PS2 - 08: A PROFICIENCY-BASED SURGICAL BOOT CAMP MAY NOT PROVIDE TRAINEES WITH A DURABLE FOUNDATION IN FUNDAMENTAL SURGICAL SKILLS
Joshua J Weis, MD, Deborah Farr, MD, Kareem Abdelfattah, MD, Deborah Hogg, BS, Daniel J Scott, MD; University of Texas Southwestern Medical Center at Dallas

Introduction: Pre-internship boot camps have become popular platforms to rapidly teach skills to surgical interns. This format has been shown to increase learners’ confidence, but it is unclear whether it translates to durable mastery of skills. This study aimed to analyze retention of knot tying and suturing skills among surgical interns four months after completing a boot camp program.

Methods: General surgery preliminary and categorical interns (n=23) underwent a baseline pre-test for 5 knot tying, 4 simple suturing, and 2 running suturing tasks. Subsequently, participants trained to proficiency scores (based on time and errors) on all tasks during a three day boot camp and took a post-test to verify proficiency. Four months later, all interns took a retention test.

Results: Complete data was available for 20 interns. Proficiency scores significantly improved on all task types from pre-test to post test and significantly regressed on all task types from post-test to retention test (Table 1). Retention percentage (retention-test score/post-test score) decreased as the tasks became more complex (knot tying=88.4%, simple suturing=85.1%, running suturing=81.4%, p=0.01). Case log numbers significantly correlated with retention of the running suturing skill (R=0.41, p=0.03) but did not correlate with retention of knot tying or simple suturing.  

Conclusions: Boot camp style training can rapidly teach fundamental surgical skills to novices; however, skills regress significantly over time with a greater degree of regression seen on more complex skills. Technical skills acquired in boot camp likely need to be supplemented with regular deliberate practice in the operating room or simulation laboratory in order to maintain proficiency.