EP156 - Teaching Ostomy Site Marking: A Multidisciplinary Course Boosts Resident Comfort and Skills

Purpose/Background: Preoperative site marking reduces stoma-related complications and improves health-related quality of life. While Wound, Ostomy, and Continence Nurses (WOCNs) often perform this task, surgeons and trainees should also be formally trained in site-marking principles. Given the current lack of consistent, multidisciplinary education in residency, we developed a single-session pilot course to teach general surgery residents the principles of site marking, appliance troubleshooting, and patient-centered communication.

Methods/Interventions: The intervention included a didactic presentation and hands-on demonstration led by a colorectal surgeon and WOCN. Standardized patient (SP) encounters were conducted before and after the session, with SPs evaluating resident performance and comfort. Residents (PGY 1–3) completed pre- and post-intervention self-assessments on a 1–5 Likert scale. SP and resident data were analyzed using Wilcoxon signed-rank tests.

Results/Outcomes: 21 residents completed the course; none had received prior formal education in site marking, and four had previously marked ostomy sites. Post-course assessments showed significant improvements in confidence related to ostomy marking (W = 231.0, p < 0.01), appliance troubleshooting (W = 210.0, p < 0.01), and recognition of anatomic considerations (W = 28.0, p = 0.02). No significant changes were noted in site marking accuracy relative to WOCN site marks (W = 50.5, p = 0.12), resident assessment of SP in multiple positions during marking (W = 12.0, p = 0.23), SP-assessed resident comfort (W = 29.0, p = 0.45), and SP confidence in resident response to scripted ostomy-related questions (W = 24.5, p = 0.07). When grouped by PGY level, improved confidence in site marking (p < 0.01 for all PGY levels) and troubleshooting (p < 0.01 for PGY1 and PGY2, p = 0.04 for PGY3) remained significant. All participants endorsed inclusion of the course in future training.

Conclusion/Discussion: Surgery residents remain underprepared for ostomy-related care, but a single multidisciplinary teaching session was well received and significantly improved confidence across all PGY levels. Although objective gains in technical accuracy and SP-rated performance did not reach statistical significance, trends toward improvement suggest value in continued integration and reinforcement. These findings support the inclusion of structured, multidisciplinary ostomy training within surgical residency curricula.