Using a Simulated Surgical Skills Station to Assess Laceration Management by Surgical and Nonsurgical Residents

Abstract

Abstract Objective To assess laceration management performance among surgical and nonsurgical postgraduate year-1 (PGY-1) residents objectively and to test for interval improvement. Methods From 2006 to 2008, 106 PGY-1 residents from 10 medical specialties were evaluated with a simulated surgical skills station using pigs' feet before and after internship. Subjects were given 11 minutes to choose the proper suture, prepare and close the wound, and answer laceration management questions. Trainees were classified as surgical (emergency medicine, general surgery, obstetrics and gynecology, orthopedics, and otolaryngology) and nonsurgical (family medicine, internal medicine, neurology, pediatrics, and transitional year). An objective checklist was used to assess performance. Results A total of 106 PGY-1 residents (age range, 25–44 years; mean, 28.7 years) participated, consisting of 41 surgical (39%) and 65 nonsurgical residents (61%). Surgical group scores improved from 78.4% to 87.7% (P < .001). Nonsurgical scores improved from 67.2% to 73.1% (P < .001). There was similar improvement between groups (surgical, 9.4%; nonsurgical, 5.9%; P  =  .21). Surgical residents outscored nonsurgical residents before (P < .001) and after (P < .001) internship. Conclusion Surgical residents outperformed nonsurgical residents before and after the PGY-1 year with similar score improvements. A simulated surgical skills station can be used to evaluate procedure performance objectively and to test for interval improvement. A simulated surgical skills station may serve as a useful adjunct to apprenticeship in assessing procedure competence.