Advanced surgical skills for exposure in trauma: a new surgical skills cadaver course for surgery residents and fellows.

BACKGROUND: Surgical education is changing owing to workforce and economic demands. Simulation and other technical teaching methods are used to acquire skills transferable to the operating room. Operative management of traumatic injuries has declined, making it difficult to acquire and maintain competence. The ASSET course was developed by the Committee on Trauma's Surgical Skills Committee to fill a surgical skills need in resident and fellow education. Using a human cadaver, standardized rapid exposure of vital structures in the extremities, neck, thorax, abdomen, retroperitoneum, and pelvis is taught.

METHODS: A retrospective analysis of 79 participants in four ASSET courses was performed. Operative experience data were collected, and self-efficacy questionnaires (SEQs) were administered before and after the course. Course evaluations and instructor evaluation data were analyzed. Student's and paired samples t tests as well as analysis of variance and Spearman ρ correlation coefficient analysis were performed using α at p < 0.05. We hypothesized that the ASSET course would teach new surgical techniques and that learner self-assessed ability would improve.

RESULTS: Participants included 27 PGY-4, 20 PGY-5, 24 PGY-6 or PGY-7 and PGY-8 at other levels of training. Self-assessed confidence improved in all body regions (p < 0.001), with the greatest increase in upper extremity and chest. Pre- and post-SEQ scores correlated with trauma operative experience. Precourse SEQ scores differed by level of training. Instructor evaluations correlated with previous experience on a trauma service. Program evaluations averaged 4.73 on a 5-point scale, with gaining new knowledge rated at 4.8 and learning new techniques at 4.72.

CONCLUSION: A standardized cadaver-based surgical exposures course offered to senior surgical residents adds new surgical skills and improves participant self-assessed ability to perform emergent surgical exposure of vital structures.