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Background In 2008, the Surgical Council on Resident Education selected 33 residency programs to pilot its General Surgery Resident Curriculum Website Portal. The portal aims to reduce program variability in curricula, align teaching and learning with essential content, and improve resident study and performance. Methods Two online surveys were sent to all program directors and their residents before releasing the portal. Data from 32 programs and 899 residents (84%) were analyzed to determine the extent to which preimplementation characteristics supported the portal's rationale and illuminated barriers to its use and impact on learning. Results The need for curriculum content and access to online texts varied markedly across programs. Residents had easy onsite access to the Internet and used it heavily for immediate purposes. Fewer residents used the Web for planned activities and proactive study. On average, residents reported studying an hour or less a day. Conclusions The portal appears to serve curricular resource needs and may better direct resident study. Programs are advised to consciously integrate the SCORE curriculum and portal into residency training and faculty development.

Background The purpose of this study was to compare the intraoperative learning needs and educational resource use of junior and senior residents. Our goal was to gain a better understanding of the progression of learning needs in surgical training. Methods Residents (n = 125) completed a previously validated, 27-item survey indicating the following: (1) the extent to which traditional learning resources are used when preparing for cases in the operating room, and (2) which intraoperative management topics in which they believed they were deficient despite preoperative preparation. Results On a scale of 1 to 5, with 5 indicating frequent use, postgraduate year (PGY)-5 residents (n = 39) indicated surgical atlases (4.15; SD, .90) and surgical texts (4.15; SD, .90) were their most frequently used resources when preparing for a case in the operating room. In contrast, PGY-1 residents (n = 32) indicated anatomy atlases (3.97; SD, .93) and advice from colleagues (3.64; SD, .90) were their most frequently used resources when preparing for a case in the operating room. Despite the differences in how the PGY-5 group and the PGY-1 group prepared for a case, of 12 intraoperative management topics both groups believed they were the least prepared for instrument use/selection and suture selection. Conclusions Today's residents represent a heterogeneous group of individuals with different learning needs based on level of experience, knowledge, and learning style. Our study highlights unexpected but critical learning needs for senior-level residents that can and should be readily addressed.

Background The Patient Assessment and Management Examination (PAME) is a standardized patient examination designed to assess management skills of senior residents. This study explored the relationship between faculty and resident self-evaluation by using PAME. Methods Nine postgraduate year (PGY) 4 and PGY5 residents were examined with a 5 case PAME. Faculty rated interactions between residents and standardized patients and residents rated themselves based on review of audio-video recordings of their interactions. We examined correlations between faculty and resident self-assessments. Results Faculty and resident ratings of physical examination skills was the only competency that correlated significantly. Correlations were not significant for the other 15 competencies (Pearson r , –.197 to .262). Correlation was no better when examined within each case. Conclusions Although PAME may be a useful tool, this study suggests that even senior residents do not assess their performance as clinicians similarly to faculty. Further research is needed to better understand the source of these disagreements.

We examined three research questions: How do residents' debts and savings compare to the general public? How do surgical residents' financial choices compare to other residents? How may institutions help residents' personal financial decisions?The Survey of Consumer Finances was modified and piloted tested to elicit financial information. The instrument was completed by 612 residents at 8 programs.Only 60% of residents budgeted expenses, and 25% and 10% maintained cash balances611 dollars and unpaid credit card balances10,000 dollars, respectively. Compared with controls, residents held greater median ratios of debt to household income (2.46 vs. 1.06, P0.0001), fewer assets to income (0.64 vs. 2.28, P0.0001), less net wealth to income -1.43 vs. 0.90, P0.0001), and lower retirement savings balance to household income (0.01 vs. 0.12, P0.0001). Surgery residents were the least financially conservative group. Mean annual resident contributions to retirement accounts were $1532 higher at institutions with versus without retirement plans (P0.01).Resident debts are higher and savings lower than the general public. This behavior is most common among surgery residents. Residents save more for retirement when they are eligible for tax-deferred retirement plans. Graduate medical programs should instruct residents on financial management.

Background: This study was designed to examine the validity of a surgery clerkship’s performance evaluation system. The study also assessed faculty members’ confidence in how clerks are evaluated and promotion decisions made. Methods: Student files from five classes (n = 339) were analyzed. A 25-item published survey designed to study faculty perceptions of a student evaluation system was distributed. Chi-square tests of independence and descriptive statistics were used. Results: Faculty survey results showed faculty perceptions of strengths and weaknesses in the evaluation system. Significant relationships were found with prior performance indicators and clerkship performance yielding evidence of concurrent and predictive validity. Conclusions: Findings provide guidance for enhancing how clerks are evaluated as well as specific profiles of students who may need special attention or additional challenges during the surgery clerkship. This study provides a model for other clerkships to assess their student evaluations systems.

Background In August 1993 the American College of Surgeons sponsored a course entitled “Surgeons as Educators” (SAE) aimed at equipping academic surgeons with the knowledge and skills necessary to enhance surgical education administration, curriculum, teaching, and evaluation. Methods The instructional design model used to construct the course called for a formal needs assessment to determine the importance, current skill level, and priority of what needed to be learned to be an effective educator. The needs assessment was accomplished using a job analysis and questionnaire approach. The 68item questionnaire was mailed to 320 academic surgeons representing eight medical schools. Results A 62% response rate was achieved. Results indicated the education-related tasks or activities that faculty felt were important to their careers, as well as their perceived level of development in each area. Descriptive statistics were used to summarize the responses that were critical to the SAE faculty in helping prioritize, sequence, and time ration course content. Collective results became the foundation for developing the SAE curriculum by the course's five faculty members. Conclusions A well-done needs assessment does not necessarily guarantee course success; however, it is the first and critical step to planning an educationally sound faculty development course or program designed for adult learners.

Background Research has shown that medical students are generally accepted by patients, but specific details that elucidate patient perceptions of the advantages and disadvantages to student involvement have not been documented. This study was designed to determine variables that influence patient satisfaction with students. Patients and Methods Patients were interviewed by one of two faculty members using a questionnaire-style format that covered 12 variables regarding patient care. Patients were asked to rate the extent to which medical students helped or hindered their hospital stay, with regard to the 12 variables. Results Patients' attitudes were favorable regardless of the students' extent of clinical experience or clinical abilities or the patients' age or length of hospital stay. Patients reported that students spent time with them and answered their questions. Most patients stated that they would allow students to participate in their future hospital care. Conclusion Positive patient-student interactions can have important effects on patients' expectations and their acceptance of future encounters with students. This fact is becoming increasingly important due to the changes in health care and the decreasing incidence of inpatient surgical encounters.

A fourth-year curriculum survey was forwarded to surgery resident program directors, clerkship directors, and residents. A 37 percent response rate was achieved with comparable representation of each respondent type from 130 institutions. The purpose of the survey was to determine how each of the 3 respondent types rated the importance of 42 subjects or clinical experiences to be taken in the fourth year of medical school for students pursuing surgical careers. The survey also included questions on such issues as externships, early match programs, and guidelines used at their institutions for their fourth year students. The results indicated a significantly high agreement among respondent types on what should comprise surgical students' fourth-year curriculum content. The majority feel the fourth year should be planned by students with an electives advisor to equally add breadth to their general professional education as well as provide prerequisite experiences in the career-chosen discipline.