Scrub Training: An EPA-aligned, mastery learning curriculum

Brittany Hasty, MD

Sarah E. Miller, BS; Sylvia Bereknyei Merrell, MS, DrPH; Susan Gates, RN; Edmund Lee, MD; James N. Lau, MD, MHPE

Disclosures

I have nothing to disclose.

150 years and counting…

Dr. Ignaz Semmelweis“Chlorinated lime solution”

Mid-19th Century Mid-19th Century

Dr. Joseph Lister5% Carbolic Acid

Late 19th Century

Objectives

Highlight the importance of scrub training for patient safety

Depict an interdisciplinary scrub training curriculum

Present student outcomes from the curriculum

Discuss the generalizability of the curriculum

Pre-Assessment

Interdisciplinary Teaching

&Evaluation Post-Assessment

Scrub Training Curriculum

Pass

Stanford Scrub Training

Pre-Assessment

Interdisciplinary Teaching

&Evaluation Post-Assessment

Scrub Training Curriculum

Pass

Stanford Scrub Training

Student Demographics

Overall Results

Pre-knowledge (%)Post-knowledge (%)

Pre-confidencePost-confidence

1

2

3

4

5Pre- and Post-Confidence Test *

*

P=<0.001 [95% CI, 0.93-1.26]*P=<0.001 [95% 12.49-17.70]* n=137

n=134

Confidence Score

***

*

**

**

Pre-confidencePost-confidenceP<0.001*C

onfidence Score

n=134

MS4

Post-knowledgePre-knowledge

n=56 n=7 n=74 n=16

* P=<0.05

Test Score (%)

Retention of Confidence in MS3s

Confidence Score

p<0.001

n=24 n=24 n=24

Retention of Knowledge in MS3s

Test Score (%)

n=31

[95%CI, -0.64-9.42]P=0.085p<0.001

[95%CI, 12.14-20.68]

Impact

Time-based education Competency-based education 2014 AAMC released 13 Core EPAs for UME

– EPA #13: Engage in daily safety habits, including hand-washing All students rotate through at least one specialty that requires

sterile technique In 2017, 40% of students matched into a specialty that requires

sterile technique

Limitations

Single institution Lack of evidence for long term retention of knowledge and

skill Building validity evidence for assessment tool Have yet to relate curriculum to improved patient outcomes

In Conclusion

Scrub training for medical students is generalizable Scrub training should be an interdisciplinary effort A formal curriculum increases students’ knowledge and

confidence in scrub training Overall, adherence to strict scrub hygiene is important for

patient safety

Questions?

Goodmancenter.Stanford.edu

@brittnhasty@GSEC_Surgery

bhasty@Stanford.edu

Thank youTeaching and Mentoring Academcy @ Stanford Medicine

Perioperative Education @ StanfordGoodman Surgical Education CenterDepartment of Surgery @ Stanford