Sara Kim

Halting the Revolving Door of Faculty Turnover: Recruiting and Retaining Clinician Educators in an Academic Medical Simulation Center

Simulation-based education is indispensable in preparing healthcare providers for patient care.1 Simulation centers and programs that serve as a critical platform for promoting patient safety and high-quality training depend on multiple requirements for success: diversified and sustainable financing,2–5 technical personnel with a long-term commitment to simulation education,6,7 simulation and information technology infrastructure designed to match priority training needs,8–12 and resources for curricular development, instruction, faculty development, and research.6,7,9,12–14 An additional requirement not widely discussed in the literature is the recruitment and retention of faculty who serve as simulation educators, which is the focus of this report.

A structured self-directed basic skills curriculum results in improved technical performance in the absence of expert faculty teaching

BACKGROUND We developed a novel curriculum teaching 20 open surgical skills in 5 general domains (instrument handling, knot tying, simple wound closure, advanced wound closure, and hemostasis). The curriculum includes online didactics, skills practice, and defined performance metrics, but is entirely self-guided with no expert oversight or teaching. METHODS Subjects included first- and second-year medical students (n = 9). Subjects first viewed a demonstration video depicting proper technique. The pretest was video-recorded performance of each skill. Subjects then completed the self-guided skills curriculum at their own pace, returning for posttesting once they met defined self-assessment criteria. Performance was evaluated through both self-assessment and blinded video review by 2 expert reviewers using previously validated scales. RESULTS After completion of the curriculum, performance improved significantly by both self-assessment (3,754 ± 1,742 to 6,496 ± 1,337; P < .01, Wilcoxon signed ranks) and expert assessment (10.1 ± 2.6 to 14.6 ± 2.7; P = .015). When analyzed by the 5 general domains, performance was significantly better for all domains by self-assessment (P < .05 for all domains) and in 4 domains by expert assessment (P < .04 for all domains other than instrument handling). CONCLUSION Completion of a self-guided basic surgical skills curriculum allows novice learners to significantly improve performance in basic open surgical skills, without traditional expert teaching. This curriculum is useful for medical students and incoming junior residents.

The effect of video review of resident laparoscopic surgical skills measured by self- and external assessment

BACKGROUND Video review of surgical skills is an educational modality that allows trainees to reflect on self-performance. The purpose of this study was to determine whether resident and attending assessments of a residents laparoscopic performance differ and whether video review changes assessments. METHODS Third-year surgery residents were invited to participate. Elective laparoscopic procedures were video recorded. The Global Operative Assessment of Laparoscopic Skills evaluation was completed immediately after the procedure and again 7 to 10 days later by both resident and attending. Scores were compared using t tests. RESULTS Nine residents participated and 76 video reviews were completed. Residents scored themselves significantly lower than the faculty scores both before and after video review. Resident scores did not change significantly after video review. CONCLUSIONS Attending and resident self-assessment of laparoscopic skills differs and subsequent video review does not significantly affect Global Operative Assessment of Laparoscopic Skills scores. Further studies should evaluate the impact of video review combined with verbal feedback on skill acquisition and assessment.

Characteristics of a surgical trainer 2010–2020

The type of individual most commonly employed as a surgical trainer is a Clinical Instructor, usually in the junior stages of a faculty position, who has voiced an interest in education and who joins initially with a great deal of enthusiasm. Unfortunately, the lifespan of such an individual as a surgical trainer in a simulation center is relatively limited.