Podium IC - Curriculum Development
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.
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.
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.
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.
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.
