Impact of a Surgical Skills Curriculum on Medical Student Procedural Experience and Confidence

There is a documented decline in formal procedural skill training in undergraduate medical education. We evaluated a simulation-based skills curriculum before the core surgical clerkship at a large academic institution on its concordance with the skills students perform during the clerkship and its impact on procedural confidence.

Between August 2021 and August 2022, students underwent a 2-d simulation-based orientation before the core surgery clerkship. Upon completion of their surgical clerkship, we surveyed medical students on their experience (simulating and/or performing) and confidence in 36 procedural skills considered important by clerkship leadership.

Of 121 eligible medical students, 36 (30%) completed the survey. Median age was 26 y (Q1-Q3 25-26), 69% identified as female, 74% as White, and 17% as Hispanic. There was a significant difference between procedures students simulated before their clerkship and those performed during their clerkship for 16 procedures (P < 0.05). Procedural confidence significantly increased after the skills orientation (P < 0.001), as well as after the duration of the clerkship (P < 0.001). Competence, as measured by skills competition times, did not differ by gender (P > 0.05) and was higher in students bound for surgical residencies (P < 0.001).

We highlight the value of a skills orientation before the surgery clerkship, as it significantly increases students' procedural confidence. However, we identified a gap between the skills students receive orientation training for and those they are expected to perform on the rotation. Our findings support the need for curricular changes that better prepare students for the surgical clerkship.