Protected block curriculum enhances learning during general surgery residency training

Travis P Webb, John A Weigelt, Philip N Redlich, Rebecca C Anderson, Karen J Brasel, Deborah Simpson
Archives of Surgery 2009, 144 (2): 160-6

BACKGROUND: Changes in medical education require a rethinking of our training paradigm. We implemented a protected block curriculum for postgraduate year (PGY)-1 and PGY-2 surgery residents.

HYPOTHESIS: A protected block curriculum promotes adult learning consistent with the 6 competencies.

DESIGN: Prospective static-group comparison with pretesting and posttesting.

SETTING: Medical College of Wisconsin, Milwaukee.

PARTICIPANTS: Eight university-based surgical residents (curriculum group) and 8 residents who did not participate in the curriculum (control group).

MAIN OUTCOME MEASURES: The curriculum occurs during protected time away from clinical activity. Predefined learning objectives and competencies were identified for PGY-1 and PGY-2 residents. Multiple choice examinations were administered to assess knowledge. The first 3 tests of the year in the PGY-2 curriculum were also given to the PGY-3 and PGY-4 and -5 residents for comparison with curriculum residents. In-training examination scores of control and curriculum residents were compared. Surgical and communication skills were assessed using checklist assessment forms. Curriculum residents evaluated the content and delivery.

RESULTS: Pretest and posttest results demonstrated acquisition of knowledge with improved aggregated mean scores from 57.5% to 71.4% for PGY-1 residents and 58.6% to 72.6% for PGY-2 residents. The average curriculum test results were 76.7% for curriculum residents, 56.9% for control residents, and 57.3% for all residents. The 2-year average in-training scores were 71.2% for curriculum and 60.3% for control residents. Assessments demonstrated improvements in communication and surgical skills.

CONCLUSIONS: A protected block curriculum enhanced surgical residents' learning compared with a traditional model. Improvement in medical knowledge was easiest to measure, but performance in other Accreditation Council for Graduate Medical Education competency areas also demonstrated improvement.

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