Quick Shot II - Curriculum
(Q010) ENHANCING SURGICAL TRAINEE WELLNESS AND PREPAREDNESS THROUGH A STRUCTURED NEAR-PEER MENTORSHIP PROGRAM
Folarin Adeyemi, MD, Titilope S Saheed, MD, Evelyn Alexander, Benjamin Rembetski, Ashlynn Mills, MD, Stephanie Worrell, MD; University of Arizona
Background:
The transition into general surgery training presents steep learning curves that impact resident well-being, confidence, and clinical performance. While mentorship is recognized as a key strategy to support this transition, structured and scalable programs remain underutilized. This single-institution pilot evaluated a structured near-peer mentorship model pairing PGY-1 interns with PGY-2 residents to enhance preparedness, confidence, and wellness during early surgical training.
Objectives:
To develop, implement, and assess a six-month near-peer mentorship curriculum designed to (1) foster belonging and role clarity, (2) improve perceived preparedness for clinical responsibilities, and (3) enhance wellness and support within the residency culture.
Methods:
All categorical and preliminary interns (n=16) participated in a six-month mentorship curriculum from July–December 2025. Each PGY-2 mentor was paired with two PGY-1 interns (2:1) in a monthly rotational model to maximize exposure, diversify connections, and align mentees with mentors who had recently completed relevant rotations. The curriculum followed the Plan–Do–Study–Act (PDSA) framework with iterative refinements from feedback. Monthly modules targeted developmental domains—reflection, confidence, communication, and leadership—and were co-developed using ChatGPT with structured prompting to generate literature-based discussion and reflection activities. Custom surveys assessed belonging, preparedness, role clarity, mentorship value, and feasibility at program initiation (Pre-Test) and midpoint using 4- or 5-point Likert scales (Strongly Agree to Strongly Disagree).
Results:
Among PGY-1 interns (n=16), 75% agreed or strongly agreed they felt belonging, 76% felt prepared for daily responsibilities, and 100% believed mentorship could positively influence their residency experience. Among PGY-2 mentors (n=6), 84% felt equipped to provide guidance, and all reported confidence identifying interns in distress. At midpoint (n=14), 57% agreed mentorship increased confidence navigating residency, 86% felt more supported, and 72% gained strategies applicable to clinical work. Logistical barriers, primarily scheduling and communication, were reported by 45%.
Conclusions:
A structured, data-driven near-peer mentorship framework is feasible and shows promise in enhancing belonging, preparedness, and wellness among early surgical trainees. Final outcomes after full module completion will inform scalability and long-term integration across surgical residency programs.
(Q011) CREATING SURGEONS FOR RURAL AMERICA: THE IMPACT OF RURAL SURGERY EXPOSURE ON CLERKSHIP STUDENTS
Danielle Shin, BS, Richard Aldan, MD, Melissa Easley, MD, Gagandeep Japra, BS, Kaitlyn Tice, BS, Luke Guy, BS, Ashley Oh, BS, Jeremy Altman, L. Renee Hilton-Rowe, MD; Medical College of Georgia at Augusta University
Background:
The American College of Surgeons projects a significant shortage of surgeons by 2034, with rural communities poised to face disproportionate impacts. Meaningful exposure to rural sites for medical students and early recruitment of physicians during training are key to addressing this disparity. Our study evaluates the impact of rural surgical clerkship sites on medical student interests in surgery and rural practice.
Methods:
Online surveys were administered to third- and fourth-year medical students following completion of their general surgery or surgical subspecialty rotations. Our surveys evaluated student perceptions of rural practice and interest in pursuing rural surgery. Responses were quantified using a Likert scale. Descriptive statistical analysis and Wilcoxon signed rank test were performed using SAS (version 9.4).
Results:
115 responses were collected, with 73 being obtained from students who completed either core or subspecialty surgery rotations at a rural site. Survey results indicated that students who rotated at rural sites developed increased interest in rural practice (p < 0.0001) and in pursuing a surgical career (p = 0.0004).
Conclusion:
Access to appropriate medical and surgical care in rural regions remains a key public health issue. It is critical for both medical students and residents to have early engagement with rural sites to facilitate interest in rural practice. The results of our study provide valuable insight into medical student perceptions of rural practice and interest in rural surgery, highlighting the value of including rural sites in medical clerkship curricula.
(Q012) DO WE NEED TO FORMALLY TEACH OPERATIVE REASONING SKILLS?
