APGO

Poster
Vicky Moy, BA

Nagaraj Gabbur, MD

Objective: To help prepare senior medical students entering surgical specialties using exercises based on AGCME Competencies.

Methods: Eight fourth year medical students who matched into surgical specialties were paired into teams of two to complete five exercises. These covered Professionalism (P); Practice Based Learning and Improvement (PBLI); Communication and Interpersonal Skills (CIS); Systems Based Practice (SBP); and Patient Care (PC). The AGCME core competency that was not covered was Medical Knowledge. Four students matched into Obstetrics and Gynecology and four matched into General Surgery. Each team consisted of one student from each specialty. Each team member had 7 ½ minutes to complete each exercise (15 minutes in total for each team). At the PC station, each team member had to perform a Laparoscopic task completing peg transfers. In the P station, a scenario about an impaired physician was presented and the team had to examine the ethics of the situation. In the CIS station, the teams had to laparoscopically cut a circle and could only accomplish this by team communication. In the PBLI station, teams were given an EBM exercise and in the SBP station, the teams had to work inter-professionally to complete a suturing task. The teams’ performances were recorded. Follow-up surveys were then sent to participants during their internship year.

Results: Each team was able to complete the PC, PBLI, SBP and P stations but failed to complete the CIS station. At each station, the general surgery resident would go first followed by the OB-GYN resident. Three of the four general surgery residents were unable to complete the CIS task. At each station involving surgical skills (PC, CIS, SBP), the OB-GYN residents on the average completed all tasks > 1 minute faster than their general surgery counterparts. In the PBLI Station, the resources most commonly used were Up-to-Date and MD Consult. In the P station, on the average, each team could only describe 2 out of the 5 ethical issues involved. Follow-up surveys revealed that participants did not think that the exercise improved their confidence level in their surgical skills before and after residency started. However the participants did think that it overall was an excellent preamble to skills needed during residency; very relevant in reviewing the ACGME competencies and a good introduction to the value of interdisciplinary teamwork.

Conclusion: ACGME competency-based surgical exercises and a teamwork approach can help senior medical students for residency. The OB-GYN residents were able to learn from the mistakes of their teammates and thus were able to complete their tasks faster. The CIS and P competencies were the weakest and warrant special attention. Further development of these exercises into a more structured elective can benefit future participants.