Podium IC - Curriculum Development
(S031) REFINEMENT OF A FORMATIVE ASSESSMENT TOOL FOR AN INFORMED CONSENT (EPA11) CURRICULUM
Catherine A Cash, BS1, Ellen J Hagopian, MD, MHPE, FSSO, FACS2; 1The University of Toledo College of Medicine, 2The Queens Cancer Center of NYC Health+Hospitals/Queens
Introduction
Informed consent is 1 of 13 core entrustable professional activities (EPA) for graduating medical students. Previous work found an informed consent curriculum and corresponding novel formative assessment tool for graduating fourth-year medical students preparing for a surgical-based residency to be effective based on student-performance and end-of-course-survey data. However, students underperformed on certain skills indicating the opportunity for refinement of the assessment tool. This study aims to identify and refine areas of the assessment tool used in the informed consent curriculum.
Methods
325 medical students across two-academic years (22-23, 23-24) received an informed consent curriculum focusing on skills to obtain informed consent. Students practiced a specialty-specific informed consent encounter with a standardized-patient (SP). Student performance was rated by the SP using a 22-line-item communication skills tool, using a defined rubric (scale 0, 1, 2) for each skill. SP-rated student performance data were tallied for each line-item. Student performance data was analyzed using an exploratory factor analysis (principal axis factoring with Promax rotation) and internal reliability test with IBM SPSS version 30 statistical package.
Results
Exploratory factor analysis was conducted on 22-line-item communication skills. Sampling adequacy was acceptable (KMO = 0.66; Bartlett’s χ²(231) = 968.27, p < .001). The scree plot indicated retention of approximately two to three factors, though the initial eigenvalue criterion yielded eight factors explaining 34.8% of variance.
Using a three-factor model, retained factors represented eight skills defined within dimensions of patient-centered engagement, diagnosis education, and procedure explanation. Items with low loadings (loading < 0.40) were excluded. The three factors accounted for 20.91% of the variance.
The Cronbach’s alpha for the 22-line-item skills assessment was acceptable (alpha = 0.660).
Conclusion
Exploratory factor analysis revealed three main constructs (patient-centered engagement, diagnosis education, and procedure explanation) of the informed consent formative assessment tool, indicating targetable areas for feedback to students. This informed consent curriculum with SP-driven formative feedback can be applied across third-year surgical clerkships to provide EPA11 instruction and performance feedback.
(S032) BREAKING THE MYTH OF SURGICAL SKILL TRANSFERENCE: INDEPENDENT DEVELOPMENT OF OPEN, LAPAROSCOPIC, AND ROBOTIC SKILLS IN RESIDENCY TRAINING
Colin Johnson, MD1, Laura Eldridge, MS1, Kristine Kuchta, MS1, Aram Rojas, MD1, Syed Mehdi, MBBS1, Sangrag Ganguli, MD2, Alessia Vallorani, MD1, Arjun Chhetri, BVSc1, Melissa Hogg, MD, MS1, Stephen Haggerty, MD1; 1Endeavor Health - Evanston Hospital, 2University of Chicago
Introduction
Over the past decade, laparoscopic surgery has declined in favor of robotic techniques, with many surgeons transitioning their practices accordingly. This transition raises the question of how surgery residency programs should adapt to optimize surgical education. With the decline of laparoscopic experience for residents, and subsequent threat of laparoscopic surgery training during residency, we aimed to assess the degree of skill transference between open, laparoscopic, and robotic surgery.
Methods
32 general surgery residents were included. During their second year of residency, each participant completed an open and laparoscopic curriculum, which included an animal-tissue module simulating an open and laparoscopic hand-sewn gastrojejunal (GJ) anastomosis. During their third year of residency, residents completed a robotic curriculum which included a GJ biotissue anastomosis graded using the Objective Structured Assessment of Technical Skills (OSATS). Residents were stratified into three groups based on open, laparoscopic, and robotic performance: High-(top 25%), middle-(50%), and low-(bottom 25%) performers.
