How We Do It: Remediation Pathways in a Surgical Simulation Curriculum for Competency Improvement

Area of Science:

• Medical Education
• Surgical Training
• Simulation-Based Learning

Background:

• Surgical competency relies on validated procedural skill assessment and remediation.
• High-fidelity simulation offers a platform for assessing resident proficiency and identifying needs for additional practice.
• Objective validation of remediation pathways in surgical training remains underexplored.

Purpose of the Study:

• To review two remediation pathways within a simulation training curriculum.
• To analyze their application in assessing general surgery resident proficiency.
• To evaluate resident and faculty perceptions of these remediation methods.

Main Methods:

• Two remediation pathways were developed for high-fidelity simulation labs: a summative process and a formative "coaching" process.
• The summative pathway involved intra-operative assessment of holistic skills for final competency judgment.
• The formative pathway provided interval feedback for specific technical skill competence, with all general surgery residents enrolled.

Main Results:

• Approximately one-third of residents utilized a remediation pathway.
• Both residents and faculty supported the remediation pathways.
• Faculty showed stronger preference for the formative coaching model over the summative assessment.

Conclusions:

• Complementary formative and summative remediation pathways constructively enhance resident competence.
• These methods support non-punitive, self-directed performance improvement.
• Standardized skill assessment programs using these pathways yield high trainee and faculty satisfaction.