Abstract:
BACKGROUND:Accurate assessment is imperative for learning, feedback and progression. The aim of this study was to examine whether surgeons can accurately self-assess their technical and nontechnical skills compared with expert faculty members' assessments. METHODS:Twenty-five surgeons performed a laparoscopic cholecystectomy (LC) in a simulated operating room. Technical and nontechnical performance was assessed by participants and faculty members using the validated Objective Structured Assessment of Technical Skills (OSATS) and the Non-Technical Skills for Surgeons scale (NOTSS). RESULTS:Assessment of technical performance correlated between self and faculty members' ratings for experienced (median score, 30.0 vs 31.0; ρ = .831; P = .001) and inexperienced (median score, 22.0 vs 28.0; ρ = .761; P = .003) surgeons. Assessment of nontechnical skills between self and faculty members did not correlate for experienced surgeons (median score, 8.0 vs 10.5; ρ = -.375; P = .229) or their more inexperienced counterparts (median score, 9.0 vs 7.0; ρ = -.018; P = .953). CONCLUSIONS:Surgeons can accurately self-assess their technical skills in virtual reality LC. Conversely, formal assessment with faculty members' input is required for nontechnical skills, for which surgeons lack insight into their behaviours.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Arora S,Miskovic D,Hull L,Moorthy K,Aggarwal R,Johannsson H,Gautama S,Kneebone R,Sevdalis Ndoi
10.1016/j.amjsurg.2011.01.024subject
Has Abstractpub_date
2011-10-01 00:00:00pages
500-6issue
4eissn
0002-9610issn
1879-1883pii
S0002-9610(11)00132-2journal_volume
202pub_type
杂志文章abstract:BACKGROUND:A review of 1993 data on length of stay (LOS) and charges for diagnosis-related group (DRG) 195 (complicated cholecystectomies) showed that Maricopa Medical Center charged more and had longer LOS than all other area hospitals. METHODS:Twenty DRG 195 charts were analyzed for the causes of the inefficiencies....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80035-x
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:Current evidence-based guidelines provide recommendations for prophylaxis and treatment of venous thromboembolism (VTE) in a variety of surgical patients. DATA SOURCES:A systematic Ovid Medline search (from 1950 to the present) was conducted for relevant articles using the following search terms: "venous th...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2009.10.007
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:Patient Reported Outcomes (PROs) capture peri-operative fatigue, pain, and quality of life and influence outcomes in gastrointestinal surgery. We compared peri-operative PROs in patients undergoing colorectal operations for neoplastic versus non-neoplastic processes. METHODS:Patients undergoing colectomy ...
journal_title:American journal of surgery
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doi:10.1016/j.amjsurg.2020.08.017
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:This pilot project involved the development of a structured, experiential, educational module using a bench model technical skills simulation and standardized patients. It integrated teaching and assessment of clinical, technical, and interpersonal skills, as well as professionalism within the context of an ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.07.003
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:The ideal treatment algorithm for suspected choledocholithiasis is not yet well defined. Imaging options include magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), and intraoperative cholangiogram (IOC). MRCP is diagnostic, while the other two modalitie...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2016.10.025
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Aging of the population necessitates consideration of the increasing number of older adults requiring emergency care. The objective of this study was to compare outcomes and presentation of octogenarian and/or nonagenarian emergency general surgery (EGS) patients with younger adults. METHODS:Based on a stan...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.01.021
更新日期:2016-08-01 00:00:00
abstract::Curettage of lymph nodes in 36 patients with cancer of the thoracic esophagus was performed in the bilateral supraclavicular, right intrathoracic and abdominal regions. The overall metastatic ratio in lymph nodes was 52.8 percent (19 of 36). It was particularly high in the right supraclavicular nodes (26.7 percent), t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90160-4
更新日期:1981-02-01 00:00:00
abstract:BACKGROUND:Metabolic syndrome (MetS) is defined by numerous comorbidities. We sought to assess MetS's effect on the 7 main emergency general surgery (EGS) procedures that constitute 80% of EGS procedures, mortalities, complications, and costs. METHODS:Data were acquired from the ACS-NSQIP database from 2005 to 2017. C...
journal_title:American journal of surgery
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doi:10.1016/j.amjsurg.2019.12.021
更新日期:2020-08-01 00:00:00
abstract::Significant arterial trauma can result from femoral arterial cannulation for cardiopulmonary bypass or intraaortic balloon pumping. Threat of imminent loss of limb or suture line disruption requires prompt surgical intervention. Delayed appearance of claudication, characteristically at 1 to 2 weeks postoperatively, is...
journal_title:American journal of surgery
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doi:10.1016/0002-9610(80)90026-4
更新日期:1980-08-01 00:00:00
abstract::Between 1971 and 1976, ninety-three patients with a clinical diagnosis of pseudocyst confirmed by ultrasonography were identified from a group of 923 patients admitted for pancreatic disease. Uncertainties in diagnosis and/or rapid progression of underlying pancreatitis led to urgent laparotomy and drainage in eleven ...
journal_title:American journal of surgery
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更新日期:1979-01-01 00:00:00
abstract::Diabetic neuropathic ulcers are thought to arise from repetitive injury during normal walking in areas of high plantar pressures. It has been suggested that metatarsal head (MTH) resection alleviates elevated pressures at the site of the ulcer and, thus, expedites healing and prevents recurrence. We investigated the e...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90203-8
更新日期:1994-03-01 00:00:00
abstract::Hemasite is a new device incorporated in a graft that is used for hemodialysis. A technique of thrombectomizing this device incorporated graft is described. ...
journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:1984-05-01 00:00:00
abstract::In this study, we sought to identify changes in the picture of a selected surgical condition during an interval of time that has brought about radical departures from previously established policies and programs. As a direct consequence, the patients take a more circuitous route to the surgeon. A significant number of...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90549-7
更新日期:1989-03-01 00:00:00
abstract:BACKGROUND:This 17-year review was undertaken to examine clinical outcomes and the changing trends in resource utilization for lower extremity bypass grafts performed in a managed care setting. PATIENTS AND METHODS:Between 1979 and 1995, 338 bypasses in 276 patients (199 men, 77 women; 62% diabetics) were carried out ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00130-4
更新日期:1996-08-01 00:00:00
abstract::Fifty men with hernias were operated on as outpatients: 42 went home the evening after surgery. The best results were obtained in patients with unilateral indirect hernias; those with direct hernias did not do quite as well. No patient required readmission to the hospital for complications. The cost was significantly ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90161-1
更新日期:1982-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine if the distance from the skin to the seroma cavity, as measured with ultrasound (US) before catheter placement, correlated with the distance from skin to MammoSite balloon catheter as measured on computerized axial tomography (CAT) after catheter placement. METHODS:...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.11.012
更新日期:2008-08-01 00:00:00
abstract::Ileal water and electrolyte absorption exceed jejunal absorption in both the basal and meal-stimulated states. The purposes of these experiments were to determine: (1) if luminal bile acids alter basal or meal-stimulated intestinal absorption, and (2) if there is site specificity or meal stimulation of intestinal bile...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80792-5
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the impact of computed tomographic (CT) scans of the abdomen on clinical outcomes and costs in young male patients presenting with suspected appendicitis. METHODS:Discharge data from the University HealthSystem Consortium was accessed for all male patients between 1...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.05.024
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Video broadcasting of surgical procedures is an important tool for education, training, and consultation. Current video conferencing systems are expensive and time-consuming and require preplanning. Real-time Internet video is known for its poor quality and relies on the equipment and the speed of the connec...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00203-2
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:We retrospectively studied whether ultrasound-guided fine-needle aspiration biopsy (US-FNAB) showed improved sensitivity in patients with palpable thyroid nodules. METHODS:A total of 70 patients (72 lesions) with thyroid nodules underwent US-FNAB and 94 patients (94 lesions) underwent FNAB guided by manual ...
journal_title:American journal of surgery
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更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:We hypothesize that medical centers that prioritize altruism can also deliver superior quality care. METHODS:Data were obtained from California's Office of Statewide Health Planning and Development, Medicare Hospital Compare, and the Joint Commission US Census Bureau's American Community Survey. Outcomes we...
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pub_type: 杂志文章,多中心研究
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更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:The purpose of this paper is to review the experience of a community surgeon performing laparoscopic antireflux procedures (LAP). The experience has been difficult and at times unsettling, and underscores the need for advanced laparoscopic expertise not normally obtained performing laparoscopic cholecystecto...
journal_title:American journal of surgery
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doi:10.1016/S0002-9610(97)89608-0
更新日期:1996-05-01 00:00:00
abstract::We reviewed 574 endoscopic sphincterotomy procedures. Fifty-six precut papillotomies were performed. Presenting conditions included choledocholithiasis, cholangitis, benign and malignant papillary strictures, and stenosing papillitis. Complications were identified in 16 percent: perforation in 9 percent, pancreatitis ...
journal_title:American journal of surgery
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更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Outpatient surgery is cost effective and convenient. The aim of this study was to determine the safety and feasibility of outpatient thyroidectomy. METHODS:Retrospective review was performed of all thyroidectomy patients from a tertiary care center between January 2004 and March 2010. RESULTS:One hundred f...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.01.023
更新日期:2011-05-01 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
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doi:10.1016/s0002-9610(97)00048-2
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:The aim of this study is to establish a relationship between critical ischemia of the lower limb and kidney dysfunction. MATERIALS AND METHODS:At rest, urine samples were collected from three groups: group A, 16 patients with critical ischemia; group B, 22 patients with stable intermittent claudication; and...
journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:2003-04-01 00:00:00
abstract::An adaptable on-line computer system for entry, retrieval, and analysis of medical discharge summaries has been developed and applied in the Trauma Service of a busy city hospital. Each summary occupied 5 to 10 minutes of the physician's time and compared favorably in cost to the standard dictated summary. While the a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90049-0
更新日期:1976-08-01 00:00:00
abstract:BACKGROUND:The upper thigh is an alternative but infrequently used site to the forearm for placement of subcutaneous polytetrafluoroethylene (PTFE) arteriovenous conduits in patients requiring hemodialysis for end stage renal failure. This site has the great advantage of easier accessibility for self-cannulation. METH...
journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:1997-04-01 00:00:00
abstract::The dose response curves for acid and pepsin output to increasing intravenous doses of pentagastrin (0.01, 0.02, 2, 8, and 16 micrograms/kg per hour) were determined in six male patients with duodenal ulcer and six with type 1 corporeal gastric ulcer before and 3 to 6 months after selective proximal vagotomy and excis...
journal_title:American journal of surgery
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更新日期:1985-11-01 00:00:00
abstract::Microvascular free tissue transfer has provided a variety of methods of restoring vascularized bone and soft tissue to difficult defects created by tumor resection and trauma. Over 7 years, 26 patients have undergone 28 free flaps for mandibular reconstruction, 15 for primary squamous cell carcinoma of the floor of th...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80550-1
更新日期:1990-10-01 00:00:00