A taxonomy of surgeons' guiding behaviors in the operating room.

Abstract:

BACKGROUND:This study explores the nature and the intention of attending surgeons' guiding behaviors performed in the operating room (OR) in order to build taxonomy of OR guiding behavior. METHODS:Nine attending surgeons and 8 surgical residents were invited to observe 8 prerecorded surgical cases from 4 common procedures and completed semistructured interviews. All video-based observations were videotaped. Thematic analysis was applied to identify surgeons' OR guiding behavior. RESULTS:Seven hundred eighty minutes of video-based observations with interviews were conducted. Sixteen types of OR guiding behaviors in 3 intention-based categories were identified: 3 of the 16 was "teaching" (18.75%), 8 of the 16 was "directing" (50%), and 5 of the 16 was "assisting" (31.25%). CONCLUSIONS:Surgeons' OR guiding behaviors were grounded in 3 behavioral intentions: teaching, directing, and assisting. This taxonomy of OR guiding behavior can be used as a basis for developing OR guiding strategy to improve residents' intraoperative competency, autonomy, and independence.

journal_name

Am J Surg

authors

Chen XP,Williams RG,Sanfey HA,Smink DS

doi

10.1016/j.amjsurg.2014.07.018

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

15-20

issue

1

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(14)00533-9

journal_volume

209

pub_type

杂志文章
  • Implications of peritoneal cytology for staging of early pancreatic cancer.

    abstract::Cytologic examination of peritoneal washings was performed in 40 patients with pancreatic ductal adenocarcinoma (35 head, 5 body) whose tumors had been selected as potentially resectable by computed tomographic (CT) findings. Saline (100 mL) was instilled and aspirated at laparoscopy in 27 patients and at laparotomy i...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(91)90356-i

    authors: Warshaw AL

    更新日期:1991-01-01 00:00:00

  • Impact of hospital volume on quality indicators for rectal cancer surgery in British Columbia, Canada.

    abstract:BACKGROUND:The relationship between hospital volume and patient outcomes remains controversial for rectal cancer. METHODS:This is a population-based database study. Patients treated with surgery for a stage I to III rectal adenocarcinoma from 2003 to 2009 were identified. High-volume hospitals (HVH) were those centers...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2016.07.007

    authors: McColl RJ,McGahan CE,Cai E,Olson R,Cheung WY,Raval MJ,Phang PT,Karimuddin AA,Brown CJ

    更新日期:2017-02-01 00:00:00

  • Endovascular treatment of abdominal aortic aneurysms.

    abstract:BACKGROUND:Endovascular treatment of abdominal aortic aneurysms is a rapidly evolving technique that has gained broad acceptance in the treatment of patients with abdominal aortic aneurysms. METHODS:A review of the English literature was done to determine the short- and long-term outcomes of endovascular repair of abd...

    journal_title:American journal of surgery

    pub_type: 杂志文章,评审

    doi:10.1016/j.amjsurg.2004.09.011

    authors: Towne JB

    更新日期:2005-02-01 00:00:00

  • The management of splenic artery aneurysms: experience with 23 cases.

    abstract:BACKGROUND:Splenic artery aneurysms (SAA) are rare clinical entities that carry the risk of rupture and fatal hemorrhage. They are being detected with increased frequency and often cause a clinical dilemma, particularly when small lesions occur in compromised patients. This paper relates our experience in the managemen...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/s0002-9610(99)80225-6

    authors: Mattar SG,Lumsden AB

    更新日期:1995-06-01 00:00:00

  • Should classification as an ACS-NSQIP high outlier be used to direct hospital quality improvement efforts?

    abstract:BACKGROUND:ACS-NSQIP classifies hospitals as "high outliers" if their performance is significantly worse than expected. We determined how often hospitals return to as-expected performance after being newly identified as outliers. METHODS:Outlier status was identified in ACS-NSQIP semi-annual reports (SARs) 2008-2011 f...

    journal_title:American journal of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.amjsurg.2017.07.026

    authors: Lawson EH,Roberts PL,Francone TD,Marcello PW,Read TE,Ricciardi R

    更新日期:2018-08-01 00:00:00

  • Partial stomach-partitioning gastrojejunostomy and the success of this procedure in terms of palliation.

