Residents' evaluation of a problem-based learning curriculum in a general surgery residency program

The Kolb learning cycle in American Board of Surgery In-Training Exam remediation: the Accelerated Clinical Education in Surgery course

BACKGROUND

Surgical training integrates the 4 steps of the Kolb learning cycle. Residents who scored at 30th percentile or less on the American Board of Surgery In-Training Exam (ABSITE) were enrolled in the Accelerated Clinical Education in Surgery (ACES) course that incorporated the Kolb cycle.

METHODS

For concrete experience, Surgical Education and Self-Assessment Program (SESAP-13) was completed according to the syllabus. For reflective consideration, further reading was done on SESAP 13 topics and corresponding ABSITE Keywords. For the abstract hypotheses step; these keywords and topics were reviewed with the mentor. Active testing involved a required weekly on-line quiz based on the syllabus.

RESULTS

Correct scores on the ABSITE increased for 78.6% of residents in the ACES course, with 28.6% scoring 30th percentile or greater. Senior percent correct scores increased by 7.3% and junior percentile scores by 12.5%.

CONCLUSIONS

Remediation using the Kolb cycle improved ABSITE performance for a majority of participants.

Developing a psychopathology curriculum during child and adolescent psychiatry residency training: general principles and a problem-based approach

Psychopathology is one of the core elements in a curriculum on child and adolescent psychiatry. Because there is no best-evidence model described for teaching this topic, an approach must be developed in each program that meets the standards set out by the Residency Review Committee and fully prepares its graduates to be competent child and adolescent psychiatrists. Methods used for teaching psychopathology may vary widely among programs and should be based on a sound educational rationale and adult learning principles that emphasize life-long, self-directed learning. This article describes an overall approach to curriculum design and expands on the use of problem-based learning as an educational method for teaching psychopathology in a child and adolescent psychiatry residency program.

Education of the Modern Surgical Resident: Novel Approaches to Learning in the Era of the 80-Hour Workweek

INTRODUCTION

Implementation of the 80-hour work week has resulted in limitations on the hours available for resident education, creating a need for innovative approaches to teach surgical residents successfully. Herein we report the methods and results of an innovative didactic learning program at a large academic surgical residency program.

METHODS

Between 2004 and 2005, based on known principles of adult education and innovative learning techniques, a didactic learning program was instituted in a major academic surgery program. The course work consisted of a structured reading program using Schwartz's Textbook of Surgery, with weekly testing and problem-based learning (PBL) groups led by surgical faculty. The residents' progress was assessed by American Board of Surgery In-Training Examination (ABSITE) training scores before and after program implementation. A resident survey was also conducted to assess residents' attitudes toward the new program. Results were reported as a mean, and categoric variables were compared using a paired Student's t-test.

RESULTS

During the academic year of the structured reading program, the mean ABSITE score improved by 10% (P=0.02) from the previous year. The postgraduate year 4 class had the largest change, with a score increase of 17% over the previous year's performance (P=0.02). Survey results demonstrated that 64% of the responders agreed that the small-group PBL was preferable for achieving educational goals. Furthermore, 89% of residents responded that the PBL groups improved interaction between residents and faculty members.

CONCLUSIONS

An innovative formal learning program based on a major surgical textbook with weekly testing and small group sessions can significantly improve surgical training in the modern era of work-hour restrictions. Furthermore, surgical trainees find this format to be innovative and useful for improving didactic teaching.

PBL in undergraduate medical education: a qualitative study of the views of Canadian residents

BACKGROUND AND OBJECTIVES

At McMaster University, the birthplace of problem-based learning (PBL), administrators and curriculum planners have begun the process of renewing the undergraduate MD curriculum. One step has been to conduct an environmental scan that includes input from medical residents.

METHODS

Individual interviews with 17 medical residents and fellows currently enrolled at McMaster University and are graduates of six Canadian medical schools.

RESULTS

PBL appears to be well known even by graduates of non-PBL Canadian medical schools. Tutors are key to a successful PBL program, should be knowledgeable about the content area under study and able to effectively facilitate groups. Tutorial problems should be realistic, up-to-date, and challenge students to investigate more than the medical aspects of the case in question. Students need to be prepared, willing to participate in peer teaching, and supportive of the group learning process. PBL programs can be improved if they incorporate elements of traditional medical programs (e.g., mini-lectures, clear learning objectives, and unbiased evaluation of student progress) while retaining the essence of student-generated learning.

CONCLUSIONS

Medical residents are an underutilized source of information about undergraduate medical programs. According to our participants, more emphasis on faculty development and upgrading health care problems will improve PBL-based undergraduate medical education.

The development of a computer-assisted curriculum in reproductive endocrinology and infertility for residents

OBJECTIVE This study was undertaken to determine the features of an effective computer-based residency curriculum in reproductive endocrinology and infertility.

STUDY DESIGN

A review of the literature to determine those features that have been used by training programs in medicine. Reproductive endocrinology and infertility division directors, current obstetrics and gynecology residents, and obstetrics and gynecology practitioners in the community were surveyed to evaluate critical subjects for study.

RESULTS

Programs most successful in using computers in training health care providers use a case-based approach that prioritizes important subjects. Areas of greatest importance to the 3 groups surveyed include infertility, dysfunctional uterine bleeding, and management of the climacteric, and several other areas were also deemed critical.

CONCLUSION

Benefits of computer-based learning include consistency, the ability to develop problem solving skills for life-long learning, and a self-paced approach, but its validity as a teaching tool will require rigorous appraisal.

Problem-based learning for surgical trainees

Problem-based learning (PBL) represents an educational technique that many medical schools have adopted for their undergraduate curricula. This article discusses the application of PBL for surgical trainees.

Lemonade from lemons: a program response to RRC-determined probation

To assess resident satisfaction as a result of changes made to an integrated surgical residency in response to probation.The University of Connecticut Integrated General Surgery Residency (UCIGSR), which consists of 5 hospitals, 18 rotations, and has a complement of 44 residents, was placed on probation by the Residency Review Committee (RRC) in Surgery in November 1998. Among the deficiencies cited by the RRC were inadequate evaluation of the program, rotations, residents, and the faculty by the residents, along with inadequate documentation issues. Lack of organized educational conferences, lack of faculty involvement, excessive service responsibilities and work hours, and hospital environmental issues were also cited. It was also apparent that morale of the residents and faculty had significantly eroded. Rather than trying patchwork "fixes" of deficiencies, we used this opportunity to reengineer the program, rededicating ourselves to educating and developing future surgeons. Task forces, including joint faculty and resident participation, were set up to develop solutions, based on the answer to the question: "Do we want a residency or not?" This focus was especially helpful to create hospital administration and faculty support.A survey was created to assess the changes made in the program. The survey included 65 questions pertaining to the learning environment, hospital and departmental support, and balance between clinical and educational responsibilities and overall working environment. Each resident was asked to fill out 3 identical surveys, 1 just before the RRC report, and the other 2 at 6-month intervals after the probation announcement. A 4-point grading scale was used.Our results were reflective of resident perceptions of improvement and increased satisfaction. These data demonstrated that the changes implemented as a result of the RRC findings had a positive effect on the residency program, and they corresponded to the areas where changes were implemented. This survey also gave us a method to evaluate ongoing changes in our residency.Probation can be a potent stimulus for improvement of a surgical residency. (Curr Surg 57:373-376. Copyright 2000 by the Association of Program Directors in Surgery.)