A Disease-Specific Hybrid Rotation Increases Opportunities for Deliberate Practice

Mackenzie R. Cook, Amanda N. Graff-Baker, Alexis M. Moren, Sarah Brown, Kelly A. Fair, Laszlo N. Kiraly, Violeta Tammy De La Melena, Su Ellen Johnson Pommier, Karen Deveney

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Importance Incorporating deliberate practice (DP) into residency curricula may optimize education. DP includes educationally protected time, continuous expert feedback, and a focus on a limited number of technical skills. It is strongly associated with mastery level learning. Objective Determine if a multidisciplinary breast rotation (MDB) increases DP opportunities. Design Beginning in 2010, interns completed the 4-week MDB. Three days a week were spent in surgery and surgical clinic. Half-days were in breast radiology, pathology, medical oncology, and didactics. The MDB was retrospectively compared with a traditional community rotation (TCR) and a university surgical oncology service (USOS) using rotation feedback and resident operative volume. Data are presented as mean ± standard deviation. Setting Oregon Health and Science University in Portland, Oregon; an academic tertiary care general surgery residency program. Participants General surgery residents at Oregon Health and Science University participating in either the MDB, TCR or USOS. Results A total of 31 interns rated the opportunity to perform procedures significantly higher for MDB than TCR or USOS (4.6 ± 0.6 vs 4.2 ± 0.9 and 4.1 ± 1.0, p <0.05). MDB was rated higher than TCR on quality of faculty teaching and educational materials (4.5 ± 0.7 vs 4.1 ± 0.9 and 4.0 ± 1.2 vs 3.5 ± 1.0, p <0.05). Interns operated more on the MDB than on the USOS and were more focused on breast resections, lymph node dissections, and port placements than on the traditional surgical rotation or USOS. Conclusions The MDB incorporates multidisciplinary care into a unique, disease-specific, and educationally focused rotation. It is highly rated and affords a greater opportunity for DP than either the USOS or TCR. DP is strongly associated with mastery learning and this novel rotation structure could maximize intern education in the era of limited work hours.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalJournal of Surgical Education
Volume73
Issue number1
DOIs
StatePublished - Jan 1 2016

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Disease
Breast
university
surgery
community
Internship and Residency
Teaching Materials
Learning
resident
Education
Medical Oncology
Health
Tertiary Healthcare
Lymph Node Excision
science
health
Radiology
didactics
pathology
Curriculum

Keywords

  • autonomy
  • breast neoplasms
  • general surgery
  • graduate medical education
  • surgery residency training

ASJC Scopus subject areas

  • Surgery
  • Education

Cite this

A Disease-Specific Hybrid Rotation Increases Opportunities for Deliberate Practice. / Cook, Mackenzie R.; Graff-Baker, Amanda N.; Moren, Alexis M.; Brown, Sarah; Fair, Kelly A.; Kiraly, Laszlo N.; De La Melena, Violeta Tammy; Pommier, Su Ellen Johnson; Deveney, Karen.

In: Journal of Surgical Education, Vol. 73, No. 1, 01.01.2016, p. 1-6.

Research output: Contribution to journalArticle

Cook, Mackenzie R. ; Graff-Baker, Amanda N. ; Moren, Alexis M. ; Brown, Sarah ; Fair, Kelly A. ; Kiraly, Laszlo N. ; De La Melena, Violeta Tammy ; Pommier, Su Ellen Johnson ; Deveney, Karen. / A Disease-Specific Hybrid Rotation Increases Opportunities for Deliberate Practice. In: Journal of Surgical Education. 2016 ; Vol. 73, No. 1. pp. 1-6.
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abstract = "Importance Incorporating deliberate practice (DP) into residency curricula may optimize education. DP includes educationally protected time, continuous expert feedback, and a focus on a limited number of technical skills. It is strongly associated with mastery level learning. Objective Determine if a multidisciplinary breast rotation (MDB) increases DP opportunities. Design Beginning in 2010, interns completed the 4-week MDB. Three days a week were spent in surgery and surgical clinic. Half-days were in breast radiology, pathology, medical oncology, and didactics. The MDB was retrospectively compared with a traditional community rotation (TCR) and a university surgical oncology service (USOS) using rotation feedback and resident operative volume. Data are presented as mean ± standard deviation. Setting Oregon Health and Science University in Portland, Oregon; an academic tertiary care general surgery residency program. Participants General surgery residents at Oregon Health and Science University participating in either the MDB, TCR or USOS. Results A total of 31 interns rated the opportunity to perform procedures significantly higher for MDB than TCR or USOS (4.6 ± 0.6 vs 4.2 ± 0.9 and 4.1 ± 1.0, p <0.05). MDB was rated higher than TCR on quality of faculty teaching and educational materials (4.5 ± 0.7 vs 4.1 ± 0.9 and 4.0 ± 1.2 vs 3.5 ± 1.0, p <0.05). Interns operated more on the MDB than on the USOS and were more focused on breast resections, lymph node dissections, and port placements than on the traditional surgical rotation or USOS. Conclusions The MDB incorporates multidisciplinary care into a unique, disease-specific, and educationally focused rotation. It is highly rated and affords a greater opportunity for DP than either the USOS or TCR. DP is strongly associated with mastery learning and this novel rotation structure could maximize intern education in the era of limited work hours.",
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