Results
Resident self-interpretation of performance was not predictive of actual performance across open (p=0.449), laparoscopic (p=0.422), or robotic (p=0.710) modules. Previous resident experience in the operating room or in the simulation lab was not predictive of performance for open (p=0.817; p=0.565) or laparoscopic modules (p=0.911; p=0.561). Robot console experience was not predictive of robotic performance (p=0.494). Previous experience with video games was predictive of being a high performer on laparoscopic (69.2%; p=0.012) and robotic modules (77.8%; p<0.001) but was not associated with open surgery performance (p=0.812). High-performance on the open module was not associated with laparoscopic (p=0.556) or robotic performance (p=0.267). Laparoscopic high-performers had worse performance on the open module compared to middle-performers (31.7±1.8 vs 32.2±1.8; p=0.033) and did not demonstrate superior performance on the robotic module (p=0.410). High robotic performance was not predictive of high-performance on the open (p=0.284) or laparoscopic modules (p=0.153).
Conclusion
There was no evidence of skill transference between surgical approaches. This suggests that skills specific for open, laparoscopic, and robotic procedures are unique and may develop independently. Surgery residency programs should emphasize simulation skill training in all three domains early in residency and continue them throughout the five years for the optimal development of surgical skills.
(S033) IDENTIFYING THE EDUCATIONAL GAP: NATIONAL ASSESSMENT OF GENERAL SURGERY RESIDENTS' PREPAREDNESS FOR MANAGING SURGICAL COMPLICATIONS
Mason Pearce, MD, Cherith Lugo, Helen Hansel, Susan Jacob, Adham Saad, MD, Shreya Narayanan, MD; University of South Florida
Introduction Surgical complications affect 3-16% of procedures, triggering the "second victim phenomenon"—emotional distress affecting 10-43% of involved providers. While complications require both technical and psychosocial management, formal training addressing patient communication and psychological coping remains limited. This study assessed surgical residents' perceived preparedness for managing complications and quantified the impact of educational interventions.
Methods This IRB-approved cross-sectional study utilized a 25-item survey developed through literature review and expert consensus. The anonymous survey was distributed electronically to 370 general surgery residencies across the US and Canada from March-June 2025. Demographics and training exposure were collected; preparedness was assessed across six domains using 0-5 Likert scales: (1) consent/risk discussion, (2) technical management, (3) patient/family communication, (4) psychosocial impact on patients/families, (5) psychosocial implications for own practice, and (6) overall independent management. Sixty general surgery residents completed the survey (response rate 6.56%). Independent t-tests compared preparedness by training exposure; Cohen's d calculated effect sizes.
Results Respondents (71.7% aged 25-34, 41.7% male) represented all training years. Over half (53.3%, 32/60) had experienced complications as primary surgeon. While residents rated complication management training as critically important (mean 4.83±0.44), overall preparedness remained low (2.68±1.15). A competence hierarchy emerged: consent discussions (4.38±0.73) > technical management (3.29±0.94) > psychosocial domains (2.85-2.86).
Formal training significantly improved preparedness (2.95±0.98 vs 1.43±1.13, p=0.011, d=1.37), as did informal training (2.89±0.97 vs 0.75±0.96, p=0.016, d=2.23). Only 18.3% received formal psychosocial training versus 55% for technical components. Preparedness gaps were universal across gender, race, and prior complication exposure (all p>0.05), indicating systemic rather than individual deficits.
Conclusion A critical training-preparedness gap exists in surgical complication management, particularly psychosocial domains. The large effect sizes associated with both formal and informal training underscore the potential impact of addressing this deficit. The universal nature of these preparedness gaps—unaffected by demographics or experience—indicates a fundamental shortcoming in current surgical curricula nationwide. These findings establish the urgent need for future work developing and implementing standardized, evidence-based complication management curricula that address both technical and psychosocial competencies in surgical training programs. Implementation could reduce the 30% of residents experiencing burnout after complications, improve patient satisfaction scores, and align with ACGME Milestone competencies.
