Abstract:
OBJECTIVE:This study used a virtual patient simulation (VPS) to quantifiably and objectively assess undergraduate (UG) to postgraduate (PG) medical learners' acquisition of the entrustable professional activity (EPA) "handover," focusing particularly on the transition to residency. This EPA is critical because it is part of a core competency for UG and PG training in both the United States and Canada, and is essential for patient safety and comprehensive professional communication. DESIGN:Data were collected from 3 separate groups of participants: 2 UG cohorts from an earlier study, as well as a PG cohort at the beginning of residency. All participants completed the same trauma VPS, which required a free text summary statement that was used as a surrogate for an oral handover. These were collected and scored independently, using previously developed validated rubrics, one procedural and the second semantic. SETTING:All study participants were from one site. The VPS case was completed online. PARTICIPANTS:Two different UG groups, one designated junior (N = 52), was studied at the beginning of their clerkship year, a second group, designated senior (N = 30), was studied at the end of their clerkship year. These groups were compared to a third group of PG learners (N = 31) during the initial 2 weeks of their residency. Informed consent was obtained from all participants. RESULTS:A procedural rubric assessed learners' cognitive knowledge of trauma care-management. A semantic rubric assessed their use of the professional language necessary for a safe and succinct clinical handover communication. An Analysis of Variance comparing scores on the procedural rubric was highly significant with Tukey LSD tests indicating that all 3 groups were significantly different. Students increased their scores on the procedural rubric at each stage of their training. A parallel Analysis of Variance comparing students' scores on the semantic rubric revealed no significant increase in scores, indicating that students did not improve in their capacity to communicate professionally as they progressed through their training. CONCLUSIONS:Taken together, these results demonstrate that training was successful in teaching cognitive-based procedures, but not effective in teaching professional communication, which is critical to the EPA handover. Greater emphasis needs to be placed on ensuring the acquisition of professional communication skills throughout the continuum of UG and PG clinical activities. Faculty development should serve as a support to assist medical educators to address this requirement. These results also demonstrate that VPS with associated objective and validated rubrics can be used as an assessment methodology to quantifiably measure learner performance with respect to the EPA handover. A similar strategy should be considered across the UG and PG continuum for other EPAs and could form the nexus for further research.
journal_name
J Surg Educjournal_title
Journal of surgical educationauthors
Posel N,Hoover ML,Bergman S,Grushka J,Rosenzveig A,Fleiszer Ddoi
10.1016/j.jsurg.2019.03.008subject
Has Abstractpub_date
2019-01-01 00:00:00pages
1258-1266issue
5eissn
1931-7204issn
1878-7452pii
S1931-7204(18)30776-1journal_volume
76pub_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::A case study is described in which collaborations between a Department of Surgery, a Department of Information Technology, and an academic health sciences library resulted in the development of an electronic surgical library available at the bedside, the deployment of tablet devices for surgery residents, and implemen...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2013.03.004
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:As medical student interest in global surgical care grows, a comprehensive curriculum is necessary to understand surgical care in resource-limited environments. METHODS:We developed a surgical elective encompassing a multiyear medical student curriculum, with the goal of improving students' understanding of...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2015.04.027
更新日期:2015-07-01 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: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: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: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:This study attempts to assess the association between surgeon personality factors (measured by the Myers-Briggs Type Indicator personality inventory (MBTI(®))) and risk tolerance (measured by the Revised Physicians' Reactions to Uncertainty (PRU) and Physician Risk Attitude (PRA) scales). DESIGN:Instrument a...
