Abstract:
OBJECTIVE:The Accreditation Council for Graduate Medical Education (ACGME) established duty-hour regulations for accredited residency programs on July 1, 2003. It is unclear what changes occurred in the national incidence of medication errors in surgical patients before and after ACGME regulations. DESIGN:Patient and hospital characteristics for pre- and post-duty-hour reform were evaluated, comparing teaching and nonteaching hospitals. A difference-in-differences study design was used to assess the association between duty-hour reform and medication errors in teaching hospitals. SETTING:We used the Nationwide Inpatient Sample database, which consists of approximately annual 20% stratified sample of all the United States nonfederal hospital inpatient admissions. PARTICIPANTS:A query of the database, including 4 years before (2000-2003) and 8 years after (2003-2011) the ACGME duty-hour reform of July 2003, was performed to extract surgical inpatient hospitalizations (N = 13,933,326). The years 2003 and 2004 were discarded in the analysis to allow for a wash-out period during duty-hour reform (though we still provide medication error rates). RESULTS:The Nationwide Inpatient Sample estimated the total national surgical inpatients (N = 135,092,013) in nonfederal hospitals during these time periods with 68,736,863 patients in teaching hospitals and 66,355,150 in nonteaching hospitals. Shortly after duty-hour reform (2004 and 2006), teaching hospitals had a statistically significant increase in rate of medication error (p = 0.019 and 0.006, respectively) when compared with nonteaching hospitals even after accounting for trends across all hospitals during this period. After 2007, no further statistically significant difference was noted. CONCLUSIONS:After ACGME duty-hour reform, medication error rates increased in teaching hospitals, which diminished over time. This decrease in errors may be related to changes in training program structure to accommodate duty-hour reform.
journal_name
J Surg Educjournal_title
Journal of surgical educationauthors
Vadera S,Griffith SD,Rosenbaum BP,Chan AY,Thompson NR,Kshettry VR,Kelly ML,Weil RJ,Bingaman W,Jehi Ldoi
10.1016/j.jsurg.2015.05.013subject
Has Abstractpub_date
2015-11-01 00:00:00pages
1209-16issue
6eissn
1931-7204issn
1878-7452pii
S1931-7204(15)00144-0journal_volume
72pub_type
杂志文章abstract:OBJECTIVE:A fundamental premise of establishing collaborative relationships between residents and nurses is a basic understanding of the attributes of each group. The intent of this study was to determine what surgical nurses know about surgical residents. DESIGN:A piloted survey tool was administered to a cross-secti...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2009.08.001
更新日期:2009-11-01 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:OBJECTIVES:To determine whether faculty could successfully evaluate residents using a competency-based modified Milestones global evaluation tool. DESIGN:A program's leadership team modified a draft Surgery Milestones Working Group summative global assessment instrument into a modified Milestones tool (MMT) for local ...
journal_title:Journal of surgical education
pub_type: 杂志文章,评审
doi:10.1016/j.jsurg.2013.08.004
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:Breast cancer incidence is rising for women in low and middle income country (LMIC)s. Growing the health care workforce trained in clinical breast exam (CBE) is critical to mitigating breast cancer globally. We developed a CBE simulation training course and determined whether training on a low-fidelity (LF) s...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.02.030
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Simulation and surgical training has moved on since its inception during the end of the last century. The trainees are getting more exposed to computers and laboratory training in different subspecialties. More needs to be done in orthopedic simulation in spinal surgery. AIMS:To develop a training system fo...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2014.04.012
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:Medical students receive limited exposure to ophthalmology and ophthalmic surgery in the preclinical curriculum. To address this gap, the authors designed a self-directed preclinical elective course in ophthalmic surgery offered in the 2013-2014 academic year to all first- and second-year students at the stud...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2015.11.005
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVES:To assess whether scholarly impact of academic ophthalmologists, as measured using the h-index, is affected by fellowship training status and to further characterize differences in productivity among the various subspecialties and by departmental rank. DESIGN:A descriptive and correlational design was used....
journal_title:Journal of surgical education
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jsurg.2014.10.010
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Very little is known of sex-related differences among medical students in the acquisition of basic surgical skills at an undergraduate level. The aim of this study was to investigate the sex differences in basic surgical skills learning and the possible explanations for sex disparities within basic surgical ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2016.04.002
更新日期:2016-09-01 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: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: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::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::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: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:BACKGROUND:Possessing adequate nontechnical skills (NTS) in operating theaters is of increasing interest to health care professionals, yet these are rarely formally taught. Teams make human errors despite technical expertise and knowledge, compromising patient safety. We designed a 1-day, multiprofessional, multidiscip...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2016.06.020
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVES:Food deprivation is a common condition for visceral surgeons and especially laparoscopic approaches require high levels of concentration. The current literature does not provide adequate answers whether intraoperative breaks, especially food intake, might influence the quality of the surgical skills. Thus, t...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.03.029
更新日期:2020-01-01 00:00:00
abstract:INTRODUCTION:Increased patient awareness, duty-hour restrictions, escalating costs, and time constraints in the operating room have revolutionized surgical education. A bovine heart model was designed for training in mitral valve repair procedures. In this article, we aimed to share our experience with this model and t...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2013.01.009
更新日期:2013-05-01 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:To conduct a needs assessment to identify gaps in communication skills training in ophthalmology residency programs and to use these results to pilot a communication workshop that prepares residents for difficult conversations. DESIGN:A mixed-methods design was used to perform the needs assessment. A pre-and...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2017.08.011
更新日期:2018-01-01 00:00:00
abstract:INTRODUCTION:We evaluated the effect of an operative coaching (OC) model on general surgery chief residents' operative efficiency (OE) measured by operative times. We hypothesized that higher levels of entrustment surgeons intend to offer resident in future similar cases are associated with improved OE. MATERIALS AND ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.12.006
更新日期:2020-12-22 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: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:OBJECTIVE:To evaluate tension at the failure of 3 commonly used sutures when suture ends were cut to 3 lengths. STUDY DESIGN:Knots were tied using U.S. Pharmacopeia Size 0-0 polyglactin 910, silk, or polydioxanone sutures. The knots were tied randomly on a jig by the same surgeon. End lengths were then cut to random l...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2009.10.003
更新日期:2009-09-01 00:00:00
abstract:PURPOSE:The Accreditation Council for Graduate Medical Education (ACGME) monitors fellow case numbers. Previous literature has shown new fellowships detrimentally affecting general surgery residency case numbers. We hypothesize that an increase in pediatric otolaryngology and pediatric urology fellowships would decreas...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2021.01.004
更新日期:2021-01-19 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:OBJECTIVES:This study evaluated the utility of a porcine flexor tendon model and standard biomechanical testing procedures to quantify the acquisition of surgical skills associated with Zone II flexor tendon repair in a trainee by benchmarking task performance outcomes relative to evidence-based standards. STUDY DESIG...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2012.01.001
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:To determine the effect of the 80-hour work week restrictions on general surgery resident operative volume in a large, community-based, university-affiliated, general surgery residency program. METHODS:We performed a retrospective review of Accreditation Council for Graduate Medical Education (ACGME) operati...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2010.05.007
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVES:The American Board of Surgery Certifying Examination (ABSCE) is an oral examination designed to evaluate a resident׳s ability to apply their cognitive knowledge to manage a broad range of clinical problems. In this study, we analyze our 5-year experience with a Philadelphia-wide mock oral examination (PMOE)....
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2014.06.019
更新日期:2014-11-01 00:00:00
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
doi:10.1016/j.jsurg.2018.07.018
更新日期:2019-01-01 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