Poster3 - 09: THE IMPACT OF INTERN YEAR ON CATEGORICAL GENERAL SURGERY TRAINEES CONFIDENCE WITHIN ACGME CORE COMPETENCIES: A PILOT STUDY
Jeffrey E Silpe, Clairice Cooper, MD, Associate Program Director, James K Lukan, MD, Program Director; University at Buffalo General Surgery Residency Program
Background: The ACGME, in 1999, introduced six core competencies that have been incorporated into instructional design and assessment among residency training programs. Although an abundance of literature exists that describes pre-residency factors which may improve confidence and performance at the start of internship, there is a paucity of literature describing the progression of residents’ confidence levels within these competencies. Surgical interns are challenged with a large cognitive load that spans the core competencies. We hypothesize that surgical interns’ confidence should increase within every ACGME core competency throughout the year.
Design: Longitudinal study.
Setting and Participants: Surveys were administered to all categorical general surgery interns before the start of internship and at the end of intern year, both electronically, at a large general surgery residency program.
Interventions: Participants self-reported demographics, level of confidence for 19 items regarding various intern year experiences representative of all core competencies (5- or 7-point Likert scales), ABSITE score, USMLE scores, research participation, operative case participation, medical school, and prior years of residency on surveys created for the purposes of this study.
Main outcome measures: Paired-t tests were used to analyze differences in means among pre- and post-intern year responses within subjects.
Results: Response rate was 67.7%, including 4 males and 2 female participants. There was a statistically significant (p<.05) increase in mean confidence level among all five items representative of interpersonal and communication skills, two of the three questions which set out to measure practice-based learning and improvement, and three of the four questions which described patient care experiences. Only one medical knowledge- and one system-based practice-related question demonstrated a statistically-significant increase in mean confidence level. There was no statistically significant difference in confidence in the only professionalism-related question.
Conclusions: Surgical intern confidence levels increase significantly among the Interpersonal and Communication Skills, Patient Care, and Practice-Based Learning and Improvement competencies. The lack of improvement in confidence among the other competencies is somewhat surprising as residency curriculums are designed to teach within all the ACMGE core competencies. This pilot study signifies the need for future research with a larger representative sample to address the stated hypothesis.