Abstract:
INTRODUCTION:Certification of completion of training in Trauma and Orthopedic (T&O) surgery in the UK requires the demonstration of operative competence in 12 index procedures, achieved through attaining a level 4 consultant-validated procedure-based assessment (PBA). The aim of this study was to evaluate the trajectory of operative learning curves related to PBA performance with respect to operative caseload and training time. DESIGN:Logbook data from consecutive 24 higher T&O trainees were compared with PBA evaluations to determine the relationship between PBA level, operative experience, training time, and indicative numbers. Learning curve gradients were calculated using trigonometry related to operative experience and training time. SETTING:A higher surgical orthopedic training program serving a single UK (Wales) Deanery. PARTICIPANTS:Twenty-four consecutive higher T&O surgery trainees. RESULTS:Median caseload to achieve level 4 competences ranged from 9 (interquartile range 6-12) for tension band wiring (olecranon or patella) to 101 (61-127) for arthroscopy, with significant variation between all 12 procedures (p < 0.001). Median number of PBAs to reach level 4 competences was 4 (2-6) with significant variation between procedures (p < 0.001). Median learning curve gradients to achieve level 4 competence for tension band wiring were 68.2° and 33.7° by caseload and training time respectively, compared with 12.2° and 45° for arthroscopy, with significant learning curve variation for all procedures related to caseload between first level 3 and first level 4 PBA (p < 0.001). Competence ratios were <1 (median 0.99, range 0.70-2.53) for 6 of the 12 indicative procedures. CONCLUSIONS:Significant learning curve trajectory variance was observed, with discrepancies between indicative operative numbers and the point at which competence was judged achieved. Numbers of index operations to achieve certification of completion of training warrant further examination.
journal_name
J Surg Educjournal_title
Journal of surgical educationauthors
Hopkins L,Robinson DBT,Brown C,Egan R,Iorwerth A,Holt M,Lewis WGdoi
10.1016/j.jsurg.2019.05.009subject
Has Abstractpub_date
2019-01-01 00:00:00pages
1569-1578issue
6eissn
1931-7204issn
1878-7452pii
S1931-7204(18)30861-4journal_volume
76pub_type
杂志文章abstract:OBJECTIVE:To test the tensile properties of knotted suture made of 4 different suture materials and exposed to petroleum gauze. STUDY DESIGN:We tested the tensile strength of United States Pharmacopeia size 0-0 gauge polydioxanone, polyglyconate, glycolide/lactide copolymer, and silk when exposed to petroleum packing ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2011.06.012
更新日期:2012-01-01 00:00:00
abstract::Omental infarction is a rare cause of acute abdomen that until recently was diagnosed only on exploratory surgery for presumed acute appendicitis or similar abdominal emergency. The increasing use of high-quality imaging, especially computerized tomography, in the diagnosis of appendicitis and the acute abdomen, has a...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2010.01.003
更新日期:2010-01-01 00:00:00
abstract:PURPOSE:The amount of financial debt incurred by Texas medical students and residents during training was examined as well as the impact of this debt on these trainees' career choices. METHOD:An invitation to participate was sent in a Web-based survey to medical students and residents at 6 university programs in Texas...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2008.09.003
更新日期:2009-01-01 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:BACKGROUND:The Accreditation Council for Graduate Medical Education Milestone Project for general surgery provided a more robust method for developing and tracking residents' competence. This framework enhanced systematic and progressive development of residents' competencies in surgical quality improvement. STUDY DES...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.04.001
更新日期:2018-11-01 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
doi:10.1016/j.jsurg.2008.05.002
更新日期:2008-11-01 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 ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.12.005
更新日期:2019-01-01 00:00:00
abstract:INTRODUCTION:Orthopedic surgery residents are at risk for daily work-related hazards and exposures. Hazards related specific to this specialty includes radiation exposure, smoke inhalation (from electrocautery), and disease transmission through contact with surgical instruments or sharps during procedures. However, min...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.05.007
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:The speciality of neurosurgery is under-represented in the majority of medical school curriculums, and those rotating within this specialty tend to be those with career aspirations within this field. Consequently, few emergency medicine trainees are exposed to this specialty. The aim of this educational proje...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.04.017
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:There is an increasing demand for physicians to possess strong personal and social qualities embodied in the concept of emotional intelligence (EI). However, the residency selection process emphasizes mainly academic accomplishments. In this system, the faculty interview is the primary means of evaluating th...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2013.03.010
更新日期:2013-07-01 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
abstract:OBJECTIVE:Compassion fatigue (CF) is the profound sense of emotional exhaustion that care providers can experience as the result of helping others in distress. CF can contribute to burnout (BO), depression, and stress-related illness. While surgeons and surgical trainees may be at high risk for developing CF, it has no...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2019.03.012
