Interdisciplinary Surgery-Anesthesia Education as a Valuable Component of Surgical Pre-Internship Training

Abstract

Background/Objective: Research has shown that skills-based workshops for medical students entering a surgical internship can improve learner self-confidence and provide opportunities for competency assessment.1,2 The ACS/APDS/ASE Resident Prep Curriculum is used nationally to prepare medical students for entrance into a surgical internship. This curriculum includes workshops traditionally taught by surgical faculty, teaching emergency procedures such as cricothyroidotomy without first-line airway interventions.3 We propose widespread adoption of an interdisciplinary airway and line workshop taught by anesthesia faculty as an educational intervention for pre-internship surgeons. Interdisciplinary medical education has been shown to improve perceptions of interdisciplinary collegiality and attitudes.4 This is the first known addition of anesthesiologists as teaching faculty in workshops designed to prepare medical students for a surgical internship. Methods: A half-day workshop for medical students entering surgical internships was designed as part of the MS4 preparation for internship rotation at IUSM beginning in Spring of 2017. The workshop consists of four stations and two discussions, all taught by anesthesia faculty. Prior to the workshop, learners receive access to presentations and videos for each procedure via an online learning management system (Canvas). The day begins with a discussion of difficult airway characteristics and facial morphologies that may necessitate an airway discussion prior to anesthesia. Learners then begin rotating through a total of four stations. Skills taught at these stations include IV and arterial line placement with and without ultrasound, basic airway management skills, management of difficult airways, and emergency airway access. Learners also complete a simulation exercise covering noninvasive respiratory support options in a patient with increasing respiratory distress. At the end of the workshop, learners participate in a debriefing session and discussion of how to avoid future anesthesia cancellations. They also complete a post-workshop evaluation before leaving. Results: The post-workshop evaluation was completed by 20 students in 2019 and 23 students in 2022. All learners agreed or strongly agreed that faculty from non-surgical specialties had important knowledge and wisdom for surgical trainees. Nearly all learners agreed or strongly agreed that the workshop was useful (41/43, 95%), boosted their clinical self-confidence in airway management (39/43, 91%), and that the skills and knowledge learned would be useful to them as interns and residents (42/43, 98%). Most learners (39/43, 91%) agreed or strongly agreed that this workshop should be mandatory for all students preparing for a surgical internship. Conclusions: This interdisciplinary surgery-anesthesia workshop was valuable to learners. The success of this workshop highlights the role of anesthesia providers in interdisciplinary education to prepare medical students for a surgical internship. We also highlight the worthiness of anesthesia faculty time in the education of future surgical colleagues; discussions on when to consult anesthesia for difficult airways and other issues may improve collegiality and camaraderie between disciplines and decrease same-day surgery cancellations.

References: 1. Peyre SE, Peyre CG, Sullivan ME, Towfigh S. A surgical skills elective can improve student confidence prior to internship. J Surg Res. 2006;133(1):11-15. doi:10.1016/j.jss.2006.02.022 2. Brunt LM, Halpin VJ, Klingensmith ME, et al. Accelerated skills preparation and assessment for senior medical students entering surgical internship. J Am Coll Surg. 2008;206(5):897-907. doi:10.1016/j.jamcollsurg.2007.12.018 3. ACS/APDS/ASE Resident Prep Curriculum. ACS. https://www.facs.org/for-medical-professionals/education/programs/acs-apds-ase-resident-prep-curriculum/. Accessed June 13, 2022. 4. Bullard MJ, Fox SM, Wares CM, Heffner AC, Stephens C, Rossi L. Simulation-based interdisciplinary education improves intern attitudes and outlook toward colleagues in other disciplines. BMC Med Educ. 2019;19(1):276. Published 2019 Jul 24. doi:10.1186/s12909-019-1700-1