Formal surgery curriculum sharpens ob.gyn. skills.(Gynecology)

RANCHO MIRAGE, CALIF. -- A formal curriculum for teaching surgery significantly improved the skills of ob.gyn. residents in performing specific surgical tasks, a 6-year study found.

The University of Washington instituted an ob.gyn. surgery curriculum for residents starting in 1997 and compared results of testing in two groups: residents whose 4 years of training included the curriculum in each year and residents who trained earlier and encountered the curriculum only during their last 1 or 2 years of training. Residents in the second group were considered controls.

The curriculum included baseline testing at the start of each academic year, prelaboratory instruction, and twice-yearly surgical skills training sessions for 24 ob.gyn. residents; training involved both inanimate lifelike models and animal laboratories.

At the end of each year, residents were tested on individual bench skills and underwent objective structured assessment of technical skills (OSATS), which served as a means to test their abilities on procedures rather than on single tasks, Gretchen M. Lentz, M.D., said at the annual meeting of the Society of Gynecologic Surgeons.

Residents who had 4 years of exposure to the curriculum showed significantly better bench skills on both laparoscopic and open surgical tasks, compared with the control group, according to Dr. Lentz of the university and her associates.

OSATS scores also were higher in the intervention group than the control group, but the difference was not statistically significant, perhaps due to the small numbers of procedures that could be evaluated. "We have to change the tasks that they do every year, so that they don't know what we're going to test them on, and it limits our numbers overall," she explained.

A previous survey of 206 ob.gyn. residency programs by Dr. Lentz and associates found only 29% had a formal training program in surgical skills. The optimal ...