更新日期:2019-01-01 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::Malrotation and volvulus are encountered early in infancy and sometimes later in childhood, but rarely in adulthood. This ailment is treated through Ladd's adhesiolysis, detorsion, and possibly bowel resection. Literature is scarce on the long-term outcomes of this procedure, especially into adulthood. We present a ca...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2011.05.020
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Workplace-based assessments (WBAs) were introduced formally in the UK in 2007. The aim of the study was to describe the use of WBAs by UK surgical trainees and examine variations by training region, specialty, and level of training. METHODS:The database of the Intercollegiate Surgical Curriculum Programme w...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2015.03.019
更新日期:2015-09-01 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:The development of the ability to estimate patient mortality preoperatively in surgical trainees has not been well studied. DESIGN:Prospective comparative study in which the expected perioperative mortality risk and the maximum tolerable mortality at which operation would still be offered were estimated by t...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2014.07.007
更新日期:2015-01-01 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:OBJECTIVE:Residency coordinators are valuable members of the education leadership administration. In General Surgery, program directors must devote time to both their clinical practice and as the leader of the education program for surgical residents. With the introduction of competencies and the Next Accreditation Sys...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.07.003
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVES:To validate the use of a novel physical model, the "Clinical Male Pelvic Trainer (CMPT) Mk 2-Advanced," for scrotal examination simulation and evaluate its use for surgical education. MATERIALS AND METHODS:A total of 7 CMPT Mk 2-Advanced scrotal models were used for teaching: normal, varicocele, testicular ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2016.10.008
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Physician satisfaction is an important and timely issue in health care. A paucity of literature addresses this question among general surgeons. PURPOSE:To review employment patterns and job satisfaction among general surgery residents from a single university-affiliated institution. METHODS:All general sur...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2007.07.004
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:Most surgical residents will learn written information via passive, massed exposure of material. Spaced repetition learning is an alternative, more effective, and efficient method to this more traditional method of teaching. We hypothesized that this method in the lead up to an Orthopedic basic sciences exami...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.07.002
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:In recent years, a significant decline in the number of medical school graduates who choose general surgery as a career has been noted in Israel. The aim of this study is to characterize the factors that deter Israeli medical students from choosing general surgery. Previous studies in the United States ident...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2010.07.015
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:The use of 3-dimensional (3D) printing in medicine has rapidly expanded in recent years as the technology has developed. The potential uses of 3D printing are manifold. This article provides a systematic review of the uses of 3D printing within surgical training and assessment. METHODS:A structured literatur...
journal_title:Journal of surgical education
pub_type: 杂志文章,评审
doi:10.1016/j.jsurg.2017.06.033
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Humanitarian surgeons face many ethical challenges. Despite increasing resident participation during humanitarian activities, minimal literature exists describing premission ethics training. METHODS:A systematic literature review was conducted to identify publications on humanitarian surgery. A 3-tiered rev...
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: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: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:Few medical school programs in Canada address challenges related to the significant increase in responsibility for patient care between medical school and residency. This is particularly important in surgery and anesthesia due to the high-acuity care required during the perioperative period. The purpose of th...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2017.08.022
更新日期:2018-01-01 00:00:00
abstract:PURPOSE:The interview process is a pivotal, differentiating component of the residency match. Our bias is toward a working interview, producing better fulfillment of the needs of both parties, and a more informed match selection for the candidates and program. METHODS:We describe a "candidate-centered" approach for in...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2012.06.004
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:To investigate the current rate of attrition in general surgery residency, assess the risk factors, and identify prevention strategies. DESIGN:A literature review of the PubMed and MEDLINE databases, from January 1, 1980 to February 1, 2016, for relevant articles. The calculated attrition rate and the statis...
journal_title:Journal of surgical education
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jsurg.2017.07.015
更新日期:2018-01-01 00:00:00