How I Do It: Process Control in Medical Student Experiences of Surgery

Abstract

Objective: Extreme variation exists in teaching and clinical exposure for medical students, both from specialty-to-specialty but also between universities. There is mounting literature highlighting the need to reform and standardize surgical education to allow for unified graduate competency. In line with the recommendations from the GMC and the Royal College of Surgeons England (RCSEng), Queens University Belfast (QUB) significantly revised their undergraduate medical programme. Within this new curriculum is the introduction of Specialty Focus week in Surgery. This report reviews the processes used in the introduction of this week.

Design: The initial week was formulated with a weekly timetable consisting of tutorials, bedside teaching and students following a peri-operative case. Run charts were populated with an alert when feedback dropped below a certain standard, which then triggered an intervention.

Participants: Feedback was collected via a QR code from the first 200 surgical student.

Settings: Belfast City Hospital in association with QUB undergraduate curriculum.

Results: Run charts resulted in an alert when feedback dropped below 8/10. Following this we implemented smaller group bedside teaching. There was a significant improvement in feedback post intervention (p = 0.04) with no further alerts. Overall feedback had a nonsignificant feedback improvement post intervention (p = 0.07) with once again, no further alerts.

Conclusion: This review has shown how we have provided some standardization of local surgical teaching, as well as having a process centered model of monitoring. This approach is easy to implement and could be reproduced elsewhere.

Keywords: longitudinal integrated clerkship; medical education; surgical education; undergraduate education.