Context and setting In an attempt to encourage and assess skills development by surgical interns in a team-building setting, the first annual Surgical Intern Olympics were held in September 2008. These took place at our institution’s Center for Experiential Learning and Assessment (CELA) during a 2-hour slot usually filled by grand rounds and resident teaching conferences.
Why the idea was necessary Scheduled at the conclusion of intern summer school (weekly didactics in July and August), the event occurred 2 months into clinical experience yet prior to the majority of the clinical year. The primary goals were to assess skills and use the findings as a springboard for curriculum development of our intern skills sessions, which occur monthly throughout the clinical year.
What was done Surgical residents in Years 1–3 of residency participated; Year 1 residents were designated as ‘athletes’, Year 2 residents as ‘coaches’ and Year 3 residents as ‘judges’. The ‘countries’ were selected from those claimed as home by different members of faculty staff at our institution. Athletes were assigned to events by their coaches and coaches were urged to encourage practice.
Events included knot tying, heart rhythm recognition, central line simulation, LAP Mentor™ tasks including camera operation and clipping, peg transfer on a video box trainer, and a scavenger hunt in the hospital in which athletes were required to document their knowledge of key ‘intern-important’ locations. These sites included areas such as radiology reading rooms, supply rooms and administrative offices. Some events were combined in order to create a biathlon (knot tying and cardiac rhythm recognition) and a triathlon (central line insertion, knot tying and a bonus event, hospital phone number recognition), necessitating individual participation in more than one event.
Performance was quantified using standard rubrics for each event and rankings were determined based on these objective scores. For example, in knot tying, interns were timed and further assessed on the style and quality of 40 knots. Total scores, consisting of a combination of this time and numerical quantification of quality, corresponded to individual rankings. Similarly, the steps of central line insertion were timed and interns were additionally assessed on their ability to perform the correct steps in the correct order. Steps were designated as ‘minor’ or ‘major’ and quantified accordingly in order to establish rankings.
Evaluation of results and impact The event was well received by junior residents as a fun, team-building experience. Athletes were awarded individual prizes for events and coaches were recognised by total medal counts for their countries. The ‘country’ of Texas (one of the nominated names) prevailed as the overall gold medal winner. Weaknesses were taken into account in the development of our intern skills sessions, which are monthly, small-group sessions for interns. For example, an additional month of knot tying and suturing was added to the curriculum, and the month of vascular access was adapted to focus on the checklist created as assessment in the Olympics.
As we reassess the Surgical Intern Olympics in the coming year, we plan to formally include medical students and to include quantified results in official resident evaluations.