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A video-based, flipped classroom, simulation curriculum for dermatologic surgery: A prospective, multi-institution study - 09/11/19

Doi : 10.1016/j.jaad.2019.03.078 
Kristina J. Liu, MD, MHS a, , Elizabeth Tkachenko, BS b, Abigail Waldman, MD a, Marko T. Boskovski, MD, MHS, MPH c, Rebecca I. Hartman, MD, MPH a, Adriane A. Levin, MD d, Bichchau M. Nguyen, MD d, Emily S. Ruiz, MD, MPH a, Victoria R. Sharon, MD e, Laura Sowerby, MD f, Jeffrey Tiger, MD f, F. Clarissa Yang, MD d, Arash Mostaghimi, MD, MPA, MPH a
a Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 
b University of Massachusetts Medical School, Worcester, Massachusetts 
c Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 
d Department of Dermatology, Tufts Medical Center, Boston, Massachusetts 
e Department of Dermatology, Zucker School of Medicine at Hofstra/Northwell, Lake Success, New York 
f Department of Dermatology, Lahey Hospital and Medical Center, Burlington, Massachusetts 

Reprint requests: Kristina J. Liu, MD, MHS, Brigham and Women's Hospital, Department of Dermatology, 221 Longwood Ave, Boston, MA 02115.Brigham and Women's HospitalDepartment of Dermatology221 Longwood AveBostonMA02115

Abstract

Background

Medical education is evolving to emphasize trainee engagement. The impact of a flipped classroom curriculum and surgical simulation on dermatology resident education has not been evaluated.

Objective

To assess the impact of video education and surgical simulation on dermatology resident procedural skills.

Methods

We created a curriculum on foundational surgical skills for 31 first- and second-year dermatology residents at 3 institutions. The flipped classroom approach replaces traditional in-person lectures with at-home viewing of instructional videos. After this self-directed learning, trainees had 3 hands-on sessions using simulated skin models. The Objective Structured Assessment of Technical Skills (OSATS) instrument was used to assess residents performing a simulated elliptical excision with intermediate repair before and after the curriculum. Residents completed precurriculum and postcurriculum surveys evaluating operative confidence and perceived value of the curriculum.

Results

Residents' total OSATS score increased from a median of 27 (interquartile range, 22-38.5) before the curriculum to 46 (interquartile range, 39.5-51.5) after the curriculum (P < .001). Self-reported confidence in surgical performance significantly improved, and residents were highly satisfied.

Limitations

Limitations include the small sample size and potential influence from concurrent learning on surgical rotations.

Conclusions

Video education and simulation are effective for improving dermatology residents' procedural skills. We hope to serve as a template for other institutions and nondermatology trainees hoping to improve procedural skills.

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Key words : dermatologic surgery, dermatology resident education, flipped classroom, medical education, simulation, surgical simulation

Abbreviations used : OSATS, GRS, IQR


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 Funding sources: Supported by the Harvard Dermatology Samuel Moschella Scholarship.
 Conflicts of interest: None disclosed.


© 2019  American Academy of Dermatology, Inc.. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 81 - N° 6

P. 1271-1276 - dicembre 2019 Ritorno al numero
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