Are COVID-Era General Surgery Interns Starting Residency Behind on Basic Surgical Skills?

Lauren Weaver; Anna Pavlova; Michelle Lunden; Melissa E Brunsvold; Daniel Kendrick

doi:10.1016/j.jsurg.2023.07.010

Are COVID-Era General Surgery Interns Starting Residency Behind on Basic Surgical Skills?

J Surg Educ. 2023 Nov;80(11):1567-1573. doi: 10.1016/j.jsurg.2023.07.010. Epub 2023 Aug 8.

Authors

Lauren Weaver¹, Anna Pavlova², Michelle Lunden³, Melissa E Brunsvold⁴, Daniel Kendrick⁴

Affiliations

¹ Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota. Electronic address: weave500@umn.edu.
² Department of Surgery, University of Minnesota, Minneapolis, Minnesota.
³ Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota.
⁴ Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota; Department of Surgery, University of Minnesota, Minneapolis, Minnesota.

PMID: 37563000
DOI: 10.1016/j.jsurg.2023.07.010

Abstract

Objective: To compare incoming general surgery interns' performance on a basic skills assessment before and after the COVID pandemic.

Design: A retrospective cohort study compared surgical skill performances of incoming general surgery interns. Each underwent an evidence-based standardized assessment (pretest) with 12-basic surgical knot tying and suturing tasks. A post-test was administered after a 3-month self-directed skills curriculum. Student's t-tests compared proficiency scores from pre-COVID vs. COVID-era general surgery interns before and after curriculum completion. p < 0.05 was significant.

Setting: Data was collected from surgical residents in an academic general surgery program in the United States.

Participants: General surgery interns from 2017 to 2019 (pre-COVID) and 2021 to 2022 (COVID-era) were included. Interns with missing data or extreme outliers were excluded. A total of 100 interns in general surgery were included in the pretest cohort (59 pre-COVID, 41 COVID-era) and 101 interns were in the post-test cohort (66 pre-COVID, 35 COVID-era).

Results: COVID-era interns scored significantly lower on the pretest compared to pre-COVID interns (COVID-era 721.9+/-268.8 vs. pre-COVID 935.9+/- 228.0, p < 0.001). After the skills curriculum both cohorts improved their proficiency scores. However COVID-era interns still scored significantly lower (COVID-era 1255.0+/-166.3 vs. pre-COVID 1369.8+/-165.6, p = 0.001).

Conclusions: This analysis objectively described deficits in fundamental surgical skills for incoming interns whose medical school education was disrupted by the COVID-19 pandemic. A targeted surgical skills curriculum partially remediated these deficiencies. However, many surgical interns may need additional intervention and potentially more time in order to fully develop their surgical skills and meet the competency requirements required for advancement.

Keywords: COVID; Practice-Based Learning and Improvement; assessment; curriculum; resident education; surgical education.

MeSH terms

COVID-19* / epidemiology
Clinical Competence
Curriculum
Education, Medical, Graduate
General Surgery* / education
Humans
Internship and Residency*
Pandemics
Retrospective Studies
United States