Abstract:
BACKGROUND:This study aimed to assess surgical trainees' knot tying technique and determine the type and security of knots created. METHODS:Twenty-five participants were requested to tie 40 knots each, using Vicryl 2-0 and Prolene 2-0 sutures. With each suture material, the participants tied: in series 1, 4 knots as they would normally do during surgery; in series 2, 4 knots with 3 throws, 4 knots with 4 throws, 4 knots with 5 throws, and 4 knots with 6 throws. All knots were tested for tensile strength using a tensiometer. Knots with tensile strength of less than 5 N were considered dangerous. RESULTS:Of the 25 participants, 2 created square knots consistently, 2 created a mixture of square and slip knots, and 21 created only slip knots. Square knots accounted for only 12.8% of all the knots. The incidence of knot slipping under tension was significantly lower with square knots (p < 0.001). Square knots had significantly higher tensile strength than slip knots (p < 0.001). For Vicryl, 4-throw square knots were superior to 6-throw slip knots (p < 0.001). For Prolene, 3-throw square knots were superior to 6-throw slip knots (p = 0.035). Some 12.6% of Vicryl knots and 5.6% of Prolene knots were dangerous and all of these were slip knots with up to 6 throws. Three out of 12 participants who thought they had created square knots actually created square knots and the rest produced slip knots. The participants' surgical experience did not have any correlation with their knot security (r = -0.044, p = 0.833). CONCLUSIONS:Knot tying is often executed with technical errors resulting in slip knots with less than optimal security and high incidence of dangerous knots. Tensiometry testing could be used as an objective assessment tool for knot-tying competency for surgical trainees.
journal_name
J Surg Educjournal_title
Journal of surgical educationauthors
Ching SS,Mok CW,Koh YX,Tan SM,Tan YKdoi
10.1016/j.jsurg.2012.07.002subject
Has Abstractpub_date
2013-01-01 00:00:00pages
48-54issue
1eissn
1931-7204issn
1878-7452pii
S1931-7204(12)00183-3journal_volume
70pub_type
杂志文章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: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:OBJECTIVES:To determine whether high fidelity simulation-based training (SBT) of interprofessional teams involving trauma transfers has an immediate impact on participants' team-based attitudes and behaviors. DESIGN:A quasi-experimental, pre-/postintervention comparison design examined high fidelity SBT of inter-profe...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2019.03.013
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Journal clubs exist in a variety of forms in medical schools across the United States. Many incorporate a full spectrum of medical specialties, some are specific to certain interest groups or specialties, and many widely vary in whether or not they are school mandated or student-run. While these clubs are ub...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.06.006
更新日期:2019-01-01 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:As the competitiveness of applicants for general surgery residency grows, it is becoming challenging for programs to differentiate qualified candidates with a genuine interest in matching at their institution. The purpose of this study was to examine geographic trends in the general surgery match in order to ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2019.09.018
更新日期:2020-01-01 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 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: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:OBJECTIVE:Effective self-assessment is a cornerstone of lifelong professional development; however, evidence suggests physicians have a limited ability to self-assess. Novel strategies to improve the accuracy of learner self-assessment are needed. Our institution's surgical entrustable professional activity (EPA) imple...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.05.005
更新日期:2020-01-01 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:Workplace-based assessments are a mandatory component of postgraduate surgical training within the United Kingdom and Ireland. Procedure-based assessments (PBAs) and direct observation of practical skills (DOPS) are integrated within the Intercollegiate Surgical Curriculum Programme online platform and aim t...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.03.005
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVES:Single incision laparoscopic surgery (SILS) offers a scar-less approach to cholecystectomy. We conducted a cadaveric randomized crossover study to compare the novice learning curves for multiport laparoscopic cholecystectomy (LC) and single incision laparoscopic cholecystectomy (SILC), and to investigate the...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2012.10.001
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVES:The effect of fellowship programs on resident training for gynecologic surgery volume has not been clearly defined. The purpose of our study is to assess resident surgical volume for laparoscopic and vaginal hysterectomy before and after initiation of a female pelvic medicine and reconstructive surgery (FPMR...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2016.11.007
更新日期:2017-01-01 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::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:Visualization tools are essential for effective medical education, to aid students understanding of complex anatomical systems. Three dimensional (3D) printed models are showing a wide-reaching potential in the field of medical education, to aid the interpretation of 2D imaging. This study investigates the us...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2017.07.023
更新日期:2018-01-01 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:OBJECTIVES:The purpose of this study was to gain an understanding of faculty and resident perception of residents' learning needs regarding operative management. Our hypothesis is that surgical faculty and residents have significantly different perceptions of residents' learning needs. DESIGN:This study used a 27-item...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2007.07.007
更新日期:2007-09-01 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:BACKGROUND:This study sought to investigate the potential of a subinternship apprentice role as a structured experiential learning opportunity by enabling final-year medical students to learn through action rather than observation. METHODS:A convenience sample of 65 final-year medical students was allocated to "intern...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2015.03.003
更新日期:2015-09-01 00:00:00
abstract:INTRODUCTION:The Association of Program Directors in Surgery convened a panel during Surgical Education Week 2016 to discuss the current state of the general surgery residency application process and to review alternative ways to evaluate the suitability of each applicant to a residency program. METHODS/RESULTS:Over 4...
journal_title:Journal of surgical education
pub_type: 杂志文章,评审
doi:10.1016/j.jsurg.2016.09.005
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:The patient experience around surgical care is poorly characterized. Medical students have a unique position on the surgical team, which allows them to observe patient experiences that may otherwise be overlooked. The objective of this study was to characterize surgical patients' experience with pain as witn...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2019.04.008
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:In efforts to maintain standards required to evaluate the high-stakes assessment, Society of American Gastrointestinal and Endoscopic Surgeons Fundamentals of Laparoscopic Surgery (FLS) requires all new proctors to complete the train-the-proctor workshop. As the pool of FLS proctors expands, new methods to s...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2014.07.008
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:Self-assessment is fundamental in surgical training to enhance learning in the absence of trainer feedback. The primary objective of this review was to assess the factors that influence accuracy of self-assessment at technical skills across all surgical specialties. The secondary objective was to assess wheth...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2019.09.016
更新日期:2020-01-01 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: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: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
abstract:PURPOSE:High-fidelity procedure simulation has been found useful for training vascular surgery residents in endovascular procedures, but the costs of acquiring, maintaining, and operating simulators represent a barrier to routine use of endovascular simulation in vascular surgery programs. Providing simulation training...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2009.07.004
更新日期:2009-11-01 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