Abstract：
:The purpose of this research was to assess reliability and construct validity of the objective structured clinical examination (OSCE) for evaluating the clinical skills of surgical residents. Reliability refers to precision of the examination and construct validity to the degree to which the examination can discriminate between different levels of training. Twenty-seven second postgraduate year surgical residents took a 38-station OSCE representing seven surgical specialties and that tested history-taking, physical examination, problem-solving, technical skills, and attitudes. A couplet methodology was used wherein a patient encounter was followed by written questions aimed at testing problem-solving and patient management capabilities. Thirty-six standardized patients were trained and 36 surgeons served as examiners marking from structured checklists. Overall reliability, Cronbach's alpha, was 0.89. Construct validity was examined by comparing the scores of the residents with those of a group of graduates of foreign medical schools applying for a "pre-internship" program. For 17 of 19 stations that both groups took, the residents performed significantly better (p less than 0.01). Individual station validity was significant for 32 of 38 stations (r = 0.36 to 0.82, p less than 0.05). The examinations took 3.83 hours at a cost of $5,293 (Canadian dollars). The OSCE has been shown to be a reliable method of assessing clinical skills of surgical residents, construct validity has been established, and inter-item validity confirmed. Reliabilities achieved exceed those traditionally required for both acceptance and promotion decisions.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Cohen R,Reznick RK,Taylor BR,Provan J,Rothman Adoi
10.1016/s0002-9610(06)80029-2subject
Has Abstractpub_date
1990-09-01 00:00:00pages
302-5issue
3eissn
0002-9610issn
1879-1883pii
S0002-9610(06)80029-2journal_volume
160pub_type
杂志文章abstract：BACKGROUND:The study investigates the relationship between motor coordination errors and total errors using a human factors framework. We hypothesize motor coordination errors will correlate with total errors and provide validity evidence for error tolerance as a performance metric. METHODS:Residents' laparoscopic ski...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.07.003
更新日期：2016-10-01 00:00:00
abstract：BACKGROUND:The purpose of this study is to compare outcomes of patients who become pregnant within the first year after surgery and those who delayed pregnancy until after 1 year after surgery. METHODS:A retrospective review was performed to identify patients who became pregnant after their gastric-bypass surgery from...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.08.041
更新日期：2006-12-01 00:00:00
abstract：BACKGROUND:Acellular dermal matrix (ADM) represents a promising new fascial substitute for repairing abdominal wall defects. METHODS:We retrospectively studied 63 patients who underwent fascial reconstruction with ADM and analyzed risk factors for recurrence and infectious wound complications. RESULTS:Postoperative w...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.11.019
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:Hemorrhage during hepatectomy remains the major cause of morbidity and mortality associated with this surgery. Traditionally, a Pringle technique is employed to reduce vascular inflow during parenchymal transection. METHODS:This paper describes a simple method to achieve unilateral vascular control during h...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00697-3
更新日期：2001-09-01 00:00:00
abstract：BACKGROUND:Mental skills training refers to the implementation of cognitive performance-enhancing strategies to promote optimal performance. We aimed to develop a surgery-specific mental skills curriculum (MSC) and obtain initial evidence of efficacy. METHODS:The developed MSC consisted of 8 proven performance-enhanci...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.06.027
更新日期：2017-02-01 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：BACKGROUND:The Limberg flap (LF) procedure is widely performed for the treatment of sacrococcygeal pilonidal sinus (SPS); however, recurrences continues to be observed. The aim of this study was to assess the relationship between LF designs and the risk of SPS recurrence. METHODS:Sixty-one cases with recurrent disease...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2017.02.008
更新日期：2017-11-01 00:00:00
abstract：BACKGROUND:Nipple discharge occurs in 2% to 5% of women. We evaluated the effectiveness of a previously proposed treatment algorithm for these patients. METHODS:Patients with pathologic nipple discharge and a negative mammogram and subareolar ultrasound were offered follow-up from 2005 to 2011 according to the algorit...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.035
更新日期：2014-08-01 00:00:00
abstract：BACKGROUND:Whether or not tumor response to chemotherapy-sensitized radiation therapy (CTRT) for head and neck cancer leads to an improved outcome is unknown. METHODS:Forty patients who received preoperative cisplatin plus simultaneous radiotherapy for operable stage III and IV head and neck cancer were reviewed retro...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00151-7
更新日期：1997-11-01 00:00:00
abstract：:A technique is described for salvage of looped forearm polytetrafluoroethylene (PTFE) vascular access grafts that fail because of thrombosis due to cephalic vein outflow obstruction. It entails reversal of blood flow direction through the graft and construction of a new venous outflow in the medial upper arm. This pro...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)91119-4
更新日期：1991-04-01 00:00:00
abstract：BACKGROUND:There is little evidence supporting or refuting clamping trials, a period of clamping thoracostomy tubes prior to removal. We sought to evaluate whether clamping trials reduce the need for subsequent pleural drainage procedures. METHODS:We conducted a retrospective cohort study of trauma patients who underw...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.01.007
更新日期：2020-08-01 00:00:00
abstract：BACKGROUND:The operative approach for esophageal cancer varies from simple palliative resection to extended esophagectomy with 3-field lymph-node dissection or en-bloc esophagectomy (EBE) depending on tumor and patient status and surgical strategy of the surgeon. The merits and demerits of such EBE are yet to be determ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2004.06.004
更新日期：2004-09-01 00:00:00
