Abstract:
BACKGROUND:Teaching professionalism effectively to fully engaged residents is a significant challenge. A key question is whether the integration of professionalism into residency education leads to a change in resident culture. METHODS:The goal of this study was to assess whether professionalism has taken root in the surgical resident culture 3 years after implementing our professionalism curriculum. Evidence was derived from 3 studies: (1) annual self-assessments of the residents' perceived professionalism abilities to perform 20 defined tasks representing core Accrediting Council on Graduate Medical Education professionalism domains, (2) objective metrics of their demonstrated professionalism skills as rated by standardized patients annually using the objective structure clinical examination tool, and (3) a national survey of the Surgical Professionalism and Interpersonal Communications Education Study Group. RESULTS:Study 1: aggregate perceived professionalism among surgical residents shows a statistically significant positive trend over time (P = .016). Improvements were seen in all 6 domains: accountability, ethics, altruism, excellence, patient sensitivity, and respect. Study 2: the cohort of residents followed up over 3 years showed a marked improvement in their professionalism skills as rated by standardized patients using the objective structure clinical examination tool. Study 3: 41 members of the national Surgical Professionalism and Interpersonal Communications Education Study Group rated their residents' skills in admitting mistakes, delivering bad news, communication, interdisciplinary respect, cultural competence, and handling stress. Twenty-nine of the 41 responses rated their residents as "slightly better" or "much better" compared with 5 years ago (P = .001). Thirty-four of the 41 programs characterized their department's leadership view toward professionalism as "much better" compared with 5 years ago. CONCLUSIONS:All 3 assessment methods suggest that residents feel increasingly prepared to effectively deal with the professionalism challenges they face. Although professionalism seminars may have seemed like an oddity several years ago, residents today recognize their importance and value their professionalism skills. As importantly, department chairpersons report that formal professionalism education for residents is viewed more favorably compared with 5 years ago.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Hochberg MS,Berman RS,Kalet AL,Zabar SR,Gillespie C,Pachter HL,Surgical Professionalism and Interpersonal Communications Education Study Group.doi
10.1016/j.amjsurg.2011.05.007subject
Has Abstractpub_date
2012-01-01 00:00:00pages
14-20issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(11)00426-0journal_volume
203pub_type
杂志文章abstract:PURPOSE:The Integrated Procedural Performance Instrument (IPPI) consists of clinical scenarios in which bench-top models are positioned to simulated patients. Trainees are required to perform technical skills while engaging with the patient. The purpose of this study was to determine whether an IPPI format examination ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.08.011
更新日期:2009-01-01 00:00:00
abstract::Seventeen cases of carcinoma of the stomach occurring late after previous gastric operation are presented. In all instances, patients had undergone gastroenterostomy, with or without gastric resection. Most patients had undergone the initial operation for peptic ulcer disease an average of 18 years before presenting w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90145-8
更新日期:1981-04-01 00:00:00
abstract::The results of aggressive surgical treatment of primary lip cancer and advanced and recurrent carcinoma of the lip are illustrated and discussed. Early detection of involved lymph nodes before capsular penetration occurs and careful and complete dissection of the submental and submandibular regions are advocated as po...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90326-3
更新日期:1976-10-01 00:00:00
abstract::A 2.5 kg thoracopagus (Siamese) twin and a 0.73 kg premature newborn developed systemic candidiasis and were treated with intravenous miconazole. The conjoined twin was in a state of severe metabolic acidosis, respiratory distress, jaundice, anuria, abdominal distension, and shock. The 0.73 kg premature infant was als...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90349-0
更新日期:1979-11-01 00:00:00
abstract:BACKGROUND:Extended release LCP-tacrolimus (LCPT) allows once-daily dosing in transplant recipients. The improved bioavailability may be beneficial for simultaneous pancreas-kidney recipients (SPK). METHODS:This is a study of 39 SPK recipients on standard immediate-release tacrolimus (IR-TAC, n = 21) or LCPT (n = 18)....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.02.027
更新日期:2020-04-01 00:00:00
abstract::In the present study, the incidence of severe brain injury was 600 percent higher for patients riding without a helmet and the incidence of all brain injuries was nearly twice as high in the nonhelmeted riders. All surviving patients with severe brain injury sustained residual long-term disability. The incidence of in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80151-x
更新日期:1988-05-01 00:00:00
abstract::Gut glutamine utilization after massive small bowel resection was studied to gain further insight into the alterations and adaptations in intestinal glutamine metabolism that occur during the development of post-resectional hyperplasia. After resection of the middle 60% of the small intestine in the rat, gut glutamine...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80603-8
