C4 - 06: RESTRUCTURING EDUCATION USING SCORE© IN EARLY TRAINING: (RESET): IMPLICATIONS FOR DEVELOPING A STANDARDIZED SURGICAL CURRICULUM IN UNDERGRADUATE MEDICAL EDUCATION
Valerie P Bauer, MD, Clerkship Director, John D Bauer, MD, Associate Dean Medical Education, C Neal Ellis, MD, Chairman Program Director; Texas Tech University Health Sciences School of Medicine- Permian Basin

Background: The Surgical Council on Resident Education (SCORE) curriculum is a level based program used in surgical residency to promote uniform skill and knowledge among surgical interns, and long-term acquisition of content knowledge needed for successful qualifying board examination [1]. Core SCORE (cSCORE) curriculum provides standardized learning objectives, content validity, and self-assessment tools that have undefined benefit to learners if offered earlier during undergraduate medical education.

Objectives: To provide proof of concept in the feasibility of early implementation of core SCORE curriculum in undergraduate medical training; (2) to identify benefit to student learners in satisfaction and NBME performance.  

Methods: SCORE accounts for medical students on surgical clerkships were created across all campuses. A third and fourth year curriculum using 2015-2016 core SCORE topics was organized and assigned to individual users. Prospective data on program use was collected from from October 2015 to June 2017 (n=36). Correlation between use and performance on shelf exam was compared to that of control group of 24 students from 2014-2015 prior to SCORE implementation. Students completed a learner satisfaction survey on a 5 point, Likert-type scale after the exam where 1=strongly disagree, 2=somewhat disagree, 3=neutral, 4= somewhat agree, and 5=strongly agree.

Results: Shelf exam scaled scores in the control group averaged 77.5 (SD + 1.13) compared to 68.0 (SD + 7.33). Overall, 94% of the students passed the shelf exam the first time. Students using SCORE averaged a total of 25 login episodes and completion of 5 modules. No correlation was found between performance on the shelf exam and number of logins to SCORE (Spearman rho=0.12, p=0.542). There was no association between likelihood of passing the NBME and number of modules completed in SCORE [chi 2(1)=0.002, p=0.960]. Learner satisfaction ratings improved with measured participation in SCORE.

Conclusion: Students failed to complete the curriculum which was unfocused and large. Data collection was small due to limited student participation in other campuses. Student confidence improved with participation, but shelf exam scores did not. Additional work needs to be done to develop an appropriate surgical curriculum for early learners.