Validation of the simulated ward environment for assessment of ward-based surgical care.


OBJECTIVE:To assess the feasibility of developing a simulated ward environment in which to assess the ward-based care of surgical patients by clinicians of varying levels of experience (construct validation). BACKGROUND:Increasing evidence points to the importance of the postoperative or ward-based phase of surgical care in determining patient outcomes. Ward-based care is determined by the clinician ward round, with the simulated ward environment potentially providing a safe environment for training and assessment. METHODS:A high-fidelity surgical ward environment was developed. Junior and senior trainees conducted ward rounds of 3 standardized surgical patients and were assessed using a checklist of assessment and management care processes, modified NOTECHS score, and fidelity questionnaire. RESULTS:Nine senior and 9 junior trainees were observed. There was no significant difference in time taken to conduct the round (37.6 ± 2.7 vs 32.6 ± 1.9 minutes, P = 0.16). Senior trainees performed significantly more assessment processes (73% ± 2.8% vs 63% ± 2.5%, P = 0.016) and completed more management tasks (73% ± 4.5% vs 59.4% ± 5%, P = 0.058). Fifteen adverse events were committed by junior trainees versus 8 by seniors (P < 0.001). Seniors scored higher on nontechnical ability (NOTECHS score 21.8 ± 0.61 vs 18.1 ± 1.12, P = 0.017). All of subjects felt the ward, patients, and scenarios were realistic. CONCLUSIONS:A high-fidelity, immersive, construct-valid ward simulator has been developed in which to observe and assess ward-based processes of surgical care.


Ann Surg


Annals of surgery


Pucher PH,Aggarwal R,Srisatkunam T,Darzi A




Has Abstract


2014-02-01 00:00:00












  • Results of omental flap transposition for deep sternal wound infection after cardiovascular surgery.

    abstract:OBJECTIVE:Our experience with omental flap transposition in the treatment of deep sternal wound infections is reviewed here with an emphasis on efficacy, risk factors for in-hospital mortality rates, and long-term results. SUMMARY BACKGROUND DATA:Even with improvements in muscle and omental flap transposition, the tim...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Yasuura K,Okamoto H,Morita S,Ogawa Y,Sawazaki M,Seki A,Masumoto H,Matsuura A,Maseki T,Torii S

    更新日期:1998-03-01 00:00:00

  • Liver transplantation for nonresectable liver metastases from colorectal cancer.

    abstract:OBJECTIVE:The objective of this pilot study was to investigate the potential for long-term overall survival (OS) after liver transplantation for colorectal liver metastases (CLMs). BACKGROUND:Patients with nonresectable CLMs have poor prognosis, and few survive beyond 5 years. CLMs are currently considered an absolute...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章


    authors: Hagness M,Foss A,Line PD,Scholz T,Jørgensen PF,Fosby B,Boberg KM,Mathisen O,Gladhaug IP,Egge TS,Solberg S,Hausken J,Dueland S

    更新日期:2013-05-01 00:00:00

  • Isolated tumor cells are frequently detectable in the peritoneal cavity of gastric and colorectal cancer patients and serve as a new prognostic marker.

    abstract:OBJECTIVE:To evaluate the prognostic significance of isolated tumor cells detected by a panel of various monoclonal antibodies. SUMMARY BACKGROUND DATA:Previously, we showed by using immunocytology that cancer cells are frequently found in bone marrow and peritoneal cavity samples of gastrointestinal cancer patients. ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Schott A,Vogel I,Krueger U,Kalthoff H,Schreiber HW,Schmiegel W,Henne-Bruns D,Kremer B,Juhl H

    更新日期:1998-03-01 00:00:00

  • Pancreatogastrostomy Versus Pancreatojejunostomy for RECOnstruction After PANCreatoduodenectomy (RECOPANC, DRKS 00000767): Perioperative and Long-term Results of a Multicenter Randomized Controlled Trial.

    abstract:OBJECTIVES:To assess pancreatic fistula rate and secondary endpoints after pancreatogastrostomy (PG) versus pancreatojejunostomy (PJ) for reconstruction in pancreatoduodenectomy in the setting of a multicenter randomized controlled trial. BACKGROUND:PJ and PG are established methods for reconstruction in pancreatoduod...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Keck T,Wellner UF,Bahra M,Klein F,Sick O,Niedergethmann M,Wilhelm TJ,Farkas SA,Börner T,Bruns C,Kleespies A,Kleeff J,Mihaljevic AL,Uhl W,Chromik A,Fendrich V,Heeger K,Padberg W,Hecker A,Neumann UP,Junge K,Kalff

    更新日期:2016-03-01 00:00:00

  • Impact of hospital volume on recurrence and survival after surgery for gastric cancer.

