers close parallels with medicine, in this case the kitchen. Expert chefs, like clinicians, must be skilled in preparing and organising their workplace (mise-en-place) [3], constantly attending to hygiene, precision, dexterity, and communication with colleagues and diners. The Medical Kitchen is an affordable and scalable instance of TS, developed to help second year medical students acquire psychomotor clinical skills while simultaneously communicating with a patient or colleague. The Medical Kitchen comprises self-guided learning of two new clinically-relevant skills followed by peer assessments; a subsequent whole class synchronous debrief; and individual guided reflections. Our team (clinical educators and a professional chef) selected ‘turning’ vegetables as a core skill, teaching students to shape courgettes or potatoes into regular and consistent shapes using a suitable knife. This requires dexterity and control, gained through repeated practice, and presents similarities with clinical skills. The knowledge gained from turning vegetables is then applied to the clinical skill of suturing while talking to a colleague, highlighting the need to integrate physical skills with sensitive communication. The Medical Kitchen programme has been delivered to over 700 second-year undergraduate medical students at Imperial College London over the course of two years. It is versatile and adaptable, having been delivered in both online and live session formats in response to the COVID-19 pandemic. Student feedback through guided reflections on perceived value has been overwhelmingly positive (though it is too early to establish the long-term effect on students’ clinical skills). The Medical Kitchen offers an innovative approach to clinical skills acquisition, using the world of professional gastronomy to simulate the clinical environment. It is an affordable and scalable programme grounded in theories of psychomotor skills development and has the potential for widespread implementation. As an example of transdisciplinary simulation, it raises wider possibilities for simulation design and innovation within clinical education. 1. Reznick RK, MacRae H. Teaching surgical skills – changes in the wind. New England Journal of Medicine. 2006;355(25):2664–2669. 2. Sadideen H, Kneebone R. Practical skills teaching in contemporary surgical education: how can educational theory be applied to promote effective learning?. The American Journal of Surgery. 2012;204(3):396–401. 3. Schlegel C, Flower K, Youssef J, Käser B, Kneebone R. Mise-en-place: Learning across disciplines. International Journal of Gastronomy and Food Science. 2019. 16:100147

Surgical Skills Curriculum Satisfaction Among Current Obstetrics and Gynecology Residents

<h3>Study Objective</h3> To determine differences in surgical skills curriculum (SSC) and exposure to surgical subspecialties for current OB/GYN residents. Identify areas for improvement and standardization among residency programs. <h3>Design</h3> Online survey using novel 54-item questionnaire. <h3>Setting</h3> Surveys distributed via email to program directors and coordinators of OB/GYN residency programs with request to forward survey to current residents. <h3>Patients or Participants</h3> Current OB/GYN residents were eligible. 114 participants answered the survey over a 4-week period from March to April 2022. <h3>Interventions</h3> N/A. <h3>Measurements and Main Results</h3> The majority of the respondents were female (87.9%), ages 28 to 32 (76.7%), and from university-based residency programs (58.6%). 60.3% of respondents reported having a structured SSC. Most SSCs were led by a mixture of generalists and subspecialists (37.9%), with the subspecialist most commonly a minimally invasive gynecologic surgeon (40.7%). Most residents reported there was not enough structure in their SSC (62.1%) and not enough time dedicated to surgical skills (61.2%). Only 7.8% of respondents were very satisfied with their program's SSC and the majority reported that surgical skills education could be improved (81.0%). Residents with structured SSCs were more likely to be satisfied with their training (5-point Likert scale mean 2.42 vs 3.64, p<.001). On average, most residents reported rotating with surgical subspecialists 16 weeks per year (31.0%) with 3-4 days in the operating room per week (59.5%). Residents reported that operating with surgical subspecialists improved their surgical skills (97.1%) and prepared them for independent surgery (94.0%). The majority of residents agreed that all programs should have a standardized SSC (84.5%) and have access to equivalent resources (89.7%). <h3>Conclusion</h3> The majority of OB/GYN residents are unsatisfied with their current SSC and agree that a standardized curriculum is needed. Exposure to surgical subspecialists improves resident surgical skills and prepares trainees for independent surgery.

