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Closing the Gap in Ostomy Care: A Structured Curriculum Improves General Surgery Resident Competence in Preoperative
Tyler M Wilson1, Ryan J Meyer1, Tamir E Bresler1
1Department of Surgery, HCA Los Robles Medical Center, Thousand Oaks, California.
Objective:
To evaluate whether a structured, simulation-based multidisciplinary teaching session could improve general surgery resident self-reported confidence and knowledge in preoperative stoma site marking.
Design:
Prospective pilot quality improvement initiative using a pre-/postintervention design. Resident confidence and knowledge were assessed immediately before and after the intervention using an investigator-developed 10-item instrument scored on a 5-point Likert scale (maximum composite score 50). Wilcoxon signed-rank test was used for comparison.
Setting:
Community-based general surgery residency program at a single institution in California.
Participants:
Twelve categorical general surgery residents (PGY1-PGY4) who voluntarily participated and completed both assessments.
Results:
All 12 residents demonstrated improvement in composite score following the intervention. Median composite score increased from 27 to 48 out of 50. The improvement was statistically significant (Z = -3.07, p = 0.002). The minimum postintervention score across all items and participants was 4, indicating every resident achieved at least a "Confident" rating following the session.
Conclusions:
A single, brief, multidisciplinary teaching session incorporating didactic instruction and simulation-based practice significantly improved resident confidence and knowledge in preoperative stoma site marking. Formal incorporation of this curriculum into general surgery residency training represents a practical, low-resource intervention with potential to reduce stoma-related complications and standardize care in settings where Wound, Ostomy, and Continence nurse (WOCN) expertise is unavailable.
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