A Disease-Specific Hybrid Rotation Increases Opportunities for Deliberate Practice

Area of Science:

• Surgical Education
• Medical Training
• Residency Programs

Background:

• Deliberate practice (DP) is crucial for achieving mastery-level learning in surgical residency.
• Optimizing residency curricula with DP can enhance trainee skill acquisition.
• Limited work hours necessitate efficient educational structures.

Purpose of the Study:

• To evaluate if a multidisciplinary breast rotation (MDB) offers increased opportunities for deliberate practice (DP) for surgical interns.
• To compare the MDB with traditional community rotations (TCR) and university surgical oncology services (USOS) regarding DP and educational value.

Main Methods:

• General surgery interns at an academic tertiary care center participated in a 4-week MDB, TCR, or USOS.
• The MDB included dedicated time in surgery, clinic, radiology, pathology, oncology, and didactics.
• Retrospective comparison of rotation feedback and resident operative volume between the different rotation types.

Main Results:

• Interns rated the MDB significantly higher for opportunities to perform procedures compared to TCR and USOS.
• The MDB received higher ratings for faculty teaching and educational materials than the TCR.
• Interns on the MDB performed more operations and focused on specific breast procedures (resections, lymph node dissections, port placements).

Conclusions:

• The MDB is a unique, disease-specific rotation that integrates multidisciplinary care and enhances deliberate practice opportunities.
• The MDB structure is highly rated by interns and offers greater potential for mastery learning than TCR or USOS.
• This novel rotation design can optimize intern surgical education within current work hour limitations.