Poster2 - 04: POST-INTERNSHIP SURGICAL BOOT CAMP INCREASES CONFIDENCE FOR INTERNS TRANSITIONING TO SENIOR RESIDENT RESPONSIBILITIES
Grace S Lee, MD, MSME, Andrew D Newton, MD, Rachel Kelz, MD, MSCE, Kristoffel Dumon, MD, Jon B Morris, MD; University of Pennsylvania

Purpose: Pre-surgical internship boot camps enhance confidence in technical and medical management skills for surgical interns. The impact of post-internship boot camps on the confidence of post-graduate year (PGY) 2 residents is unknown. We hypothesized that a post-internship boot camp would improve PGY2 resident confidence in managing tasks and responsibilities of senior residents.

Methods: A one-time mandatory two-hour boot camp curriculum at our simulation center was implemented in July 2016 for all PGY-2 residents who were expected to perform in-house senior on duty (SOD) responsibilities at our institution. In 2016, the curriculum included central line placement, arterial line placement, chest tube placement, emergency airway management, and night-time patient phone call triage. After feedback, the 2017 curriculum replaced patient phone calls with mock code scenarios. Confidence was measured on a 1 to 5 Likert scale prior to and immediately after the boot camp. Three month follow-up was assessed in the 2017 cohort. Data were analyzed with the sign-rank test or Wilcoxon rank-sum where appropriate.

Results: Thirty one PGY-2 residents (n=16 in 2016, n=15 in 2017) completed the boot camp curriculum. Confidence in being the SOD was significantly increased immediately after the boot camp (median 2 vs. 3 in 2016, 2 vs. 4 in 2017, p<0.001). Confidence was significantly increased in placing central lines (median 3 vs. 4 in 2016, 2 vs. 4 in 2017, p<0.001), placing chest tubes (median 3 vs. 4, p=0.01), managing emergency airways (median 1.5 vs 3.5 in 2016, 3 vs. 4 in 2017, p<0.001), and running a code (median 2 vs. 4, p=0.03). Three month follow-up in 2017 (n=10) demonstrated no significant difference in confidence compared to immediate post-boot camp results.

Conclusions: Boot camps can improve confidence in skills expected of PGY-2 residents assuming in-house senior resident responsibilities. As trainees navigate changing expectations and graduated autonomy throughout residency, surgical boot camps can facilitate transitions between levels of responsibilities.