Can a Structured, Video-Based Cadaver Curriculum Demonstrating Proficiency Enhance Resident Operative Autonomy?

Area of Science:

• Surgical Education
• Medical Simulation
• Resident Training

Background:

• Resident autonomy is crucial for surgical education, impacted by work hour restrictions and advanced techniques like robotics.
• Standardized training is needed to ensure exposure to fundamental surgical skills beyond clinical experience.
• Emory University's Department of Surgery developed a cadaver-based curriculum to enhance operative skills and resident autonomy.

Purpose of the Study:

• To evaluate the effectiveness of a cadaver-based simulation curriculum in standardizing fundamental operative skills.
• To assess the impact of the curriculum on resident proficiency and autonomy in the operating room.
• To improve confidence in trainee operative skills through objective evaluation.

Main Methods:

• A 6-hour cadaver-based session focusing on core surgical exposures and maneuvers was conducted.
• Residents were grouped by postgraduate year (PGY) and led by chief residents.
• Skills were assessed via oral board format and video-recorded performance, evaluated by blinded faculty.

Main Results:

• Senior residents (PGY3-5) achieved an 86% pass rate, while junior residents (PGY1-2) had a 70% pass rate.
• Overall, 21% of residents did not achieve competence, with junior residents less successful than seniors.
• Faculty grading congruence improved significantly over 5 years, with >80% agreement in the last two years.

Conclusions:

• Cadaveric skills courses with objective competency confirmation are valuable additions to surgical training.
• Video-recorded skill evaluation enhances resident and attending confidence in operative abilities.
• This curriculum positively influenced the granting of surgical autonomy in the operating room.