opinion surveys. Student performance on relevant questions of theNBME shelf exam was examined for retention of material.

RESULTS: Quiz scores improved 10% after the content delivery,regardless of format (89%-99%,p�0.0007). Performance on theshelf exam for lecture-related questions was equivalent betweencohorts (78% computer-based, 82% didactic,p�0.61; nationalaverage�69.5%). Surveys indicated that 97% preferred the gameshow format to didactic lessons and requested more lectures ofthis format.

CONCLUSIONS: Our software provides a feasible lecture alter-native and resulted in equal short term retention of material.Students preferred this format. One-year follow-up (in progress)will assess long-term retention. Future plans include multi-departmental and multi-institutional studies of feasibility andequivalency.

Interactive multi-site video teleconferencing as ameans to increase surgical resident and staffparticipation at core teaching conferencesAndrew R Watson, MD, Kenneth Lee, MD,Timothy Billiar, MD, FACS, James Luketich, MD, FACSUniversity of Pittsburgh Medical Center, Pittsburgh, PA

INTRODUCTION: Rotations at multiple teaching sites can providesurgical residents with diverse training experiences, but may requiresubstantial travel time in order for residents and faculty to attendcentrally located core teaching conferences. We investigated the im-pact of linking teaching sites via bi-directional fully interactive videoteleconferencing on resident and faculty participation and time uti-lization.

METHODS: Beginning in October 2006 weekly mortality and mor-bidity conferences were teleconferenced to two remote hospitals.Attendance and participation at the remote sites were recorded, andtravel time saved was calculated.

RESULTS: Over a 21 week period 13 conferences were successfullytelecast. Total remote site attendance consisted of 61 residents and 20attendings. Visual and audio interaction among all attendees waspossible, and oral presentations, discussion slides, pathology, andradiology could be viewed at all three sites simultaneously. Eight caseswere presented remotely. Based on an average round trip commutefrom the remote locations of one hour, 61 resident and 20 attendinghours were saved. The estimated value of the attending hours savedwas $114,325 revenue (hourly $5716.28)-calculated using averagesalary, overhead, clinic revenue, and OR revenue.

CONCLUSIONS: Training within the 80 hour week may conflictwith a large, multi-hospital training program. Resident travel is in-efficient and video teleconferencing enables remote participation.The implications of this technology are significant in terms of resi-dent education time saved and staff surgeon participation. The po-tential money saved in decreasing surgeon travel time may warrantinstitutions investing in such technology.

Team play in surgical education: Let simulationhelp usSteven Cohen, DO, Alagappan Annamalai, MD, James Maurer, MD,Ronnie Combs, RPA, George Bennedetto, Kenneth Rifkind, MD,Jose Torres, MD, Dan Ruiz, MD, James Turner, MDNew York Hospital, Flushing, NY

INTRODUCTION: Simulation based training is suited to low stressenvironments on real life emergencies. Simulation can improve sur-gical education & likely patient care in crisis situations by employinga team approach emphasizing interpersonal & communication skills.

METHODS: In a NYS Certified Level I trauma center, trauma alertswere assessed by a standardized video process. Variables measured in-cluded; presence of a team leader, following a team leader, number ofhealthcare workers in a defined position, time to intubation & spinestabilization. Thirty cases were video analazyed pre & post simulationtraining. Simulation training was provided in various trauma situationsfollowed by a debriefing period. The data sets were compared via a t-testfor significance. Nominal data was analyzed using a Fischer exact test.

RESULTS: All data were compared pre to post simulation. Thenumber of health care workers involved in trauma resuscitationsdecreased from 8.5 to 5.7 per trauma, p � 0.001. The percent ofpeople in role positions increased from 57.8% to 83.6%, p�0.46.The time to intubation from paralysis decreased from 3.9 min to 2.8min, p�0.05.The presence of a definitive team leader increased from64 % to 90%, p�0.05. The rate of spine stabilization increased from82% to 100%, p�0.08. During review of simulation modules ’fol-lowing the ATLS algorithm’ improved from 56% to 83%.

CONCLUSIONS: High stress situations simulated in a low stress envi-ronment can improve team interaction and educational competencies.Providing simulation training as a tool for surgical education enhances

Objective structured clinical exam reducesvariability in the assessment of medical students insurgery clerkshipsPaul N Suding, MD, Susan C Ahearn, BSN, Samuel E Wilson, MD,Russell A Williams, MDUniversity of California at Irvine, Orange, CA

INTRODUCTION: Clinical evaluations and oral examinations areused to assess medical student performance in surgery clerkships, yetthey are inherently subjective and at risk for variability in grading.Objective structured clinical exams (OSCE) enable a standardizedpatient experience to reduce variability in medical student grades andassess clinical skills and surgical knowledge.

METHODS: There were 301 medical students in our surgery clerk-ship over 3.3 years. All students were given a written examination andstandard clinical evaluation. For the initial 3 years of the study allmedical students also underwent oral examinations conducted bytwo randomly assigned faculty members. In the final year of the studywe developed an OSCE that replaced the oral examination. In theOSCE medical students performed history and physical exams offour individuals portraying patients with common surgical scenarios.We analyzed the grades of the medical students before and after

S85Vol. 205, No. 3S, September 2007 Surgical Forum Abstracts