Preliminary evaluation of the impact of an experimental surgical training course based on the acquisition of basic technical skills by surgical interns during their first rotation

Context: In the French surgical education system, technical skill acquirement in surgery is based on real situations immersion and apprenticeship. There are new constraints affecting the surgical practice in academic hospital centres and it could reduce the efficacy of this unique surgical technical skill (STS) teaching approaches. Objective: To evaluate the impact of an experimental training course based on the acquisition of basic surgical skills (suture, ligature) on inanimate models outside the operative room. This training course was done in addition to the usual real situations immersion and apprenticeship learning approaches. Method: During a standardized suture and ligature drill, which was proposed 3 months after the beginning of the first semester, we compared the performances (scores and time) of a group of residents exposed to the training course to those of a group of residents not exposed to the training course. Results: The mean score obtained was 23.9 (15?28) and 17.1 (2?24) in the exposed group and in the non-exposed group, respectively: p=0.036. The score obtained from the test assessing knowledge of surgical equipment was also higher in the exposed group. The mean time to complete the suture drill had a favourable tendency in the exposed group. Conclusion: Our results suggest that there is a positive and measurable impact of a training course given at the beginning of residency in surgery on the early acquisition of basic surgical technical skills. This type of teaching based on simulation should be a valuable complement to the immersion/apprenticeship teaching approaches for STS knowledge transmission. Contexte?: L'apprentissage de l'habilet? technique chirurgicale (HTC) dans le syst?me fran?ais de formation en chirurgie repose essentiellement sur l'immersion en situation r?elle et le compagnonnage. De nouvelles contraintes p?sent sur l'exercice de la chirurgie dans les centres hospitaliers universitaires et pourraient r?duire l'efficience de ce mode unique de transmission de l'HTC. Objectif?: ?valuer l'impact sur l'acquisition de gestes chirurgicaux ?l?mentaires (suture, ligature) d'un stage d'initiation ? la gestuelle chirurgicale (SIGC) bas? sur l'apprentissage et l'entra?nement sur mod?le inanim? hors bloc op?ratoire en compl?ment du mode habituel d'apprentissage par immersion compagnonnage. M?thodes?: Nous avons compar? lors d'un exercice standardis? de suture et ligature propos? 3 mois apr?s le d?but du premier stage hospitalier, les performances (scores et dur?e) d'un groupe d'internes premier semestre expos? au SIGC, ? celles d'un groupe d'internes premier semestre non expos?s. R?sultats?: La moyenne du score de performance obtenu, ?tait de 23,9 (15?28) pour le groupe expos? contre 17,1 (2?24) pour le groupe non expos? (p=0,036). Le test de connaissance du mat?riel ?tait aussi en faveur du groupe expos?. Le temps moyen de suture ne montrait qu'une tendance en faveur du groupe expos?. Conclusion?: Nos r?sultats sugg?rent un impact positif et mesurable d'un stage de technique pr?liminaire en d?but d'internat de chirurgie sur la rapidit? d'acquisition de gestes de base de chirurgie. Ce type d'enseignement bas? sur la simulation pourrait ?tre un compl?ment essentiel au principe d'immersion/compagnonnage pour la transmission de l'HTC.