(S034) MOTIVATIONS AND SELF-EVALUATION BEHIND SURGICAL RESIDENTS’ SELF-REGULATED LEARNING: A QUALITATIVE STUDY
Ye Lim Lee, BS, Aileen Gozali, MD, Jessica Santhakumar, MTM, Brandon Cowan, MD, Patricia O'Sullivan, EdD, MS; UCSF
Introduction
Self-regulated learning (SRL), as defined by Zimmerman, is a cyclical process of forethought, performance, and self-reflection that enables learners to direct their own growth. While surgical educators have identified behavioral ways to foster SRL, residents’ motivations to engage in SRL and attitudes toward self-evaluation are less examined. This qualitative study explores these underlying drivers to better understand how surgical residents sustain their learning and assess their development over time.
Methods
We conducted 30-minute semi-structured interviews with senior-level surgical residents at an academic medical center until we reached information sufficiency. Using directed content analysis, two researchers applied deductive codes sensitized by Zimmerman’s SRL framework, with particular emphasis on self-motivation beliefs (forethought phase) and self-evaluation (self-reflection phase). Additional inductive codes were generated as needed. The codes were then organized into themes through iterative discussions.
Results
Fourteen surgical residents participated: 10 senior residents and 4 in dedicated research years, representing general surgery (n=8), plastic surgery (n=2), obstetrics and gynecology (n=1), vascular surgery (n=1), otolaryngology (n=1), and neurosurgery (n=1). Within Zimmerman’s concepts of motivation, we identified two themes with five subthemes. For self-evaluation, we identified four themes (see Table).
Residents’ motivations for SRL reflected both professional identity formation (driven by the desire for intraoperative autonomy, responsibility to patients, and anticipation of future roles) and personal values, including a desire for competence in addition to curiosity and interest. While these factors sustained their engagement in SRL, the self-evaluation phase was often described as challenging. Residents struggled to gauge their own progress in isolation from peers and consequently established personal benchmarks, such as the degree of operative autonomy and objective measures like case duration. Meanwhile, faculty feedback was recognized for its potential value as a tool for self-evaluation but often viewed as inconsistent and subjective.
Discussion
Surgical residents’ motivation to learn is multifactorial, driven by a blend of professional identity formation and personal values. However, meaningful self-evaluation remains difficult, hindered by limited opportunities for peer comparison, which further prompts residents to rely on different metrics of their choice. Programs can leverage these insights to cultivate SRL and provide frameworks for residents to monitor and evaluate their growth over time.
(S035) BEYOND THE BOOTCAMP: A STUDENT-DRIVEN ELECTIVE TO INTEGRATE SENIOR MEDICAL STUDENTS WITH SURGERY RESIDENTS FOR SIMULATION-BASED OPERATIVE TRAINING
Liza M Rosenbloom, MD, MPH, Talia R Arcieri, MD, Jessica M Delamater, MD, MPH, Avery M Hebert, MD, Akshat Sanan, MD, Ray Gonzalez, Laurence R Sands, MD, MBA, Nicholas H Carter, MD; University of Miami Miller School of Medicine, Miami, Florida
Background:
Despite the proliferation of surgery “bootcamp” rotations for senior medical students, technical skills remain an area of perceived poor preparation for students entering surgical residencies. Based on a student proposal, we designed a novel elective that integrated senior medical students pursuing surgical residency into simulation-based operative training for surgical residents. We hypothesized that students would demonstrate improved technical performance and self-perceived readiness for residency and that residents would gain confidence in their intraoperative teaching and procedural leadership.
