Abstract：
BACKGROUND:Surgical observation is an integral part of surgical training. Junior residents, who have limited understanding of the procedures being performed, use observation to gain an initial exposure to surgical techniques. This study explores the challenges junior residents face from a cognitive standpoint when they are observing surgery. METHODS:Four focus groups were conducted with 18 general surgery junior residents. Transcripts from these focus groups were analyzed using a qualitative interpretative approach and the findings were explored through the lenses of discovery learning and cognitive load theory. RESULTS:Surgical observation is perceived by residents as a learning activity with rich potential. However, two main challenges were identified: directing their attention to the most pertinent element during observation and making sense of what is happening during procedures. CONCLUSIONS:This study can inform strategies to help junior residents observe surgeries more efficiently to help make surgical observation a better learning experience.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Raîche I,Hamstra S,Gofton W,Balaa F,Dionne Édoi
10.1016/j.amjsurg.2018.11.031subject
Has Abstractpub_date
2019-08-01 00:00:00pages
430-435issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(18)30102-8journal_volume
218pub_type
杂志文章abstract：BACKGROUND:Surgical energy-based devices emit energy, which can interfere with other electronic devices (eg, implanted cardiac pacemakers and/or defibrillators). The purpose of this study was to quantify the amount of unintentional energy (electromagnetic interference [EMI]) transferred to an implanted cardiac defibril...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.09.011
更新日期：2014-12-01 00:00:00
abstract：:The influence of pancreatic acinar cell atrophy and fibrosis on islet tissue autotransplantation was studied in dogs. Thirty-nine dogs underwent pancreatic duct ligation. After 6 weeks marked acinar cell atrophy and fibrosis developed, similar to that in human chronic pancreatitis. Intravenous glucose tolerance testin...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90248-2
更新日期：1980-02-01 00:00:00
abstract：:We describe our experience with a supraumbilical skin-fold incision for pyloromyotomy in infants. Our technique uses a vertical fascial incision. This approach provides excellent exposure to the pylorus, allows greater operative flexibility, and results in a superior cosmetic outcome compared to the traditional right ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(97)89628-6
更新日期：1996-04-01 00:00:00
abstract：PURPOSE:The Integrated Procedural Performance Instrument (IPPI) consists of clinical scenarios in which bench-top models are positioned to simulated patients. Trainees are required to perform technical skills while engaging with the patient. The purpose of this study was to determine whether an IPPI format examination ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.08.011
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:The Limberg flap (LF) procedure is widely performed for the treatment of sacrococcygeal pilonidal sinus (SPS); however, recurrences continues to be observed. The aim of this study was to assess the relationship between LF designs and the risk of SPS recurrence. METHODS:Sixty-one cases with recurrent disease...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2017.02.008
更新日期：2017-11-01 00:00:00
abstract：BACKGROUND:Surgeons who have demonstrated excellence through extensive publication in the medical education literature can provide valuable guidance for new surgeons interested in educational research. METHODS:National databases identified members of the Association for Surgical Education (ASE) who have accumulated th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00301-9
更新日期：2000-03-01 00:00:00
abstract：:Blocking factors are small polypeptide molecules that may appear in the serum of patients with cancer. These factors block the transformation of lymphocytes in culture to nonspecific mitogens such as phytohemagglutinin or concanavalin A and, therefore, may reflect changes in the immunocompetence of the patient. Blocki...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90377-3
更新日期：1975-08-01 00:00:00
abstract：BACKGROUND:Laparoscopic deroofing has been shown to produce good patient satisfaction and to have results similar to those of open surgical techniques. We evaluated the feasibility and efficacy of laparoscopic deroofing using an argon beam coagulator (ABC) in the patients with nonparasitic liver cysts. METHODS:Laparos...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01361-2
更新日期：2003-03-01 00:00:00
abstract：BACKGROUND:Traditional treatment of breast abscesses involves incision and drainage, with and without ultrasound guidance. These procedures cause considerable discomfort and morbidity for the patient. This study was conducted to determine whether needle aspiration of breast abscesses without ultrasound guidance was an ...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(01)00683-3
更新日期：2001-08-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to evaluate the involvement of inflammatory mediators in patients undergoing Lichtenstein tension-free hernioplasty (LH) using polypropylene prosthetic materials or conventional Bassini hernia repair (BH). METHODS:Thirty patients male with unilateral inguinal hernia without com...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0002-9610(00)00445-1
更新日期：2000-09-01 00:00:00
abstract：:Surgical clips (metallic or plastic) are frequently used for hemostasis and tumor marking. This study evaluated the radiographic and computerized tomographic appearance of different clips and their relative interference with computerized tomographic scans. Metallic clips (stainless steel, tantalum, and titanium) can a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90142-9
更新日期：1984-05-01 00:00:00
abstract：:Despite immediate operation, patients with abdominal aortic injuries and profound hypovolemic shock do not respond to the usual methods of resuscitation and die soon after celiotomy, prior to control and repair of the aortic injury. The rate of aortic hemorrhage exceeds the ability to restore blood volume. Shock becom...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90385-4
更新日期：1979-08-01 00:00:00
abstract：BACKGROUND:The influence of blood transfusions in the risk of postoperative infection remains controversial. We examined the association between autologous (AB) and homologous (HB) blood transfusions with postoperative infection in elective surgery. METHODS:The medical records of 991 Medicare patients aged > or =65 ye...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00242-1
更新日期：1999-12-01 00:00:00
abstract：:We found clinical phlebitis in 57 of 88 patients with peripheral hyperalimentation (65%). To determine if this was a problem common to all intravenous fluid therapy at our hospital, we performed a point-prevalence study. The prevalence of phlebitis in nonhyperalimentation intravenous patients was 18% (84 of 456 patien...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0002-9610(05)80266-1
更新日期：1990-02-01 00:00:00
abstract：BACKGROUND:We developed a model for capitation and global pricing for carotid endarterectomy. METHODS:A care algorithm for diagnosis, perioperative management, and postoperative care using cost data was developed. Perioperative care charges were extrapolated from a 1-year experience and applied to models to determine ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00128-7
更新日期：1998-08-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to investigate the relationship between perforated appendicitis and patient with diabetes using a population-based data set. METHODS:This study used data from the Longitudinal Health Insurance Database 2005 in Taiwan. We identified 4,806 patients hospitalized with acute appendi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.08.041
更新日期：2016-10-01 00:00:00
abstract：:The determination of surgical risk is a major problem in general surgical practice and many studies have attempted to predict postoperative outcome. Clinical judgment is still a fundamental skill with which the experienced surgeon can estimate the risk of postoperative infectious morbidity. Predictive scores based on ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81207-3
更新日期：1993-02-01 00:00:00
abstract：BACKGROUND:Recently, limited abdominal computed tomography (CT) scans have been reported (Rao, New England Journal of Medicine, 1998) to have accuracy as high as 98%. We compare our hospital's CT accuracy ordered by emergency room (ER) physicians with that of experienced surgeons provided only with the ER history and p...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(02)00850-4
更新日期：2002-05-01 00:00:00
abstract：BACKGROUND:Clinically evident Anastomotic Leakage (AL) remains one of the most feared complications after colorectal resections with primary anastomosis. The primary aim of this systematic review and meta-analysis was to determine whether Prophylactic Drainage (PD) after colorectal anastomoses confers any advantage in ...
