Abstract:
BACKGROUND:Performance feedback or debriefing in surgery is increasingly recognized as an essential means to optimize learning in the operating room (OR). However, there is a lack of evidence regarding the current practice and barriers to debriefing in the OR. METHODS:Phase 1 consisted of semistructured interviews with surgical trainers and trainees to identify features of an effective debriefing and perceived barriers to debriefing. Phase 2 consisted of ethnographic observations of surgical cases to identify current practice and observed barriers to debriefing. RESULTS:Surgical trainers and trainees identified key features of effective debriefing with regard to the approach and content; however, these were not commonly identified in practice. Culture was recognized as a significant barrier to debriefing across both phases of the study. CONCLUSIONS:There is a disparity between what the surgical community views as effective debriefing and actual debriefing practices in the OR. Improvements to the current debriefing culture and practice within the field of surgery should be considered to facilitate learning from clinical practice.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Ahmed M,Sevdalis N,Vincent C,Arora Sdoi
10.1016/j.amjsurg.2013.01.007subject
Has Abstractpub_date
2013-04-01 00:00:00pages
434-40issue
4eissn
0002-9610issn
1879-1883pii
S0002-9610(13)00053-6journal_volume
205pub_type
杂志文章abstract:BACKGROUND:The increased utilization of expanded criteria kidney donors has necessitated the reevaluation of multiple donor risk factors to insure the best outcome from this valuable resource. Reports of decreased graft survival in recipients of kidneys from donors with > or =20% glomerular sclerosis (GS) have led many...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00502-x
更新日期:2000-12-01 00:00:00
abstract::Fifty-three patients with upper gastrointestinal bleeding and proven esophageal varices were treated by intravascular injection sclerotherapy of the varices using a mixture of ethanolamine oleate, bovine thrombin and cephalothin. An intraesophageal balloon was used to impede craniad flow during the injection. Except i...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90191-x
更新日期:1982-04-01 00:00:00
abstract:BACKGROUND:Portal vein embolization (PVE), proposed to induce contralateral hepatic hypertrophy before major hepatectomy, carries some negative side effects since growth rate of metastases in the future remnant liver (RL) can be more rapid than that of nontumoral liver parenchyma. Therefore, metastases in the RL should...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01373-9
更新日期:2003-03-01 00:00:00
abstract::An analysis of unsuccessful extractions of retained biliary calculi using basket catheters reveals more than half the failures are related to the selection, placement, and size of the T tube. A new T tube has been developed which will improve postoperative access to the common duct and facilitate removal of retained c...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90164-2
更新日期:1978-06-01 00:00:00
abstract:BACKGROUND:The underutilization of radiation therapy after breast-conserving surgery in early-stage breast cancer patients has been attributed to the inconvenience and potential side effects of whole-breast radiation treatment regimens. Accelerated partial-breast irradiation (APBI) involves twice-daily treatments more ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.06.024
更新日期:2016-07-01 00:00:00
abstract::The social, economic and political challenges accompanying our rapidly transforming global health environments have created unique social challenges that demand cross-sector solutions. Four cross-sector partnerships are reviewed with a special focus on sector roles, change management, phases of partnership development...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01143-1
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:The influence of blood transfusions in the risk of postoperative infection remains controversial. We examined the association between autologous (AB) and homologous (HB) blood transfusions with postoperative infection in elective surgery. METHODS:The medical records of 991 Medicare patients aged > or =65 ye...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00242-1
更新日期:1999-12-01 00:00:00
abstract::Radionuclide lymphograms provide invaluable preoperative information on many truncal melanomas of the skin that require elective regional lymph node dissection. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80138-0
更新日期:1985-05-01 00:00:00
abstract:BACKGROUND:Medical student mistreatment remains a concern, particularly in the surgery clerkship. This is a single academic institution's report of medical student perceptions of a mistreatment program embedded in the surgery clerkship. METHODS:Students who completed the surgery clerkship and the mistreatment program ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.01.001
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate graft patency and limb salvage rates for infrainguinal polytetrafluoroethylene (PTFE) bypass grafts using distal anastomotic Taylor vein patch in patients lacking suitable vein conduit. METHODS:We reviewed 44 patients who underwent infrainguinal bypass between Januar...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00791-7
更新日期:2001-12-01 00:00:00
abstract::Experience with 37 patients with adult colovesical fistula over the past 19 years is reviewed. Specific guidelines for treatment of adult colovesical fistula are influenced by the location and cause of the fistula, the patient's general condition, the presence of a pelvic abscess and the presence of colonic obstructio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90421-3
更新日期:1980-07-01 00:00:00
abstract::The results of surgical treatment for chronic pancreatitis at our clinic and in the eight leading institutions of Japan were reviewed in a total of 328 cases. Abdominal pain disappeared or was alleviated in about 90 percent of the patients who survived more than 6 months after operation. There was no significant diffe...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90338-x
更新日期:1981-09-01 00:00:00
abstract::The lifetime risk for developing thin (< or =1 mm) melanoma continues to increase steadily. Although generally associated with an excellent prognosis, it also has a proven capacity to metastasize. There has been increasing interest in using sentinel lymph node biopsy to improve staging for thin melanoma. However, it i...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2005.05.011
更新日期:2005-08-01 00:00:00
