Poster Session II - Curriculum Development
(P010) DEVELOPMENT AND IMPLEMENTATION OF A NOVEL SURGICAL FACULTY DEVELOPMENT PROGRAM WITHIN A LARGE ACADEMIC HEALTH SYSTEM
John Stratigis, MD, MSEd, Eric Gantwerker, MD, MMSc, Bailey Roberts, MD, PhD, Colleen Nofi, MD, PhD, Vincent Eng, Jared M Huston, MD; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Introduction:
Core faculty within general surgery residency programs are essential to training the next generation of competent and skilled surgeons. Many surgical faculty, however, must fulfill their teaching responsibilities without any formal training in adult learning theories, principles, or instruction methods. To enhance faculty educational skills and promote a more robust learning environment, we created and implemented a regional faculty development program termed Fundamentals of Surgical Education, or FuSE. The primary goal was to provide busy clinical surgeons with a solid foundation in learning theory and a practical framework for application of this knowledge within their practices at a large academic health system in New York.
Methods:
Nine early-career (56%, <5y) attending surgeons working at five geographically distinct urban or suburban clinical sites enrolled in the pilot program. The mean age is 36.7y, and 44.4% of the cohort are female. Their primary specialties include bariatric/MIS, colorectal, general surgery, pediatric surgery, surgical oncology, or trauma surgery. Longitudinal sessions consist of virtual or in-person meetings for ninety-minutes monthly. Session topics include foundations of learning theory, teaching in the clinic or operating room, facilitating didactics, giving effective feedback, and dealing with challenging learners. Faculty are assigned pre-work before sessions and complete post-session surveys on the overall effectiveness of the lesson and facilitator, achievement of the stated learning objectives, and suggestions for improvement.
Results:
Pre-course Likert-scale surveys show that the cohort is most confident (88%) with intraoperative teaching, and least confident (22%) when dealing with difficult learners. 11% believe they have sufficient understanding of educational theory. 33% are familiar with effective feedback methods. Half-way through the program, most faculty favor in-person to virtual sessions, and receiving pre-session assignments to facilitate their learning. At the conclusion of the first 5 sessions, 100% of respondents reported that these sessions have enhanced their learning and ability to educate trainees.
Conclusions:
Here we describe a novel academic surgical faculty development program (FuSE), including the rationale, curricular design, implementation strategies, and preliminary outcomes. This and future iterations of the program will hopefully serve as models for larger regional and/or national faculty development initiatives to enhance general surgery resident education.
(P011) TRAINEE PERCEPTIONS OF A TRANSITION TO THE LONGITUDINAL INTEGRATED CLERKSHIP (LIC) MODEL FOR SURGICAL EDUCATION: A MIXED METHODS STUDY
Colleen E McDermott, MD, MPH, Katie Glasgow, MD, Laura Lambert, MD, FACS, FSSO, Kshama Jaiswal, MD, Kirstyn Brownson, MD; University of Utah
Background: An LIC model has been explored as an alternative to traditional block clerkships (TBC). In the LIC, students spend 2.5 days per month with a faculty mentor in each specialty. They also participate in a 2-week inpatient surgical block. This represents a departure from the resident-led inpatient team model. There has been little research investigating surgical trainees’ perceptions regarding the LIC, despite the potential impact on their development as educators. Our study aims to learn more about how these key stakeholders view the LIC.
Methods: A survey instrument was developed in Qualtrics which included multiple-choice questions, Likert-scale items, and free-response. It was approved by the local Institutional Review Board (IRB), and distributed to trainees via listserv. A brief thematic analysis of free-response feedback on LIC was conducted in Excel. All other analyses were performed in STATA. A Wilcoxon Signed-Rank Test was used to evaluate ordinal data.
Results: 80 responses were collected from 170 trainees across 7 surgical specialties with a response rate of 47%. 49% of respondents were fellows or senior residents (PGY4+). Trainees recommended 10 weeks of inpatient surgical experience for surgery-bound students and 5.8 weeks for those not pursuing surgery. They believe the LIC model to be inferior in terms of the following learning objectives: interprofessional teamwork, presenting patients, clinical testing, clinical reasoning, documentation (p<0.0001), patient interviewing, and physical examination (p<0.05). Trainees perceived TBCs as superior in encouraging students to pursue surgical careers, preparation for residency and career, comprehensive exposure to surgical disease, and establishing a strong surgical education foundation (p<0.0001); it was equivalent to LIC in terms of mentorship (p=0.37). Qualitative analysis of trainee concerns revealed the following themes: 1) poor overall educational quality 2) unrealistic experience for a surgical field, 3) detrimental to residents 4) implementation concerns.
