Abstract:
OBJECTIVE:In academic settings, surgical residents often serve as co-surgeon in complex operations such as pancreatic resections. These operations are typically performed by fellowship-trained primary surgeons with extensive experience in the field. Our study aimed to evaluate how the participation of general surgery residents in these complex operations affected patient outcomes. Our hypothesis was that resident involvement as co-surgeon would not adversely impact key patient outcomes including complications, readmission, and mortality. DESIGN:A REDCap database of perioperative variables for patients undergoing pancreatic resection was established at a single independent academic medical center. The database was populated via retrospective chart review. Patient demographics, surgical indications, operative time, estimated blood loss, postoperative hospital length of stay, intensive care unit length of stay, postoperative complications, and 30- and 90-day survival for patients with and without cancer were reviewed. We further categorized the data based on the designation of a general surgery resident or a second staff surgeon as co-surgeon in each operation. SETTING:The study was performed at the Marshfield Clinic Health System-Marshfield Medical Center, an independent academic medical center located in central Wisconsin. PARTICIPANTS:Data were abstracted from the medical records of all adult patients (18 years of age and older) who underwent pancreatic resection from 2007 to 2018 (n = 173). RESULTS:173 pancreatic resections were performed by 8 different primary staff surgeons over 10.5 years. All co-surgeons were either another staff surgeon or a senior-level (postgraduate year 4 or 5) general surgery resident. Perioperative and postoperative patient outcomes were statistically similar in both groups. CONCLUSIONS:Resident involvement as co-surgeon in complex pancreatic resections constituted no increased risk for patients at our institution. Senior residents should continue to operate on these important learning cases under appropriate staff supervision.
journal_name
J Surg Educjournal_title
Journal of surgical educationauthors
Gabel SA,Morrison ZD,Sharma R,Wernberg JAdoi
10.1016/j.jsurg.2020.04.006subject
Has Abstractpub_date
2020-01-01 00:00:00pages
1528-1533issue
6eissn
1931-7204issn
1878-7452pii
S1931-7204(20)30121-5journal_volume
77pub_type
杂志文章abstract:INTRODUCTION:Autonomy is of foremost concern in the current era of surgical residency, and it is especially important to trainees when considering their surgical education. Factors impacting trainee independence include the restriction of clinical work hours and the development of advanced minimally invasive techniques...
journal_title:Journal of surgical education
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更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:The practice of obstetrics and gynecology poses specific ethical challenges for informed consent (IC). Data regarding resident confidence with the IC process are lacking. Our objective was to evaluate obstetrics and gynecology residents' education, experience, and confidence related to IC. DESIGN:This was a ...
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abstract:OBJECTIVE:There have been numerous advances to accelerate and improve quality and dexterous proficiency of surgical training to meet the growing US demand of graduating surgeons. The authors aimed to investigate the learning effects of such limited visual input on the surgical proficiency in untrained novice surgeons. ...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
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更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:Clerkship students feel increased anxiety and lack of confidence when it comes to surgery. This study assessed whether participation in Surgical Exploration And Discovery (SEAD), a 2-week intensive surgical program that includes career information, simulation workshops, and operating room observerships, would...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.03.010
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abstract:OBJECTIVE:As the competitiveness of applicants for general surgery residency grows, it is becoming challenging for programs to differentiate qualified candidates with a genuine interest in matching at their institution. The purpose of this study was to examine geographic trends in the general surgery match in order to ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2019.09.018
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abstract:BACKGROUND:Improved access to surgical care could prevent a significant burden of disease and disability-adjusted life years, and workforce shortages are the biggest obstacle to surgical care. To address this shortage, a 5-year surgical residency program was established at Kamuzu Central Hospital (KCH) in July 2009. As...
journal_title:Journal of surgical education
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abstract:BACKGROUND:In 2013, we developed an education workshop to enhance the teaching skills of surgical fellows. We sought to investigate the feasibility of the monthly educational workshop format and its effect on participant teaching skills. STUDY DESIGN:Surgical and medical education faculty created a broadly applicable ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2016.02.001
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE:Operative experience in rural fellowship programs is largely unknown. The 2 of the most rural minimally invasive surgery (MIS)/bariatric fellowships are located in the upper Midwest. We hypothesized that these 2 programs would offer a similar operative experience to other U.S. programs in more urban locations...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2016.04.012
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:A fundamental aspect of surgical planning in liver resections is the identification of key vessel tributaries to preserve healthy liver tissue while fully resecting the tumor(s). Current surgical planning relies primarily on the surgeon's ability to mentally reconstruct 2D computed tomography/magnetic resonan...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2017.07.031
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:This study aimed to determine the emotional intelligence (EI) of surgical faculty and evaluate its relationship with resident evaluations of faculty behaviors. DESIGN:This study retrospectively collected faculty EI scores as well as general surgery resident evaluations of faculty. Parametric and nonparametri...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.03.019
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Compare characteristics of U.S. medical school graduates with U.S.-born and foreign-born international medical school (IMG) graduates. DESIGN:Retrospective analysis. SETTING:East Carolina University, a tertiary care teaching hospital. PARTICIPANTS:Demographic data, United States Medical Licensing Examinati...
