Abstract:
BACKGROUND:As plastic surgery programs transition toward competency-based medical education curricula, it is important to critically assess current methods of evaluating trainee competence. The purpose of this systematic review was to identify and evaluate assessment tools for technical and nontechnical competencies in plastic surgery. METHODS:A systematic search using keywords related to competency-based medical education, assessment, and plastic surgery was conducted. Two independent reviewers extracted data pertaining to study characteristics, study design, and psychometric properties. Data pertaining to the establishment of competence and barriers to tool implementation were noted. RESULTS:Twenty-three studies were included in this review. Technical competencies were assessed in 16 studies. Nontechnical competencies were assessed in five studies. Two studies assessed both technical and nontechnical competence. Six tools were implemented in a simulated setting and 17 tools were implemented in a clinical setting. Thirteen studies (57 percent) did not report reliability scores and nine (39 percent) did not report validity scores. Two tools established clear definitions for competence. Common barriers to implementation included high demands on resources and time, uncertainty about simulation transferability, and assessor burnout. CONCLUSIONS:A number of tools exist to assess a range of plastic surgery skills, in both clinical and simulated settings. There is a need to determine the transferability of simulated assessments to clinical practice, as most available tools are simulation-based. Although additional psychometric testing of current assessment tools is required, particularly in the nontechnical domain, this review provides a base on which to build assessment frameworks that will support plastic surgery's transition to competency-based medical education.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
McKinnon VE,Kalun P,McRae MH,Sonnadara RR,Fahim Cdoi
10.1097/PRS.0000000000004586subject
Has Abstractpub_date
2018-08-01 00:00:00pages
217e-231eissue
2eissn
0032-1052issn
1529-4242pii
00006534-201808000-00042journal_volume
142pub_type
杂志文章abstract::Limited visibility characteristic of cleft palate repair presents both ergonomic and educational challenges to cleft surgeons. Despite widespread recognition and reporting, posture-related spine disorders continue to represent a significant and potentially career-limiting problem for cleft/craniofacial surgeons. In ad...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000007291
更新日期:2020-11-01 00:00:00
abstract::Surgery is accepted as one of the most demanding professions that create both physical and mental strain on the performers. Therefore, the authors aimed to elucidate the mental burden of surgeons, which is dedicated to operative stress. They also tested the hypotheses that participating in surgery creates mental stres...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000133166.50279.7c
更新日期:2004-09-15 00:00:00
abstract:BACKGROUND:Cicatricial lower eyelid ectropion is caused by a shortening of the anterior lamella, with resultant eversion of the eyelid away from the globe. Treatment is typically surgical; however, the author hypothesized that a nonsurgical injection of hyaluronic acid filler could stretch the tethered skin and act as ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000299382.31856.d8
更新日期:2008-03-01 00:00:00
abstract::Contemporary studies and observations have left no doubt that occlusive dressings are superior to open treatment after laser resurfacing. The currently available occlusive dressings, however, are time-consuming to apply, often dislodge shortly after application, and most require reapplication. The authors report a cro...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000021884.52700.B2
更新日期:2002-09-15 00:00:00
abstract::Previous criticism about suction lipectomy for the correction of gynecomastia was related to the cannulae available at the time. With the improved design and tensile strength of the cannula, gynecomastia can be more easily corrected. The procedure can be completed with more control of the final contour and with fewer ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199409000-00023
更新日期:1994-09-01 00:00:00
abstract::Thirty-nine children with moderate-to-severe velopharyngeal incompetency were randomly assigned to either prosthetic or surgical palatal management. A classification for evaluating velopharyngeal incompetency was designed. The prosthetic speech appliance, when obtained and tolerated, corrected velopharyngeal incompete...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198005000-00009
更新日期:1980-05-01 00:00:00
abstract:BACKGROUND:The major drawback of adipose grafting is its clinical unpredictability, which leads to surgeon and patient dissatisfaction. The mechanisms underlying angiogenesis and regeneration of the graft tissue are still unclear. METHODS:Mouse adipose tissue was processed using two different methods (fragmental and i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000965
更新日期:2015-03-01 00:00:00
abstract::To date, a paucity of information is available on the optimal management of obstructive sleep apnea in Down syndrome, which may have particularly important implications in this already vulnerable patient population. The objective of this study was to evaluate prospectively the results of a new surgical approach for th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199703000-00004
更新日期:1997-03-01 00:00:00
abstract::The choice of microvascular anastomotic technique, end-to-end versus end-to-side, is still an item of debate. A review of the literature reveals no difference in patency rates in animal models where there is no size discrepancy. The available clinical evidence stems from Godina's early experience, proclaiming a higher...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199704000-00029
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:Abdominal donor-site flaps, including the transverse rectus abdominis musculocutaneous (TRAM) and deep inferior epigastric artery (DIEA) perforator flaps, are standard in autologous breast reconstruction. With significant variation in the vascular anatomy of the abdominal wall, preoperative imaging is essent...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:2008-01-01 00:00:00
abstract::Blood flow was measured in the canine saphenous artery using electromagnetic flowmetry. Significant increase in blood flow was noted after occlusion of the distal femoral artery. However, after raising a saphenous island flap there was no significant change in the blood flow before and after distal femoral artery occl...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198302000-00017
更新日期:1983-02-01 00:00:00
abstract::The anatomic boundaries and vascular supply of the subgaleal fascia have been described previously. The thin and malleable subgaleal fascia was selected for difficult reconstructive problems in seven patients. This flap has been based on either the supraorbital or the superficial temporal vascular leash. The subgaleal...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199104000-00003