abstract：:Colonic and rectal anastomotic strictures occur with an incidence ranging from 3% to 30%. Several factors, such as defunctionalization, anastomotic leak, ischemia, radiation, and neoplasms, have been implicated in their pathogenesis. Management of large bowel strictures is generally based on their cause, location, and...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.02.030
更新日期：2008-04-01 00:00:00
abstract：:A case is reported of hypercalcemia persisting for seven years after kidney transplantation, with normocalcemia being achieved after subtotal parathyriodectomy. The finding of post-transplantation hyperparathyroidism of this extreme duration, in association with several other reports of hyperparathyroidism persisting ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90296-8
更新日期：1976-07-01 00:00:00
abstract：:Limb ischemia due to blunt trauma, dissecting hematoma, and cardiac dysfunction jeopardizes limbs and lives more than is generally appreciated. Delay in diagnosis after blunt trauma led to major amputation in 21 percent of our patients. Current principles avoid those hazards. Five patients presented with acute limb is...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90513-x
更新日期：1982-08-01 00:00:00
abstract：:Only 3 per cent of all melanomas arise in the mucosa of the head and neck region. Melanomas of mucosal origin in this series differed from their cutaneous counterpart in that size of the primary lesion did not influence prognosis. Regional lymph node metastases were infrequent and did not seem to influence prognosis. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90393-2
更新日期：1977-10-01 00:00:00
abstract：BACKGROUND:Prognosis in peritoneal carcinomatosis from gastric cancer has improved with cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy. The aim of this study was to identify predictive factors for incomplete CS. METHODS:Forty-five patients undergoing laparotomy for gastric cancer with periton...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.06.009
更新日期：2013-06-01 00:00:00
abstract：BACKGROUND:We previously reported on a pilot trauma multidisciplinary crisis resource course titled S.T.A.R.T.T. (Simulated Trauma and Resuscitative Team Training). Here, we study the course's evolution. METHODS:Satisfaction was evaluated by postcourse survey. Trauma teams were evaluated using the Ottawa global rating...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.07.024
更新日期：2016-07-01 00:00:00
abstract：:Nitric oxide (NO), a paracrine-acting gas enzymatically synthesized from L-arginine, is a unique biologic mediator that has been implicated in a myriad of physiologic and pathophysiologic states. It is an important regulator of vascular tone and may be the mediator of the hemodynamic changes involved in sepsis and cir...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(05)80017-0
更新日期：1995-09-01 00:00:00
abstract：:A technique for the repair of inguinal hernias in elderly patients with weak abdominal muscles has been presented. It consists of the overlapping of the flaps of the aponeurosis of the external oblique muscle according to the method previously proposed by Andrews. To date, the technique has given good results, even in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90419-1
更新日期：1983-09-01 00:00:00
abstract：:From 1972 to 1987, 403 patients underwent a composite resection consisting of segmental mandibulectomy and neck dissection for the treatment of bucco-pharynx squamous cell carcinoma (303 patients had postoperative radiotherapy [XRT], 29 patients had preoperative XRT, and 100 patients had tissue salvage performed after...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80350-2
更新日期：1993-10-01 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：BACKGROUND:The optimal surgery for patients with renal hyperparathyroidism has been controversial, as either subtotal parathyroidectomy (subtotal PTX) or total parathyroidectomy with auto-transplantation (total PTX-AT) may be employed. METHODS:Adult patients having subtotal PTX or total PTX-AT for secondary hyperparat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.07.018
更新日期：2017-11-01 00:00:00
abstract：:Fifty-two patients with ulcerative colitis and colorectal cancer undergoing colectomy at the Mount Sinai Hospital between 1973 and 1988 were studied retrospectively to determine the correlation of age, sex, duration of colitis, tumor location, number of cancers, tumor differentiation, colloid content, presence of sign...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80638-5
更新日期：1992-07-01 00:00:00
abstract：INTRODUCTION:The optimal duration of adjuvant endocrine therapy in early ER + breast cancer has been controversial. This article aims to provide an overview of the evidence. METHODS:A search of the literature was conducted via MEDLINE using appropriate keywords. Eligible studies were screened and relevant articles wer...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2018.07.052
更新日期：2019-01-01 00:00:00
abstract：BACKGROUND:The current trend in breast cancer treatment is toward breast conservation and selective use of axillary lymph node dissection. Patient eligibility criteria for treatment without axillary dissection are evolving. METHODS:We retrospectively reviewed the tumor registry over a 10-year period at Naval Medical C...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00249-8
更新日期：1996-11-01 00:00:00
abstract：:The accuracy of operative cholangiograms can be increased by radiomanometry. This study identified 17 patients among 198 studied whose choledocholiths would have likely been missed by routine cholangiography. These are almost invariably small stones the fate of which would be conjectural if left behind. In the present...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90305-1
更新日期：1977-12-01 00:00:00
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：BACKGROUND:Increased anesthesia time may lead to respiratory complications in patients receiving tracheostomy, which contributes to patient morbidity. METHODS:The American College of Surgeon's National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for cases of planned tracheostomy (CPT 31600) f...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.07.059
更新日期：2018-10-01 00:00:00
abstract：:Five patients with infected abdominal aortoiliac aneurysms were treated. The diagnosis was made preoperatively based upon fever, leukocytosis, positive blood culture findings, and presence of an aneurysm in all five patients. Two patients had salmonella species, two had staphylococcus species, and one had bacteroides ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80137-5
更新日期：1988-05-01 00:00:00