    abstract:BACKGROUND:In the 1990s, partial stomach-partitioning gastrojejunostomy (PSPG) was introduced. Benefits of this method are that it preferentially shunts food away from the obstructed duodenum or pylorus, thus reducing reflex emesis. METHODS:A retrospective review of patients undergoing PSPG for malignant obstruction f...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2012.11.015

    authors: Arrangoiz R,Papavasiliou P,Singla S,Siripurapu V,Li T,Watson JC,Hoffman JP,Farma JM

    更新日期:2013-09-01 00:00:00

  • Surgical treatment of infected prosthetic dialysis arteriovenous grafts: total versus partial graft excision.

    abstract:BACKGROUND:Thirty-five percent of hemodialysis patients with polytetrafluoroethylene grafts lose their access secondary to infection. We hypothesized that partial graft excision (PGE) for infection increases the incidence of vascular anastomotic complications when compared with total graft excision (TGE). METHODS:The ...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2006.09.028

    authors: Schutte WP,Helmer SD,Salazar L,Smith JL

    更新日期:2007-03-01 00:00:00

  • The value of diverting loop ileostomy on the high-risk colon and rectal anastomosis.

    abstract:INTRODUCTION:The need for diverting loop ileostomies to protect high-risk anastomoses has been questioned recently by several authors. This study was designed to evaluate the potential benefits and complications of diverting loop ileostomies in a high-risk anastomosis population. METHODS:Ninety-four consecutive patien...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2007.01.005

    authors: Bax TW,McNevin MS

    更新日期:2007-05-01 00:00:00

  • Hepatobiliary scanning using 99mTc-pyridoxylideneglutamate.

    abstract::Technetium 99m-pyridoxylideneglutamate (99mTc-PG) administered intravenously is excreted by hepatocytes into the bile canaliculi and enters the gallbladder through the cystic duct and consequently, can be used for scanning the hepatobiliary ductal system. A total of 166 patients representing 27 normal subjects, 84 pat...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(77)90204-5

    authors: Matolo NM,Stadalnik RC,Wolfman EF Jr

    更新日期:1977-01-01 00:00:00

  • Morbidity and mortality of ostomy closure.

    abstract::Ostomy closure following the Hartmann procedure is perceived to be associated with higher morbidity and mortality rates than is ostomy closure following divided colostomy, loop colostomy, and divided ileostomy-colostomy so that ostomy closure after Hartmann procedure may be denied to certain patients. To test that per...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(91)90125-w

    authors: Mosdell DM,Doberneck RC

    更新日期:1991-12-01 00:00:00

  • Vascular complications of the intra-aortic balloon pump.

    abstract::The lower extremity complications of 100 consecutive patients who required the placement of an intra-aortic balloon pump (IABP) during a 3-year period were studied. Indications for the IABP included hypotension during cardiac catheterization (33%) or coronary angioplasty (13%), hemodynamic instability after open heart...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/s0002-9610(05)81192-4

    authors: Mackenzie DJ,Wagner WH,Kulber DA,Treiman RL,Cossman DV,Foran RF,Cohen JL,Levin PM

    更新日期:1992-11-01 00:00:00

  • Meckel's diverticulum: should it be excised incidentally at operation?

    abstract::Meckel's diverticulum is the most common congenital abnormality of the small intestine, occurring in about 2 per cent of the population. Complications of a Meckel's diverticulum, including hemorrhage, inflammation, bowel obstruction, and neoplasms, occur in 15 to 33 per cent of cases and invariably demand operative tr...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(75)90345-1

    authors: Michas CA,Cohen SE,Wolfman EF Jr

    更新日期:1975-06-01 00:00:00

  • Role of surgery in multimodality therapy for gastrointestinal lymphoma.

    abstract::Between 1973 and 1989, 49 patients with gastrointestinal lymphomas were treated at the Virginia Mason Medical Center, Seattle, Washington, and followed in the tumor registry. The purpose of this review was to determine the influence of treatment on long-term survival of these patients. The mean age was 63 years (range...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(91)90902-p

    authors: Rackner VL,Thirlby RC,Ryan JA Jr

    更新日期:1991-05-01 00:00:00

  • Early postoperative small bowel obstruction: A review.

    abstract::Early postoperative small bowel obstruction (ESBO) is a challenging problem. Although it is usually amenable to non-operative management, a significant proportion of patients will require re-operation. Certain causes of ESBO and types of index procedures should prompt consideration for early re-operation. A laparoscop...

