Integrating Surgical Skills Education into the Anatomy Laboratory Harras Zaid, B.S,* Derek Ward, B.A,* Amanda Sammann, M.D., M.P.H,* , † Frank Tendick, Ph.D,† Kimberly S. Topp, P.T., Ph.D,‡ , § and John Maa, M.D† ,1 *School of Medicine; †Department of Surgery; ‡Department of Physical Therapy and Rehabilitation Science; and §Department of Anatomy, University of California, San Francisco, California Submitted for publication June 11, 2008 Background. Preclinical education plays a pivotal role in improving the quality of patient care and safety. Early exposure to surgical skills training and surgical mentors enhance students’ retention and confidence in those skills, and may promote their interest in surgery. Methods. Based upon a needs assessment survey of surgical education at UCSF, we introduced a curricu- lum to teach basic surgical techniques in the preclini- cal years with the intent of emphasizing several important skills and providing students with exposure to surgical mentors in a small group environment. We then surveyed the students to assess satisfaction with the new curriculum and the effect on perceptions re- garding a career in surgery. Results. Rising fourth y students at UCSF identified the need for increased exposure to basic surgical skills in preparation for third y clerkships. Collaboration be- tween the Departments of Anatomy and Surgery subse- quently produced an integrated suturing curriculum in the anatomy lab as part of the first y medical school coursework. The curriculum offered a focused expo- sure to skills identified by senior students as important for their clinical rotations. The vast majority of respon- dents agreed or strongly agreed that the exercise was enjoyable and worth continuing, and that their inter- actions with the surgeon volunteers were positive. Furthermore, 33% stated that their interest in surgery increased after the exercise. Qualitative comments praised both the experience and surgical faculty par- ticipation. Conclusion. A needs-based surgical skills curricu- lum can be integrated into the traditional first-y anat- omy course without detracting from didactic instruction in anatomy. Furthermore, students re- ceived early exposure to surgical mentors and skills training, which may translate into greater confidence on the wards and increased interest in surgical ca- reers. Ó 2010 Elsevier Inc. All rights reserved. Key Words: skills laboratory; anatomy laboratory; su- turing skills; undergraduate medical education; needs assessment. INTRODUCTION The 2004 Blue Ribbon report to the American Surgi- cal Association called upon surgeons to develop a greater role in undergraduate medical education [1]. A key recommendation was that surgical faculty and residents should be involved in the education of medical students in the first 2 y, teaching alongside the instruc- tors from the basic science disciplines. Although sur- gery has seen a decrease in the applicant pool over the past decade, surgeon involvement in medical educa- tion has been shown to positively influence students’ in- terest in and choice of careers in the field [2–5]. Thus, the role of surgeon educators in the preclinical realm is not limited to skills training, but also to provide stu- dents with an opportunity to explore surgical careers through positive mentorship. In traditional medical school curricula, students typ- ically have little or no exposure to surgical skills or sur- geon educators before their third y clerkships. For many years, the acquisition of important surgical skills has typically occurred in the operating room. This prac- tice has been challenged by cutbacks in operating room time, reduced resident work hours, and the ethical is- sue of novices learning procedures on patients [6]. For optimal skill acquisition, medical education research has demonstrated that early and repeated practice of skills, such as the physical examination can enhance 1 To whom correspondence and reprint requests should be ad- dressed at Department of Surgery, University of California, San Fran- cisco, 521 Parnassus, C 347 San Francisco, CA 94143-0790. E-mail: maaj@surgery.ucsf.edu. 0022-4804/10 $36.00 Ó 2010 Elsevier Inc. All rights reserved. 36 Journal of Surgical Research 158, 36–42 (2010) doi:10.1016/j.jss.2008.08.012