C1 - 06: EVALUATING A NOVEL SURGICAL RISK ASSESSMENT CURRICULUM FOR MEDICAL STUDENTS
Samantha L Ahle, MD, Raymond A Jean, MD, Alexander S Chiu, MD, Kevin Y Pei, MD; Yale School of Medicine

Purpose: Predicting surgical risk is challenging and medical professionals, including medical students, frequently overestimate postoperative morbidity and mortality.  Risk-adjusted models are abundant yet there is no curriculum to teach risk assessment to students. We hypothesize that a risk assessment curriculum will improve medical students’ confidence in and familiarity with assessing surgical risk.

Methods:  Third year medical students at a tertiary, academic medical center participated in a one-hour interactive session at the beginning of their surgical clerkship.  Students first predicted the likelihood of postoperative morbidities and mortality without the use of risk-adjusted models, then were instructed on use of the National Surgical Quality Improvement Program calculator.  The session facilitator encouraged reflection and debriefed students about the results.  Students completed pre- and post-intervention surveys assessing their familiarity with risk-adjusted models, and confidence in predicting postoperative complications and death using a 1-5 Likert scale with 5 being the most confident.  At the end of their 12-week rotation, participants completed a follow-up survey about their use of risk adjusted models. Paired t-test was used to compare mean scores.

Results:  63/90 (70%) students completed the risk assessment curriculum with pre- and post-surveys. Following the session, students felt more confident in predicting postoperative complications (pre-mean 1.9 vs. post-mean 3; p < .0001) and postoperative death (pre-mean 1.7 vs. post-mean 2.7; p < .0001), felt they could more accurately predict postoperative complications (pre-mean 1.8 vs. post-mean 2.4; p < .0001), and felt more likely to use risk-adjusted models in the future (pre-mean 1.9 vs. post-mean 3.5; p < .0001).  27/90 (30%) of students completed the additional post-rotation survey, twelve weeks after their initial assessment. Of those students, 65% continued to feel more confident in predicting postoperative morbidities and mortality. Further, 35% of students queried used the calculator ‘1-4 times’ during their rotation, and 83% of students believed the risk assessment session was valuable.

Conclusions: This novel risk assessment curriculum improved student confidence towards assessing surgical risk. Nearly all students recognized value of formalized curriculum, and many continued to consult risk-adjusted models after the course.  Future studies will incorporate this curriculum for residents and staff surgeons.