    journal_title:American journal of surgery

    pub_type: 杂志文章,评审

    doi:10.1016/j.amjsurg.2019.11.008

    authors: Ong AW,Myers SR

    更新日期:2020-03-01 00:00:00

  • Robotic and hybrid robotic transversus abdominis release may be performed with low length of stay and wound morbidity.

    abstract::The objective of our study was to compare length of stay and wound complications after hybrid robotic transversus abdominis release (hrTAR) vs. robotic transversus abdominis release (rTAR) Two cohorts of patients undergoing robotic (rTAR) and hybrid robotic (hrTAR) performed by two surgeons at a single institution wer...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2017.10.053

    authors: Halka JT,Vasyluk A,DeMare AM,Janczyk RJ,Iacco AA

    更新日期:2018-03-01 00:00:00

  • Laparoscopic Roux-en-Y gastric bypass in morbidly obese and super morbidly obese patients.

    abstract:BACKGROUND:Our objective was to compare the outcomes after laparoscopic Roux-en-Y gastric bypass (RYGB) in morbidly obese (body mass index [BMI] <50) patients with super morbidly obese (BMI >50) patients. METHODS:A prospective analysis of 120 patients who underwent laparoscopic RYGB at a community based teaching hospi...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2003.08.017

    authors: Dresel A,Kuhn JA,McCarty TM

    更新日期:2004-02-01 00:00:00

  • Prospective study using skin staplers in head and neck surgery.

    abstract:BACKGROUND:A prospective trial was undertaken to investigate the advantages and disadvantages of stapled skin closure versus conventional nylon sutures in head and neck surgery. PATIENTS AND METHODS:The study included 20 consecutive patients who underwent extensive surgery in which their skin was closed with staples. ...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/s0002-9610(99)80327-4

    authors: dos Santos LR,Freitas CA,Hojaij FC,Araújo Filho VJ,Cernea CR,Brandão LG,Ferraz AR

    更新日期:1995-11-01 00:00:00

  • The utility of routine preoperative computed tomography scanning in the management of veterans with colon cancer.

    abstract:BACKGROUND:The aim of this study is to assess the clinical utility of routine preoperative computed tomography (CT) scanning in patients with cancer of the intraperitoneal colon. METHODS:From November 1997 to June 2001, all patients at VA Puget Sound Healthcare System with a diagnosis of colon cancer were referred for...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/s0002-9610(02)00841-3

    authors: Barton JB,Langdale LA,Cummins JS,Stelzner M,Lynge DC,Mock CN,Nason KS,Billingsley KG

    更新日期:2002-05-01 00:00:00

  • Clamping trials prior to thoracostomy tube removal and the need for subsequent invasive pleural drainage.

    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

    authors: Becker JC,Zakaluzny SA,Keller BA,Galante JM,Utter GH

    更新日期:2020-08-01 00:00:00

  • Needle aspiration of breast abscesses.

    abstract:BACKGROUND:Traditional treatment of breast abscesses involves incision and drainage, with and without ultrasound guidance. These procedures cause considerable discomfort and morbidity for the patient. This study was conducted to determine whether needle aspiration of breast abscesses without ultrasound guidance was an ...

    journal_title:American journal of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0002-9610(01)00683-3

    authors: Schwarz RJ,Shrestha R

    更新日期:2001-08-01 00:00:00

  • Evaluation of ultrasound-guided fine-needle aspiration biopsy for thyroid nodules.

    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

    pub_type: 杂志文章

    doi:10.1016/S0002-9610(97)00274-2

    authors: Hatada T,Okada K,Ishii H,Ichii S,Utsunomiya J

    更新日期:1998-02-01 00:00:00

  • Laparoscopic Hill repair in patients with abnormal motility.

    abstract:BACKGROUND:Gastroesophageal reflux is frequently associated with abnormal motility in the body of the esophagus. Concern for dysphagia has led surgeons to perform less competent procedures in this group, or to avoid surgery altogether. The current study was undertaken to evaluate our experience with the laparoscopic Hi...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/S0002-9610(96)00062-1

    authors: Aye RW,Mazza DE,Hill LD

    更新日期:1997-05-01 00:00:00

  • Feasibility, reliability and validity of a new assessment form for use with basic surgical trainees.