journal_title：American journal of surgery
pub_type： 杂志文章,meta分析
doi：10.1016/j.amjsurg.2019.05.006
更新日期：2020-01-01 00:00:00
abstract：:In the present study, we determined values for peritoneal fluid and blood ammonia, amylase, and lactic acid content in 11 dogs after experimental bowel strangulation. In the nine survivors of this group, we demonstrated a near linear increase in peritoneal fluid lactic acid over a 24-hour period, during which the plas...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90311-5
更新日期：1989-07-01 00:00:00
abstract：BACKGROUND:To evaluate if laparoscopic adrenalectomy (LA) has changed the indications for adrenalectomy. METHODS:Retrospective analysis of patients with adrenal lesions referred from 1992 to 2004. Patients were divided into 2 groups, those before and those after the introduction of LA. RESULTS:One hundred eighty pati...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.02.003
更新日期：2005-05-01 00:00:00
abstract：BACKGROUND:Silicone venous access devices (VADs) are commonly used for multiple intravenous infusions and blood sampling in chronically ill patients, particularly cancer patients. These devices are susceptible to malfunctions most commonly characterized by difficulty infusing fluids or withdrawing blood. We hypothesize...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00124-5
更新日期：1999-07-01 00:00:00
abstract：BACKGROUND:Temporary abdominal wound closure is sometimes desirable when tension-free approximation of the wound edges is impractical or when reexploration is planned. METHODS:The behavior of a composite prosthesis (PL-PU99) designed by our group was evaluated as a method of temporary abdominal closure in white New Ze...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.06.014
更新日期：2004-09-01 00:00:00
abstract：BACKGROUND:Since any intraductal papillary mucinous neoplasm (IPMN) is at least premalignant, avoiding conversion to invasion by pancreatic resection should provide a survival advantage-but how much? METHODS:We reviewed 100 cases of IPMN that were resected. Survival was compared between 3 groups: noninvasive IPMN (n =...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.01.020
更新日期：2005-05-01 00:00:00
abstract：BACKGROUND:Changes in surgical training have raised concerns about residents' operative exposure and preparedness for independent practice. One way of addressing this concern is by optimizing teaching and feedback in the operating room (OR). The objective of this study was to perform a systematic review on perioperativ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2016.12.014
更新日期：2017-07-01 00:00:00
abstract：BACKGROUND:Incisional hernias are common. Optimal repair is one of the most analyzed and debated topics; however, there is no consensus as to the appropriate surgical technique. METHODS:An Institutional Review Board-approved protocol was designed using an Internet-based survey site (www.surveymonkey.com) to assess pra...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.08.002
更新日期：2007-11-01 00:00:00
abstract：BACKGROUND:Postoperative expectations after stapled hemorrhoidopexy are still being clarified. Our purpose was to evaluate how outcome is affected by staple line height (SLH) above the dentate line and specimen histology. METHODS:A prospective database identified demographics, SLH, histology, narcotic use, return to w...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.09.015
更新日期：2007-03-01 00:00:00
abstract：BACKGROUND:This study aimed to determine the role of fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) in the follow-up of patients who underwent total thyroidectomy and iodine-131 ((131)I) ablation therapy for differentiated thyroid cancer and presented increased thyroglobulin levels with negative ...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(00)00381-0
更新日期：2000-06-01 00:00:00
abstract：:A series of 168 patients who underwent 177 inguinal lymph node dissections from 1979 to 1989 were retrospectively reviewed to determine the incidence and severity of postoperative complications as well as the perioperative risk factors associated with them. Operative mortality was 0%, whereas the incidence of moderate...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81181-x
更新日期：1992-11-01 00:00:00
abstract：:From 1972 to 1981, 430 patients were treated for bleeding peptic ulcer. Two hundred ten of the patients were treated surgically and 220 medically. In the surgically treated patients, mortality was high among those with posterior duodenal peptic ulcer and after gastrectomy rather than after vagotomy. Mortality after em...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90170-3
更新日期：1984-03-01 00:00:00
