Results of a Surgical Simulation Course Designed to Improve Surgery Clerkship Performance.

BACKGROUND AND OBJECTIVES: During the 2015-2016 academic year, Rocky Vista University College of Osteopathic Medicine (RVUCOM) conducted a required 1-week surgical simulation course as the first week of students' 8-week surgical clerkship. This course was adapted from a pilot RVUCOM surgical simulation course and other surgical simulation courses identified in the literature. The objectives of this course were to teach surgical skills and clinical knowledge, aid students in adjusting to the stress of a surgical clerkship, and improve students' confidence and abilities during the clerkship.

METHODS: In all, 148 students participated in the surgical simulation course. Subjective assessment of this course included each student completing a daily standardized stress survey and student feedback surveys at the end of the course and at the end of the surgical clerkship. Objective assessment of this course compared precourse and postcourse tests of surgical knowledge and instrument identification, as well as comparison of NBME Surgery Subject Assessment percentile ranks of this class with 3 prior classes.

RESULTS: Daily stress surveys indicated decreased stress on day 5 compared to day 1 (p < 0.01). Students' confidence level increased significantly on day 5 compared to day 1 (p < 0.01). Student feedback surveys demonstrated students' perception that surgical skills and clinical skills had been learned during the course and that the course improved their performance during the surgical clerkship. NBME Surgery Subject Assessment percentile rank improved significantly (p < 0.01) from a mean percentile rank of 36.94 for 3 previous classes to a mean percentile rank of 43.82 for the class who completed the simulation course. Surgical knowledge improved significantly (p < 0.001) from a pretest mean score of 47.02% to a posttest mean score of 55.14%. Surgical instrument identification improved significantly (p < 0.001) from a pretest mean of 13.81% to a posttest mean of 95.28%.

CONCLUSION: The RVUCOM surgery simulation course significantly improved student performance academically and helped students acclimate to stress, increase their confidence level, and acquire surgical skills needed during the third-year surgery clerkship.