Hemasree Yeluru, MD, Sook C Hoang, MD; University of Virginia
Background
Ensuring operative competency for surgical residents continues to be a challenge for surgical educators. Although entrustable professional activities (EPAs) can be used to assess readiness, critics argue that it lacks actionable feedback to the trainees. Current operative coaching programs have focused on technical skills with the use of video-based learning, EPAs, cadaver-based education, and sim-based learning, however these approaches neglect the non-technical aspects that support a surgical resident to reach independent practice. A missing factor in surgical training may be operative reasoning, which can be divided into forward planning, troubleshooting, and situational awareness.
Methods
A pilot operative reasoning coaching program was implemented at a single institute general surgery residency. Prior to implementation, trainees were provided an anonymous needs assessment survey to define challenges that residents face and associated gaps in skill. Participants were defined as residents who were in their third and fourth years of clinical training. Participants were queried on their perception of degree of autonomy, reasoning skill, troubleshooting ability, and support received from attendings intraoperatively. These data were measured on a 5-point Likert scale.
Results
10 residents out of 14 residents participated in the survey (71%). 30% of residents reported they are frequently unaware of the next step during an operation. Only 40% of residents reported feeling confident in troubleshooting errors during a critical portion of a case. 50% reported they frequently attempt to brainstorm a solution without relying on the attending. Greater than 70% stated they do not feel comfortable asking for a moment to pause during critical portions of a case. Additionally, there was a wide variance of data of whether the residents had clear expectations set for them prior to the start of the case.
Discussion
The needs assessment survey highlights notable gaps in operative reasoning among mid-level general surgery residents. Many residents report limited confidence and autonomy when faced with intraoperative challenges. We propose a targeted, and individualized coaching intervention that emphasizes operative reasoning as a core component of surgical education. This program will be continually assessed to determine its impact on resident performance.
(Q013) NEEDS ASSESSMENT FOR AN EDUCATIONAL CURRICULUM ON EMERGENCY CONVERSION FROM ROBOTIC THORACOSCOPY TO OPEN THORACOTOMY
Caroline Ricard, MD1, Dena Shehata1, Deanna Plewa1, Feiran Lou, MD2, Cameron T. Stock, MD1, Susan Moffatt-Bruce, MD1, Elliot Servais1, Ammara Watkins, MD1; 1Lahey Hospital and Medical Center, 2UMass Memorial Health
Introduction: Robotic assisted thoracoscopic surgery is the most common operative approach in the United States for anatomic lung resection. However, surgeon experience and confidence with emergency conversion (EC) to open thoracotomy is unknown. We sought to describe this educational gap by conducting a needs assessment for an EC curriculum for thoracic surgeons.
Methods: An online needs assessment survey was conducted for an EC curriculum for thoracic surgeons. The survey was developed by a group of stakeholders and revised after being piloted on a representative group of thoracic surgeons. We surveyed thoracic surgeons globally regarding their experience and confidence with EC; experience and confidence of their bedside assistant with EC; interest in an EC curriculum; and content and format for an EC curriculum. Surveys were distributed via the General Thoracic Surgery Club and Thoracic Outcomes Research Network listservs, and private social media outlets.
Results: Forty-five thoracic surgeons responded, reflecting viewpoints across North America. Only 40% of thoracic surgeons received EC training during residency or fellowship. Only 28.3% of surgeons report the presence of an EC protocol at their hospital, while 67.4% of surgeon respondents have had to perform EC intraoperatively. Some surgeons (26.1%) felt that their bedside assistant’s experience with EC influences their decision or timing to convert. Most surgeons (80.5%) demonstrated interest in participating in an EC curriculum. The most positively rated stakeholders to participate in the EC curriculum were the surgeon (97.8%), bedside assistant (97.8%), surgical resident/ fellow (95.7%), surgical technician (89.1%), circulating nurse (93.5%), and anesthesiologist (69.6%). The most positively rated content topics were EC rehearsal with the bedside assist (100%); troubleshooting robotic faults (100%) and bleeding scenarios (100%) that may necessitate EC; and communication best practices between the surgeon, bedside assist, anesthesiologist, and staff (100%). The most highly rated learning methods were group discussion, videos, and hands-on practice.
Conclusions: This needs assessment demonstrates that thoracic surgeons have inconsistent experience and confidence with EC, a strong interest in an EC curriculum, a desire to train the entire thoracic surgery team using experiential learning methods. Development of learning objectives and formal curricula for EC are needed to bridge this educational gap.
