Orientation to the Operating Room: An Introduction to the Surgery Clerkship for Third-Year Medical Students

Abstract

Introduction: The operating room is a complex environment in which individual team members perform specific tasks according to their role. A simulation activity was created to introduce medical students on the surgery clerkship to issues relating to patient safety, infection control, and regulatory requirements. Methods: This activity takes place prior to general surgery rotation operative experiences, and addresses the need for students to practice roles they will perform while participating in patient care. The activity includes a simulated operation, an assessment, and a scripted debriefing. Among other tasks, students practice safe patient transfer and monitoring, donning sterile garb, preparing the surgical site, and being active participants in a sign-in and time-out. Students are assessed on assigned tasks, their ability to maintain sterility, and the degree to which they engage with their team. Results: Students reported the simulation helped them better understand how they could become involved on their first day in the operating room. Students also reported they were more confident when in the operating room. This finding also extended to students who had previously been in the operating room during a prior OB/GYN rotation. Discussion: Patient safety is paramount when in the operating room, and this simulation activity fills a current gap in student's practical knowledge as they prepare to enter their surgery clerkship. Giving medical students the information and skills needed to be safe and effective members of the operating team prior to entering the operating room is of benefit to the surgical team, students, and patients.

Faculty development review: Improving learning in the operating theatre

“…Other initiatives include dedicated courses or workshops run before a surgical placement in order to help students be more prepared for the theatre environment (for example teaching them about infection control), 9‐11 and these have been positively received by students. Evidence would suggest that students who feel welcome enjoy their time in theatre more, are more likely to try and attend theatre again and are more likely to be interested in a surgical career 11,12 …”

“…There is contradictory evidence in the literature as to how much active involvement or “scrubbing in” to the operation improves the student’s learning experience 11,17 . There is also variation between surgeons and students as to how involved students think they should, or can be, during an operation 10 . It may be that being scrubbed at the table gives students a better view of the operation.…”

“…Other initiatives include dedicated courses or workshops run before a surgical placement in order to help students be more prepared for the theatre environment (for example teaching them about infection control), [9][10][11] and these have been positively received by students.…”

“…11,17 There is also variation between surgeons and students as to how involved students think they should, or can be, during an operation. 10 It may be that being scrubbed at the table gives students a better view of the operation.…”

Introductory Surgical Skills Course: Technical Training and Preparation for the Surgical Environment

“…Multiple curricula have been published concerning basic suturing skills including knot tying and suturing, in addition to simulations for introducing students to the surgery clerkship. 7–10 However, our course's sessions were designed to build upon one another, beginning with basic technical and nontechnical surgical skills and culminating in an operation performed on a cadaver in order to allow students to apply the skills learned in a simulated operative experience. Overall, this course provides a broad spectrum of resources that institutions can implement to facilitate preclinical medical students' interest in the surgical profession along with helping them prepare for the surgery core clerkship.…”