C2B - 12: MEDICAL SCHOOL BOOT CAMPS AND SUTURING SKILLS: IS THERE A BENEFIT?
Robert McMillan, MD1, Philip Redlich, MD, PhD1, Robert Treat, PhD1, Matthew Goldblatt, MD, FACS1, Thomas Carver, MD1, Christopher M Dodgion, MD, MSPH, MBA1, Zane Prewitt, MD1, Jacob R Peschman, MD1, Christopher S Davis, MD, MPH1, Jeremy Grushka, MDCM, MSc, FRCSC, FACS2, Lisa Olson1, Theresa Krausert1, Brian Lewis, MD1, Michael J Malinowski, MD1; 1Medical College of Wisconsin, 2McGill University Health Centre
Introduction: M4 boot camps are designed to improve preparedness of students entering residency. We have previously reported a benefit of boot camps on suturing skills of incoming residents, and now report on a second cohort. Our goal was to evaluate the impact of boot camps on intern suturing skills when measured during surgical residency orientation.
Methods: 27 interns completed questionnaires over two-consecutive years regarding their M4 boot camp experiences. In June of 2016 and 2017, interns were evaluated on suturing (18 one-point items), knot tying (16 one-point items), overall performance (1 five-point item), and quality (1 five-point item) by three surgeons, blinded to the questionnaire results, using modified assessment forms published by the APDS/ACS for OSATS and global rating evaluation. Descriptive statistics are reported with means (Mn) and standard deviation (s). The association of skills is reported with Spearman rho (SpR) correlations and inter-rater reliability determined by intraclass correlation coefficients (ICC). Analysis generated with IBM® SPSS® 24.0.
Results: Over two years, 16 of 27 (59%) interns reported boot-camp training. In comparing groups with and without training, 6 of 12 interns (2016) with training had higher suturing scores (Mn(s)=14.9(2.3) vs 12.8(3.7), p<0.048). Scores in knot tying (11.8(4.1) vs 9.5(3.7), p=0.081), overall performance (2.4(0.8) vs 2.2(0.8), p=0.344), and quality 2.4(0.8) vs 2.2(0.7), p=0.409) did not reach statistical significance. 10 of 15 interns (2017) with training demonstrated no statistical difference in suturing (8.2(5.3) vs 8.1(4.3), p<0.95), knot tying (8.5(4.3) vs 7.8(5.0), p<0.61), overall performance (2.0(1.1) vs 1.7(1.0), p=0.471), and quality (1.9(1.0) vs 1.7(0.9), p=0.651). When analyzed in aggregate, scores in suturing (10.4(5.4) vs 10.5(4.6), p<0.947), knot tying (9.5(4.4) vs 8.6(4.3), p=0.385), overall performance (2.1(1.0) vs 2.0(0.9), p<0.385), and quality (2.0(0.9) vs 2.0(0.8), p<0.943) demonstrated no statistical significance. There was significant correlation in all skill evaluations (SpR range=0.63-0.90), p<0.001) and ratings were consistent (ICC(2,1)=0.24-0.60, p<.03).
Conclusions: Despite M4 boot-camp training, we did not demonstrate a statistically significant advantage in suturing skills at the start of residency. Further study is warranted to evaluate the benefit of boot camps on technical skills of incoming residents.