(Q014) SCAFFOLDING FIDELITY, COMPLEXITY, AND AUTONOMY IN SURGICAL SIMULATION: A FRAMEWORK-BASED, COGNITIVE LOAD–INFORMED PROOF-OF-CONCEPT STUDY
Dheeraj Baji, MD, Rachael Acker, MD, Gracia M Vargas, MD, Ari Brooks, MD, Noel Williams, MD, Kristoffel Dumon, MD; University of Pennsylvania
Background:
Early surgical simulation curricula often teach isolated technical skills without a clear progression, leading to redundant exposure, variable realism, and cognitive overload. Educational theories suggest that learning improves when tasks are scaffolded from simple to complex, with guidance gradually reduced as autonomy increases and cognitive load is balanced for optimal performance. We designed a framework-based curriculum that intentionally scaffolded fidelity, complexity, and autonomy across multiple simulation modules. This study reports early outcomes from its first implementation.
Methods:
A phased longitudinal program for PGY-1 general surgery residents was implemented: Bootcamp, Module 1, and Module 2. Bootcamp emphasized foundational psychomotor skills—such as knot-tying, basic suturing, and OR safety and workflow under close faculty supervision and was co-facilitated with interprofessional operative staff. Module 1,2 introduced a six-domain framework: Non-technical/cognitive skills, Bedside procedures, High-fidelity simulation, Tissue lab, Laparoscopic skills, and Core procedural skills (part-task training). For module 1, activities included open and laparoscopic instrument identification, central venous line placement, appendectomy, and others. Module 2 included, bowel anastomosis, stoma creation, laparoscopic suturing, and others. Quantitative and qualitative data were collected immediately after each module. Learners rated engagement, satisfaction, and confidence (5-point Likert) and overall experience (1–10). Open-ended survey responses were analyzed using a deductive content approach guided by predefined constructs: fidelity and readiness and thematic analysis was done.
Results:
From Bootcamp to Module 1, proportions of learners rating ≥4 (“agree”/“strongly agree”) increased for engagement (86.7%→100%), satisfaction (70%→93%), and confidence (73%→85%). Module 2 sustained universal engagement and relevance while increasing realism and independence. Thematic analysis revealed (1) progressive autonomy with less instructor prompting, (2) improved realism and procedural flow, and (3) enhanced instructional efficiency. Faculty feedback corroborated improved sequencing and reduced redundancy.
Conclusion:
This study demonstrates that structured scaffolding, integrating increasing fidelity, complexity, and learner autonomy within a six-domain frameworkenhances learner engagement, realism, and cognitive efficiency while improving instructional coherence across simulation modules. The model provides a reproducible template for designing progressive simulation curricula anchored in educational theory. Building on these results, future Modules 3 and 4 will extend the scaffolded design across an academic year to evaluate longitudinal skill development, learner autonomy, and curricular sustainability.
(Q015) INTEGRATING SINGLE-STAGE LAPAROSCOPIC CHOLECYSTECTOMY WITH COMMON BILE DUCT EXPLORATION INTO SURGICAL EDUCATION: SIMULATION, CURRICULUM DESIGN, AND EARLY CLINICAL EXPERIENCE
Errol MICHAEL Hunte, MD, Lauren Cournoyer, MD, Marrcoandrea Giorgi, MD; Brown Health
Exposure to common bile duct exploration (CBDE) during residency remains limited with management of choledocholithiasis often dominated by gastroenterology. Spyglass Discover™-assisted laparoscopic CBDE (LCBDE) presents an opportunity to expand surgical ownership of biliary disease while enhancing trainee experience in advanced endoscopy. Here we describe the implementation of a LCBDE program at an academic institution. We theorize that our approach to simulation before OR participation promotes trainee confidence while providing meaningful exposure to advanced biliary surgery.
Methods
In this single institution educational implementation study a stepwise program was developed within the MIS division. Our curriculum components included: (1) simulation-based preparation using dry-lab choledochoscopy stations with stone retrieval; (2) curriculum integration via biliary lectures, service conferences, and protected academic time; (3) intraoperative exposure in port placement, access, and supervised choledochoscopy; and (4) structured video-based feedback. Patients (Feb–Jun 2025) underwent trainee-aided LCBDE with laparoscopic cholecystectomy. Trainee participation and early clinical outcomes were tracked and compared with institutional outcomes data.
