The Teaching of Procedural Skills During Surgery Rotation: Are Students Learning Enough?

Abstract

This study has several aims: 1. assess student exposure to procedural skills training during the core surgery rotation, 2. determine whether procedural goals set by the Yale Department of Surgery are being met, 3. investigate potential discrepancies in education in procedures based on the gender of the student, and 4. evaluate who is providing the majority of procedural training to students (i.e. residents or faculty, women or men, etc). An original survey was distributed to third-year medical students at the completion of their core surgery clerkship. It assessed their experiences with a list of 22 procedures and collected demographic data. These data were analyzed based on student gender, core surgical rotation site, and instructor level. On average, students met expectations of exposure to 6 out of 13 procedures considered important for students to learn by the Department of Surgery, but did not have the expected level of exposure to the remaining 7 listed procedures. There were few overall gender differences among student regarding the level of experience with procedures; however, at the Veterans Administration Medical Center, men reported significantly more experience in 4 of the 22 procedures. The vast majority of instruction in procedural skills was performed by surgical housestaff, with both female housestaff and female attendings teaching a greater proportion of procedures than their representation in the residency/faculty body would predict. Medical students at Yale are not gaining experience with surgical procedures to the extent that the department believes they should. In general, there is equal experience with procedures between genders. A formalized checklist of procedures may be helpful in assuring that students have adequate exposure to the surgical procedures they are expected to encounter