journal_title:Journal of surgical education
pub_type: 杂志文章,评审
doi:10.1016/j.jsurg.2013.07.014
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Endoscopic totally extraperitoneal inguinal hernia repair (TEP-IHR) requires practice and training to perform well. We developed a simple, low-cost, inanimate model to teach surgical residents inguinal anatomy and the technique of mesh insertion for a safe, endoscopic TEP-IHR. The objective of this study was...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2017.09.003
更新日期:2018-01-01 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: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:OBJECTIVE:With USMLE Step I score reports becoming pass/fail, research output may become a more important factor for applicants in the integrated plastic surgery match. The authors aim to assess the research output of successful applicants and bibliometric variables associated with matching at higher tier programs. DE...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.06.026
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Surgeon engagement with social media is growing rapidly. Innovative applications in diverse fields of health care are increasingly available. OBJECTIVE:The aim of this review is to explore the current and future applications of social media in surgical training. In addition, risks and barriers of social med...
journal_title:Journal of surgical education
pub_type: 杂志文章,评审
doi:10.1016/j.jsurg.2018.04.004
更新日期:2018-11-01 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:OBJECTIVE:Complex vascular anatomy has always been a difficult point for medical students. Gastrocolic trunk (Henle trunk) has many branches and variations, involving the venous reflux of the stomach, right colon, and pancreas. This study investigated the effects of 3 dimensional (3D) printing technology on medical int...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.02.031
更新日期:2020-01-01 00:00:00
abstract:PURPOSE:Residents seek postresidency fellowship training to increase competency with novel surgical techniques and augment their fund of knowledge. Research productivity is a vital component of advancement in academic urology. Our objectives were to use the h-index (an objective and readily available bibliometric that ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2013.10.010
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Clinician-scientist numbers have been stagnant over the past few decades despite awareness of this trend. Interventions attempting to change this problem have been seemingly ineffective, but research residency positions have shown potential benefit. OBJECTIVE:We sought to evaluate the effectiveness of a cli...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2017.10.003
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:The Accreditation Council for Graduate Medical Education mandates resident physician training in the principles and applications of research. To provide a robust early foundation for effective engagement in scholarship, we designed a novel clinical scholarship program (CSP) for PGY1 general surgery residents....
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.01.001
更新日期:2018-01-01 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: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:OBJECTIVE:To develop a written practical examination and scoring system for assessing trainee skills in basic soft-tissue techniques. DESIGN:A brief written practical examination was developed to assess the ability of trainees to sketch preoperative plans and postoperative results for common soft-tissue techniques: si...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2010.12.006
更新日期:2011-05-01 00:00:00
abstract:PURPOSE:The purpose of the study was to develop a model that predicts an individual applicant's probability of successful placement into a surgical subspecialty fellowship program. METHODS:Candidates who applied to surgical fellowships during a 3-year period were identified in a set of databases that included the elec...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2011.11.006
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:Many general surgery residents interrupt clinical training for research pursuits or advanced degrees during dedicated research time (DRT). We hypothesize that time required to obtain a second degree during DRT decreases resident publication productivity. DESIGN, SETTING, AND PARTICIPANTS:All consecutive cate...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2016.08.001
更新日期:2017-01-01 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 ...
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:OBJECTIVE:To conduct focus group interviews with operating room (OR) personnel to determine components of effective teamwork to inform a revision of a teamwork assessment instrument. DESIGN:Qualitative research study targeting OR personnel using semi-structured focus group interviews of interprofessional OR personnel....
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.09.019
更新日期:2020-11-04 00:00:00
abstract:BACKGROUND:The use surgical simulation across all subspecialties has gained widespread adoption in the last decade. A number of factors, including the small number of trainees, identified gaps in surgical skill training from cross-sectional surveys, increased national collaboration, and support from the national specia...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2017.11.008
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:Given rising rates of physician burnout, the potential for clinical skills training programs to develop and reinforce resilience-associated traits in medical students warrants investigation. The primary objective of this study was to examine the impact of a hemorrhage control training program on resilience-as...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.06.007
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:As of 2012, 39% of medical student graduates were nonwhite, yet very few nonwhite women graduates chose to become surgeons. METHODS:To better understand issues regarding nonwhite women in surgery, an online survey was sent to surgeons across the United States. Results are based on self-reported data. Mean d...
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: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: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