Thoracic surgical content of an undergraduate surgical curriculum

The surgical services have long been an excellent training ground for teaching clinical skills common to all physicians. The thoracic surgical service provides an additional opportunity to offer experience in trauma, resuscitation, and the management of many emergency situations common to all medical and surgical illness. With the use of a methodology previously reported by the Association for Surgical Education, a survey was developed and circulated among surgical department chairmen, directors of thoracic surgical training programs, and the medical school classes of 1978 who had completed 5 postgraduate years of training and/or practice. A modified Delphi technique was used to assess the information, and the rank order of mean scores for knowledge and skills was constructed for the various categories within the thoracic surgery curriculum. The Pearson product-moment correlation for the rank order of knowledge and skills demonstrated a high degree of correlation between directors and students (0.904 and 0.917, respectively), directors and chairmen (0.948 and 0.982, respectively), and between students and chairmen (0.900 and 0.952, respectively) for knowledge and skills. The most important knowledge categories were critical care and resuscitation (rank order 2.15), hemodynamic measurements and analysis (2.10), pulmonary embolus (2.06), and assessment of pulmonary function (1.92). The most important skills listed were thoracentesis (1.92), endotracheal intubation (1.86), and central vein cannulation (1.69). Analysis of data such as these permits construction of a surgery curriculum responsive to the goals and objectives of the faculty and implements the viewpoints of many individuals representing multiple backgrounds to formulate the most appropriate content for undergraduate surgical education.