    abstract:BACKGROUND:Some, but not all, studies using registry data have suggested a small but significant long-term survival advantage following a curative surgical resection of gastric cancer at hospitals where the volume of such surgeries is high. However, because such data may be significantly influenced by the impact of pos...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验


    authors: Enzinger PC,Benedetti JK,Meyerhardt JA,McCoy S,Hundahl SA,Macdonald JS,Fuchs CS

    更新日期:2007-03-01 00:00:00

  • Aggressive resection of metastatic disease in selected patients with malignant gastrinoma.

    abstract::Fifteen patients with Zollinger-Ellison syndrome followed at the National Institutes of Health with extensive metastatic disease had an actuarial 5-year survival of 20%. Therefore, in 1982 a prospective study to examine the effect and feasibility of removing all gross tumor in selected patients with extensive metastat...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Norton JA,Sugarbaker PH,Doppman JL,Wesley RA,Maton PN,Gardner JD,Jensen RT

    更新日期:1986-04-01 00:00:00

  • Extended local resection for advanced gastric cancer: increased survival versus increased morbidity.

    abstract:OBJECTIVE:To characterize factors predictive of improved survival following gastrectomy with additional organ resection for the treatment of gastric cancer. SUMMARY BACKGROUND DATA:Recent large series have reported significant survival disadvantages to patients who have undergone gastrectomy with splenectomy or pancre...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Martin RC 2nd,Jaques DP,Brennan MF,Karpeh M

    更新日期:2002-08-01 00:00:00

  • Benefit-risk balance of reoperation for persistent medullary thyroid cancer.

    abstract:OBJECTIVE:This investigation aimed at exploring the prospects of a cure for persistent medullary thyroid cancer (MTC) stratified by basal calcitonin levels before reoperation and the number of lymph node metastases previously removed at outside facilities. BACKGROUND:There is no evidence-based information supporting t...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Machens A,Dralle H

    更新日期:2013-04-01 00:00:00

  • Use of radionuclide imaging in the early diagnosis and treatment of renal allograft rejection.

    abstract::Data are presented on the clinical application of radionuclide imaging to evaluate changes in cadaver transplant function in the immediate postoperative period. The method uses orthoiodohippuric acid (hippuran) administered IV, with scintillation imaging, and curve analysis by a digital computer. An initial study is a...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Mandel SR,Mattern WD,Staab E,Johnson G Jr

    更新日期:1975-05-01 00:00:00

  • Definitive surgical treatment of infected or exposed ventral hernia mesh.

    abstract:OBJECTIVE:To discuss the difficulties in dealing with infected or exposed ventral hernia mesh, and to illustrate one solution using an autogenous abdominal wall reconstruction technique. SUMMARY BACKGROUND DATA:The definitive treatment for any infected prosthetic material in the body is removal and substitution. When ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Szczerba SR,Dumanian GA

    更新日期:2003-03-01 00:00:00

  • Is competency assessment at the specialist level achievable? A study for the national training programme in laparoscopic colorectal surgery in England.

    abstract:OBJECTIVES:To develop, validate, and implement a competency assessment tool (CAT) for technical surgical performance in the context of a summative assessment process for the National Training Programme in Laparoscopic Colorectal Surgery (NTP). BACKGROUND:The NTP is an educational initiative by the National Cancer Acti...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Miskovic D,Ni M,Wyles SM,Kennedy RH,Francis NK,Parvaiz A,Cunningham C,Rockall TA,Gudgeon AM,Coleman MG,Hanna GB,National Training Programme in Laparoscopic Colorectal Surgery in England.

    更新日期:2013-03-01 00:00:00

  • Intermittent Pneumatic Compression in Addition to Standard Prophylaxis of Postoperative Venous Thromboembolism in Extremely High-risk Patients (IPC SUPER): A Randomized Controlled Trial.

    abstract:OBJECTIVE:To assess the efficacy of adjunctive IPC to standard prophylaxis of postoperative VTE in patients at extremely high-risk. SUMMARY OF BACKGROUND DATA:The standard prophylaxis for postoperative VTE is insufficient in extremely high-risk patients. It is unclear whether an adjunctive use of IPC would result in a...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Lobastov K,Sautina E,Alencheva E,Bargandzhiya A,Schastlivtsev I,Barinov V,Laberko L,Rodoman G,Boyarintsev V

    更新日期:2020-11-12 00:00:00

  • Accelerated wound healing with stapled enteric suture lines. An experimental study comparing traditional sewing techniques and a stapling device.

    abstract::The healing of 3-cm longitudinal colotomies closed with either Czerny-Lembert suture lines (CLSL) or TA-30 staple lines (SSL) were studied in 28 mongrel dogs using bursting strength (BS) measurements. Dogs from each group were sacrificed on postoperative days (POD) 1 through 7. Mean BS for the SSL in all 14 dogs was 1...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Ballantyne GH,Burke JB,Rogers G,Lampert EG,Boccia J

