C2B - 11: EFFICACY OF SELF-DIRECTED SURGICAL SKILLS TRAINING IN TEACHING BASIC SUTURING AND LAPAROSCOPIC SKILLS TO MEDICAL STUDENTS
Kaitlin A Ritter, MD, Jeremy M Lipman, MD, FASCRS; Cleveland Clinic

Introduction: Surgical skills training has traditionally relied upon sessions with teaching from an already proficient instructor. Recent work has explored the efficacy of self-directed learning and the ability of trainees to acquire technical skills independently. We applied a self-directed learning model to the education of medical students during our surgical residency preparatory course (Boot Camp) to assess the ability of trainees to achieve proficiency in basic suturing and laparoscopic skills.

Methods: Graduating medical students at our institution have the option to participate in a Boot Camp. Basic laparoscopic and open procedural skills training is included as an entirely self-directed curriculum with no instruction from course faculty. Students received an instructional manual outlining eleven suturing and four laparoscopic tasks from a pre-designed skills curriculum. Participants were observed performing the tasks and baseline data was collected. Students had unrestricted access to the skills laboratory and were provided with take home practice supplies. During the four week Boot Camp, time was allocated for self-directed practice and reminders regarding post-test assessment were provided. No instruction was provided on these specific skills. At the end of four weeks, students were re-assessed and post-test scores were recorded.

Results: Fifty-five medical students participated over four years. Men represented 56.4% and 96% were right handed. Students achieved improvement in task speed for all laparoscopic skills and 10/11 open suturing skills. Mean improvements were clinically significant and ranged from 16-197 seconds with effect size >0.6 in 8/11 open and 3/4 laparoscopic skills (Table 1). Improvements in completion time reached statistical significance in eight of the eleven open suturing skills and all four of the laparoscopic skills. A significant improvement in proficiency was also demonstrated in eight of the eleven open suturing skills (Table 1).

Conclusions: Our results demonstrate medical students are able to utilize an entirely self-directed model to significantly improve timing and proficiency of surgical skills performance. These findings support the utility of this model in the training and educational development of students.