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:The effect of sex on fine-needle aspiration (FNA) diagnosis of thyroid cancer remains unknown. This study determines the reliability of FNA when evaluating thyroid nodules ≥4 cm in women and men. METHODS:Prospectively collected data of 1,068 patients who underwent FNA and thyroidectomy at a tertiary medical...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.04.001
更新日期:2013-11-01 00:00:00
abstract::Severe fasting hypoglycemia and hypoinsulinemia occurred in a sixty-six year old woman with an intrahepatic mesenchymal tumor. An extract from the tumor was potent in inhibiting the arginine-induced glucagon secretion from the isolated perfused porcine pancreas. This observation supports the theory recently advanced t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90095-8
更新日期:1978-02-01 00:00:00
abstract:BACKGROUND:In view of the indolent nature of most cancers of the thyroid, particularly of the papillary and follicular variety, the decision to remove a segment of the upper aerodigestive tract when the cancer is either close to or invading this area is a difficult one. It was felt relevant to review the experience at ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80136-9
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:Laparoscopic parastomal hernia repair can be technically challenging. We herein present a simplified technique of laparoscopic parastomal hernia repair. METHODS:This technique entails fixation of the rolled mesh to the anterior abdominal wall before unfolding it, each side of the mesh is unfolded and fixed ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.06.034
更新日期:2008-09-01 00:00:00
abstract:PURPOSE:To provide an algorithm for the management of hepatic cysts through an analysis of our series over 16 years. METHOD:We reviewed the surgical management and outcome of patients with hepatic cysts between 1984 and 2000 at a single institution. Data were collected by chart review, telephone interview, and follow-...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00611-0
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to analyze the influence of age on both the risk of hepatectomy and the prognosis in patients with hepatocellular carcinoma (HCC). METHODS:Patients undergoing an initial hepatectomy for HCC were classified into 2 age groups: 75 years or over (n = 113) and less than 75 years (n ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.05.026
更新日期:2015-04-01 00:00:00
abstract::Histologic material from 42 cases diagnosed as gastric lymphoma at Hartford Hospital was reviewed, confirming the diagnosis in 37. Three cases of pseudolymphoma were found. The incidence of gastric lymphoma has increased steadily over the past 50 years: 35 percent of cases occurred during the past decade. Most patient...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90194-5
更新日期:1982-04-01 00:00:00
abstract::A controlled prospective study was conducted to compare the results of kidney preservation and transplantation in regard to the type of perfusate used for perfusion preservation. Cryoprecipitated plasma, plasma protein fraction and serum albumin solution were used as perfusate. Between February 1979 and July 1980, 176...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9610(81)90137-9
更新日期:1981-04-01 00:00:00
abstract:BACKGROUND:Many trauma surgeons and trauma centers use routine exploration of Gerota's fascia (GE) for renal gunshot wounds (RGSW). The purpose of this study was to assess whether RGSW can be selectively explored for patients who undergo exploratory laparotomy. METHODS:Retrospective 10-year review of all patients who ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.09.023
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:The results and advantages of laparoscopic cholecystectomy in the geriatric population have received minimal attention. Several early reports related high conversion rates complications and mortality. This case series review is focused on the results of laparoscopic cholecystectomy in the geriatric populatio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.11.031
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Randomized controlled trials have shown equivalent outcomes for laparoscopic-assisted colectomy (LAC) and open colectomy (OC) when performed by well-trained surgeons experienced in both techniques. Our goal was to evaluate the outcomes of LAC at a population level. METHODS:Using the prospectively collected ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.11.015
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Increased surgical workforce diversity diminishes health disparities. METHODS:Researchers recruited and nonrandomly enrolled participants into intervention and comparison groups for a quasi-experimental study of the impact of a seminar course on student exposure to diverse mentorship and service through sur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.07.031
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:The efficacy of antibiotics in appendicitis remains controversial, and physicians are not confident in prescribing antibiotics as the first line treatment. This network meta-analysis was conducted to assess the efficacy and safety of individual antibiotics in uncomplicated appendicitis. METHODS:Randomized c...
