Abstract：
BACKGROUND:The transformation of a trainee into a surgeon is influenced strongly by communication patterns in the operating room (OR). In the current era of limited educational opportunities, elucidation of teaching and learning strategies in this environment is critical. The aim of this study was to further understand the elements of an effective communicative instructional interaction (CII) as perceived by surgical residents. METHODS:Qualitative research methodology was used to explore University of British Columbia surgery residents' perceptions of what constitutes an effective CII in the OR. Purposeful sampling was used to select participants from various years of training. Eighteen residents participated in semistructured interviews to facilitate reflection of their OR experiences. Interviews were transcribed, analyzed, and fed back to residents to confirm their accuracy. Independent coding and analysis led to the development of key emergent themes. RESULTS:Themes represented the interplay of ideals expressed by the residents. The primary emergent theme was that both teacher and learner play a major role in the creation of an effective CII. The ideal teacher had an instructional plan, facilitated surgical independence, and showed support and empathy for the surgical resident. The ideal resident was receptive, prepared, and acknowledged limitations. The contextual constraints of the OR played a central role in learning, and residents identified ways to maintain educational value despite primarily nonmodifiable contextual elements (ie, time constraints). CONCLUSIONS:In a unique environment such as the OR, both teacher and learner may benefit by an enhanced understanding of the elements of an effective CII.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Vikis EA,Mihalynuk TV,Pratt DD,Sidhu RSdoi
10.1016/j.amjsurg.2008.01.004subject
Has Abstractpub_date
2008-05-01 00:00:00pages
594-8; discussion 598issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(08)00096-2journal_volume
195pub_type
杂志文章abstract：BACKGROUND:In 1997 the National Kidney Foundation put forth guidelines for hemoaccess through its Dialysis Outcomes Quality Initiative (DOQI). Some centers have been able to meet these standards; most have not. METHODS:A retrospective review was made of our database of more than 3,500 hemoaccess procedures from 1986 t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.01.018
更新日期：2004-05-01 00:00:00
abstract：:A case of massive air embolus secondary to use of an intravenous infusion pump is presented. The pump is unable to detect air entering the intravenous line if the air enters distal to the air detection device. A simple solution is presented. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90163-6
更新日期：1979-02-01 00:00:00
abstract：BACKGROUND:Medical schools are undergoing major curricular reform, partly in attempts to increase the number of graduates pursuing careers in the generalist disciplines. These reforms have often resulted in a shortening of the surgery clerkship, decreasing students' experiences in several domains important to the gener...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)89595-5
更新日期：1997-03-01 00:00:00
abstract：BACKGROUND:Our objective was to compare the outcomes after laparoscopic Roux-en-Y gastric bypass (RYGB) in morbidly obese (body mass index [BMI] <50) patients with super morbidly obese (BMI >50) patients. METHODS:A prospective analysis of 120 patients who underwent laparoscopic RYGB at a community based teaching hospi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.08.017
更新日期：2004-02-01 00:00:00
abstract：:Pediatric gastroesophageal reflux is common and its complications may be serious. The diagnosis is being suspected and confirmed with increasing frequency in children because of heightened awareness of the symptoms peculiar to pediatric patients. Thirty-one children who underwent Nissen fundoplication for gastroesopha...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90114-2
更新日期：1980-12-01 00:00:00
abstract：:Approximately 60% of patients who die from melanoma have gastrointestinal (GI) metastases at autopsy, yet antemortem diagnosis is uncommon. A retrospective review was completed on 32 patients who underwent an operation at Memorial Sloan-Kettering Cancer Center between 1977 and 1987 for complications of melanoma metast...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90070-t
更新日期：1991-09-01 00:00:00
abstract：BACKGROUND:Esophageal cancer mortality is increased in African Americans relative to white patients. The reasons for this are unknown but are thought to be related to inadequate access to health care secondary to a higher poverty rate in African American populations. METHODS:The National Health Interview Survey databa...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.12.055