journal_title:Journal of surgical education
pub_type: 杂志文章
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更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:In North America, the number of craniofacial surgery fellowship graduates is increasing, yet an analysis of practice settings upon graduation is lacking. We characterize the practice types of recent graduates of craniofacial fellowship programs in the United States and Canada. DESIGN:A 6-year cohort of crani...
journal_title:Journal of surgical education
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jsurg.2016.08.014
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:The effect of surgery resident participation on breast cancer recurrence has not been previously reported. The objectives of this study were to determine if resident participation was associated with either immediate postoperative or long-term breast cancer outcomes. DESIGN:We retrospectively reviewed a pros...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2015.06.011
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:To evaluate whether implementing the formal Surgical Research Methodology (SRM) Program in the surgical residency curriculum improved research productivity compared with the preceding informal Research Seminar Series (RSS). METHODS:The SRM Program replaced the RSS in July 2009. In the SRM Program, the curric...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2014.01.012
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to explore the views and expectations that practicing general surgeons have of their junior colleagues who have recently finished training. DESIGN:This is a qualitative study performed using focus group data consisting of open-ended questions concentrating on essential qualiti...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.09.010
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:Wrong-site surgery (WSS) is considered a sentinel event by the Joint Commission. The education of spine surgery fellows on WSS is unknown. Our objective was to evaluate North American spine surgery fellows' education, awareness, and experience with WSS. DESIGN:Observational survey study. SETTING:Spine surge...
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:INTRODUCTION:The level of interest expressed by medical students toward the field of general surgery has decreased. The aims of this study were to (1) describe an educational scheme in surgical anatomy that increases interaction between practicing surgeons and first-year medical students and (2) garner feedback and opi...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2009.04.005
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:To investigate whether preclinical laparoscopy training offers a benefit over standard apprenticeship training and apprenticeship training in combination with simulation training. DESIGN:This randomized controlled trial consisted of 3 groups of first-year surgical registrars receiving a different teaching me...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2013.04.001
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:There exists a lack of technology to reliably and routinely capture high-quality video of open surgical procedures. To critically evaluate and compare new and existing technology solutions, we must have widely accepted evaluation criteria for intraoperative camera devices. The objective, therefore, was to dev...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.06.011
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:To describe and evaluate a root cause analysis (RCA)-based educational curriculum for quality improvement (QI) practice-based learning and implementation in general surgery residency. DESIGN:A QI curriculum was designed using RCA and spaced-learning approaches to education. The program included a didactic se...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2015.05.005
更新日期:2015-11-01 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::Giant colonic diverticulum is a rare complication of diverticular disease of the colon and is thought to result, in most cases, from a "ball-valve" effect. The presentation and clinical course can be variable and confusing. The most common symptoms are abdominal pain and a palpable abdominal lump, with many patients p...
journal_title:Journal of surgical education
pub_type: 杂志文章,评审
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更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:To determine, given a fixed amount of training, the optimal distribution of sessions needed to acquire intracorporeal endoscopic suturing skills and to retain said skills for 1 to 6 months. DESIGN:A randomized controlled trial consisted of 6 study groups who received identical laparoscopic suturing training ...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2013.01.005
更新日期:2013-05-01 00:00:00
abstract::Multiple endocrine neoplasia type 2A (MEN2A) is an autosomal dominant syndrome that is associated with hyperparathyroidism in 20% to 30% of adult gene carriers. The appropriate surgical management of these patients remains in question. Approaches to this disease range from selective gland resection to a subtotal parat...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2008.02.003
更新日期:2008-05-01 00:00:00
abstract:PURPOSE:To evaluate the effect of the 30-hour restriction on resident operative participation and assess whether the 30-hour restriction can be extended in certain cases to enhance educational experience and continuity of care without being detrimental to the 80-hour limit. METHODS:In September 2006, we administered a...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2007.08.006
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Declining trends in surgery have been well-researched in the North American region, but little is known about the international dynamics affecting this phenomenon. A comprehensive approach to this emerging issue is lacking. OBJECTIVES:Our objective in this study is to explore global trends related to medica...
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
abstract:BACKGROUND:Nontechnical skills are of increasing focus for safe and effective performance in the operating room. Assessment tools have been developed in Europe, Africa, and Asia but not adapted to the unique aspects of surgical delivery in the United States. Our objective was to use the Non-Technical Skills for Surgeon...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.09.010
更新日期:2020-10-08 00:00:00
abstract:OBJECTIVE:To1 describe the development and evaluate the feasibility of a surgical objective structured clinical examination (OSCE) for the purpose of competency assessment based on the Royal College of Canada's CanMEDS framework. DESIGN:A unique surgical OSCE was developed to evaluate the clinical and surgical managem...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.02.018
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To determine 2020 residency cycle application practices and to model potential consequences in the 2021 cycle if (1) applicants scheduled an uncapped number of interviews; (2) applicants were capped to schedule 12 interviews; (3) residency programs kept their number of interview offers unchanged; and (4) prog...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.08.033
更新日期:2020-09-14 00:00:00
abstract:OBJECTIVE:Surgical trainees are subject to pressure from variety of stakeholders to secure board certification from the American Board of Surgery (ABS). To meet these expectations, trainees must pass a written qualifying exam (QE) and an oral certifying exam (CE) within 7 years of completing general surgery residency. ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.08.047
更新日期:2020-09-16 00:00:00