Methods:
Fourth-year medical students served as first assistants in two six-hour live porcine operative simulation labs for surgical residents practicing common hemorrhage control procedures. Surgical faculty evaluated the technical performance of students using the Ottawa Surgical Competency Operating Room Evaluation (O-SCORE). Students and residents completed REDCap surveys to evaluate technical confidence and operative experience using 5-point Likert scores and open-ended questions. Paired pre- and post-elective performance was analyzed with Wilcoxon signed-rank tests. Qualitative data underwent thematic analysis.
Results:
Six medical students and six general surgery residents participated in the elective; all students and 83% of residents completed post-course surveys. Students demonstrated median improvement in instrument handling, suture selection, square knots, first-assistant skills, safe entry into the abdomen, and abdominal exploration and packing (all p<0.05). Students self-reported improvement in their ability to function as a surgical first assistant (mean Likert score 4.83) and strongly agreed that they felt more prepared for surgical residency following participation in this elective (4.83). Residents reported that medical student integration encouraged the resident to verbalize surgical steps more clearly (4.80), improved resident confidence in leading an operation (4.60), and enhanced the value of the operative simulation (4.60). Thematic analysis identified four key themes: confidence building, feedback, hands-on practice in a low-stakes setting, and mentorship. Both groups highlighted the value of a structured, collegial environment that fostered skill development and professional growth.
Conclusions:
A paired simulation elective improved medical student technical performance and self-perceived readiness for residency while enhancing resident confidence in teaching skills and knowledge of procedures. Integration of fourth-year students into resident operative simulation may yield dual educational benefit for both students and residents.
(S036) EMPOWERING UNDERREPRESENTED UNDERGRADUATES AS FUTURE PHYSICIANS WHILE CULTIVATING EARLY HEALTH EDUCATORS
Xinyi Luo, MD, Hiyori Roberts, Danielle Tatum, Jacquelyn Turner, MD, MBA; Tulane University
Introduction:
Efforts to diversify the health workforce increasingly emphasize pathway programs, yet few models simultaneously support learners entering medicine and develop early-career clinician-educators. The Introduction to the Medical Profession: a Rotation to Empower StudentS (IMPRESS) program is a trainee-designed, 6-week pathway for underrepresented and economically disadvantaged undergraduates. The program combines mentorship, clinical exposure, research, and simulation-based skills training. IMPRESS is facilitated by medical students and residents who work closely with the education faculty, providing them structured opportunities in curriculum design. We evaluated IMPRESS as a dual-impact model that builds medical interest and skills among undergraduates while cultivating early educator identity, competencies, and leadership among trainees.
Methods:
We used a mixed-methods design. Undergraduates completed pre/post medical knowledge tests, MCAT self-efficacy surveys, and laparoscopic Fundamentals of Laparoscopic Surgery (FLS) tasks. The primary outcome was intent to pursue medicine; secondary outcomes were knowledge, confidence, and technical skill acquisition. Continuous data are reported as median (IQR) and categorical data as frequency. Focus group transcripts were coded independently by two researchers using a Social Cognitive Theory framework.
Results:
Three cohorts (n=35) completed IMPRESS; 69% were Black/African American, 43% were from households earning <$50,000/year, and 26% were first-generation college students. After the program, 34/35 planned to pursue medicine. Median knowledge scores improved from 54.5% to 63.6% (P=0.01); 32/35 achieved laparoscopic proficiency within three attempts; self-efficacy improved in 10/11 domains. Satisfaction was high (34/35 rating 9–10/10).
Residents and medical students reported meaningful gains in curriculum design, structured teaching, research dissemination, and longitudinal mentorship. Trainees described IMPRESS as a scaffolded entry point into academic medicine, providing real-world educator responsibilities typically reserved for senior trainees. Qualitative themes included Confidence/Empowerment, Embodied Mentorship, Shared Experience, and Structured Support. Students cited strengthened sense of belonging and identity (“I am more than capable of being a surgeon”).
Conclusion:
IMPRESS offers a replicable, multi-impact model that advances workforce diversity and accelerates educator development. The program supports undergraduates’ readiness for medicine while intentionally building medical student and resident teaching, curriculum-building, and leadership skills—positioning IMPRESS as a pathway not only into medicine, but into academic surgery and education leadership.
