A human factors curriculum for surgical clerkship students

Arch Surg. 2010 Dec;145(12):1151-7. doi: 10.1001/archsurg.2010.252.


Hypothesis: Early introduction of a full-day human factors training experience into the surgical clerkship curriculum will teach effective communication skills and strategies to gain professional satisfaction from a career in surgery.

Design: In pilot 1, which took place between July 1, 2007, and December 31, 2008, 50 students received training and 50 did not; all received testing at the end of the rotation for comparison of control vs intervention group performance. In pilot 2, a total of 50 students were trained and received testing before and after rotation to examine individual change over time.

Setting: University of Massachusetts Medical School.

Participants: A total of 148 third-year medical students in required 12-week surgical clerkship rotations.

Interventions: Full-day training with lecture and small-group exercises, cotaught by surgeons and educators, with focus on empathetic communication, time management, and teamwork skills.

Main outcome measures: Empathetic communication skill, teamwork, and patient safety attitudes and self-reported use of time management strategies.

Results: Empathy scores were not higher for trained vs untrained groups in pilot 1 but improved from 2.32 to 3.45 on a 5-point scale (P < .001) in pilot 2. Students also were more likely to ask for the nurse's perspective and to seek agreement on an action plan after team communication training (pilot 1, f = 7.52, P = .007; pilot 2, t = 2.65, P = .01). Results were mixed for work-life balance, with some trained groups scoring significantly lower than untrained groups in pilot 1 and no significant improvement shown in pilot 2.

Conclusions: The significant increase in student-patient communication scores suggests that a brief focused presentation followed by simulation of difficult patient encounters can be successful. A video demonstration can improve interdisciplinary teamwork.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Clinical Clerkship / methods*
  • Clinical Competence
  • Communication*
  • Confidence Intervals
  • Curriculum*
  • Education, Medical, Undergraduate / methods
  • Educational Measurement
  • Empathy
  • Female
  • General Surgery / education*
  • Humans
  • Interprofessional Relations
  • Male
  • Odds Ratio
  • Physician-Patient Relations*
  • Pilot Projects
  • Professional-Patient Relations
  • Students, Medical / statistics & numerical data