abstract::DVT involving the lower extremities is a frequent (25-40 percent of patients) complication of major thoracic, abdominal, and pelvic surgery in patients beyond the age of 40 years. Herein, we have reported a recently completed large prospective, randomized multicenter investigation of the prophylaxis of postoperative D...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1985-10-08 00:00:00
abstract:BACKGROUND:Arizona has no organized statewide trauma system. We looked at the 1997 and the 1998 Uniform Hospital Discharge Data Set (UHDDS) for the State of Arizona, and examined the trauma mortality data at both trauma hospitals and nontrauma hospitals. METHODS:All qualifying mortalities based on hospital data from 1...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00807-8
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Peritoneal macrophages play an important role in the immune response after abdominal operations. The stress response after these operations has been associated with impaired phagocytosis by peritoneal macrophages. This study examined the influence of minimally invasive techniques and preoperative corticoster...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.07.023
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:Chest wall recurrence (CWR) in the setting of previous mastectomy and breast reconstruction can pose complex management dilemmas for clinicians. We examined the impact of breast reconstruction on the treatment and outcomes of patients who subsequently developed a CWR. METHODS:Between 1988 and 1998, 155 brea...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.11.006
更新日期:2004-02-01 00:00:00
abstract::The records of patients treated for upper gastrointestinal bleeding from 1974 through 1978 were reviewed. Five percent of this group (69 patients) had bleeding due to the Mallory-Weiss syndrome. Only 36 percent of patients had a correct admitting diagnosis. Esophagogastroscopy proved the most reliable diagnostic tool,...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90425-6
更新日期:1981-11-01 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::Common duct stones retained after choledocholithotomy were removed in 11 patients under intravenous sedation using the Olympus fiberoptic choledochoscope passed through a T-tube tract. A total of 39 stones were removed during 12 procedures, with one patient requiring 2 procedures for complete stone removal. All common...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90332-3
更新日期:1980-04-01 00:00:00
abstract::Serum transferrin is an important protein used to assess visceral protein status in patients requiring nutritional support. Since serum transferrin assays are not readily available in all institutions and there is a correlation between the serum transferrin level and TIBC, Blackburn's formula to compute the serum tran...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90337-4
更新日期:1984-11-01 00:00:00
abstract::A procedure of tape-guided living donor left hepatectomy is described. A tape was placed along the anterior wall of the inferior vena cava for left liver with caudate lobe, and along Arantius' ligament for left liver without caudate lobe. The final step of liver transection was applied by dividing the liver parenchyma...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.09.044
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:The treatment for a contralateral breast cancer (CBC) presents a growing dilemma given the expanding number of long-term survivors. We hypothesize that there will be specific surgical treatment trends with demographic differences between the treatment groups. METHODS:The Surveillance, Epidemiology, and End ...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2014.05.010
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:An assessment was made of the change and the effect of a histamine H(2)-receptor blocker (H(2)-blocker) or omeprazole on gastric pH after surgery. METHODS:Eighty patients who underwent colon resection for colorectal cancer were divided into groups of 20. Group I received neither H(2)-blocker nor omeprazole....
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.2002.10.002
更新日期:2004-01-01 00:00:00
abstract:PURPOSE:Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for full-thickness excision of benign and malignant rectal neoplasms located 4 to 24 cm above the anal verge. Entrance into the peritoneal cavity during TEM has been regarded as a complication that mandates conversion to open laparotomy f...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.01.004
更新日期:2004-05-01 00:00:00
abstract::Though morbidity and mortality rates following pancreatic resection have improved in recent years, they are still around 35% and 5%, respectively. Typical complications, such as pancreatic fistula, abscess, and subsequent sepsis, are chiefly associated with exocrine pancreatic secretion. In order to clarify whether th...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/0002-9610(92)90264-r
更新日期:1992-01-01 00:00:00
abstract::In this 6-year study of 101 limbs requiring surgical intervention for upper-extremity vascular trauma, most patients were male, young, and injured by penetrating objects. Injured vessels included 13 axillary/subclavian, 23 brachial, 40 radial, and 25 ulnar arteries. Concomitant injuries included nerve injury in 50 cas...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80313-7
更新日期:1990-08-01 00:00:00
abstract:BACKGROUND:Mesenteric vein thrombosis (MVT) is an uncommon type of intestinal ischemia associated with significant mortality and morbidity because of its delay in diagnosis. METHODS:A retrospective analysis of 9 patients treated surgically for MVT during 1982 to 1997 was performed. RESULTS:Nine patients underwent sur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00532-8
更新日期:2001-01-01 00:00:00
abstract::The difficulties created by an unsuccessful initial operation can usually be avoided by choosing experienced surgeons, identifying four glands, and selectively excising grossly abnormal parathyroid tissue. Patients with multiple endocrine adenomatosis or familial hyperparathyroidism should have a subtotal parathyroide...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90412-3
更新日期:1982-10-01 00:00:00
abstract:BACKGROUND:Breast cancer in a young person is considered by many to be a rare and very aggressive disease. Theories regarding the aggressiveness of the disease are varied. This study was undertaken in an attempt to help formulate guidelines regarding screening for and treatment of breast cancer in the young patient. P...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80007-8
更新日期:1995-09-01 00:00:00