    更新日期:1985-03-01 00:00:00

  • Is ambulatory laparoscopic Roux-en-Y gastric bypass associated with higher adverse events?

    abstract:OBJECTIVE:To determine the impact of length of stay upon 30-day outcomes. BACKGROUND:It has been recommended the goal length of stay (LOS) after laparoscopic Roux-en-Y gastric bypass (LRYGB) should be 1 day to improve resource utilization. This study's aim was to assess LRYGB outcomes by LOS. METHODS:Data were obtain...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Morton JM,Winegar D,Blackstone R,Wolfe B

    更新日期:2014-02-01 00:00:00

  • Human umbilical veins and autogenous veins as canine arterial bypass grafts.

    abstract::Glutaraldehyde treated human umbilical veins (Dardik Biograft) were used to bypass short segments of the femoral artery in 15 dogs and were compared to autogenous jugular veins placed in the contralateral femoral artery of each animal. All 15 autogenous jugular veins remained patent for the four month period of observ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Oblath RW,Buckley FO Jr,Donnelly WA,Green RM,Deweese JA

    更新日期:1978-08-01 00:00:00

  • Molecules, cancer, and the surgeon. A review of molecular biology and its implications for surgical oncology.

    abstract::Interactions between molecules control intra- and intercellular physiology. Cancer is emerging as a disease in which individual molecules are either overproduced, mutated, expressed at inappropriate stages of development, or lost due to inheritance or aberrant mitotic division. The major players in this contest of cel...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审


    authors: Arbeit JM

    更新日期:1990-07-01 00:00:00

  • Reversal of mortality for congenital diaphragmatic hernia with ECMO.

    abstract::Extracorporeal Membrane Oxygenation (ECMO) has been available to neonates with respiratory failure at the University of Michigan School of Medicine since June 1981. In order to evaluate the impact of this type of pulmonary support, a retrospective analysis of 50 neonates with posterolateral congenital diaphragmatic he...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审


    authors: Heiss K,Manning P,Oldham KT,Coran AG,Polley TZ Jr,Wesley JR,Bartlett RH

    更新日期:1989-02-01 00:00:00

  • Surgical adverse outcomes in patients with schizophrenia: a population-based study.

    abstract:OBJECTIVE:To validate the global features of postoperative adverse outcomes for surgical patients with schizophrenia. BACKGROUND:Patients with schizophrenia were known to have a higher risk of complications during hospitalization. Quality of care has become the key factor in reducing their potential mortality afterwar...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究


    authors: Liao CC,Shen WW,Chang CC,Chang H,Chen TL

    更新日期:2013-03-01 00:00:00

  • Going the Extra Mile: Improved Survival for Pancreatic Cancer Patients Traveling to High-volume Centers.

    abstract:OBJECTIVE:This study compares outcomes following pancreaticoduodenectomy (PD) for patients treated at local, low-volume centers and those traveling to high-volume centers. BACKGROUND:Although outcomes for PD are superior at high-volume institutions, not all patients live in proximity to major medical centers. Theoreti...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Lidsky ME,Sun Z,Nussbaum DP,Adam MA,Speicher PJ,Blazer DG 3rd

    更新日期:2017-08-01 00:00:00

  • Assessing risk in liver transplantation. Special reference to the significance of a positive cytotoxic crossmatch.

    abstract:OBJECTIVE:The authors determined the impact of a positive cytotoxic crossmatch on the outcome of liver transplantation. SUMMARY BACKGROUND DATA:Liver allografts rarely undergo hyperacute rejection, but transplants performed across a positive cytotoxic crossmatch tend to follow a different clinical course, with higher ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Doyle HR,Marino IR,Morelli F,Doria C,Aldrighetti L,McMichael J,Martell J,Gayowski T,Starzl TE

    更新日期:1996-08-01 00:00:00

  • Sentinel node staging of resectable colon cancer: results of a multicenter study.

    abstract:OBJECTIVE AND SUMMARY BACKGROUND DATA:Sentinel lymph node (LN) sampling, a technique widely used to manage breast cancer and melanoma, seeks to select LNs that accurately predict regional node status and can be extensively examined to identify nodal metastatic disease not detected by standard histopathological staging....

