Abstract:
OBJECTIVES:Food deprivation is a common condition for visceral surgeons and especially laparoscopic approaches require high levels of concentration. The current literature does not provide adequate answers whether intraoperative breaks, especially food intake, might influence the quality of the surgical skills. Thus, the primary aim of this trial was to analyze the influence of food deprivation on the laparoscopic performance. DESIGN SETTING AND PARTICIPANTS:37 laparoscopic novices participated from 10/2017 to 04/2018 in this single center, prospective-randomized trial and were trained during laparoscopic training sessions until they reached a predefined level of proficiency. Subsequently, participants were randomized into 3 different groups: food deprivation of 8 hours, 4 hours, or carbohydrate loading directly prior to the laparoscopic exam. The exam comprised PEG-transfer, precise cutting, gallbladder resection and surgical knot. MAIN FINDINGS:Completion time for PEG-transfer, precise cutting, gallbladder resection and surgical knot was 63s, 139s, 192s and 272s respectively. Participants starving for 8 hours performed 3 of 4 tasks more slowly whilst participants starving for 4 hours performed 3 of 4 tasks faster than the average. Analyzing self-reported level of appetite revealed: Students with an intermediate level were significantly faster (p <0.05) during complex procedures compared to participants that reported hunger prior to performing these tasks (192s vs. 307s). Additionally, hungry students had been more inaccurate during the surgical knot (p <0.05) whilst students with intermediate appetite level tend to be most accurate (p - value 0.012). CONCLUSIONS:The subjective level of appetite rather than the absolute number of fasting hours influences the laparoscopic performance most. Thus, any extreme level of appetite may be avoided and surgeons may achieve the best performance when they have an intermediate level of appetite. In consequence, heavy meals may be omitted immediately prior to demanding laparoscopic procedures and surgeons may have access to mini-breaks and refreshers during major procedures.
journal_name
J Surg Educjournal_title
Journal of surgical educationauthors
Bechtolsheim F,Oehme F,Weitz J,Oppermann N,Reissfelder C,Mees ST,Yang Cdoi
10.1016/j.jsurg.2020.03.029subject
Has Abstractpub_date
2020-01-01 00:00:00pages
1236-1243issue
5eissn
1931-7204issn
1878-7452pii
S1931-7204(20)30095-7journal_volume
77pub_type
杂志文章abstract:OBJECTIVES:During the last 2 decades, the advent of new technologies in trauma patient care may have resulted in a decreased number of diagnostic peritoneal lavage (DPL) evaluations. In this study, it is hypothesized that fewer DPL are being performed at a midwestern trauma center. Such negative trends may make the inc...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2011.02.003
更新日期:2011-07-01 00:00:00
abstract:INTRODUCTION:We evaluated the effect of an operative coaching (OC) model on general surgery chief residents' operative efficiency (OE) measured by operative times. We hypothesized that higher levels of entrustment surgeons intend to offer resident in future similar cases are associated with improved OE. MATERIALS AND ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.12.006
更新日期:2020-12-22 00:00:00
abstract:OBJECTIVES:Although development of trainees' competency in interpersonal communication is essential to high-quality patient-centered surgical care, nontechnical skills present assessment challenges for residency program directors. The Communication Assessment Tool (CAT) demonstrated internal reliability and content val...