journal_title:American journal of surgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.amjsurg.2018.10.009
更新日期:2019-07-01 00:00:00
abstract::Abdominal muscular contractions may have a protective influence against the development of indirect inguinal hernia. A portion of the transversus abdominus muscles acts on the internal inguinal rings and produces a closure mechanism during voluntary abdominal muscular activity. It follows, therefore, that injury or in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90108-8
更新日期:1982-03-01 00:00:00
abstract::Transplantation of adult kidneys into very small children is not performed in most centers because of concerns regarding the technical difficulty of the procedure. Advantages of the procedure include the possibility of living related donor transplantation and the increased availability of adult donor kidneys as compar...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90071-5
更新日期:1983-02-01 00:00:00
abstract:BACKGROUND:Variable results regarding general surgery residency program (GSRP) impact on patient outcomes and charges are reported. The aim of this study was to determine any significant differences in patient outcomes and cost with a new GSRP. METHODS:We analyzed all laparoscopic appendectomies (lap-ap), cholecystect...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.11.016
更新日期:2017-07-01 00:00:00
abstract::Percentage and levels of circulating T-lymphocytes were studied in forty-six patients with squamous cell carcinoma of the head and neck before and/or after treatment and compared with control values obtained in fifty-one healthy volunteers. Mean percentages of circulating T-cells and mean T-cell levels in cancer patie...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90481-x
更新日期:1975-10-01 00:00:00
abstract:BACKGROUND:Primary hyperparathyroidism (HPT) is an undertreated disease. This study's purpose is to determine if the calcium levels correlate with prevalence of symptoms and surgical treatment in patients with primary HPT. METHOD:Patients treated in 2006-2015 with serum calcium≥10.0 mg/dL and PTH>65 pg/mL were identif...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.09.010
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:To evaluate if laparoscopic adrenalectomy (LA) has changed the indications for adrenalectomy. METHODS:Retrospective analysis of patients with adrenal lesions referred from 1992 to 2004. Patients were divided into 2 groups, those before and those after the introduction of LA. RESULTS:One hundred eighty pati...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.02.003
更新日期:2005-05-01 00:00:00
abstract::Between September 1982 and April 1988, 60 cirrhotic patients with prior variceal hemorrhage were randomized to undergo the placement of an elective shunt (distal splenorenal: 26; nonselective: 4) or long-term endoscopic sclerotherapy (n = 30). Eighty-six percent of patients had alcoholic cirrhosis, and 33% were classi...
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/s0002-9610(05)80400-3
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:The role of stereotactic fine-needle aspiration cytology (SFNAC) in the diagnosis of nonpalpable breast lesions is poorly defined. PATIENTS AND METHODS:Data were prospectively collected from 225 consecutive patients with nonpalpable breast lesions who had aspiration cytology followed by immediate surgical e...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(05)80116-3
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:This study aims to test associations between perioperative blood transfusion and postoperative morbidity and mortality after major abdominal operations. METHODS:The 2014 ACS NSQIP dataset was queried for all patients who underwent one of the ten major abdominal operations. Separate multivariable regression ...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2018.02.015
更新日期:2018-09-01 00:00:00
abstract::The traditional treatment of pneumothorax has been with a chest tube and hospitalization. A series of 35 patients with 41 pneumothoraces treated on an outpatient basis is presented here. A no. 12 chest tube connected to a Heimlich valve led to successful treatment in 88 percent of the cases. Failure of treatment requi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(81)80006-2
更新日期:1981-07-01 00:00:00