Results
10 patients with known symptomatic choledocholithiasis were enrolled and underwent LCBDE. We had 100% trainee involvement (PGY-2-6) with all trainees receiving simulation exposure prior to OR participation. We noted progressively increasing trainee competence as measured by their completion of key milestones: scope navigation, duodenum cannulation, and stone clearance. We observed 100% stone clearance with no complications or readmissions in our population. Median LOS was 2.0 days (mean 2.39) compared with historical ERCP + cholecystectomy mean of 5.08 days from our institution.
Discussion
Integration of LCBDE into surgical education proved feasible, safe, and effective. Simulation, structured curriculum, and progressive operative teaching enabled early and meaningful trainee exposure to advanced biliary surgery without compromising outcomes. It expands resident exposure to advanced endoscopy and offers an alternative to GI-dominated pathways, restoring surgical ownership of choledocholithiasis management and provides a reproducible framework for other institutions. Next steps include formalizing a competency checklist, integrating objective assessment tools, and combining these results with financial analyses for publication.
Conclusion
Single-stage LCBDE functions as a clinical innovation and an educational platform. Embedding simulation, multidisciplinary teaching, and structured operative involvement expands resident and fellow competencies in advanced endoscopy and biliary surgery—domains traditionally underrepresented in general surgical training.
(Q016) LOW-COST SIMULATION FOR HIGH-IMPACT LEARNING IN MANAGING BENIGN ANORECTAL CONDITIONS
Abigail J Hatcher, MD, MSc, Blake T Beneville, MD, Cory Fox, BA, Danyi Wang, BA, Paul E Wise, MD, Michael M Awad, MD, PhD, MHPE, Kerri A Ohman, MD; Washington University in St. Louis
Introduction:
Anorectal conditions are commonly encountered in general surgical and colorectal practice. Despite their prevalence, General Surgery (GS) residents often graduate with limited hands-on experience in managing these conditions, with the ACGME only requiring a minimum of 20 anorectal cases during residency. To standardize and broaden experience with these procedures, this study aimed at delivering to junior residents a simulation focused on multiple anorectal pathologies and related technical skills.
Methods:
A pilot study was conducted targeting PGY-1 and PGY-3 GS residents prior to their transition to consult and chief roles respectively, with colorectal surgery faculty and fellows serving as instructors for the 1.5-hour lab. Hemorrhoid, fistula, and abscess models were adapted from previously described methods (Figure 1). Procedures included hemorrhoidectomy, banding, fistula probing seton placement, and abscess incision and drainage (I&D) with mushroom catheter placement. Pre- and post-lab surveys investigated residents' prior clinical experience, procedural confidence, and lab feedback.
Results:
The study uncovered differences in experience between PGY-1 (n=17) and PGY-3 (n=13) residents, with PGY-3s reporting higher rates of performing the tested procedures. Self-reported confidence improved post-simulation for all procedures (p<0.05), specifically in performing a perirectal I&D (1.952.81 on a 5-point Likert scale from “not at all” to “extremely confident”) and hemorrhoidectomy (1.67-->2.63). All residents lacked experience with banding, exhibiting a marked increase in confidence performing one post-simulation (1.52-->2.74; p<0.05). Confidence in placing a mushroom catheter rose in PGY-1s (1.46-->2.84; p<0.05). Resident feedback for lab was overall positive with a mean of 3.5/5 (SD 1.05) in applicability to real-world scenarios, rating the experience between moderately and very useful. 78% of participants believed the lab was appropriate for PGY-1 and PGY-3 learners.
Conclusions:
Our novel simulation enhanced resident confidence in managing anorectal conditions, although knowledge scores remained static, indicating a need for iterative education sessions. The rise in confidence scores, though not to the level of complete procedural readiness, suggests that participants appropriately demonstrated progression toward proficiency, reflecting realistic skill development for junior trainees. The pilot revealed that the simulation lab shortened the educational gap, but continuous practice and integrated knowledge reinforcement are essential for comprehensive skill acquisition.
(Q017) IMPACT OF STOP THE BLEED TRAINING INTEGRATION INTO MEDICAL STUDENT CURRICULUM
Jessica Santhakumar, MTM1, Elizabeth Raby1, Matthew Y Lin, MD2, Sarah Garden, RN3, Andre R Campbell4; 1University of California, San Francisco School of Medicine, 2University of California, San Francisco Department of Surgery, 3Trauma Program Zuckerberg San Francisco General Hospital, 4Zuckerberg San Francisco General Hospital Department of Surgery
Introduction: Studies estimate that hemorrhage or its complications cause 40% of trauma-related deaths. Stop the Bleed (STB) is a national curriculum training bystanders to administer life-saving care for traumatic bleeding until medical help arrives. However, limited instructor availability constrains teaching as many community members as possible. We evaluate the implementation and student perceptions of STB training during surgery clerkship curriculum with the goal of preparing medical students to serve as instructors.
