The Challenge of Entering the Operating Room

Medical students often find the transition from the classroom to the operating room (OR) overwhelming. This challenge frequently stems from a lack of formal training on how to prepare for complex operative cases. Consequently, establishing robust surgical clerkship readiness is essential for students to maximize the educational value of their clinical rotations. Without a structured approach, many students enter the OR as passive observers rather than informed participants.

Researchers recently addressed this educational gap by developing a comprehensive case preparation curriculum. They utilized Kern’s six-step approach to create a multimodal intervention consisting of instructional videos and a guided chart review worksheet. Specifically, the curriculum taught students how to navigate electronic health records effectively and identify critical patient information before scrubbing in. This proactive strategy aims to align student expectations with the fast-paced reality of surgical practice.

Improving Surgical Clerkship Readiness via Kern’s Approach

To evaluate the effectiveness of the new curriculum, a study at a single medical institution randomized 73 third-year medical students into two preparation groups. One group accessed instructional videos and worksheets only, while the other participated in a resident-facilitated activity. This in-person session required students to perform a targeted chart review using a structured worksheet as a guide. The intervention sought to determine if facilitated learning could further enhance surgical clerkship readiness compared to self-directed study.

The results demonstrated significant benefits for those who engaged in the in-person activity. Specifically, 100% of the students who completed the resident-led session reported reading about the patient’s history before every operation. In contrast, only 67% of the video-only group adopted this critical habit. Furthermore, students rated the helpfulness of the facilitated session an average of 8 out of 10. These findings suggest that while digital tools are helpful, active and facilitated preparation significantly improves student behavior and confidence.

Integrating these activities into clerkship orientation allows institutions to standardize the preparation process. By providing students with the tools to understand a patient’s surgical history and operative indications, educators can enhance the overall quality of the intraoperative experience. Ultimately, these structured materials help transform students into integrated members of the surgical team, ensuring they are prepared for the technical and clinical demands of the OR.

Frequently Asked Questions

What are the key components of a surgical case preparation curriculum?

A successful curriculum often includes instructional videos on navigating electronic health records, structured worksheets for targeted chart reviews, and resident-facilitated sessions to guide students through patient history and operative goals.

How does reading patient history improve the OR experience for students?

Reviewing a patient’s history before scrubbing in allows students to understand the indications for surgery, anticipate potential complications, and engage more meaningfully with the surgical team during the procedure.

Why is the Kern approach used in medical curriculum development?

Kern’s six-step approach provides a systematic framework that includes needs assessment, goal setting, and educational strategy development, ensuring that the curriculum addresses specific learner deficits and institutional needs.

Disclaimer: This content is for informational and educational purposes only and does not constitute medical advice. It is not intended to be a substitute for professional medical judgment, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

Acker RC et al. Getting Prepared: Strengthening Clerkship Student Readiness for the Operating Room Through a Case Preparation Activity. J Surg Educ. 2026 Jun 17. doi: undefined. PMID: 42308578.

Kern DE, Thomas PA, Hughes MT, Chen BY. Curriculum Development for Medical Education: A Six-Step Approach. 3rd ed. Baltimore, MD: Johns Hopkins University Press.

Smith LM et al. Student-Informed Guidelines on Preparing for the Core Surgery Clerkship. American College of Surgeons (ACS).