Protected block curriculum enhances learning during general surgery residency training

Changes in medical education require a rethinking of our training paradigm. We implemented a protected block curriculum for postgraduate year (PGY)-1 and PGY-2 surgery residents.

A protected block curriculum promotes adult learning consistent with the 6 competencies.

Prospective static-group comparison with pretesting and posttesting.

Medical College of Wisconsin, Milwaukee.

Eight university-based surgical residents (curriculum group) and 8 residents who did not participate in the curriculum (control group).

The curriculum occurs during protected time away from clinical activity. Predefined learning objectives and competencies were identified for PGY-1 and PGY-2 residents. Multiple choice examinations were administered to assess knowledge. The first 3 tests of the year in the PGY-2 curriculum were also given to the PGY-3 and PGY-4 and -5 residents for comparison with curriculum residents. In-training examination scores of control and curriculum residents were compared. Surgical and communication skills were assessed using checklist assessment forms. Curriculum residents evaluated the content and delivery.

Pretest and posttest results demonstrated acquisition of knowledge with improved aggregated mean scores from 57.5% to 71.4% for PGY-1 residents and 58.6% to 72.6% for PGY-2 residents. The average curriculum test results were 76.7% for curriculum residents, 56.9% for control residents, and 57.3% for all residents. The 2-year average in-training scores were 71.2% for curriculum and 60.3% for control residents. Assessments demonstrated improvements in communication and surgical skills.

A protected block curriculum enhanced surgical residents' learning compared with a traditional model. Improvement in medical knowledge was easiest to measure, but performance in other Accreditation Council for Graduate Medical Education competency areas also demonstrated improvement.