QS42. Practice in a Dry Lab Setting Leads to Improved Laparoscopic Surgical Performance in the Operating Room

286 ASSOCIATION FOR ACADEMIC SURGERY AND SOCIETY OF UNIVERSITY SURGEONS—ABSTRACTS students interested in medicine. Methods: 44 (92%) of 48 participants of a summer research, shadowing, and mentorship program returned blinded questionnaires which focused on the program’s impact on their scholarly skills, career choices, and goals. The program interfaced academic surgeons with students interested in careers in medicine and enabled students to participate in research projects, attend daily lectures, and shadow physicians in the OR, clinic, and hospital. Proficiency in scholarly skills, before and after the program, was scored by the participants utilizing a Likert scale (0⫽none to 10⫽proficient). Results: 93% of participants were in or had completed college; only 7% had advanced degrees. With the program, proficiency in scholarly skills improved (Table). Over the last five years, participants co-authored 112 national presentations (29 video presentations), 46 published abstracts, and 57 peer-reviewed published manuscripts. 92% developed more favorable opinions of a career in medicine; 8% felt the experience deterred them from a career in medicine because of lifestyle and studious demands. 77% felt the program promoted a career in Surgery; 82% felt it elevated their goals to become leaders in American medicine. Of four participants not returning questionnaires, one is Director of Transplantation at a major university and one is a university-based anesthesiologist. Conclusions: Shadowing opportunities, mentoring, and didactic teaching of scholarly skills for college / graduate students interested in medicine fosters academic productivity and elevation of career goals. Academic surgeons can favorably influence career choices and goals for students interested in careers in medicine.

Medical Terminology Abstract Writing Statistical Analysis Graph/Table Construction Manuscript Writing Video Production

Before Program

After Program

5 (5 ⫾ 2.7) 2 (3 ⫾ 1.6) 3 (3 ⫾ 2.0) 5 (5 ⫾ 2.5)

8 (8 ⫾ 1.9)ⴱ 8 (7 ⫾ 2.0)ⴱ 8 (7 ⫾ 2.0)ⴱ 8 (8 ⫾ 1.9)ⴱ

2 (3 ⫾ 1.8) 1 (2 ⫾ 2.3)

7 (7 ⫾ 2.2)ⴱ 8 (7 ⫾ 3.2)ⴱ

Data are presented as median (mean ⫾ SD). ⴱScholarly skills more proficient after summer program, p⬍0.001, Wilcoxon matched pairs test. QS42. PRACTICE IN A DRY LAB SETTING LEADS TO IMPROVED LAPAROSCOPIC SURGICAL PERFORMANCE IN THE OPERATING ROOM. Marie K. Stelzer, Matthew P. Abdel, Michael P. Sloan, Jon C. Gould; University of Wisconsin Hospitals and Clinics, Madison, WI Background: Surgical residents have traditionally acquired laparoscopic surgical skill in the operating room. Restricted resident work hours, increased costs of operating room time, and a focus on medical errors have necessitated that developing surgeons practice preliminary laparoscopic skills outside of the operating room. Research has demonstrated that practice in surgical simulators leads to improved performance in that particular simulator. Our hypothesis is that these skills acquired in a dry laboratory setting are real and transferable to a live operating room experience. Methods: Fourteen first-year general surgery trainees participated in this study. None of the subjects had previous laparoscopic or simulator experience. All participants performed two standardized tasks in a video trainer: pegboard transfer and intracorporeal knot tying. Both of these tasks are a part of the validated MISTELS (McGill Inanimate System for the Training and Evaluation of Laparoscopic Skills) system. The MISTELS scoring system was used to objectively measure performance. Prior to any skills lab training, subjects were videotaped performing two tasks in a live porcine model: running the small bowel and intracorporeal knot

tying. A six week intensive and supervised period of structured dry lab skills training ensued. Surgical interns participating in this study were trained in the skills lab to proficiency levels derived from more experienced senior residents in our laboratory. At the end of six weeks, task performance was assessed once again for both the standardized dry lab and live porcine tasks. For the pegboard transfer task, performance scores were derived according to the formula: 300 minus time in seconds to complete the task minus a penalty for each peg dropped during transfer. For the intracorporeal knot task, performance scores were calculated according to the formula: 600 minus time in seconds to complete the task minus a penalty for slip knots. Surgical skills in the porcine model were assessed using a modified GOALS (Global Objective Assessment of Laparoscopic Skills) instrument in a blinded manner by two expert laparoscopists. Live operative surgical skill was evaluated based on four domains: depth perception, bimanual dexterity, efficiency and tissue handling. Each domain of laparoscopic skill was graded on a 5-point Likert scale (1 ⫽ worst possible score, 4 ⫽ best possible score for each domain). Results: After structured training, the mean dry lab intracorporeal knot tying score increased from 275.2 to 457.5 (p ⬍ 0.01). Dry lab pegboard transfer scores increased from a mean of 108.9 to 192.1 (p ⬍ 0.01). In the live porcine model, GOALS knot tying scores increased from a mean of 7.8 prior to skills lab training to 15.0 after training (p ⬍ 0.01). GOALS scores for the bowel running task increased from a mean of 9.0 pre-training to 13.7 post training (p ⬍ 0.01). Conclusion: Practice in a laparoscopic simulator leads to improved performance not only in that simulator but also in a live operative model. We believe that this is evidence that the laparoscopic manual skills developed in a dry laboratory setting are real laparoscopic surgical skills that are transferable to the operating room. This study further validates the utility of simulation labs as a means of preparing developing surgeons to safely and efficiently participate in surgical cases on actual patients. QS43. ARE STUDENTS LEARNING WHAT FACULTY ARE INTENDING TO TEACH. Susan Skaff Hagen, Mohammed J. Shaikh, Marcy E. Rosenbaum, Kimberly Ephgrave; University of Iowa Carver College of Medicine, Iowa City, IA Introduction: Medical students learn an overwhelming amount of information in a short amount of time, estimated at 13 facts/ concepts per hour. (1) In most cases, the lecturer is a medical doctor without formal training in teaching. A great deal of literature has been devoted to assessing how students learn and retain this information. Many authors have concentrated on the format, the length and the appropriate evaluation of the lectures, most commonly evaluated by a post-test. (2-10) Very little research has been dedicated to evaluating free recall of information following a lecture. This study was designed to explore if third year medical students rotating through the general surgery clerkship can demonstrate knowledge gained in a lecture without being prompted by a post-test quiz and to assess if the knowledge gained during a lecture is the same as that which the lecturer identified as a key concept. Methods: Prior to lecturing the third year students during their general surgery clerkship, faculty submitted 3-6 key concepts of their lecture. Immediately following the lecture, students completed an anonymous, paper and pencil evaluation describing 3-6 concepts they learned. The qualitative data was analyzed using QRS’s NVivo. The codebook and coding was performed by two members of the team and discrepancies resolved with the 3 rd member. A code was considered significant if more than 5 students reported a similar theme. Each statement was coded as “general”, “specific” or “very specific” intending to measure the depth of the statement. All statements were coded into twelve broad categories such as: basic science, risk factors, symptoms, physical exam, work-up, differential diagnosis, etc. Each session was also coded individually for specific themes. Finally,