Conclusions: Trainees favored TBC in terms of perceived efficacy in accomplishing overall educational goals and skill development. Trainees felt that a minimum of 5.8 weeks of inpatient surgical exposure was necessary for all medical students. Thematic analysis of LIC feedback revealed specific perceptions of LIC shortcomings.
(P012) SHIFTING PARADIGMS: THE INFLUENCE OF MODERN UNDERGRADUATE SURGICAL EDUCATION ON RECENT GRADUATE PERCEPTIONS
Brett Norling, MD1, Nell Maloney Patel, MD2, Randi Lassiter, MD1; 1University of Minnesota Medical School, Department of Surgery, 2Rutgers Robert Wood Johnson Medical School, Department of Surgery
Introduction: Undergraduate medical education has undergone significant change in response to high rates of student burnout, the COVID-19 pandemic, and increasing hyper-specialization of medicine. These changes have resulted in modifications in length and delivery of core surgical clerkships. As a result, student expectations and experiences have evolved over time.
Methods: An externally validity tested anonymous survey was distributed via email to all practicing physicians and surgery faculty a large US medical school, as well as a subset of recent graduates from the medical school. The survey collected quantitative and qualitative data regarding clerkship structure, valuable experiences, Likert scales, and demographic data. Data was stored securely and analyzed using Microsoft Excel and STATA.
Results:?400 survey responses were received. 391 responses were included, of which 73.4% were faculty and 27.6% were trainees. Median age of the faculty and trainee groups was 41 and 30, respectively (p<0.001). More trainees self-reported being non-white (27.8% versus 20.1; p=0.105). Similar proportions of faculty and trainees were working in a surgical specialty (26.5% versus 29.5%). Faculty reporter higher median optimal length of the surgical clerkship compared to trainees (6 weeks IQR 4,8 versus 5 weeks IQR 4,8; p<0.001). Trainees were less likely to take overnight call during their core clerkship (62.6% versus 86.9%; p<0.001) and more likely to believe this was an unimportant aspect of the clerkship compared to faculty (67.6% versus 28.5%; p<0.001). Faculty rated the core clerkship as valuable to their current practice more frequently than trainees (71.9 % versus 59.8%; p=0.022). Around half (55.1%) of all participants reported their experience on a surgical clerkship influenced their specialty choice. Both groups frequently reported scrubbing cases as one of the most important experiences during their surgical clerkship (89.0%). Significantly more faculty endorsed overnight call as an important experience compared to trainees (24.7% versus 7.4%; p<0.001).
Conclusion: Faculty and trainees have differing ideas regarding the value of the core surgical clerkship as it relates to their current practice. Trainees desire shorter surgical clerkships in comparison to faculty and view overnight call as less critical. Shared opinions remain regarding the value of scrubbing cases during surgical clerkships.
(P013) PREPPP TRIAL: HANDS-ON HYBRID PAIN MITIGATION PROGRAM FOR OPERATIVE-RELATED PAIN
Steven L Cochrun, MD, Tony Boualoy, MD, David Girardot, DPT, Kevin Pei, MD; Parkview Health
Introduction:
Surgeons, both in training and in practice, experience work-related pains. These pains have been shown to contribute to shorter careers, decreased work satisfaction, and increased burnout. There have been some attempts to address this through intervention, but most are retroactive in design. Our previous study revealed the benefit of self-education on proactively mitigating pain. The subsequent phase of this study assesses the effectiveness of a hybrid, hands-on intervention for reducing operative-related pains.
Methods:
General surgery residents (PGY 1-3) were enrolled in a prospective observational study performed at a single institution over a 4-week period. The residents received self-education addressing posture and the benefits of exercise related to pain mitigation. Residents participated in a weekly hands-on intervention with a certified physical therapist. Point-of-care feedback and recommendations were provided according to OSHA first-aid principles. Weekly assessments were followed up with pre- and post-test evaluations utilizing Likert scale.
Results:
10 residents were included in the study. 50% reported their pain actively deterred their learning and 60% felt they were not appropriately addressing pain with personal regimens (stretching and strengthening most commonly). Pre-intervention pain scores averaged 3.25 out of 10, with upper thoracic spine and neck most affected. Post-intervention, 80% recorded pain reduction, with an average pain score of 1.13 out of 10. Pain frequency reduced by 1 to 2 days. 55% of residents experienced an improvement in average functional status and accountability. 70% of residents felt comfortable incorporating an intervention into weekly schedule, but only 50% were in favor of a virtual component.
