Background: With time and cost constraints, implementing an effective, yet efficient, skills curriculum poses significant challenges. Our purpose is to describe a successful curriculum administrative structure that promoted faculty buy-in and accountability, learner responsibility, and acceptable resource usage. Methods: A total of 14 American College of Surgery (ACS) modules were included in the postgraduate year 1 curriculum. Before arrival, 2 modules were sent to newly matched residents. Remaining modules were administered over a 4-month period, with integrated, independent practice opportunities, as well as 4 mentored and 1 peer practice sessions. A total of 2 verifications of proficiency (VOP) progress exams and 1 final comprehensive VOP were administered. To promote faculty ownership, 1 faculty member was asked to lead each module. Module leaders attended an orientation and development session, and created an instructional management plan. Each module was taught by the leader and 2 additional faculty coinstructors, and evaluated by residents. Equipment, resource costs, and man-hours were tracked. Results: Faculty buy-in was demonstrated by enthusiastic participation, with only 2 absences. Residents gave high ratings to all the modules (range, 4.22-4.89/5). Curriculum costs were approximately $21,500, reduced from potential costs of $187,000 if all simulators would have been purchased new. The estimated budget for year 2 is $17,000. Conclusion: It is critical for new curricula to have resident and faculty buy-in, accountability for quality teaching and learning, and reasonable resource use. We provide suggestions for structuring a curriculum to ensure accomplishment of these important drivers.
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