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Survey of dermatology residency programs shows increase in skills-based training, assessment
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Recent survey results suggest that the use of simulation-based training and skills-based assessment is increasing among dermatology residency programs over the use of apprenticeship-based surgical training, according to researchers.
“Advances in educational theory have encouraged surgical residency programs to shift away from the apprenticeship-based training model and toward a curriculum centered on extended periods of deliberate practice, where individuals repetitively practice defined tasks to improve particular aspects of performance,” Joseph F. Sobanko, MD, director of dermatologic surgery education and assistant professor of dermatology at the Hospital of the University of Pennsylvania, and colleagues wrote. “This method, coupled with rigorous skills assessment, provides trainees with specific, informative feedback.”
Joseph F. Sobanko
Sobanko and colleagues conducted a survey of program directors at 117 Accreditation Council for Graduate Medical Education-approved dermatology residency programs from 2013 to 2014. Forty-two program directors responded.
More than half (57%) answered that they devote 10 to 30 hours each year to didactics dedicated to surgery. Among the respondents, 21% said that they spend less than 10 hours each year on surgical didactics, and 21% answered that they spend more than 30 hours each year. Most of the programs (69%) use simulation models and 48% of those use more than one model. Formal assessment-guided feedback in evaluating surgical skills was also used by 62% of the programs, and among those, 77% use procedure-specific checklists, 50% use global rating scales, and 19% use objective structured assessment of technical skills.
Regarding resident roles in surgery, the researchers found that residents assume the role of primary surgeon in nearly 100% of excisional surgeries, but only in 52% graft and flap reconstructions. The responses also showed that 29% of residents are the primary surgeons in Mohs micrographic surgery, though the researchers noted that previous studies results have varied between 18% and 42%.
“Dermatology residency programs are incorporating deliberate practice-based tenets in the surgical curriculum,” the researchers concluded. “The results of this study provide a benchmark for dermatology residency programs to assess and improve the quality of dermatologic surgery training during residency.”
Disclosure: The researchers report no relevant financial disclosures.
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