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 resonance (CT/MR) images into 3D and plan resection margins. This creates significant cognitive load, especially for trainees, as it relies on image interpretation, anatomical and surgical knowledge, experience, and spatial sense. The purpose of this study is to determine if 3D reconstruction of preoperative CT/MR images will assist resident-level trainees in making appropriate operative plans for liver resection surgery. DESIGN:Ten preoperative patient CT/MR images were selected. Images were case-matched, 5 to 2D planning and 5 to 3D planning. Images from the 3D group were segmented to create interactive digital models that the resident can manipulate to view the tumor(s) in relation to landmark hepatic structures. Residents were asked to evaluate the images and devise a surgical resection plan for each image. The resident alternated between 2D and 3D planning, in a randomly generated order. The primary outcome was the accuracy of resident's plan compared to expert opinion. Time to devise each surgical plan was the secondary outcome. Residents completed a prestudy and poststudy questionnaire regarding their experience with liver surgery and the 3D planning software. SETTING AND PARTICIPANTS:Senior level surgical residents from the Queen's University General Surgery residency program were recruited to participate. RESULTS:A total of 14 residents participated in the study. The median correct response rate was 2 of 5 (40%; range: 0-4) for the 2D group, and 3 of 5 (60%; range: 1-5) for the 3D group (p < 0.01). The average time to complete each plan was 156 ± 107 seconds for the 2D group, and 84 ± 73 seconds for the 3D group (p < 0.01). A total 13 of 14 residents found the 3D model easier to use than the 2D. Most residents noticed a difference between the 2 modalities and found that the 3D model improved their confidence with the surgical plan proposed. CONCLUSIONS:The results of this study show that 3D reconstruction for liver surgery planning increases accuracy of resident surgical planning and decreases amount of time required. 3D reconstruction would be a useful model for improving trainee understanding of liver anatomy and surgical resection, and would serve as an adjunct to current 2D planning methods. This has the potential to be developed into a module for teaching liver surgery in a competency-based medical curriculum.
journal_name
J Surg Educjournal_title
Journal of surgical educationauthors
Yeo CT,MacDonald A,Ungi T,Lasso A,Jalink D,Zevin B,Fichtinger G,Nanji Sdoi
10.1016/j.jsurg.2017.07.031subject
Has Abstractpub_date
2018-01-01 00:00:00pages
792-797issue
3eissn
1931-7204issn
1878-7452pii
S1931-7204(17)30384-7journal_volume
75pub_type
杂志文章abstract:OBJECTIVE:To assess reactions by program directors (PDs) to a preview of a scenario from the Fundamentals of Surgery Curriculum (FSC), which is a case-based interactive curriculum developed by the American College of Surgeons's (ACS) Division of Education and designed to be delivered online to first-year (PGY-1) surgic...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2008.05.014
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:In single-incision laparoscopic surgery (SILS), operating through 1 incision presents ergonomic challenges. No consensus exists on whether articulating instruments (ARTs) may help. This study evaluated their effect on simulated SILS, hypothesizing that they would affect performance and workload. DESIGN:Surge...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2014.08.004
更新日期:2015-01-01 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
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:OBJECTIVE:Camera assistance is important for proper visualization of the operative field in laparoscopic surgery. Navigation grid (NG) has been designed to help the camera assistants focus the camera on the target operative field. This is a randomized, controlled trial to study the effect of the NG on performance of ca...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.09.015
更新日期:2020-10-02 00:00:00
abstract:OBJECTIVE:Breast cancer is the most common cancer diagnosed in low and middle-income countries. Growing the number of health care personnel trained in diagnostic procedures like breast core needle biopsy (BCNB) is critical. We developed a BCNB simulation-training course that evaluated skill acquisition, confidence, and...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2019.11.014
更新日期:2020-01-01 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: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:OBJECTIVE:Short-term, high-volume surgical training experiences can lead to successful skills transfer and be an effective method of training surgical providers in low-resource settings. However, immediate skills acquisition does not guarantee long-term performance of surgical procedures by trainees. This study aims to...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2019.08.009
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to analyze the decay of information with multiple sequential patient handoff reports given by third-year medical students who have not had standardized patient handoff training. METHODS:We examine the information decay of quantitative parameters included in 2 different simulated...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2013.12.002
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Cooperative learning is used often as part of the problem-based learning (PBL) process. But PBL does not demand that students work together until all individuals master the material or share the rewards for their work together. OBJECTIVE:A cooperative learning and assessment structure was introduced in a PB...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2011.07.010
更新日期:2012-03-01 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: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
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
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:INTRO:This project expanded upon previous exploration of emotional intelligence during the habituation for military second year medical students undergoing high-stress simulation with trauma and surgical skill training. The objective was to interpret emotional intelligence data before and after hyper-realistic immersio...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.04.020
更新日期:2020-01-01 00:00:00
abstract:PURPOSE:As laparoscopy continues to permeate general surgery, there is an increased need for residents to acquire advanced laparoscopic skills during a surgical training program. To underscore its importance, the Accreditation Council of Graduate Medical Education (ACGME) recently increased the requirements for laparos...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2007.06.013
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:To determine which teaching method-otoscopy simulation (OS), web-based module (WM), or standard classroom instruction (SI)-produced greater translation of knowledge and otoscopy examination skills to real patients. DESIGN:In a prospective randomized controlled nonclinical trial, medical students were randomi...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2017.12.011
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:Living kidney donation is a unique operation, as healthy patients are placed at risks inherent with major surgery without physical benefit. The ethical implications associated with any morbidity make it a high-stakes procedure. Fellowships are faced with the dilemma of optimizing fellow training in this deman...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.01.005
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To review the ability of junior doctors (JDs) in identifying the correct anatomical site for intercostal chest drain insertion and whether prior Advanced Trauma Life Support (ATLS) training influences this. DESIGN:We performed a prospective, observational study using a structured survey and asked a group of ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2015.01.022
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to identify academic differences between male and female candidates applying to our obstetrics and gynecology (OBGYN) residency. METHODS:We reviewed the Electronic Residency Application Service applications of candidates applying to our residency program from 2005 to 2009. Acade...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2013.03.012
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:We aimed to evaluate resident operative times in relation to postgraduate year (PGY), case difficulty and resident stress while performing a single surgical procedure. DESIGN:We prospectively examined operative times for 268 laparoscopic cholecystectomies, and analyzed relationships between PGY, case difficu...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.08.002
更新日期:2019-01-01 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
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:OBJECTIVE:Training for the Fundamentals of Laparoscopic Surgery (FLS) skills test can be expensive. Previous work demonstrated that training on an ergonomically different, low-cost platform does not affect FLS skills test outcomes. This study compares the average training cost with standard FLS equipment and medical-gr...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2016.11.013
更新日期:2017-01-01 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:OBJECTIVE:The purpose of the study was to determine the optimal number of throws to ensure knot security. STUDY DESIGN:Knots were tied with 3, 4, 5, or 6 square throws with 0-gauge coated polyester, polydioxanone, polypropylene, and polyglactin 910. The suture was soaked in 0.9% sodium chloride and subsequently transf...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2010.11.001
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:The Massachusetts General Hospital (MGH) Department of Surgery established the Global Surgery Initiative (GSI) in 2013 to transform volunteer and mission-based global surgery efforts into an educational experience in surgical systems strengthening. The objective of this newly conceived mission is not only to ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2014.12.018
更新日期:2015-07-01 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: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