(S037) CLOSING THE LOOP: SUSTAINED GAINS IN COMMUNICATION AND CONFIDENCE THROUGH A MULTIDISCIPLINARY TRAUMA SIMULATION CURRICULUM
Nicole Ivan, DO, Natalie Domingue, MD, Daniel Moncada, MS, Jack Gersten, Allison Superneau, DO, Bao-Ling Adam, PhD, Erika Mabes, DO; Medical College of Georgia
Background:
A Multidisciplinary Trauma Simulation Curriculum (MTSC) was implemented at a Level 1 academic trauma center to enhance communication, teamwork, and procedural readiness among interprofessional trauma teams. Over three years, the program expanded to include trauma-guidelines orientation for emergency medicine, surgery, and nursing trainees, followed by monthly high-fidelity simulations emphasizing structured team roles and closed-loop communication. This study assesses the MTSC’s long-term effects on participant confidence, knowledge, and perceived team performance using mixed-methods survey analysis.
Methods:
A retrospective mixed-methods analysis was performed using post-simulation surveys collected over three consecutive years of MTSC delivery. Quantitative data from 15 Likert-scale items were summarized descriptively and compared across participant role, trauma-rotation, and simulation-experience groups using Kruskal–Wallis tests with Holm-adjusted Conover post-hoc comparisons. Reliability was assessed using Cronbach’s α. Qualitative free-response items were analyzed inductively to identify recurring themes related to participant experience and program impact.
Results:
Forty-nine participants representing surgery, emergency medicine, nursing, and respiratory therapy completed surveys. Agreement-scale items demonstrated excellent reliability (α = 0.93) and frequency-scale items moderate reliability (α = 0.66). Overall mean Likert scores were 4.27 ± 0.6 for agreement-based items and 4.15 ± 0.7 for frequency-based items, indicating positive perceptions of the MTSC across communication, teamwork, and procedural confidence. By role, surgery residents reported significantly higher agreement for items related to communication, teamwork, and procedural readiness compared with emergency medicine residents and others (all p < 0.05). Participants with prior simulation exposure reported stronger agreement than those without exposure for items assessing confidence, collaboration, and performance under stress (all p < 0.05). No differences were identified by trauma-rotation experience. Qualitative themes included strengthened closed-loop communication, improved role clarity via the zero-point survey, enhanced procedural proficiency, psychological safety fostered by structured debriefing, appreciation for multidisciplinary collaboration, and requests for increased frequency and institutional support reflecting logistical needs for sustainability.
Conclusions:
After three years, the MTSC demonstrated sustained educational and cultural influence on trauma team dynamics. Ongoing participation was associated with improvements in confidence and collaboration, bridging professional silos and reinforcing interprofessional readiness. The MTSC represents a replicable model for interprofessional trauma training adaptable to diverse trauma systems.
Figure 1: Inductive codes that emerged from textual data along with representative quotes.
(S038) LISTENING TO LEARNERS: A RESIDENT-DRIVEN NEEDS ASSESSMENT OF A COMPREHENSIVE GENERAL SURGERY CURRICULUM
Abigail J Hatcher, MD, MSc, Blake T Beneville, MD, Nikki E Rossetti, MD, MSc, MPHS, Jennifer Yu, MD, MPHS, Michael M Awad, MD, PhD, MHPE; Washington University in St. Louis
Intro
General surgery (GS) residency education is guided by multiple ACGME requirements. The American Board of Surgery’s SCORE portal provides a national didactic curricular framework, but implementation guidance is limited, and simulation and on-rotation learning domains are not addressed. Programs therefore face a challenge balancing operative and clinical service demands with comprehensive, structured educational experiences that advance competency-based training and milestone attainment. We performed a targeted needs assessment at a large academic GS program to evaluate and inform curricular revision across three educational domains: didactic, simulation, and on-rotation.
