Poster4 - 08: THE WHITE BOARD TECHNIQUE FOR SURGICAL RESIDENT EDUCATION
Alexander D Neusner, MD1, Allison Bruff, MD1, Zoe Maher, MD2, Susan E Mackinnon, MD3, Huaquing Zhao, PhD, MS2, I. Janelle Wagner, MD2; 1Temple University Hospital, 2Lewis Katz School of Medicine Temple University, 3Washington University School of Medicine in St. Louis
Background: Preparation for surgical cases is one of the most integral and challenging aspects of surgical residency training. The White Board Technique (WBT) is a method of surgical education that allows the surgical resident to display and be evaluated on his or her preparation for a case. We hypothesize that implementation of the WBT improves resident case comprehension and preparedness.
Methods: 48 general surgery residents and fellows at (redacted) participated in this prospective, cohort interventional study to evaluate the effectiveness of the WBT. Dry erase boards were installed in each operating room. The WBT required the operative senior resident to write the case steps on the right side of the board, while the junior resident wrote the relevant medical history on the left side of the board. The attending surgeon then reviewed and annotated the board with the team prior to the start of the case. Residents and attendings completed a 6 question Likert scale survey after each case, designed to assess resident case preparedness and comprehension. A cumulative score was then calculated. The surveys were completed for 3 months prior to implementation of the WBT and for 3 months after the implementation of the WBT. Survey results were then compared with a T test and Wilcoxon rank-sum test.
Results: Between March 2017 and July 2017, 94 surveys were completed by surgical residents. After implementation of the WBT, trainees spent more time on average preparing for cases (21.6 vs 26.5 minutes, p=0.359). Pre-operative case preparation improved significantly (4.0 vs 4.7, p= 0.0266). Comprehension of indications for the procedure significantly improved between pre- and post-intervention (4.4 vs 4.9, p= 0.0307). Cumulative scores significantly improved, (20.2 vs 20.9, p= 0.0339). Although not all scores in each category had a statistically significant improvement, an overall trend of increased scores was observed.
Conclusions: The WBT significantly improved resident and fellow case preparation time, comprehension of indications, and overall sense of preparedness, with positive trends identified in knowledge of common errors, steps of procedure, and post-operative complications. The WBT is an effective method of improving and evaluating resident preparedness for surgical cases.