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND:Both one- and two-stage approaches have been widely used for patients with asymmetric bilateral cleft lip. There are insufficient long-term outcome data for comparison of these two methods. The purpose of this retrospective study was to compare the clinical outcome over the past 20 years. METHODS:The senior...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004327
更新日期:2018-05-01 00:00:00
abstract::Breast cancer is the tumor with the highest prevalence and incidence in women. Reduction mammaplasty is one of the most common procedures performed in Brazil by the plastic surgeon, and it is not uncommon for the surgeon to find a breast tumor during the operation or afterward, when the histopathological report is rec...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000152683.62899.50
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:Facial contour augmentation is an entity often encountered by reconstructive surgeons. To date, very different autologous tissues such as fat, dermofat, dermal fascia, muscle, cartilage, and bone in the manner of grafts or flaps according to the requirements of the defect have been used for facial augmentati...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000252002.76466.cf
更新日期:2007-03-01 00:00:00
abstract::A distally based fasciocutaneous flap for heel coverage is reported. Its blood supply depends on distal septocutaneous perforators interconnected with the suprafascial plexus. A "turn-down" transposition and distal deepithelialization were utilized to avoid kinking of the pedicle. After a 1-year follow-up, it has prov...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199001000-00022
更新日期:1990-01-01 00:00:00
abstract::There are several anecdotal clinical articles claiming wound healing and scar superiority using obsidian (volcanic glass) scalpels. In order to determine if skin incisions made with obsidian were superior to those made with standard surgical steel, wound tensile strength, scar width, and histology were assessed in 40 ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract::Nine patients with complex extremity injuries were treated with emergency free-flap transfers over a 3 1/2-year period. The transferred emergency free flaps were performed to cover exposed vital structures. All flaps survived without infection. Complete and careful assessment of the systemic condition of the patient a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:In 1984, Terzis introduced the "babysitter" procedure, a new concept in facial reanimation. It involves two stages, with coaptation of ipsilateral 40 percent hypoglossal to facial nerve on the affected side, performed concomitantly with cross-facial nerve grafting and secondary microcoaptations 8 to 15 month...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31819ba4bb
更新日期:2009-03-01 00:00:00
abstract::The possible immunologic reactivity of silicone gel remains speculative and controversial. In this laboratory, a quantitative lymphocyte localization assay has been developed and well studied using pure lymphocytes collected by the technique of lymph vessel cannulation in sheep. The kinetics of antigen-specific immune...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199508000-00016
更新日期:1995-08-01 00:00:00
abstract::Recently, there have been many new designs in both the surface texture and chemical composition of breast implants that claim reduced constrictive capsular formation. The purpose of this study was to utilize a quantitative method to determine the firmness of capsules formed around saline-filled smooth silicone, textur...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199405000-00002
更新日期:1994-05-01 00:00:00
abstract::The purpose of this study was to identify important sociodemographic factors affecting the utilization of immediate and early delayed postmastectomy breast reconstruction in the United States. Using the Surveillance, Epidemiology, and End Results (SEER) program, all cases of mastectomy-treated breast cancer that were ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000041438.50018.02
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:The authors present their experience using an established chemotherapeutic agent as a scarless treatment for vascular birthmarks. One hundred sixty-four of more than 600 patients seen in the authors' center received intralesional bleomycin injection over 5 years. METHODS:Patient demographics, clinical respo...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31820e923c
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Patients with palatal clefts are predisposed to developing speech and language abnormalities. Emerging evidence indicates that children with cleft lip and/or cleft palate have higher rates of learning disabilities than the general population and differences in brain morphology. METHODS:Magnetic resonance im...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181881f54
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Mandibular distraction osteogenesis has proven to be an effective treatment for upper airway obstruction related to micrognathia. Changes in the aerodigestive space can help facilitate tracheostomy removal in children and prevent tracheostomy in newborns. However, this may also precipitate changes in the abi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000227740.48021.c3
更新日期:2006-08-01 00:00:00
abstract::A graphic and written anatomic data sheet (ADS) for facial aesthetic surgery and body contour surgery is presented as a tool for: (1) analyzing surgical maneuvers and their effect on final outcome; (2) recording individual anatomic variations; (3) communicating data between office personnel and colleagues; (4) aiding ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199304000-00030
更新日期:1993-04-01 00:00:00
abstract::Constriction rings are associated with amniotic band syndrome and most often present in the extremities. Constriction bands of the trunk are rare, and a standard of surgical care remains elusive. Traditional methods of constriction ring excision rely on soft-tissue rearrangement with multiple Z-plasties, but renewed i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000903
更新日期:2015-02-01 00:00:00
abstract::Not only is the long temporal vertical flap not centered on the temporosuperficial artery, but it is also countercurrent to this artery. The difficulties of its design are largely compensated for by the natural aspect of the anterior area once achieved. It must be emphasized that all techniques of transplantation can ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198411000-00007
更新日期:1984-11-01 00:00:00
abstract:BACKGROUND:Attempted separation of craniopagus twins has continued to be associated with devastating results since the first partially successful separation with one surviving twin in 1952. To understand the factors that contribute to successful separation in the modern era of neuroimaging and modern surgical technique...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000002269
更新日期:2016-07-01 00:00:00
abstract::The appropriate management of frontal sinus fractures is controversial. Experience with 78 frontal sinus fractures over a 9-year period was reviewed, and the fractures were classified into anterior wall, anterobasilar, and frontal skull fracture extensions. The presence of a concomitant CSF leak or an air-fluid level ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198710000-00003
更新日期:1987-10-01 00:00:00