Boot Camp in a Box: Initial Experience with Pre-Training Skills Preparation for New Interns
Sheina Theodore, M.D., Heather M. Grant, M.D., John J. Budrow, B.S., Gladys L. Fernandez, M.D., David Tashjian, M.D., Neal E. Seymour, M.D.. University of Massachusetts Medical School – Baystate, Springfield, Massachusetts
Purpose: In order to increase selected skills at onset of training, we provided PGY-1 trainees with materials and instructions to practice as well as the opportunity to share video-recorded performance and receive feedback.
Methods:
Knot tying and suturing kits, instruments and supplies, and video instructions for task performance were sent (n = 10), with instructions to practice: 1- and 2-handed knot tying, interrupted and running suturing, until self-assessed comfort was achieved or the 8-week timepoint before start of training. Each trainee returned a video of each task, which was graded for time and errors using an itemized evaluation instrument. Feedback was provided. Task performance was repeated and reassessed at the time of "Boot Camp" and again eight weeks after start of training. Composite performance scores were compared for the three time points using repeated measures ANOVA with post hoc tests.
Results:
Compliance with instruction for practice and return of video recorded tasks in the months before start of PGY-1 training was high, with only 1 of 10 failing to return knot-tying videos. A significant pattern of performance change (p < 0.05) with an initial decrease between the pre-employment practice and Boot Camp followed by an increase to the highest level of performance two months after start of training.
Conclusion:
A high level of compliance was achieved. We attribute the consistently lower scores on the tasks during Boot Camp tests to the single-opportunity higher stakes test conditions. Subsequent achievement of significantly higher performance may have been helped by incentivized pre-training practice.
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