Objective

2

To establish and evaluate a milestone-driven training system for the surgical competency of surgical residents

and explore an effective pathway for achieving homogenized training outcomes.

Methods

2

A historical control study design was adopted. Since 2023

the surgical specialty base at The First Affiliated Hospital

Zhejiang Univer

sity School of Medicine

has implemented a milestone-driven surgical competency training system. This system is theoretically grounded on competency-based medical education and a milestone evaluation system and includes four core elements: phased competency objectives

systematic training courses

diversified assessment methods (integrating formative

interim

and summative evaluations)

and standardized training tutorials. The control group consisted of 231 residents trained under the traditional model from 2020 to 2022

while the observation group included 220 residents trained under the new model from 2023 to 2024. Training effectiveness was evaluated using graduation examination pass rates and scores

skills competition scores

and teaching satisfaction. Inter-group comparisons were performed using

t

-test and chi-square test.

Results

2

The first-attempt pass rate for the graduation theoretical examination was higher in the observation group than in the control group

but the difference was not significant [99.09% (218/220) vs. 96.54% (223/231)

χ

2

=2.32

P

=0.128

]

. The mean score of the observation group was significantly higher than that of the control group (435.32±13.01 vs. 430.73±13.92

t

=3.62

P

<

0.001). In the 2024 skills competition

trainees from our institution scored significantly higher than provincial averages in both open surgery skills (81.66±1.58 vs. 75.96±2.15

P

<

0.05) and laparoscopic surgery skills (62.68±3.11 vs. 47.12±4.11

P

<

0.05). Teaching satisfaction survey showed that satisfaction rates exceeded 89% across all training modules.

Conclusions

2

The milestone-driven surgical competency training system can effectively improve the quality of resident training and provides a practical and operational pathway for achieving homogenized training outcomes.