PS2-05: CONFIDENT, NOT COMPETENT: LARGE SCALE IMPLEMENTATION OF ACS-ASE SURGICAL SKILLS CURRICULUM
Jennifer Calzada, MA, MPH, Christopher DuCoin, MD, MPH, FACS; Tulane University School of Medicine

The ACS-ASE surgical skills curriculum was utilized as the basis for core skills simulation orientation for 192 new third year medical students, during the Spring of 2018. Skills included: suturing, male and female urinary catheterization, phlebotomy, and IV starts. Students were provided through an online LMS, procedure videos, the ACS-ASE procedure guides (modified), and rubrics.

Students were divided into groups and assigned 3 hour time blocks. They were randomly paired to rotate through skills stations and complete peer review. All students completed a confidence and simulation effectiveness survey prior to beginning skills stations and the same survey after skills. 

Through the use of a 5-point Likert confidence scale on pre and post surveys, we determined both learners’ perceptions of simulation effectiveness and self-confidence in their skills. All questions resulted in an overall increased mean, ranging from a low of a 3% increase for simulation helps me learn procedural skillsto a high of 46% increase for I am confident in my advanced suturing skills.

Through the use of the ACS-ASE checklist, students skills were assessed by both peer review and expert review, through the use of video recordings. The mean peer review checklist total was 95%, where the mean expert checklist was only 61%.  This comparison of expert to peer review ratings and student’s own skills confidence demonstrated that confidence did not equal competence. 

We think this implementation of modules of the ACS-ASE surgical skills curriculum demonstrates that simulation contributed to increased learner confidence in their skills. However, it did not contribute to actual skills improvement when assessed by experts. We hypothesize this can be improved through in-person skills demonstration sessions with expert faculty instead of solely relying on prior exposure and self-guided learning with video and procedure guides.