Conclusion:
Implementation of a hands-on, hybrid intervention focusing on surgeon ergonomics and pain mitigation has demonstrated decreased overall pain, improved consistency, accountability, and effectiveness in their regimens. Further efforts will be directed at scaling up the program and completion of long-term follow-up to determine efficacy and feasibility of a structured pain mitigation program.
(P014) IS SEEING BELIEVING? SURGICAL RESIDENT INTERPRETATIONS OF ABDOMINAL CT SCANS AND IMPLICATIONS FOR TRAINING
Ryan D Rosen, DO1, Daphne Pate, BA2, Mahmoud Abbas, MD3, Wilson Mesquita, MD4, David A Edelman, MD1; 1Department of Surgery, Wayne State University, 2Wayne State University School of Medicine, 3Department of Radiology, Emory University, 4Department of Surgery, North Alabama Medical Center
BACKGROUND: The American Board of Surgery mandates that general surgery residents (GSR) achieve proficiency in radiologic imaging interpretation, yet the ACGME does not require a formal radiology curriculum or dedicated rotation during surgical training. We sought to evaluate the ability of GSR to correctly interpret abdominopelvic CT scans compared to their radiology resident (RR) counterparts.
METHODS: Video recordings of four abdominopelvic CTs depicting common general surgery conditions were chosen. An anonymous survey was developed using the Qualtrics© platform and distributed through the APDS listserv, emailed to program directors and coordinators of all ACGME-accredited general surgery and radiology programs, and promoted on social media. RR were included as a control group to evaluate differences in diagnostic accuracy.
RESULTS: 112 responses were collected (91 GSR, 21 RR). None of the GSR reported formal radiology curricula; the primary sources of radiology education were informal instruction from senior residents (85.7%) and independent imaging review (78.0%). Nearly all GSR (92.3%) reported making clinical decisions based on independent interpretations. 84.6% of GSR would find a radiology curriculum valuable, and 7.7% felt it should be mandatory.
Diagnostic accuracy was 71.6% for GSR compared to 85.3% for RR (p=.098), with senior GSR (PGY-4/5) significantly outperforming junior residents (PGY-1) at 82.8% vs. 31.5% (p<.001). GSR performed comparably to RR in identifying common findings such as small bowel dilation (87.6% vs. 94.4%, p=.402), free fluid (73.2% vs. 88.9%, p=.154), and pericolonic inflammation (72.3% vs. 100%, p=.072). They were less accurate in recognizing subtle features such as a transition point (44.3% vs. 83.3%, p=.002), pneumatosis intestinalis (43.1% vs. 81.8%, p=.02), portovenous gas (52.9% vs. 90.9%, p=.02), and pneumoperitoneum (54.7% vs. 100%, p=.023).
CONCLUSIONS: GSR demonstrated proficiency in interpreting abdominopelvic CT scans, but frequently missed subtle features that impact patient management. As most GSR report making clinical decisions based on independent image interpretation, there is a need to consider incorporating structured radiology education into surgical training.
(P015) SURGICAL ERGONOMICS: AN ASSESSMENT OF NEEDS AND BARRIERS TO IMPLEMENTATION
Sorasicha Nithikasem, BS2, NaYoung K Yang, MD, MPH1, Darya Dehkan, BE2, Jaclyn Joki, MD3, Jason Young, PT2, Lauren Sacco, PT, DPT, MBA3, Hayk Petrosyan, PhD3, Arlen R Ray, PT3, Nicholas Russoniello2, Gerard Rangel3, Sara J Cuccurullo, MD3, Nell Maloney Patel, MD2; 1Columbia University Irving Medical Center, 2Rutgers Robert Wood Johnson Medical School, 3Hackensack Meridian Health John F. Kennedy University Medical Center
Background:
Surgical Ergonomics encompasses a variety of techniques to help promote physical wellness and career longevity, such as appropriate footwear and surgical gear, postural adjustments, “Microbreaks”, and operating room (OR) table height adjustment. Recognizing the critical impact of wellbeing on a surgeon’s career longevity, our institution partnered with our Physical Medicine & Rehabilitation (PM&R) Department and Physical Therapy to implement an institutional Surgical Ergonomics initiative, including intraoperative microbreaks with specific exercises, a home exercise program, and environmental improvements.
