PERCEPTIONS OF MEDICAL STUDENTS ON UNDERGRADUATE BASIC SURGICAL SKILLS TRAINING

EDITOR,

Applications to surgical training programmes are on the decline[1,2]. This is probably due to a combination of factors, including changes in undergraduate curricula and a gender shift in undergraduates. Despite the introduction of a national undergraduate surgical curriculum, undergraduate training and proficiency in basic surgical skills (BSS) varies widely^3,4. We explored the impact of structured BSS workshops on undergraduate students' suturing confidence, interest in pursuing a surgical career and their perceptions of the importance of BSS training.

A qualitative analysis was undertaken of 193 medical students (68% female), ranging from years 1 to 5, attending seven standardised surgical skills workshops run by Scrubs student surgical society (Queen's University Belfast) between October 2018 and March 2019. Anonymous, pre-defined, 5-point Likert scale pre- and post-workshop questionnaires were used. The workshops included several basic surgical knots with instrumental and hand ties on both artificial and animal tissue models, as well as basic laparoscopic skills.

70% of students reported increased suturing confidence post­workshop (p<0.001) (Fig. 1). Additionally, 74% of students reported that the workshop had increased their interest in pursuing a surgical career.

Figure 1.

Pre- and post-workshop responses of students (n=193) to the statement ‘I would be confident suturing a wound under direct supervision’

Analysis of pre-workshop questionnaires of senior students (years 4-5, n=62) revealed that only 53% agreed (or strongly agreed) that they would be confident suturing a wound under direct supervision. 74% of senior students reported that they had no experience suturing in clinical practice.

Looking more broadly at undergraduate basic surgical skills training, 94% of students agreed (or strongly agreed) that BSS were important in the undergraduate curriculum. 97% of students agreed (or strongly agreed) that they would like to receive more BSS training in the future and 83% agreed (or strongly agreed) that this would have an influence on their future career choices.

This study has demonstrated that BSS training can increase student suturing confidence and boost interest in pursuing a surgical career. This is on the background of low levels of pre-workshop confidence and clinical experience of suturing in senior students. The power of these workshops to stimulate interest in surgery is likely due to three key factors. Firstly, gaining positive practical surgical experiences helps attract those interested in a hands-on specialty. Secondly, increased suturing confidence better equips students to participate more fully in surgical placements. Lastly, close interaction between demonstrators and students facilitates the development of role models and mentors, which is thought to be one of the main factors in directing career aspirations⁵.

Medical schools and student surgical societies should work together to ensure students receive sufficient high-quality BSS training. Material costs for running such workshops are low, however recruiting surgical demonstrators can be challenging. Better collaboration with surgical trainees could help address this issue. Trainees are motivated to gain teaching experience, have completed surgical skills courses, can provide clinical context to skills and are ideal role models for students.

In summary, simple structured BSS workshops can increase student confidence in essential surgical skills acquisition and increase interest in surgery as a career. Medical schools and student surgical societies should work together to improve undergraduate BSS training.