Abstract:
AIMS:Assessing endoscopic technical skills competency in a structured manner is a topical issue, in light of several workforce factors that may affect the training of future endoscopists. To date there has been little attempt to comprehensively assess both generic and specific technical skills in lower gastrointestinal endoscopies; the current study aimed to develop and validate a tool that can assess these varied skills. METHODS:Hierarchical task analyses of generic and specific technical skills were constructed on flexible sigmoidoscopy and colonoscopy after expert panel discussions. Generic technical skills are subtasks (eg, movements of the control wheel) that allow the endoscopist to complete a main task (specific technical skills), for example, reaching the cecum. Weighted Likert scales were then constructed individually for generic and specific technical skills for each procedure. Two observers assessed each procedure independently. RESULTS:A total of 135 endoscopic procedures were performed by 9 consultants and 12 registrars. Mean inter-rater reliability Cronbach alphas were .83 and .80, P < or =.05, for generic and specific skills, respectively, for each procedure. Construct validity results using analysis of variance (ANOVA) for consultants and trainees were significant for each procedure, P = .005, P = .003 for generic, and P = .012, P = .004 for specific technical skills. CONCLUSIONS:This new assessment/self-appraisal tool for lower gastrointestinal endoscopies seems to have face, content, concurrent, and construct validities. The tool has the possibility of being used in training and self-appraisal. We aim to modify and apply this tool to other endoscopic procedures in the future, such as endoscopic retrograde cholangiopancreatography (ERCP), endoluminal and transluminal procedures.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Sarker SK,Albrani T,Zaman A,Patel Bdoi
10.1016/j.amjsurg.2007.10.024subject
Has Abstractpub_date
2008-09-01 00:00:00pages
450-5issue
3eissn
0002-9610issn
1879-1883pii
S0002-9610(08)00318-8journal_volume
196pub_type
杂志文章abstract::Immunologic changes after blood transfusions cannot be studied ethically in normal individuals. We therefore studied two comparable groups of patients with atherosclerotic cardiovascular disease who received similar drug treatment and experienced a similar degree of surgical trauma, except that one group received an a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(92)90114-7
更新日期:1992-02-01 00:00:00
abstract:BACKGROUND:Making a conflict of interest declaration is now mandatory at continuing medical education CME accredited events. However, these declarations tend to be largely perfunctory. This study sought to better understand physician perceptions surrounding conflict of interest. METHODS:The same PowerPoint (Microsoft,...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.01.012
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Base Deficit (BD) and lactate have been used as indicators of shock and resuscitation. This study was done to determine the association of BD and lactate and to determine if one is superior. METHODS:A retrospective review from 3/2014-12/2016 was performed. Data included demographics, systolic BP, ISS, BD, l...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.01.025
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Bioethics education has been recommended as a formal component of surgical residency training. The best method for teaching bioethics to residents is unclear. We compared the effectiveness of a standardized patient (SP)-based seminar to a traditional seminar format for teaching bioethics to surgical resident...
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/j.amjsurg.2004.08.066
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Penetrating injury independently predicts the need for surgeon presence (NSP) upon arrival. Penetrating injury is often used as a trauma triage indicator, however, it includes a wide range of specific mechanisms of injury. We sought to compare firearm-related and non-firearm related pediatric penetrating inj...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.06.003
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate the impact of subcarinal dissection on short-term outcomes and survival after esophagectomy in patients with thoracic esophageal squamous cell carcinoma. METHODS:Patients without subcarinal dissection were matched randomly to patients with subcarinal dissection i...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.10.044
更新日期:2013-09-01 00:00:00
abstract::Evaluation of postoperative swallowing ability in thirty-eight patients having had partial laryngectomy indicates that there are marked differences in the degree of dysphagia among individuals with similar surgical defects. This variation in swallowing disability, however, appears to have definable limits. Rehabilitat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90266-0
更新日期:1978-10-01 00:00:00
abstract::Diabetic foot wounds affect an estimated 15% of all patients with diabetes. These wounds are typically multifactorial in origin. Neuropathy of the foot and impaired wound healing are frequently associated with peripheral arterial occlusive disease. These factors combine to contribute to the development of foot ulcers....