Methods:
Before implementing the initiative, a needs assessment survey was distributed among medical students, residents, fellows, and attendings. The survey assessed demographics, general attitudes toward surgical ergonomics, OR-related pain, pain’s impact on career decisions, and barriers to implementing ergonomic interventions. Descriptive statistics were then analyzed.
Results:
99 participants completed the survey, including 17 medical students, 73 residents and fellows, and 9 attendings. Key barriers to implementation included workplace culture (79.8%), adherence (70.7%), lack of resources (70.7%), and limited education (47.5%). All attendings reported OR-related pain, with 66.7% never having been taught ergonomic techniques, though all expressed interest in learning them. Among residents and fellows, 79.2% reported OR pain, mainly in the neck (78.9%), back (59.6%), and shoulders (59.6%), described as soreness (89.5%), fatigue (70.2%), and stiffness (59.6%). Due to OR pain, 19.4% of residents considered less physically demanding subspecialties. The main barriers to adopting microbreaks included forgetting to implement them (61.5%) and OR culture (53.8%). Residents were particularly interested in learning about footwear (84.4%), postural adjustments (77.8%), and microbreaks (64.4%). Among medical students, 82.4% reported OR pain, with 41.2% reconsidering surgery as a career.
Conclusion:
Our study reveals prevalent OR-related pain impacting career decisions for residents and students, emphasizing the need for a sustainable Surgical Ergonomics initiative to overcome barriers like culture, adherence, and access to resources. We are conducting a longitudinal study to assess adherence to this program over the coming months.
(P016) ASSESSING FIRST-YEAR MEDICAL STUDENTS’ MOTIVATIONS FOR JOINING A MENTORSHIP PROGRAM SUPPORTING UNDERREPRESENTED MINORITIES: HOW WE DO IT AND ARE WE MEETING EXPECTATIONS?
Alexandria L Soto*1, Giussepe Yanez*1, Rebecca A Zasloff1, Michael Mensah-Mamfo1, Akosua D Odei1, Paula Viza Gomes1, Cathlyn K Medina1, Camryn Thompson1, Rodney Reeves2, Gayle A DiLalla, MD2, Cory J Vatsaas, MD2; 1Duke University School of Medicine, 2Department of Surgery, Duke University Hospital
*These authors contributed equally to the abstract.
Introduction: Pipeline programs that provide early clinical exposure and mentorship are integral to improving the recruitment of underrepresented in medicine (URiM) students into surgery. Studies demonstrate that intentional mentorship from surgical faculty and near-peers are predictors of mentee success. The ASPIRES (Advancing Student Preparedness and Involvement for Representation & Equity in Surgery) Program was established to facilitate early clinical exposure and foster meaningful connections between URiM students and URiM allies in the Department of Surgery. This study details the structure of the ASPIRES Program, examines first-year URiM students’ motivations for participation, and compares these motivations to the program’s goals.
Methods: ASPIRES paired first-year URiM students with surgical faculty for a seven-month mentorship experience. This includes monthly 1-on-1 career development discussions and a minimum of two operative experiences. Students also attended technical skill workshops, research mixers, and subspecialty exploration panels. At program initiation, students responded to the prompt, “Why are you interested in participating in ASPIRES?” A thematic analysis of their de-identified responses was conducted using Nvivo14. Two independent reviewers coded each response using a 26-factor thematic codebook developed iteratively. Discrepancies were resolved through discussion.
Results: Across three program cohorts (2022-2024), 73 responses (Black/African America=64.9%, Latinx/Hispanic=35.1%, women=63.5%, RR=100%) were collected. Analysis revealed five thematic categories motivating students to apply to the ASPIRES program: mentorship, preparation, exposure, career facilitation, and environment (Figure). Mentorship (non-specific, 62.7%), preparation for career success (44.0%), and seeking representation/like-minded community (41.3%) were the most frequently reported motivators. Early exposure, informing career decisions, and exploration were motivators reported by a third of respondents. Only 13.3% of applicants were motivated by a desire to understand the “hidden curriculum” and only 6.7% expected experiential learning from the program.
Conclusion: Applicants to this URiM mentorship program sought mentorship, exposure to surgery, and representation—aligning closely with the program’s mission. Their desire for representation and connection with like-minded peers, along with early exposure to surgery, were key motivators for applying. ASPIRES provides intentional mentorship aligned with URiM students’ motivators. This program holds the potential to increase representation and promote equity within surgery.