更新日期：2004-07-01 00:00:00
abstract：:Miliary tuberculosis is the most lethal form of tubercular disease. If dissemination of tubercle bacilli occurs without therapy, death is almost certain. The importance of establishing an etiologic diagnosis as promptly as possible in patients receiving immunosuppressive therapy is self-explanatory. The presence of a ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90402-x
更新日期：1975-09-01 00:00:00
abstract：BACKGROUND:This study explores assistance-seeking and reporting behaviors in surgical residents faced with stressful circumstances. METHODS:Three surgical societies distributed a multiple choice, free-text response survey to residents. RESULTS:One hundred sixty-four residents (39% male) responded; 58% of women (43% m...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.05.011
更新日期：2015-10-01 00:00:00
abstract：:The lecture activity of neurology and neurosurgery faculty at allopathic medical schools during the academic years 1985-1986 through 1987-1988 was surveyed. Lectures were categorized into three combinations for analysis: first- and second-year basic science, first- and second-year clinical, and third- and fourth-year ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90213-5
更新日期：1994-03-01 00:00:00
abstract：BACKGROUND:We have previously shown the inhibitory effects of keyhole limpet hemocyanin (KLH) against breast and pancreatic cancer in vitro. We hypothesize that its actions in breast and pancreas cancer cells are via apoptotic or cytokine pathways. METHODS:Two breast cancer cell lines, ZR75-1 and MCF-7, and one pancre...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.10.005
更新日期：2005-06-01 00:00:00
abstract：:Forty-two patients (age range: 70 to 86 years) underwent pancreaticoduodenectomy between 1970 and 1990 for carcinomas of the pancreas (23), ampulla (8), common bile duct (5), duodenum (5), or islet cells (1). After resection, reconstruction was done by either pancreaticojejunostomy (13) or pancreaticogastrostomy (25);...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90104-l
更新日期：1991-12-01 00:00:00
abstract：:We reviewed the results of 133 bone scans and 63 liver scans (computed tomography, liver-spleen radionuclide scan, or ultrasonography) obtained for the preoperative evaluation of breast cancer patients. Information on the preoperative staging of breast cancer (TNM classification) was available in 131 of 133 patients. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80512-4
更新日期：1993-02-01 00:00:00
abstract：BACKGROUND:While vascular patency and overall viability of the gut can be evaluated perioperatively, damage to the mucosal barrier can hardly be judged in the perioperative setting and, moreover, will probably determine the clinical course. METHODS:In 19 consecutive cases with intestinal ischemia, the clinical course ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00048-2
更新日期：1997-07-01 00:00:00
abstract：BACKGROUND:Burnout affects surgical residents' well-being. OBJECTIVE:We sought to identify factors associated with burnout among surgery residents. METHODS:An electronic/anonymous survey was sent to surgical residents at 18 programs, consisting of demographic/programmatic questions and validated scales for burnout, d...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.07.004
更新日期：2020-06-01 00:00:00
abstract：:Reports in the surgical literature are conflicting as to whether appendectomy "in passing" during laparotomy for trauma or for some other disease state does or does not significantly increase patient morbidity or mortality. A chart survey of all appendectomies (342 for acute appendicitis and 146 as incidental procedur...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0002-9610(83)90150-2
更新日期：1983-06-01 00:00:00
abstract：:Of six healthy laboratory workers with no history of illness caused by Pseudomonas aeruginosa, four exhibited positive skin responses at 24 hours, strong inhibition of leukocyte migration, and marked stimulation of blastogenesis of peripheral lymphocytes when exposed to a "cocktail" of three phenol-killed strains of P...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90160-x
更新日期：1977-06-01 00:00:00
abstract：BACKGROUND:A nonintrusive e-mail reminder incorporating teaching tips and manuscripts was developed to supplement resident-as-teacher curricula. METHODS:Ten high-yield manuscripts and 10 teaching tips exemplifying the themes of mentorship or role modeling, teaching methods, adult learning theory, feedback, and the res...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.05.004
更新日期：2017-01-01 00:00:00