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究


    authors: Bertagnolli M,Miedema B,Redston M,Dowell J,Niedzwiecki D,Fleshman J,Bem J,Mayer R,Zinner M,Compton C

    更新日期:2004-10-01 00:00:00

  • Local Recurrence and Breast Oncological Surgery in Young Women With Breast Cancer: The POSH Observational Cohort Study.

    abstract:OBJECTIVE:To assess clinical and surgical factors affecting local recurrence and survival in young breast cancer patients in the Prospective study of Outcomes in Sporadic versus Hereditary breast cancer (POSH). BACKGROUND:Emerging data suggest young age is a predictor of increased local recurrence. METHODS:POSH is a ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究


    authors: Maishman T,Cutress RI,Hernandez A,Gerty S,Copson ER,Durcan L,Eccles DM

    更新日期:2017-07-01 00:00:00

  • Clinical behavior and prognostic factors of periampullary adenocarcinoma.

    abstract:OBJECTIVE:The authors evaluated the outcome and potential prognostic factors of 60 patients with surgically resected periampullary tumors. SUMMARY BACKGROUND DATA:Periampullary carcinomas exhibit different clinical behaviors according to their site of origin. There are no prognostic factors for deciding the type of su...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Chan C,Herrera MF,de la Garza L,Quintanilla-Martinez L,Vargas-Vorackova F,Richaud-Patín Y,Llorente L,Uscanga L,Robles-Diaz G,Leon E

    更新日期:1995-11-01 00:00:00

  • Steroids in the treatment of clinical septic shock.

    abstract::A prospective (Part I) and a retrospective (Part II) study were used to determine the safety and efficacy of corticosteroids in the treatment of septic shock. In Part I, 172 consecutive patients in septic shock admitted over an 8-year period were treated with either steroid or saline: 43 received dexamethasone (DMP), ...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Schumer W

    更新日期:1976-09-01 00:00:00

  • Cytology of peritoneal lavage performed during staging laparoscopy for gastrointestinal malignancies: is it useful?

    abstract:OBJECTIVE:To evaluate the potential benefit of cytology of the peritoneal lavage obtained during diagnostic laparoscopy for staging gastrointestinal (GI) malignancies. SUMMARY BACKGROUND DATA:Peritoneal lavage is a simple procedure that can be performed during laparotomy for GI tumors. Tumor cells in the lavage fluid ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Nieveen van Dijkum EJ,Sturm PD,de Wit LT,Offerhaus J,Obertop H,Gouma DJ

    更新日期:1998-12-01 00:00:00

  • Early cholecystectomy for acute cholecystitis: a prospective randomized study.

    abstract::A randomized clinical trial was undertaken to compare early and delayed cholecystectomy for acute cholecystitis. Patients entering early (n = 83) or delayed (n = 82) surgery groups were comparable with regard to prerandomization data. One patient in the early group and five in the delayed group refused surgery (p < 0....

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Järvinen HJ,Hästbacka J

    更新日期:1980-04-01 00:00:00

  • The relationship between extent of thyroid cancer surgery and use of radioactive iodine.

    abstract:UNLABELLED:By linking surgeon surveys to the National Cancer Database, we found that surgeons' tendency to perform more extensive thyroid resection is associated with greater use of radioactive iodine for stage I thyroid cancer. OBJECTIVE:To determine the relationships between surgeon recommendations for extent of res...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Haymart MR,Banerjee M,Yang D,Stewart AK,Doherty GM,Koenig RJ,Griggs JJ

    更新日期:2013-08-01 00:00:00

  • Recurrent carotid artery stenosis following endarterectomy.

    abstract::Spectral analysis was used to examine 257 carotid arteries in 227 patients who had undergone carotid endarterectomy at 1, 3, 6, and 12 months after surgery and annually thereafter. Routine intraoperative completion angiography ensured that the operations were technically satisfactory. Postoperative restenoses were ide...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Thomas M,Otis SM,Rush M,Zyroff J,Dilley RB,Bernstein EF

    更新日期:1984-07-01 00:00:00

  • Improving continuing medical education for surgical techniques: applying the lessons learned in the first decade of minimal access surgery.

    abstract:OBJECTIVE:To examine the first decade of experience with minimal access surgery, with particular attention to issues of training surgeons already in practice, and to provide a set of recommendations to improve technical training for surgeons in practice. SUMMARY BACKGROUND DATA:Concerns about the adequacy of training ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审


    authors: Rogers DA,Elstein AS,Bordage G

    更新日期:2001-02-01 00:00:00

  • Incorporation of Procedure-specific Risk Into the ACS-NSQIP Surgical Risk Calculator Improves the Prediction of Morbidity and Mortality After Pancreatoduodenectomy.

    abstract:OBJECTIVE:This multicenter study sought to evaluate the accuracy of the American College of Surgeons National Surgical Quality Improvement Program's (ACS-NSQIP) surgical risk calculator for predicting outcomes after pancreatoduodenectomy (PD) and to determine whether incorporating other factors improves its predictive ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究


    authors: McMillan MT,Allegrini V,Asbun HJ,Ball CG,Bassi C,Beane JD,Behrman SW,Berger AC,Bloomston M,Callery MP,Christein JD,Dickson E,Dixon E,Drebin JA,Fernandez-Del Castillo C,Fisher WE,Fong ZV,Haverick E,Hollis RH,House MG

    更新日期:2017-05-01 00:00:00