August 19, 2016
By Joe Stumpe
Dr. Marilee McBoyle remembers the excitement of beginning her surgery residency.
"You would wait and wait just to place a few sutures," McBoyle, a 1977 graduate of KU School of Medicine-Wichita said. Along with the excitement, however, there was uncertainty and anxiety: after all, nobody's born knowing how to stitch up patients and perform surgical procedures.
That's where the surgical skills lab at Via Christi Hospital-St. Francis comes in. The lab allows KU surgical residents to practice surgical skills "in a calm environment outside of the operating room," said McBoyle, who is the skills lab's medical director.
The lab, filled with laparoscopic box trainers and a simulator, is located on the hospital's third floor near the operating rooms.
McBoyle said the lab was started a decade ago as required by the Residency Review Committee of the American Board of Surgery. As the 80-hour maximum work week restriction for residents went into effect, it became imperative for surgical education to become more efficient during the allotted time.
"We had to learn to get more bang for the buck," McBoyle said.
First-year residents in the five-year surgery residency program spend the most time in the lab. They usually have skills sessions twice a month and can return to the lab on their own for additional practice.
Faculty surgeons lead the sessions in procedures that include laparoscopic suturing, vascular procedures, trauma, ultrasound, central lines, and colonoscopy.
"The surgeons desire to raise the bar by sharing their expertise," McBoyle said. In addition to working with models, laparoscopic trainers and a computer simulator, the residents have sutured on pigs' feet and pigs' hearts.
Recently, McBoyle asked residents what areas they needed more training in. They asked for extra sessions in ventilator management, central line placement, anticoagulant therapy, and nutrition guidelines. McBoyle found specialists in those areas to address the requests.
"It's their lab," McBoyle said. "We can say, what's happening in your professional life that you need additional teaching?"
Performing laparoscopic and robotic surgery, when the surgeon's hands aren't in direct contact with the area of the patient's body being worked on, are probably the most difficult skills for residents to learn, McBoyle said.
She notes that the skills lab is used by fourth- and fifth-year residents to prepare for the FLS (Fundamentals of Laparoscopic Surgery) exam, which measures time and accuracy in doing laparoscopic procedures. Medical students on the surgical clerkship spend time in the lab learning knot tying and suturing. The lab is also available to surgeons practicing new techniques.
McBoyle, a clinical associate professor at KU, completed her surgical residency at St. Francis in 1982 and pursued a fellowship in Burn and Trauma Surgery at the University of New Mexico before returning to Kansas to join Wichita Surgical Specialists. Her practice evolved from general surgery to focus on breast surgery.
In 2000, she began working with third-year medical students during their surgical clerkship, helping prepare them for their oral exams and critiquing their case presentations. In addition to the skills lab, she supervises the surgery residency clinic at Via Christi St. Francis and is medical director of Via Christi Wound Healing and Hyperbaric Medicine.KU School of Medicine-Wichita