Integrating Surgical Skills into Pre-Clinical Years of Medical School

Introduction: Current literature indicates that medical students lack competency and understanding of basic surgical principles when entering clinical rotations. Studies show early surgical exposure can improve student competence and confidence upon entering surgical clerkships. The purpose of this study is to create early exposure to routine operative procedures, surgical anatomy and dissection planes before entering surgical clerkships. Methods: Twenty-one pre-clinical medical students interested in pursuing surgical careers were selected to participate in this study. The course consisted of 3 educational presentations followed by a surgical procedure. The procedures, led by surgical residents, consisted of a skin cancer resection with adjacent tissue flap closure, hysterectomy, and cholecystectomy. All students completed a pre- and post-study competency exam of surgical anatomy and surveys to determine confidence levels with surgical skills. Basic statistics were utilized to evaluate the data. Results: An overall 51% improvement in knowledge of surgical anatomy was shown in the competency exam. In the pre-survey 90% (n=19) reported lack of confidence in suturing and preparedness for clerkships. In the post-survey 95% (n=20) reported confidence in these areas. Also, in the pre-survey 76% (n=16) felt unprepared to handle surgical tools while assisting in surgery. However, post-survey all students reported confidence. All students indicated that the experience reinforced the surgical relevance of gross anatomy and encouraged incorporation of the study into the curriculum. Conclusion: This study improved confidence in pre-clinical medical students understanding of surgical anatomy and basic surgical skills. This may enhance learning and improve performance during surgical clerkships.