The Plan-Do-Study-Act (PDSA): An Iterative Approach to Optimize Residents Performance in the American Board of Surgery in-Training Exam (ABSITE).

INTRODUCTION: American Board of Surgery (ABS) In-Training Examination (ITE), or ABSITE, preparation requires an effective study approach. In 2014, the ABS announced the alignment of ABSITE to the SCORE® Curriculum. We hypothesized that implementing a Plan-Do-Study-Act (PDSA) approach would help surgery residents improve their performance on the ABSITE. METHOD: Over 20 years, in a single institution, residents' ABSITE performance was evaluated over 3 timeframes: Time A (2004-2013), no specific curriculum; Time B (2014-2019), an annual comprehensive ABSITE-simulated SCORE®-based multiple-choice exam (MCQ) was administered; and Time C (2020-2023), like Time B with the addition of the PDSA approach for those with less than 60% correct on the ABSITE-simulated SCORE®-based exam. At the beginning of the academic year, in July, all residents are encouraged to (1) initiate a study plan for the upcoming ABSITE using SCORE® guided by the published ABSITE outlines content topics (Plan), (2) take an ABSITE-simulated SCORE®-based exam in October (Do), (3) assess the results/scores (Study), and (4) identify appropriate next steps (Act). Correlational analysis was performed to evaluate the association between ABSITE scores and ABSITE-simulated SCORE®-based exam scores in Time B and Time C. The primary outcome was the change in the proportions of ABSITE scores <30th percentile. RESULTS: A total of 294 ABSITE scores of 94 residents (34 females and 60 males) were analyzed. We found stronger correlation between the correct percentage on ABSITE and ABSITE-simulated SCORE®-based exam scores in Time C (r = 0.73, p < 0.0001) compared to Time B (0.62, p < 0.0001). The percentage of residents with ABSITE scores lower than 30th percentile dropped significantly from 14.0% to 3.7% (p = 0.016). CONCLUSION: Implementing the Plan-Do-Study-Act (PDSA) approach using the SCORE® curriculum significantly enhances residents' performance on the ABSITE exam. Surgery residents are encouraged to use this approach and to utilize the SCORE-contents outlined by the ABS in their study plan.

History of surgical training in Kalamazoo.

This narrative reviews the history and evolution of surgical training in Southwest Michigan, particularly Kalamazoo, over the past 100 years. During this time, the de novo growth of medical treatment and the gradual and progressive establishment of medical and surgical training, paralleled with innovation, have shaped the clinical practices in Southwest Michigan. The surgical expertise that exists in Kalamazoo has made it one of the most important headquarters for surgical innovation, not only in the United States, but in the world. The surgical training program in Kalamazoo began in the 1960s, and this accredited general surgery residency program has graduated numerous successful surgeons. Currently this program is one of several training programs at Western Michigan University Homer Stryker M.D. School of Medicine (WMed), the only medical school in Southwest Michigan. Under the leadership of Dean Surgeon Dr. Paula Termuhlen and Chair Dr. Robert Sawyer, a bright future in surgical education, research, and innovation is highly anticipated. Expectations of future growth in this program will provide a significant pipeline for graduating physicians and surgeons for decades to come.

Gender perception bias of operative autonomy evaluations among residents and faculty in general surgery training.

BACKGROUND: Resident operative autonomy (ROA) is critical and a shared responsibility of both faculty and residents during training. We hypothesize that there is a perception of gender bias in residents' performance as evaluated by faculty and residents. METHOD: Over a period of five academic years, between July 2014 and June 2019, ROA was evaluated using the Zwisch score. Reciprocal evaluations were completed by faculty and residents. RESULTS: 39 surgeons (30 males, 9 females) and 42 residents (25 males, 15 females) completed 2360 evaluations (1180 by faculty, and a matched number by residents). PGY level was significantly associated with granting a higher level of autonomy. Gender of residents didn't affect the level of granted autonomy as evaluated by faculty. However, on self-evaluations, female residents rated their degree of autonomy lower than that of their male counterparts. CONCLUSION: Gender did not influence the perception of autonomy granted as evaluated by faculty. However, on self-evaluations, female residents reported a lower degree of autonomy received.