Mastery of Operative Suturing/Stapling in Intestinal Surgery (MOSIS) Development of a Military General Surgery...

Area of Science:

• Surgical Education
• Medical Simulation
• Gastrointestinal Surgery

Background:

• Surgical residents require specialized training in intestinal surgery techniques.
• Military surgical readiness necessitates proficiency in open intestinal procedures.
• Existing curricula may not adequately address the nuances of suturing and stapling in intestinal surgery.

Purpose of the Study:

• To develop and evaluate the Mastery of Operative Suturing/Stapling in Intestinal Surgery (MOSIS) curriculum.
• To enhance open intestinal surgery competency among general surgery residents.
• To improve military surgical readiness through simulation-based training.

Main Methods:

• Utilized the ADDIE instructional design framework for curriculum development.
• Established validity through expert consensus and standardized evaluator training.
• Assessed resident performance using binary task checklists and technical assessment rubrics.
• Compared performance across postgraduate year (PGY) levels.

Main Results:

• Hand-sewn anastomosis performance significantly improved with resident training level (PGY-1 to PGY-5).
• Correct task completion for single-layer end-to-end anastomosis increased from 78.6% to 100%.
• Correct task completion for two-layer side-to-side anastomosis improved from 83.3% to 100%.
• Stapled anastomosis accuracy was uniformly high across all PGY levels with no significant differences.

Conclusions:

• The MOSIS curriculum effectively develops open intestinal surgery skills, particularly hand-sewn techniques.
• Significant gains in hand-sewn anastomotic performance demonstrate the curriculum's educational impact.
• The MOSIS model is feasible, reproducible, and applicable for military surgical training programs.
• Emphasis on hand-sewn techniques is crucial for expeditionary and resource-limited environments.