Needs Assessment for a Resuscitative Thoracotomy Curriculum for General Surgery Residents in the Northeast Region

Caroline Ricard; Deanna Plewa; Jack Vernamonti; Erin M Scott; Dmitry Nepomnayshy; Eric Benoit

doi:10.1016/j.jsurg.2023.08.020

Needs Assessment for a Resuscitative Thoracotomy Curriculum for General Surgery Residents in the Northeast Region

J Surg Educ. 2023 Dec;80(12):1843-1849. doi: 10.1016/j.jsurg.2023.08.020. Epub 2023 Sep 27.

Authors

Caroline Ricard¹, Deanna Plewa², Jack Vernamonti³, Erin M Scott⁴, Dmitry Nepomnayshy⁵, Eric Benoit⁶

Affiliations

¹ Simulation Department, Lahey Hospital and Medical Center, Burlington, Massachusetts. Electronic address: caroline.anne.ricard@gmail.com.
² Simulation Department, Lahey Hospital and Medical Center, Burlington, Massachusetts.
³ General Surgery Department, Maine Medical Center, Portland, Maine.
⁴ General Surgery Department, UMass Memorial Medical Center, Worcester, Massachusetts.
⁵ Simulation Department, Lahey Hospital and Medical Center, Burlington, Massachusetts; General Surgery Department, Lahey Hospital and Medical Center, Burlington, Massachusetts.
⁶ General Surgery Department, Lahey Hospital and Medical Center, Burlington, Massachusetts; Trauma and Acute Care Surgery Department, Lahey Hospital and Medical Center, Burlington Massachusetts.

PMID: 37770295
DOI: 10.1016/j.jsurg.2023.08.020

Abstract

Introduction: Resuscitative thoracotomy (RT) is a high-acuity low occurrence (HALO) procedure with which general surgical resident (GSR) experience and confidence are unknown. We sought to identify and describe this educational gap by conducting a targeted needs assessment for an RT curriculum for GSRs.

Methods: An online regional needs assessment survey was conducted for an RT curriculum for GSRs. The survey was developed by a group of trauma stakeholders and revised after being piloted on a small, representative group of GSRs. We surveyed GSRs in the Northeast region regarding their experience and confidence with RT; interest in an RT curriculum; and content, format, and scope for an RT curriculum.

Results: The survey response rate was 43%, reflecting the viewpoints of GSRs at 8 major training centers across the Northeast. Only 13% of respondents were interested in pursuing a career in Trauma and Critical Care despite 97% of them training at a Level I Trauma Center. Twenty-nine percent and 33% of GSRs had ever assisted with or performed RT, respectively. Twenty-one percent of GSRs reported feeling confident performing RT. Most respondents (98%) agreed or strongly agreed that an RT curriculum would add value to their general surgery education. The most positively rated content topics were resuscitative maneuvers (100% positive responses [PR]), when to cease resuscitative efforts (100% PR), and morbidity and mortality associated with RT (98% PR). The most highly rated learning methods were individual RT simulation time (97% PR) and a tour of the trauma bay equipment (97% PR).

Conclusions: This needs assessment demonstrates a lack of experience and confidence with RT, a strong learner interest in an RT curriculum, and a desire for experiential learning methods. Learning objectives are defined herein, and the next steps involve developing educational materials for an RT curriculum for GSRs.

Keywords: curricular development; emergency; graduate medical education; resuscitative thoracotomy; simulation; trauma.

MeSH terms

Clinical Competence
Curriculum
General Surgery* / education
Internship and Residency*
Needs Assessment
Thoracotomy