Preliminary Assessment of a Scientific Curriculum in a Surgical Residency Program

Abstract

A structured, basic science curriculum was instituted for surgical residents of the University of Connecticut (Farmington) Integrated Residency Program during the 1990-1991 academic year in concordance with American Board of Surgery guidelines. The impact of the new program was measured by comparing performance on monthly basic science examinations, the in-training examination, and "mock" oral examinations for the 1990-1991 academic year with that of the preceding academic year. While monthly examination scores improved for the entire group of residents (67.7 vs 64.6), in-training and oral examination scores did not change significantly. Categorical residents generally demonstrated superior performance and greater improvement than did preliminary residents. Data analysis suggested that the new curriculum was an effective educational device and that university-designed monthly examinations were valid testing instruments, but there was an apparent incongruity between the goals of the curriculum and the American Board of Surgery In-Training Examination.

Interventions That Affect Resident Performance on the American Board of Surgery In-Training Examination: A Systematic Review

“…8 There were 8 articles evaluating the effect of didactic conferences on resident performance on the ABSITE. [12][13][14][15][16][17][18][19] The design and major findings of these studies are summarized in Table 2. These were generally resident-directed or faculty-directed structured teaching conferences.…”

“…The teaching sessions were either weekly or bimonthly focusing either on the basic sciences 15 or on a combined basic and clinical sciences curriculum. [16][17][18] Teaching sessions usually involved textbook or journal review, 15,17 didactic lectures, [15][16][17][18] or in-depth question-and-answer discussion sessions. 17,18 Didactic conferences were combined with the administration of MCEs, as well as annual oral examinations for senior residents in 1 study.…”

“…17,18 Didactic conferences were combined with the administration of MCEs, as well as annual oral examinations for senior residents in 1 study. 15 All except 2 studies compared ABSITE performance before and after initiation or expansion of didactic conferences. [15][16][17][18] In these 6 studies, 2 reported no significant improvement in ABSITE scores 15,18 despite substantial improvement in overall resident satisfaction 18 and improvement in monthly MCE scores, 15 3 studies reported improvement in mean ABSITE percentile rank with resident-directed 17 and faculty-directed didactic teaching, 16,17 and 1 study demonstrated significant improvement in PGY 1 to 2 resident scores but no improvement in PGY 3 to 5 scores.…”

Expanding Resident Conferences While Tailoring Them to Level of Training: A Longitudinal Study

“…These results have been attributed to differences in the curricula used-specifically faculty involvement and teaching to the stated goal of improving ABSITE performance. [2][3][4][12][13][14][15][16][17][18] ABSITE scores probably reflect to a greater extent individual resident factors rather than the content or structure of the resident didactic conference. 3,4,[12][13][14][15][19][20][21][22][23][24] Of all factors, resident self-preparation and methods that encourage active learning are likely most important and predictive of ABSITE success.…”