Evaluating the outcomes of changes in undergraduate surgery education: Interns' views on their preparedness for surgical rotations

This paper outlines a study of the outcomes of a curriculum reform project which took place from 1990-1993 in the Department of Surgery at the Flinders University of South Australia. The project aimed to change the teaching of undergraduate surgery in the final two years of the existing six year medical course. A questionnaire was sent to the first graduates of the new program who were working as interns in 1995 and interviews were conducted with those in the Flinders Medical Centre. The interns responded with higher levels of agreement about their preparation for the surgical aspects of their work than did graduates in a similar survey in 1991. The questionnaire examined differences between the perceived importance of selected surgical knowledge, skills and understanding in the interns' current work and effective preparation for them. Significant differences were found only for understanding of the principles of pre and post operative care. There was a higher level of agreement for effective preparation in simple surgical skills and procedures than in the 1991 survey. From the questionnaire and interview data it is concluded that there should be increased attention to the general principles of surgical management, to the clinical diagnosis of common surgical conditions and to pre and post operative care through providing all students with meaningful attachments to general surgical units. There should be continuing attention to the balance between student initiative and program structure in the undergraduate surgery program.