The recommended textbook for the course is Lawrence’s Essentials of General Surgery, now in its fifth edition.
The authors surveyed the 133 members of the 2014-2015 third-year class, and 92 (69.2%) responded. Regarding each resource used, they could answer with one of four choices: always, usually, sometimes, never.
The students used review books significantly more often than the Internet, which was second. The most popular review book was Dr. Pestana’s Surgery Notes, used by 74% of respondents; NMS Surgery and Surgical Recall were used by 46% and 37% of the class, respectively.
More than half the class (56%) said they never used a textbook. Only 8.7% used Lawrence’s Essentials of General Surgery even though it could be obtained on loan in both print and electronic forms from the school. Almost 20% of students said they read formal textbooks such as Greenfield, Sabiston, and Schwartz.
Considering the price differential between Pestana at as little as $15 and the traditional textbooks costing anywhere from $60-$150, it's surprising that any student would buy the latter which contain much more information than anyone could assimilate during an 8-week rotation.
Despite its reputation as a flawed scientific site, Wikipedia led the list of Internet resources with 39.1% of users followed by UpToDate at about 33% and the school's faculty generated intranet sites at just under 30%.
Scores on the National Board of Medical Examiners surgery examination were not significantly related to the resources used, nor did high-or low-scoring students use significantly different materials. The average score for the Florida students was statistically similar to the overall national average.
Did the students learn surgery? It depends on whether you consider the NBME test a good indicator of learning.From the authors' discussion, "To an extent, there is likely a sense of studying for the test instead of studying to understand surgery."
What is the bottom line?
The authors of the paper had hoped to use the survey results as a needs assessment tool to help them update their online curriculum, but they concluded, "As relationships between exam performance and resource use had no correlation within the study, this suggests that much of a student's objective performance relies heavily on abstract factors that are challenging to define and quantify."
In other words, "We don't know what to do with the information."