In July 2010, the Society of Neurological Surgeons initiated nationwide boot camp courses designed to teach incoming postgraduate Year 1 (PGY1) trainees fundamental skills related to the field of neurosurgery. According to a new paper in the Journal of Neurosurgery, follow-up tests and surveys returned from course attendees 6 months after completion of the courses show that the first-year residents retained the knowledge and skills they had learned and found the courses relevant and beneficial to their residency experiences and to patient care. The success of the boot camp courses is described and discussed in this paper, “Society of Neurological Surgeons boot camp courses: knowledge retention and relevance of hands-on learning after 6 months of postgraduate year 1 training. Clinical article,” by Nathan R. Selden M.D., Ph.D., and colleagues, published online ahead of print.
In 2009, the Accreditation Council for Graduate Medical Education (ACGME) incorporated PGY1 (also known as the intern year) training into neurosurgery residency programs. Prior to that time, PGY1 training had been separate and focused on general surgery. In response to this change, the Society of Neurological Surgeons (SNS), composed of neurosurgery department chairpersons, residency program directors, and leading educators, created a nationwide curriculum of “boot camp” courses in 2010. Held at six regional centers throughout the US, the 2-day collection of courses is attended by all new PGY1 trainees in ACGME-accredited neurosurgery residency programs. The weekend courses are held in July, the month in which PGY1 training begins.
The neurosurgical boot camp courses focus on patient care, medical knowledge, communication, supervision, and professionalism. The courses include nine 30-minute didactic lectures and 7 hours of hands-on learning at simulated skills stations. Participants are asked to complete questionnaires before, immediately after, and 6 months after the weekend boot camp.
To ascertain the overall effectiveness of the boot camp courses, the authors looked at the initial experience in 2010. In that year 186 PGY1 residents attended. All 186 participants completed pre-course and immediate post-course questionnaires; 164 participants (88 percent) completed the 6-month post-course questionnaire. The focus of the current paper was on the sustained effect of the boot camp experience, as indicated by responses to the 6-month post-course survey. Some of the questions in it were designed to assess how well the new residents retained knowledge learned from the courses. Other questions centered on participants’ ratings of the usefulness of the didactic topics covered as well as that of the patient care and surgical simulations. Responses to knowledge-based questions demonstrated statistically significant evidence of learning and retention 6 months after completion of the courses (p < 0.001). Ninety-nine (99) percent of PGY1 residents who responded to the 6-month post-course questionnaire indicated that the boot camp courses provided them with knowledge and skills that were beneficial to their residency experiences and improved patient care; 98 percent of the residents indicated that the courses met their neurosurgical learning objectives.
The authors report that the success of the courses was clearly evident 6 months after completion of the first boot camp in 2010. Since that time, feedback from PGY1 residents and faculty has led to further development of the course curriculum, such as inclusion of a clinical crisis simulation. In addition, the SNS Subcommittee on Boot Camp Courses is working on developing valid skills assessment of several hands-on tasks, with the “ultimate goal . . . to demonstrate a relationship between introductory simulated training and safe performance of procedures and operative skills in the live clinical environment.” In many neurosurgical residency programs, participation in hands-on skill simulations is a prerequisite for further training in the clinical environment.
Lead author and national course director, Dr. Nathan Selden, commented, “the boot camp courses allow residents to try, fail, and then succeed in their application of neurosurgical skills and knowledge first in a protected, risk-free environment. Their experience prepares them for mentored patient care in a safe and effective clinical teaching environment.”
“Because of duty hour restrictions,” Dr. Selden added, “simulated experience for young surgical trainees is increasingly important to their learning and most of all to the best patient outcomes now and in the future.”
Selden NR, Anderson VC, McCartney S, Origitano TC, Burchiel KJ, Barbaro NM. Society of Neurological Surgeons boot camp courses: knowledge retention and relevance of hands-on learning after 6 months of postgraduate year 1 training. Clinical article. Journal of Neurosurgery, published online, ahead of print, April 16, 2013; DOI: 10.3171/2013.3.JNS122114.
Disclosure: Dr. Selden serves as chair of the SNS Subcommittee on Boot Camp Courses and as secretary of the Congress of Neurological Surgeons. Dr. Barbaro serves as chair of the SNS Committee on Resident Education. Dr. Burchiel serves as secretary of the SNS. Course directors and faculty received no honoraria or other incentives for participation. The authors have no personal financial or institutional interest in any of the drugs, materials, or devices described in the article. The SNS PGY1 Boot Camp courses were entirely funded by individual unrestricted educational grants from Stryker to each of the 6 regional center host institutions, plus in-kind material donations and equipment loans from Stryker, Medtronic, Integra Neurosciences, Carl Zeiss, Ethicon, and Teleflex. No funds or materials beyond those required directly for the administration of the boot camp courses were disbursed.