    abstract:BACKGROUND:To establish feasibility, reliability and validity of a newly designed basic surgical training (BST) assessment form. METHODS:The assessment form was evaluated among trainees on the South-east Scotland BST rotation over 18 months. Feasibility was indicated by response rate. Reliability was determined using ...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/s0002-9610(01)00647-x

    authors: Paisley AM,Baldwin P,Paterson-Brown S

    更新日期:2001-07-01 00:00:00

  • Veterans Affairs general surgery service: the last bastion of integrated specialty care.

    abstract:BACKGROUND:In a time of increasing specialization, academic training institutions provide a compartmentalized learning environment that often does not reflect the broad clinical experience of general surgery practice. This study aimed to evaluate the contribution of the Veterans Affairs (VA) general surgery surgical ex...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2011.06.015

    authors: Poteet S,Tarpley M,Tarpley JL,Pearson AS

    更新日期:2011-11-01 00:00:00

  • Fate of aortic graft removal.

    abstract::Reoperation to remove an aortic graft was performed in 18 patients. The need for removal was infection in the majority. A changing flora was seen in aortic graft infection with gram-negative organisms predominating. Despite a standardized approach with total graft removal, aortic closure, and extraanatomic reconstruct...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(83)90371-9

    authors: Martin-Paredero V,Busuttil RW,Dixon SM,Baker JD,Machleder H,Moore WS

    更新日期:1983-08-01 00:00:00

  • Association of pre-operative medication use with unplanned 30-day hospital readmission after surgery in oncology patients receiving comprehensive geriatric assessment.

    abstract:BACKGROUND:This study aimed to determine whether pre-operative medication use is associated with unplanned 30-day readmission in elderly people undergoing cancer surgery. METHODS:Patients aged 65 years or older who were scheduled for cancer surgery and presented for comprehensive geriatric assessment were included. Co...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2019.06.020

    authors: Jeon MS,Jeong YM,Yee J,Lee E,Kim KI,Lee BK,Rhie SJ,Chung JE,Gwak HS

    更新日期:2020-06-01 00:00:00

  • A history of the American Board of Surgery: vignettes from the certifying examination: The Edgar J. Poth Memorial Lecture.

    abstract::The American Board of Surgery was established in 1937 to certify surgeons who through training, experience, and examination meet the highest standards of surgical care. This lecture was given as the Edgar Poth lecture at the April 2015 meeting of the Southwestern Surgical Congress. Dr Poth was a surgical educator from...

    journal_title:American journal of surgery

    pub_type: 历史文章,杂志文章

    doi:10.1016/j.amjsurg.2015.05.038

    authors: Walker JP

    更新日期:2015-12-01 00:00:00

  • Treatment of acute gynecologic infections with trovafloxacin. Trovafloxacin Surgical Group.

    abstract:BACKGROUND:Trovafloxacin, a broad-spectrum fourth-generation quinolone with gram-positive and gram-negative aerobic and anaerobic bacterial activity, is available in oral and intravenous formulations. The objective of this prospective, multicenter, double-blind, randomized study was to compare the efficacy of trovaflox...

    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/s0002-9610(98)00223-2

    authors: Roy S,Koltun W,Chatwani A,Martens MG,Dittrich R,Luke DR

    更新日期:1998-12-01 00:00:00

  • Meta-analysis of laparoscopic inguinal hernia trials favors open hernia repair with preperitoneal mesh prosthesis.

    abstract:BACKGROUND:This meta-analysis was performed to determine the degree to which improvements in open hernia repair (OHR) in the last decade have altered the relative benefit of laparoscopic hernia repair (LHR). METHODS:Twenty-seven comparative trials including 4,688 randomized patients were evaluated. RESULTS:Within the...

    journal_title:American journal of surgery

    pub_type: 杂志文章,meta分析

    doi:10.1016/s0002-9610(02)00878-4

    authors: Voyles CR,Hamilton BJ,Johnson WD,Kano N

    更新日期:2002-07-01 00:00:00

  • Edema volume, not timing, is the key to success in lymphedema treatment.

    abstract:BACKGROUND:There are currently between 1 and 2 million breast cancer survivors in the United States. Is the advocated, early intervention the key to successful treatment, or are there other, more important factors? METHODS:Responses to combined decongestive therapy (CDT) for 69 women were analyzed with regard to durat...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/s0002-9610(99)00185-3

    authors: Ramos SM,O'Donnell LS,Knight G

    更新日期:1999-10-01 00:00:00