Impact of an in-person small group surgical skills course for preclinical medical students in an era of increased e-learning

ObjectiveThe COVID-19 pandemic led to a dramatic decrease in face-to-face teaching. This can particularly impact medical students' skills development. This prompted development of an in-person surgical skills course as guided by the General Medical Council "Outcomes for Graduates" facilitated by tutors with surgical experience. This study aimed to primarily assess participant confidence in surgical skills following the course. DesignThis was an interventional study assessing both qualitative and quantitative data collected prior to, during, and post course completion. Data were collected from students via online forms, which included a mixture of "Yes/No" responses, self-assessed confidence levels via Likert scales, and free type questions. SettingThe study assessed feedback for a 5-session surgical skills course delivered at the authors' institution. This is a newly designed course using low-cost materials which was free for all attendees. ParticipantsParticipants were all in the first or second year of medical school. There was capacity for 60 students, and all attendees provided informed consent to participate. ResultsA total of 446 students applied for the course with 58 participants in the final study, 31% of whom had prior surgical skills experience. There was a statistically significant increase in student confidence levels following the course for all taught surgical skills (P = .0001). Participants were also more confident that they possessed the skills required for clinical placements (P = .0001) and to work as a junior doctor (P = .01). Thematic qualitative analysis revealed a reliance on third parties for previous surgical experience; this course improved knowledge and skills for future practice. Limitations included session duration and equipment choice. ConclusionThis study demonstrates high demand and student satisfaction from this course, offering a potential framework to improve undergraduate surgical skills teaching. The results presented here have the potential to inform wider curricula development across medical schools in the future. CompetenciesMedical knowledge; practice-based learning and Improvement.

1001 Surgical Escape Rooms: A Novel Approach for Teaching Surgical Skills

Abstract Aim Traditional classroom-based teaching of surgical skills has been used commonly in the past. Although, use of an escape room is a new form of a practical teaching method to deliver surgical skills teaching. We compared and assessed effectiveness of the traditional classroom teaching versus practical escape room teaching of the basic surgical skills. Method Two teaching sessions were delivered to third year medical students. Each session consisted of two groups and two sessions. Each group received either the classroom-based teaching or the escape room teaching, then switching over to the other teaching. Each student was asked to complete a questionnaire before the session, after the first and the second teaching session. Teaching covered interrupted suturing, wound management, and administration of local aesthetic. Likert scores were used to collect feedback. Results Total 24 third year medical students attended the two teaching sessions. 100% either agreed or strongly agreed the classroom teaching was useful, compared to 75% for the escape room. 67% either agreed or strongly agreed that escape room style teaching is a better learning method than traditional teaching. Although, 79% either agree or strongly agree that escape room style teaching is a useful adjunct to the traditional teaching. 100% either agree or strongly agree that this teaching will improve their clinical practice. Conclusions Traditional classroom-based teaching is a more useful form of teaching compared to the escape room. Although escape room teaching is a useful adjunct to the current common form of classroom based surgical teaching.

158 Virtual Interactive Surgical Skills Classroom: A Parallel-Designed, Non-Inferiority, Adjudicator-Blinded, Randomised Controlled Trial (VIRTUAL)

Abstract Introduction Virtual classroom training (VCT) is a novel educational method that permits accessible, distanced interactive expert instruction. We aimed to evaluate the efficacy of VCT in comparison to face-to-face training (FFT) and non-interactive computer-based learning (CBL) for basic surgical skills training. Method 72 participants recruited from five London medical schools underwent stratified block randomisation into three equal intervention groups based on subjective and objective suturing experience. VCT was delivered via the BARCO weConnect platform and FFT was provided by expert instructors. Optimal student-to-teacher ratio was used, 12:1 for VCT and 4:1 for FFT. The assessed task was interrupted suturing with hand-tied knots. The primary outcome was post-intervention Objective Structured Assessment of Technical Skills (OSATS) score, adjudicated by two blinded experts and adjusted for baseline proficiency. Results VCT was non-inferior to FFT (adjusted difference 0.44, 95% CI: -0.54 to 1.75, delta 0.675), VCT was superior to CBL (adjusted difference 1.69, 95% CI 0.41 to 2.96) and FFT was superior to CBL (adjusted difference 1.25, 95% CI 0.20 to 2.29). FFT alone was associated with student travel expenses (mean £4.88, SD 3.70). Instructor hours used per student for VCT and FFT were 0.25 and 0.75, respectively. Conclusions VCT has a similar educational benefit to FFT and is a suitable modality of high-quality surgical skills education. VCT provides greater accessibility and resource efficiency compared to FFT. VCT satisfies the requirement for social distancing during the COVID-19 pandemic and is better than non-interactive CBL. VCT has the potential to improve global availability and accessibility of surgical skills training.