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/S0002-9610(03)00302-7
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:There are currently between 1 and 2 million breast cancer survivors in the United States. Is the advocated, early intervention the key to successful treatment, or are there other, more important factors? METHODS:Responses to combined decongestive therapy (CDT) for 69 women were analyzed with regard to durat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00185-3
更新日期:1999-10-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.06.015
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Antiphospholipid (APL) antibodies are a heterogenous group of antibodies that have been associated with an increase in bleeding complications and a marked increase in thrombotic events, both of which result in significant patient morbidity and mortality. PATIENTS AND METHODS:A retrospective analysis of pati...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80285-2
更新日期:1995-08-01 00:00:00
abstract::The antiproliferative effects of somatostatin on hepatocytes stimulated by hepatocyte growth factor (HGF) or epidermal growth factor (EGF) were investigated using primary cultures of adult rat hepatocytes. Somatostatin inhibits HGF-induced (at a dose of 10 ng/mL) or EGF-induced (at a dose of 100 ng/mL) 3H-thymidine in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(92)90271-r
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Colorectal liver metastases with hepatic vein (HV) involvement may require combined resection of the liver and HV. However, the short- and long-term outcomes of such a procedure remain unclear. METHODS:We reviewed 16 cases of liver resection with major HV resection and reconstruction. RESULTS:The patients ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.08.040
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Endoscopic retrograde cholangiopancreatography is a challenging procedure performed by surgeons and gastroenterologists. We employed cognitive task analysis to identify steps and decision points for this procedure. METHODS:Standardized interviews were conducted with expert gastroenterologists (7) and surgeo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.05.006
更新日期:2015-10-01 00:00:00
abstract::A retrograde method for mastectomy that performs the axillary dissection first is described, and experience with eighty-six cases of infiltrating carcinomas of the breast treated in that manner is presented. The method has reduced the number of standard radical procedures by more than half, and a decrease in operative...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90182-3
更新日期:1976-06-01 00:00:00
abstract::Resection of malignancies of the upper face and skull base may result in complex bone and soft tissue defects. To better define the optimal management of these defects, we conducted a retrospective review of 75 consecutive patients who underwent closure of 76 craniofacial defects after malignant tumor excision from 19...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90160-f
更新日期:1991-10-01 00:00:00
abstract:BACKGROUND:Wound healing and chronic wounds are serious public health issues. While wounds heal, cellular stores of antioxidants are depleted. d-ribose-l-cysteine (DRLC) is a precursor to the antioxidant glutathione. The effect of oral supplementation with DRLC on wound healing was studied in rats. METHODS:A rodent mo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.11.014
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Medical schools increasingly employ the standardized patient interaction (SPI) as a teaching and testing modality to prepare students for USMLE Step 2 Clinical Skills (Step 2 CS). However, little is known about the perceptions medical students have toward SPIs. We hypothesized that the SPI would increase the...
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/j.amjsurg.2004.09.013
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:Invasive lobular carcinoma (ILC) presents special challenges to treating physicians because of the diffuse infiltrative growth pattern. As sentinel lymph node dissection (SLND) is rapidly replacing axillary lymph node dissection (ALND) in the management of patients with early-stage breast cancer, we sought to...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.06.021
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:A high rate of facial nerve paralysis (FNP) develops after parotid surgery, but there have been few clinical trials on treatments to improve recovery times. This study evaluated the efficacy of prednisolone in these patients. METHODS:A total of 123 patients who underwent parotidectomy without injury to the ...
journal_title:American journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.amjsurg.2008.04.010
更新日期:2008-11-01 00:00:00
abstract::Treatment failure and survival in 209 patients with squamous cell carcinoma of the floor of the mouth treated with surgery as the single curative modality are reported. Fifty percent of the patients had stage III and IV disease. The primary tumor was excised with 1 to 2 cm margins and the mandible was resected in 73 p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90118-9
更新日期:1989-10-01 00:00:00
abstract:BACKGROUND:Numerous protocols for laparoscopic skills training using simulator-based laboratories have proven effective. However, little is known about the availability and uniformity of such facilities. The purpose of this study was to evaluate the prevalence, utilization, and costs of skills laboratories currently in...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2005.05.048
更新日期:2006-01-01 00:00:00
abstract::Prehospital and emergency room recordings of hemodynamic vital signs frequently play a major role in the evaluation and treatment of trauma victims. Guidelines for resuscitation and treatment are affected by absolute cutoffs in hemodynamic parameters. To determine the sensitivity of various strata of systolic blood pr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90649-1
更新日期:1989-05-01 00:00:00
abstract:OBJECTIVE:A large number of necrotizing soft tissue infections (NSTI) treated at a single institution over an 8-year period were analyzed with respect to microbial pathogens recovered, treatment administered, and outcome. Based on this analysis, optimal empiric antibiotic coverage is proposed. METHODS:A retrospective ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00360-3
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Radioguided surgery can also be used for the simultaneous guidance to a nonpalpable primary tumor and sentinel lymph nodes. METHODS:Retrospective review of a prospective database. The surgeon used a gamma probe for guidance to an iodine-125 labeled titanium seed at the primary lesion and technetium-99 label...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00716-4
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:mesh techniques are the preferable methods for repair of small ventral hernias, as a primary suture repair shows high recurrence rates. The aim of this prospective study was to compare the retromuscular sublay technique with the intraperitoneal underlay technique for primary umbilical hernias. METHODS:from ...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.amjsurg.2010.01.022
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:The authors determined the radiological misdiagnosis rate of primary epiploic appendagitis (PEA) and its impact on patient management and hospital resource use. METHODS:A total of 660 computed tomography scans performed for clinically suspected diverticulitis (348 cases) or appendicitis (312 cases) were rev...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00103-2
更新日期:1998-07-01 00:00:00
abstract::Despite immediate operation, patients with abdominal aortic injuries and profound hypovolemic shock do not respond to the usual methods of resuscitation and die soon after celiotomy, prior to control and repair of the aortic injury. The rate of aortic hemorrhage exceeds the ability to restore blood volume. Shock becom...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90385-4
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:Elderly patients are at an increased risk of protein-energy malnutrition (PEM) which increases the risk of morbidity/mortality. We evaluated the association between hypoalbuminemia at the time of emergency department (ED) admission and in-hospital complications among geriatric trauma patients. METHODS:This ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.06.013
更新日期:2016-07-01 00:00:00
abstract::We found that the mortality rate was no greater in patients with necrotizing enterocolitis complicated by perforation compared with the rate in those with other causes of perforation in similar weight classes. Iatrogenic injuries had a 50 percent mortality rate in all gestational age and birth weight categories and, t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80111-9
更新日期:1988-03-01 00:00:00