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Purpose: Today’s general surgery interns are faced with increased duty hours restrictions and stringent competency-based supervision milestone requirements (i.e., direct to indirect supervision). Working within these constraints, we instituted a unique two month intern curriculum incorporating knowledge-based, experiential, and practical components.
Methods: All interns underwent a two month bootcamp curriculum consisting of two 2½ hour knowledge-based and skills/sim-man didactic sessions per week and completion of the 25 core ACS Fundamentals of Surgery online self study modules followed by a standardized patient Clinical Skills Assessment (CSA) lab. To evaluate this program and its impact, we used several assessment tools: Master Interview Rating Scale (MIRS), self assessment and intern absite scores. Data were analyzed by independent group t-tests and chi square test of proportions.
Results: 82% of intern respondents agreed or strongly agreed with the utility, relevance, and execution of the bootcamp. After initiation of the new curriculum, the proportion of residents scoring in the top quartile increased from 10% to 50% (p=.0001). The CSA scores after this two month bootcamp paralleled the scores typically seen at the end of internship (p=.96).
Conclusions: Recent changes in intern duty hours and supervision rules mandate residency training programs to evaluate and institute competency-oriented curricula to provide interns the necessary knowledge and practical skills to attain clinical competence. Experience with the Clinical Skills Assessment demonstrated that interns could achieve clinical competency earlier with a focused curriculum geared toward this goal.