Instituting a Surgical Skills Competition Increases Technical Performance of Surgical Clerkship Students Over Time

Introduction: Surgical skills training varies greatly between institutions and is often left to students to approach independently. Although many studies have examined single interventions of skills training, no data currently exists about the implementation of surgical skills assessment as a component of the medical student surgical curriculum. We created a technical skills competition and evaluated its effect on student surgical skill development. Methods: Second-year medical students enrolled in the surgery clerkship voluntarily participated in a surgical skills competition consisting of knot tying, laparoscopic peg transfer, and laparoscopic pattern cut. Winning students were awarded dinner with the chair of surgery and a resident of their choice. Individual event times and combined times were recorded and compared for students who completed without disqualification. Disqualification included compromising cutting pattern, dropping a peg out of the field of vision, and incorrect knot tying technique. Timed performance was compared for 2 subsequent academic years using Mann-Whitney U test. Results: Overall, 175 students competed and 71 students met qualification criteria. When compared by academic year, 2015 to 2016 students (n = 34) performed better than 2014 to 2015 students (n = 37) in pattern cut (133 s vs 167 s, p = 0.040), peg transfer (66 s vs 101 s, p < 0.001), knot tying (28 s vs 30 s, p = 0.361), and combined time (232 s vs 283 s, p = 0.009). The best time for each academic year also improved (105 s vs 110 s). Fundamentals of Laparoscopic Surgery proficiency standards for examined tasks were achieved by 70% of winning students. Conclusions: Implementation of an incentivized surgical skills competition improves student technical performance. Further research is needed regarding long-term benefits of surgical competitions for medical students.