TY - JOUR
T1 - A Disease-Specific Hybrid Rotation Increases Opportunities for Deliberate Practice
AU - Cook, Mackenzie R.
AU - Graff-Baker, Amanda N.
AU - Moren, Alexis M.
AU - Brown, Sarah
AU - Fair, Kelly A.
AU - Kiraly, Laszlo
AU - De La Melena, Violeta Tammy
AU - Pommier, Suellen J.
AU - Deveney, Karen
N1 - Publisher Copyright:
© 2015 Association of Program Directors in Surgery.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - 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.
AB - 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.
KW - autonomy
KW - breast neoplasms
KW - general surgery
KW - graduate medical education
KW - surgery residency training
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U2 - 10.1016/j.jsurg.2015.09.005
DO - 10.1016/j.jsurg.2015.09.005
M3 - Article
C2 - 26481268
AN - SCOPUS:84952919554
SN - 1931-7204
VL - 73
SP - 1
EP - 6
JO - Journal of Surgical Education
JF - Journal of Surgical Education
IS - 1
ER -