journal_title:Journal of surgical education
pub_type: 杂志文章,评审
doi:10.1016/j.jsurg.2016.04.016
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:Given limitations in surgical educational resources, more efficient teaching methods are needed. We sought to evaluate 3 strategies for improving skills in subcuticular suturing-practice with an instructional video, practice with expert instructor supervision, and independent practice. DESIGN:Fifty-eight med...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2011.04.006
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:To determine if playing music would affect novice surgical trainees' ability to perform a complex surgical task. BACKGROUND:The effect of music in the operating room (OR) is controversial. Some studies from the anesthesiology literature suggest that OR music is distracting and should be banned. Other nonblin...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.08.020
更新日期:2020-09-08 00:00:00
abstract::The scope of patient management increasingly crosses the defined lines of multiple medical specialties and services to meet patient needs. Concurrently, many hospitals and health-care systems have adapted new multidisciplinary team structures that provide patient-centric care as opposed to the more traditional discipl...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2007.10.003
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVES:Primary: Assess the ability of faculty graders to predict the objectively measured strength of distal radius fracture fixation. Secondary: Compare resident skill variation and retention related to other knowable training data. DESIGN:Residents were allowed 60 minutes to stabilize a standardized distal radiu...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.01.019
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:This study aimed to assess surgical trainees' knot tying technique and determine the type and security of knots created. METHODS:Twenty-five participants were requested to tie 40 knots each, using Vicryl 2-0 and Prolene 2-0 sutures. With each suture material, the participants tied: in series 1, 4 knots as t...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2012.07.002
更新日期:2013-01-01 00:00:00
abstract:PURPOSE:We developed a system of resident-driven, evidence-based standardization of care in our trauma-surgical intensive care unit (TSICU). Our main purposes are to improve patient care and outcomes and to help the residents develop practical competency in practice-based learning and improvement and in systems-based p...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2008.01.003
更新日期:2008-03-01 00:00:00
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journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2015.06.001
更新日期:2015-11-01 00:00:00
abstract:INTRODUCTION:It has been previously demonstrated that medical students do not achieve an adequate musculoskeletal knowledge base on graduation from American medical schools. Several curriculums have been developed to address this measured deficit. Students entering orthopedic surgery residencies have a better musculosk...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2014.01.007
更新日期:2014-09-01 00:00:00
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journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.07.012
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:To examine if there were circadian variations in surgeons' ability to diagnose acute appendicitis. DESIGN:Retrospective database study of all patients admitted to an acute surgical procedure under the potential diagnosis of acute appendicitis in a 4-year period. The day was divided into 2 time intervals, day...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2015.11.003
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:Nontechnical skills, such as situation awareness, decision making, leadership, communication, and teamwork play a crucial role on the quality of care and patient safety in the operating room (OR). In our previous work, we developed an interdisciplinary training program, based on the NOTSS (Non-Technical Skill...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2021.01.011
更新日期:2021-01-27 00:00:00
abstract:BACKGROUND:Global surgery is a rising field within academic surgery. With the publication of recent landmark papers highlighting the need for increased global efforts to combat surgical disease, many general surgery residents seek opportunities to gain clinical, research, and educational experience related to global su...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.03.017
更新日期:2020-01-01 00:00:00
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journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2019.04.001
更新日期:2019-01-01 00:00:00
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journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2019.11.015
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:There is a growing need to address the global burden of surgical disease along with increasing interest in international surgical practice, necessitating an understanding of the challenges and issues that arise on a systems level when practicing abroad. DESIGN:This elective is a month-long rotation in which ...
journal_title:Journal of surgical education
pub_type: 杂志文章,评审
doi:10.1016/j.jsurg.2015.09.019
更新日期:2016-03-01 00:00:00
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journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2008.07.009
更新日期:2008-09-01 00:00:00
abstract:INTRODUCTION:Since the introduction of laparoscopic surgery for cholecystectomy in 1989, the growth of minimally invasive surgery (MIS) has increased significantly in the United States. There is a growing concern that the pendulum has now shifted too far toward MIS and that current general surgery residents' exposure t...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2013.09.002
更新日期:2013-11-01 00:00:00
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journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2010.05.006
更新日期:2010-07-01 00:00:00
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journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2013.09.006
更新日期:2014-05-01 00:00:00
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journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2015.01.010
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:The Luke Commission, a provider of comprehensive mobile health outreach in rural Swaziland, focuses on human immunodeficiency virus testing and prevention, including the performance of over 100 circumcisions weekly. Educational objectives for medical student global health electives are essential. Learning re...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2017.09.015
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Mannequin and computer-based simulators are useful for the practice of patient management, physical procedures, and competency. However, they are ineffective in teaching clinical medicine. StepStone Interactive Medical Software (SS) is a web-based medical learning modality that provides the user with a highl...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2012.05.013
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:To compare career choices of residency graduates from Independent Academic Medical Center (IAMC) and University Academic Medical Center (UAMC) programs and evaluate program directors' perceptions of residents' motivations for pursuing general surgery or fellowships. DESIGN:From May to August 2011, an electr...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2012.05.006
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Surgical education is evolving as work hour constraints limit the exposure of residents to the operating room. Potential consequences may include erosion of resident education and decreased quality of patient care. Surgical simulation training has become a focus of study in an effort to counter these challen...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2015.06.021
更新日期:2015-11-01 00:00:00
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journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2019.09.016
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:International Medical Graduates (IMGs) secured greater than 10% of all general surgery (GS) residency positions in the US during the past decade. The Match process remains competitive, with a significant number of IMGs performing dedicated research before residency application. The impact of such research rem...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.06.003
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Feedback plays an important role in the learning process. However, often this may be delivered in an unstructured fashion that can detract from its potential benefit. Further, students may have different preferences in how feedback should be delivered, which may be influenced by which method they feel will l...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2015.04.017
更新日期:2015-09-01 00:00:00