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Abstract

Background: Residency orientations are often focused on administrative obligations and less often focused on program-specific skills training. Introduction of these skills during the orientation period has been shown to improve resident confidence and proficiency. The purpose of this quality improvement project is to propose the introduction of a skills-focused portion of orientation in a condensed “boot camp” fashion to improve the transition to residency from medical school.

Methods: The skills-based orientation curriculum was developed by reviewing the Accreditation Council for Graduate Medical Education (ACGME) milestones and prior literature on the topic. The simulations were planned using resident and faculty collaboration. A pre- and post-orientation survey was created to evaluate skill improvement after completing orientation. The survey was completed in 2023 and 2024 by the incoming resident classes. A paired T-test was performed for data analysis of the survey results with a two-tailed p-value < 0.05 considered significant.

Results: There were 10 participants in the orientation boot camp with a 100% completion rate of the pre- and post-orientation surveys. Overall, 14/25 questions noted statistically significant improvement during the orientation period. The most noticeable advances were in tasks that had dedicated sessions focused on an isolated skill. There were marked improvements in resident comfort level with interpreting fetal heart rate tracings (p=0.0095), placing a fetal scalp electrode (p=0.0005), and inserting an intrauterine device (IUD) or Nexplanon (p=0.0019 and 0.0012, respectively). Sessions where multiple skills were covered in one session did not yield significant results.

Conclusion: Adding the boot camp to orientation served as an effective way to improve the procedural abilities and clinical acumen of incoming residents. Given the success of this program among the OB/GYN residency at Reading Hospital, other surgical and procedural-based residency programs may benefit from implementation of a skills-based boot camp as part of their standard orientation curriculum.

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