Poster5-05: A SURGICAL TEACHING AND RESIDENT (STAR) COACHING PROGRAM IMPROVES THE CLERKSHIP EXPERIENCE
Phillip Dowzicky, MD, Jennifer Fieber, MD, Cary B Aarons, MD, Jon B Morris, MD, Ari D Brooks, MD, MS; University of Pennsylvania

Purpose: Medical students often request more directed feedback and observation during their surgery clerkship.  We hypothesized that a resident teaching and coaching program focused on direct observation and feedback would improve the surgical clerkship educational experience.

Methods: The STAR Program consisted of surgery residents coaching small groups of clerkship students a half-day every week with direct patient contact.  Residents received educational material on teaching skills and effective feedback.  Each student was observed performing a history and physical exam (PE), received resident feedback, and presented to an attending surgeon. Student feedback was formative. Residents and attendings did not evaluate or grade students. Students were surveyed pre-clerkship, post-STAR program, and at clerkship end. Using a 5-point Likert scale, surveys evaluated satisfaction, observation compliance, confidence, and Objective Structured Clinical Examination (OSCE) preparedness.

Results: In the first 12-weeks, 32 students participated in the STAR program with survey completion rates of 63% (pre-encounter), 100% (post-STAR), and 56% (clerkship end).

1. Satisfaction: Approximately 94% of students were satisfied with feedback received. Students rated the opportunity to present to an attending, receive feedback, and ask questions most favorably[FJ1] .

2.Observation: Prior to the STAR program, 58-65% of medical students were observed performing a patient history and/or PE and 84% were observed presenting a patient during their surgery clerkship. After the initiation of the STAR program, 100% of students were observed performing a history, physical exam, and presentation.

3. Confidence: Completion of the STAR program was significantly associated with increased confidence in patient history taking (mean 3.83 vs. 3.57; p=.004), performing a PE (mean 3.77 vs. 3.35; p=.007), and presenting to an attending (mean 3.61 vs. 3.05; p=.017).

4. OSCE score: Prior to STAR program initiation, medical students averaged a 2.89/4 for preparedness and 3.34/4 for confidence presenting to a faculty preceptor following their OSCE.  After the STAR program, medical students averaged a 2.90/4 for preparedness and  3.53/4 for confidence presenting to a faculty preceptor following their OSCE.

Conclusion: Our STAR Program pilot suggests that a protected, low-stress environment for focused, directed observation of medical students is associated with an improvement in clerkship satisfaction and confidence in multiple domains.