Methods: Since 2019, we administered STB courses during 3rd year medical student surgery clerkships. These 3 hour trainings were traditionally led by registered nurses with hourly rates of $77-135 to fulfill the course-required 10:1 student to instructor ratio. Course completion qualifies learners to become instructors, and starting in March 2023, interested medical students volunteered to join the cadre of instructors. We describe the ability to implement the course for 6 years and evaluated responses to a 5 item post-course student survey to assess student’s perceptions of the course and willingness to become an instructor between February 2019 to September 2025.
Results: STB training was offered 39 times during general surgery clerkships from 2019-2025 reaching 838 medical students. Of the 20% of learners completed the feedback form, 99.4%(n=168) of respondents agreed that course content was delivered clearly, and 98.8%(n=167) of respondents felt confident that they would be able to help an injured person who was bleeding. 14.8%(n=124) of respondents expressed interest in becoming instructors, and 16 went on to teach courses. Since March 2023, medical students have joined as Associate Instructors to deliver 17 classes, reaching 403 community members. Volunteer medical student instructors provided a cost-saving benefit to the program by offsetting the cost of paid instructors and freeing up paid instructors for clinical responsibilities.
Conclusions: We conclude based on a sustained period of integration that STB can be taught to the entire class of medical students and expand instructor pools. Recruiting medical students as volunteer instructors provides students with opportunities for community engagement while offsetting the personnel cost of nursing instructors. This model can be applied in other medical schools to benefit both medical students and the community.
(Q018) FROM CURIOUS TO CONFIDENT: EVALUATING LEARNING OUTCOMES IN A DIVERSITY-FOCUSED SURGICAL PIPELINE PROGRAM
Tasha Posid, MA, PhD, Lisa Cunningham, MD, Megan Leitnaker, Vivian Wong, MD, Emily Huang, MD; The Ohio State University Wexner Medical Center
Introduction:
Early exposure to surgical careers and research is critical for medical students, particularly those from historically underrepresented backgrounds. Surgical residency, including competitive specialties (e.g., Urology), requires students to demonstrate longitudinal clinical experiences, research engagement and scholarship, and relies on key mentors to provider Letters of Recommendation, yet few programs provide structured, assessed preparation. Our pilot summer program (Surgical Education Research Fellowship, or SERF JR.) provided two complementary weekly didactic sessions—Careers in Surgery / Pathways to Surgery and a structured Research Curriculum—designed to enhance understanding of surgical careers/pathways and research skills.
Methods:
Undergraduate medical students in the 8-week program attended two consecutive weekly sessions (60–90 minutes each): (1) Careers in Surgery / Pathways to Surgery, covering specialty options, residency preparation, and career navigation, which were presented by institution faculty in that specialty; and (2) Research Curriculum, covering study design, data analysis, and academic writing (Figure 1), presented by a PhD Education Specialist who previous designed this curriculum. Students completed pre/post-session assessments for each didactic session, evaluating knowledge across specific topics and overall satisfaction with the subject content.
Results:
Twelve undergraduate students participated in this pilot program. Across the Careers in Surgery didactic sessions, students indicated significant pre-to-post gains in understanding surgical specialties (Mean=18.8% gained knowledge, p<0.001), application pathways, and mentorship strategies (range: 8.1%-25.7% gains in subject matter knowledge, all ps<0.01). Research Curriculum didactic sessions similarly showed improved knowledge of key research topics (Mean=19.3% gained knowledge, p<0.001), including study design, data interpretation, and academic writing skills (range: 16.7%-30.0%, all ps<0.01). Additionally, students reported high satisfaction across all measured aspects of the surgery (p<0.001) and research (p<0.001) metrics collected.
Conclusion:
Structured, timepoint-assessed weekly didactics in surgical careers and research effectively increase medical student knowledge and confidence in these areas. These findings provide evidence for the educational impact of intentional, time-protected teaching sessions within pipeline programs, supporting replication and scale-up in other equity-centered surgical training initiatives. That is, although these types of immersive summer program serve to increase early exposure to surgery and research, data from these evaluations indicate gains in subject knowledge as well.