abstract：:Herein, we have described the surgical management of 23 patients with chronic intestinal ischemia. The patients presented most commonly with postprandial pain and weight loss. Diagnosis was confirmed by angiography, including lateral aortography. Surgery included bypass with Dacron being the most common graft material...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90301-5
更新日期：1984-07-01 00:00:00
abstract：BACKGROUND:Most patients with primary hyperparathyroidism undergo localization prior to operation with variable success. Therefore, in this study we investigated the safety of parathyroidectomy without imaging. METHODS:A prospective database of 2057 surgical patients with primary hyperparathyroidism from 2001 to 2019 ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.04.029
更新日期：2020-09-01 00:00:00
abstract：BACKGROUND:Pediatric magnet ingestions are increasing. Commercial availability of rare-earth magnets poses a serious health risk. This study defines incidence, characteristics, and management of ingestions over time. METHODS:Cases were identified by searching radiology reports from June 2002 to December 2012 at a chil...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.028
更新日期：2014-05-01 00:00:00
abstract：:The presentation, surgical management, and clinical outcome in 153 patients with biliary pancreatitis has been reviewed. Only 37 percent of our patients demonstrated any of Ranson's 11 prognostic signs of severe pancreatitis, and only 3 percent had 3 or more signs. Fourteen patients underwent emergency operation withi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90028-0
更新日期：1986-01-01 00:00:00
abstract：BACKGROUND:Surgery for Crohn's disease is not intended for cure, but rather to relieve symptoms and treat complications. Perioperative morbidity, the fear of creating short bowel syndrome, and the tendency of the disease to recur convinced many physicians to refer their Crohn's patients for surgery only when life-threa...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00102-5
更新日期：1997-09-01 00:00:00
abstract：:A new, improved drainage system has been specifically designed to provide either closed suction drainage for the ambulating patient or sump drainage for the patient confined to bed. This drainage system is made of silicone that has a hydrogel coating with a low coefficient of friction. This coating facilitates removal...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80089-1
更新日期：1985-02-01 00:00:00
abstract：:Gastric restrictive surgery has evolved over the past decade as the treatment of choice for morbid obesity. We reviewed our experience with 289 patients who underwent gastric surgery for morbid obesity. Comorbid diseases included respiratory insufficiency in 19 percent of the patients, hypertension in 36 percent, diab...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90438-8
更新日期：1989-01-01 00:00:00
abstract：BACKGROUND:Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are sequelae of severe trauma. It is unknown if certain races are at greater risk of developing ALI/ARDS, and once established, if there are racial differences in the severity of lung injury or mortality. METHODS:Retrospective cohort stu...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.02.003
更新日期：2011-04-01 00:00:00
abstract：BACKGROUND:Immunosuppressed patients have an increased risk of developing anal cancer, but little data exists regarding outcomes of this population. METHODS:A retrospective review of anal cancer patients at a single academic institution from 2006 to 2017 was performed. RESULTS:19 (14%) of 136 anal cancer patients wer...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.08.011
更新日期：2020-01-01 00:00:00
abstract：BACKGROUND:The prognostic value of traditional staging classification for colorectal cancer has changed little since Dukes created the first staging scheme. Some patients with known metastatic disease are long-term survivors, while other patients with local disease die early. New intraoperative cancer detection technol...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80295-5
更新日期：1995-10-01 00:00:00
abstract：BACKGROUND:This study explores the nature and the intention of attending surgeons' guiding behaviors performed in the operating room (OR) in order to build taxonomy of OR guiding behavior. METHODS:Nine attending surgeons and 8 surgical residents were invited to observe 8 prerecorded surgical cases from 4 common proced...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.07.018
更新日期：2015-01-01 00:00:00
abstract：BACKGROUND:Intestinal obstruction (IO) is a common pediatric surgical emergency in sub-Saharan Africa with high morbidity and mortality, but little is known about its etiopathogenesis in Malawi. METHODS:Retrospective analysis of patients seen from February 2012 to June 2014 at Kamuzu Central Hospital in Lilongwe, Mala...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.11.024
更新日期：2016-04-01 00:00:00
