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 DESIGN:Single-subject repeated measures research design. Bench-top set-up of apparatus undertaken in a University Research laboratory. After initial directed learning, a trainee repaired 70 fresh flexor digitorum profundus tendons within the flexor sheath using either a Pennington or ventral-locking-loop modification of a two-strand Kessler core repair. Tendon repairs were then preconditioned and distracted to failure. Key biomechanical parameters of the repair, including the ultimate tensile strength (UTS), yield strength, 3 mm gap force and stiffness, were calculated. Repairs were divided into 3 categories, early (first 10 days), intermediate (ensuing 10 days), and late repairs (final 10 days), and potential changes in repair properties over the training period were evaluated using a general linear modeling approach. RESULTS:There was a significant change in the mechanical characteristics of the repairs over the training period, evidencing a clear learning effect (p < 0.05). Irrespective of the repair technique employed, early and intermediate repairs were characterized by a significantly lower UTS (29% and 20%, respectively), 3 mm gap (21% and 16%, respectively), and yield force (18% and 23%, respectively), but had a higher stiffness (33% and 38%, respectively) than late repairs (p < 0.05). The UTS of late repairs (47-48 N) were comparable to those published within the literature (45-51 N), suggesting surgical competence of the trainee. CONCLUSIONS:This simple, low-cost porcine model appears to be useful for providing preclinical training in flexor tendon repair techniques and has the potential to provide a quantitative index to evaluate the competency of surgical trainees. Further research is now required to identify optimal training parameters for flexor tendon repair and to develop procedure-specific standards for adequate benchmarking.
journal_name
J Surg Educjournal_title
Journal of surgical educationauthors
Zetlitz E,Wearing SC,Nicol A,Hart AMdoi
10.1016/j.jsurg.2012.01.001subject
Has Abstractpub_date
2012-07-01 00:00:00pages
504-10issue
4eissn
1931-7204issn
1878-7452pii
S1931-7204(12)00002-5journal_volume
69pub_type
杂志文章abstract:PURPOSE:We implemented and evaluated the outcomes of a proficiency-based program to enhance basic suturing and knot-tying skills in surgical interns. METHODS:A suturing and knot-tying "masters program" was implemented for 9 surgical interns. Assessment consisted of timed and videotaped technical performance (TP) of 6 ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2011.04.005
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:To assure that orthopaedic residents have the knowledge needed to critically appraise the medical/surgical literature and the skills needed to design and conduct musculoskeletal and orthopaedic research. SETTING:Residency program of the Department of Orthopaedic Surgery, Sports Medicine and Rehabilitation a...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2010.04.002
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Feedback plays an important role in the learning process. However, often this may be delivered in an unstructured fashion that can detract from its potential benefit. Further, students may have different preferences in how feedback should be delivered, which may be influenced by which method they feel will l...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2015.04.017
更新日期:2015-09-01 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: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:BACKGROUND:In 2013, we developed an education workshop to enhance the teaching skills of surgical fellows. We sought to investigate the feasibility of the monthly educational workshop format and its effect on participant teaching skills. STUDY DESIGN:Surgical and medical education faculty created a broadly applicable ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2016.02.001
更新日期:2016-07-01 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::Of all the clinical competencies, the least understood are Systems-Based Practice and Practice-Based Learning and Improvement. With a shift to competency-based education and evaluation across the spectrum of surgical education and practice, a clear understanding of the power and utility of each competency is paramount...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2009.12.001
更新日期:2010-03-01 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: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:OBJECTIVE:The Accreditation Council for Graduate Medical Education mandates resident physician training in the principles and applications of research. To provide a robust early foundation for effective engagement in scholarship, we designed a novel clinical scholarship program (CSP) for PGY1 general surgery residents....
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.01.001
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:The development of the ability to estimate patient mortality preoperatively in surgical trainees has not been well studied. DESIGN:Prospective comparative study in which the expected perioperative mortality risk and the maximum tolerable mortality at which operation would still be offered were estimated by t...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2014.07.007
更新日期:2015-01-01 00:00:00
abstract:PURPOSE:The interview process is a pivotal, differentiating component of the residency match. Our bias is toward a working interview, producing better fulfillment of the needs of both parties, and a more informed match selection for the candidates and program. METHODS:We describe a "candidate-centered" approach for in...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2012.06.004
更新日期:2012-11-01 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: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:OBJECTIVE:Using a laparoscopic box trainer fitted with motion analysis trackers and software, we aim to identify differences between junior and senior residents performing the peg transfer task, and the impact of a distracting secondary task on performance. DESIGN:General surgery residents were asked to perform the la...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.07.012
更新日期:2021-01-01 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
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: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:To design a low cost ($40), realistic and fluoroscopy-free percutaneous Kirschner wire hand fracture fixation training instrument kit for home-based skill acquisition during the COVID-19 pandemic. DESIGN:A 3D-printed hand was designed from a computed tomography scan of a healthy hand. These data were used to...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.05.027
更新日期:2020-01-01 00:00:00
abstract:PURPOSE:Recent studies have focused on surgeons' nontechnical skills in the operating room (OR), especially leadership. In an attempt to identify trainee preferences, we explored junior residents' opinions about the OR leadership style of teaching faculty. METHODS:Overall, 20 interns and 20 mid-level residents complet...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2015.08.009
更新日期:2016-01-01 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::Malrotation and volvulus are encountered early in infancy and sometimes later in childhood, but rarely in adulthood. This ailment is treated through Ladd's adhesiolysis, detorsion, and possibly bowel resection. Literature is scarce on the long-term outcomes of this procedure, especially into adulthood. We present a ca...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2011.05.020
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Evaluation of fundamental surgical skills is invaluable to the training of medical students and junior residents. This study assessed the effectiveness of crowdsourcing nonmedical personnel to evaluate technical proficiency at simulated vessel ligation. STUDY DESIGN:Fifteen videos were captured of participa...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2017.09.030
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:OBJECTIVE:To1 describe the development and evaluate the feasibility of a surgical objective structured clinical examination (OSCE) for the purpose of competency assessment based on the Royal College of Canada's CanMEDS framework. DESIGN:A unique surgical OSCE was developed to evaluate the clinical and surgical managem...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.02.018
更新日期:2020-01-01 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: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:INTRODUCTION:Oral and poster presentations at major meetings serve to rapidly present and share study results with the scientific community. On the other hand, full-text publication of abstracts in peer-reviewed journals provides dissemination of knowledge. The purpose of this study was to evaluate the publication rate...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2014.02.002
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:The study purpose is to evaluate the Surgical Council on Resident Education (SCORE) Curriculum regarding American Board of Surgery Qualifying Examination (ABS QE) outcomes. The goal is to perform effect size analyses, sensitivity analyses, and sample size analyses with opportunity cost estimates required to f...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2015.09.009
更新日期:2016-01-01 00:00:00