- 作者：Bethany Skinner ; MD ; skinnerb@med.umich.edu" class="auth_mail" title="E-mail the corresponding author ; Helen Morgan ; MD ; Emily Kobernik ; MPH ; Neil Kamdar ; MA ; Diana Curran ; MD ; David Marzano ; MD ; Maya Hammoud ; MD
- 关键词：preoperative ; education ; curriculum ; residency ; preparedness ; milestones
- 刊名：Journal of Surgical Education
- 出版年：2016
- 出版时间：July-August 2016
- 年：2016
- 卷：73
- 期：4
- 页码：735-740
- 全文大小：209 K
Design
The Decision to Incision curriculum was developed by a team of medical educators with the goal of teaching and evaluating 5 skills pertinent to Milestone 1: Preoperative consent, patient positioning, Foley catheter placement, surgical scrub, and preoperative time-out. Competence, overall skill performance, and knowledge were assessed by evaluator rating using checklists before and after the educational intervention. Differences between preintervention and postintervention skills performance and competence were assessed using Wilcoxon rank test and Fisher exact test, respectively.
Setting
Clinical Simulation Center at an academic medical center.
Participants
Overall, 29 fourth year medical students matriculating into Obstetrics and Gynecology residencies.
Results
The proportion of participants meeting Milestone competence significantly increased in all 5 skills, with competence achieved in 95.6% (95% CI: 92.1-99.0) of posttest skills assessments. Median overall performance also significantly improved for all 5 skills, with 83.6% (95% CI: 77.3-89.9) earning scores of 4 out of 5 or greater on the posttest. For knowledge testing, the proportion of correct responses significantly increased for both topics evaluated, from 45.2% to 99.7% (p < 0.0001) for positioning and from 32.8% to 83.1% (p < 0.0001) for time-out.
Conclusions
The decision to incision curriculum significantly improved preoperative skills, including skills that may be required on day 1 of residency. This curriculum also facilitated achievement and documentation of competence in multiple Milestones.