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Abstract
As surgical training evolves to incorporate a framework of competency-based assessment, the need for structured training experiences and valid assessments of surgical skill is mounting. One of the potential benefits of competency-based surgical education is more efficient learning, with significant savings in the time and cost of training. For basic microsurgical skills, these training experiences increasingly occur outside of the operating room in a simulated setting. Validated assessment scales specific to microsurgery have been developed and shown to provide an efficient and reliable assessment of performance. The way in which residents are motivated to train and achieve these skills efficiently in a simulated setting, however, is less well-defined. We hypothesize that using proficiency targets in a training curriculum will improve both the self-directed practice of residents and overall performance. We therefore aim to compare the outcomes of microsurgical skills practice without explicit performance targets to the same training protocol that includes criterion-level proficiency targets. The amount of self-directed practice time by each resident will be recorded. After fourteen weeks of practice, residents will be assessed performing several drills. Performance outcomes include the time required to complete the task and assessment of technical skills using a previously validated rating scale. The results of this study will assist in determining the optimal method in which to encourage efficient and accurate practice by residents in an independent setting. As competency-based education continues to evolve, training residents effectively outside of the operating room will lead to better performance and more efficient advancement through the residency program.

Biography
Tiffany Nicole Ballard, MD, is a resident in the Integrated Plastic Surgery Residency Program at the University of Michigan (Ann Arbor, MI). As a first-generation college student at DePauw University (Greencastle, IN), she graduated with a Bachelor of Arts degree in Biochemistry. She completed her medical training at Vanderbilt University (Nashville, TN), where she was elected to Alpha Omega Alpha. During her upcoming research year, she will have the opportunity to combine her interests in breast surgery and health services research while evaluating the effects of race, ethnicity, and other socio-demographic variables on breast reconstruction outcomes among patients enrolled in the Mastectomy Reconstruction Outcomes Consortium (MROC) Study.