Methods:
Using a mixed-methods design guided by Kern’s Six-Steps to curricular development (Figure), we conducted semi-structured focus groups with residents to identify strengths, limitations, and priorities across clinical and non-clinical topics (NCT). Anonymized transcripts were inductively coded and thematically analyzed. Findings informed development of a follow-up survey to quantitatively stratify desired changes. A curriculum committee including GS faculty and residents operationalized results to modify the curriculum across the three domains.
Results
Of 70 total GS residents, 67 (96%) participated in focus groups during protected education time and 50 (71%) completed the survey. Participants across all postgraduate levels identified strengths including resident-run didactic and simulation curricula, robust faculty engagement, and sessions such as M&M, mock orals, and NCT lectures. Balancing protected education time with operative and clinical demands remained a key challenge. Residents desired stricter enforcement of protected educational time, clearer on-rotation learning objectives, fewer overlapping sessions, improved resource access, and more intentional curricular sequencing. In response, the committee developed and implemented (1) a leadership-endorsed SCORE-based didactic block schedule, (2) a PGY-1 on-rotation pilot curriculum, and (3) a learning management system for centralized scheduling and resource-sharing. Additionally, schedule adjustments led to reduced conflicts between didactic and simulation sessions.
Conclusion
A resident-centered needs assessment produced actionable insights that drove program-wide curricular restructuring. Concurrent evaluation of all three educational domains ensured that curricular modifications addressed individual components while accounting for their interdependence. Future work will formally evaluate the impact of these changes on resident satisfaction, engagement, and competency-based skills acquisition. This approach provides a replicable framework for iterative curricular evaluation and improvement, grounded in Kern’s model and resident learning needs.
(S039) EXPLORING CORE SURGICAL DISEASE EXPOSURE IN A LONGITUDINAL INTEGRATED CLERKSHIP
Dalton Hegeholz, MD, Ting Sun, PhD, Gabrielle Moore, MD, M. Libby Weaver, MD, Kirstyn E Brownson, MD, Motaz Selim, MD, Kshama Jaiswal, MD; University of Utah
Background:
Longitudinal Integrated Clerkships (LICs) are an innovative approach to medical education, whereby medical students participate in longitudinal, immersive clinical experiences. Within the model, the variety of student exposure to core surgical disease processes is unknown. The relationship between exposure variety and career interest is also unknown. This study aims to investigate the setting and variety of student exposure to direct patient care experiences in core surgical disease processes. We also sought to determine if increased exposure relates to surgical career interest.
Methods:
A cross-sectional survey was administered to 123 medical students following participation in the surgical LIC. The instrument collected data on setting of exposure (e.g., clinical, didactic learning, independent study) to ten core surgical diseases (Figure 1) and students’ reported pre-LIC and post-LIC career interests. Descriptive statistics summarized exposure learning setting and frequency for the ten listed core diseases. Correlational analyses and logistic regressions investigated the relationship between disease exposure and post-LIC career interest.
Results:
Of 120 respondents (response rate 98%), 118 answered career interest questions and 119 answered disease exposure questions. 70.6% (n = 84) reported clinical exposure to five or more of the ten established core diseases. Median disease exposure was 6.0 pathologies (interquartile range: 4.0 – 7.0). In the clinical setting, hernias were the most frequently seen disease process (n = 101; 84.2%) and thyroid disease was the least common (n = 23; 19.3%). (Figure 1) 70.6% (n = 84) respondents reported learning about all ten core diseases through any combination of clinical exposure, didactic learning, or independent study. Only 3.4% (4/119) reported no structured learning for five or more diseases. No association was found between variety of disease exposure and post-LIC career interest.
Conclusions:
This cohort of students had a wide variety of disease exposure, but clinical exposure gaps still exist. Greater clinical exposure variety via direct patient care experiences was not associated with surgical career interest. LIC models require ongoing evaluation and refinement to better understand student performance and identify areas for curriculum improvement.
