Beyond the Red Line (BTRL): a course to provide the foundations for medical student surgical success in the operating room and beyond

The surgery clerkship rotation is known to broaden anatomical understanding and enhance interest in surgical specialties, but little is known about effects of earlier pre-clinical surgical exposure. This study evaluates the impact of a hands-on surgical skills course on pre-clinical students’ confidence in the operating room (OR), suturing, identifying basic surgical anatomy, and establishing surgical mentorship.

Forty-six first-year medical students at an academic institution self-selected to participate in this IRB-approved course. This 3.5-day course was offered three times during an academic year. Students participated in a 2-day surgical education workshop taught by general surgeons and spent 1.5 days in the OR with a surgeon mentor. A 15-question 5-point Likert-scale pre- and post-survey was administered. Wilcoxon signed rank, Kruskal–Wallis, and Mann–Whitney tests were performed.

Students reported improved confidence with scrubbing, gowning, gloving, suturing, knot tying, basic surgical anatomy, and maintaining sterility in the OR after participation (p < 0.05). 90% of students reported increased confidence in scrubbing into an OR case (p < 0.05) and 81% were more confident in identifying a surgeon mentor (p < 0.05). There was no difference in confidence for scrubbing into a case or demonstrating suturing between students interested in surgical versus medical fields (p = 0.26, p = 0.38).

Early surgical exposure improves students’ confidence with skills training, hands-on OR experiences, and OR mentorship. This 3.5-day course provides an effective foundational introduction to surgical education for pre-clerkship students and improves overall confidence in the OR regardless of future residency interests.