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A Mentorship-Based Preclinical Elective Increases Exposure, Confidence and Interest in Surgery Patrick M. Mulvaney, BA 1 Suma Sangisetty, MD 1 Brian C. Drolet, MD 1,2 Beth A. Ryder, MD, FACS 1 William G. Cioffi, MD, FACS 1 1 Department of Surgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital 2 Division of Plastic Surgery
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Disclosures Financial support provided by the Rhode Island Hospital Office of Graduate Medical Education for SurveyMonkey® licensing Preliminary data from this study were presented as a poster at the American College of Surgeons Clinical Congress, October 2012 No conflicts of interest
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Outline Describe course rationale, programming and structure Report results from student surveys
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Rationale Health Research and Safety Agency predicts a shortage of over 20,000 general surgeons by 2020 Exposure to surgery translates into favorable opinions of the field (O’Herrin, 2003 and 2004; Naylor, 2010) Preclinical years viewed as a potential target for intervention (Bland, 2003) Methods identified or utilized to improve interest: Surgeons as anatomy lab instructors (Zaid, 2010) Surgical skills workshops (Markovic, 2012) Student-resident mentorship (Nguyen, 2006) Structured course offering (Sammann, 2007)
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Course Purpose and Goals Identify medical students interested in surgery Provide an opportunity for these students to explore surgical interests through a structured course Maintain and enhance professional interest in surgery through education and resident mentorship
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Course Logistics Started in the fall of 2012, 4 th class is currently in session 12-week course, grading: pass/fail Average enrollment: 8 students (range: 5-11) Didactic 6 case modules led by BR, BD and SS 1 case presentation led by each student Experiential 8 operative experiences 2 departmental conferences (Grand Rounds, M&M, etc.) 1 of each of the following: outpatient clinic, team rounds, skills session (laparoscopic or suturing/knot tying)
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Leadership Structure
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Study Design IRB-approved, anonymous survey of students Administered to: Elective students before the course Elective students after the completion of all requirements Non-elective M1 and M2 students at the Warren Alpert Medical School of Brown University 29 multiple-choice questions on a five-point Likert Scale in a self-administered electronic format
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Results Elective (test) group: n=24 (100% response rate) General (control) cohort: n=147 (67% response rate) Overall course satisfaction: 4.8/5 Significant difference (p<0.01) in most pre- vs. post- course metrics aimed at assessing confidence, exposures and perceptions of surgery
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Composite Results (1= least through 5= most)
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Exposure
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Confidence
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Conclusions A preclinical elective centered around mentorship can effectively improve exposure, confidence and interest in surgical careers Effective course implementation requires: Institutional support Effective leadership Dedicated resident-mentors Motivated students
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Future Work Continued improvement based on student feedback Evaluate course impact on: Clerkship performance Match rates
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Thank you Questions
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References Physician Shortage Spreads Across Specialty Lines. AAMC. (Accessed Aug. 8, 2012, at https://www.aamc.org/newsroom/reporter/oct10/152090/physician_shortage_spreads_across_specialty_lines.html.) Bland KI. The recruitment of medical students to careers in general surgery: emphasis on the first and second years of medical education. Surgery 2003;134(3):409-13. Markovic J, Peyser C, Cavoores T, Fletcher E, Peterson D, Shortell C. Impact of endovascular simulator training on vascular surgery as a career choice in medical students. J Vasc Surg 2012;55(5):1515-21. Naylor RA, Reisch JS, Valentine RJ. Do student perceptions of surgeons change during medical school? A longitudinal analysis during a 4-year curriculum. Journal of the American College of Surgeons 2010;210(4):527-32. Nguyen SQ, Divino CM. Surgical residents as medical student mentors. American journal of surgery 2007;193(1):90-3. O'Herrin JK, Lewis BJ, Rikkers LF, Chen H. Why do students choose careers in surgery? The Journal of surgical research 2004;119(2):124-9. O'Herrin JK, Lewis BJ, Rikkers LF, Chen H. Medical student operative experience correlates with a match to a categorical surgical program. American journal of surgery 2003;186(2):125-8. Sammann A, Tendick F, Ward D, Zaid H, O'Sullivan P, Ascher N. A surgical skills elective to expose preclinical medical students to surgery. The Journal of surgical research 2007;142(2):287-94. Zaid H, Ward D, Sammann A, Tendick F, Topp K, Maa J. Integrating Surgical Skills Into the Anatomy Laboratory. 2010; 158(1): 36-42
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