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 suturing (simple interrupted, subcuticular, and vertical mattress) and tying tasks (1-handed, 2-handed, and tie on pass) preinstruction (baseline) and at 4 months. Feedback and remediation were done after 4 months, and interns were retested until goals were met. TP was scored on a 1-5 scale (1 = novice, 3 = proficient, and 5 = expert). The results were compared with 6 end of PGY2 year residents and rotation evaluations, case numbers, and American Board of Surgery In-Training Examination (ABSITE) scores. The data are mean ± standard deviation (SD); statistical analysis was by 1-way ANOVA, Kruskal-Wallis test, and Pearson correlation. RESULTS:The total combined task times improved significantly from initial (1289 ± 301 seconds) to final assessment (770 ± 139 seconds, p = 0.0003) and between 4-month assessment (1092 ± 253 seconds) and final assessment (p = 0.0237), but not baseline to 4-month assessment (p = 0.213). Final TP scores were improved significantly (baseline, 1.87 ± 0.81; 4-month assessment, 2.63 ± 0.75; and final assessment 3.51 ± 0.39 [p < 0.001]. All interns reached proficiency on 6/6 tasks but not until 10.1 months (range, 4-12 months) and 2.4 assessment sessions (range, 1-3). No significant differences in final total task times or TP scores were found between interns (770 ± 139 seconds and TP, 3.51 ± 0.39) and end of PGY-2 residents (677 ± 109 seconds and TP, 3.6 ± 0.43). The total task time and rotation technical comments were associated significantly, but TP scores, case numbers, and ABSITE scores were not. CONCLUSIONS:Training, feedback, and remediation are necessary to reach proficiency in basic suturing and knot tying. This program provides an objective assessment of interns' skills not discernible by conventional measures.
journal_name
J Surg Educjournal_title
Journal of surgical educationauthors
Schill M,Tiemann D,Klingensmith ME,Brunt LMdoi
10.1016/j.jsurg.2011.04.005subject
Has Abstractpub_date
2011-11-01 00:00:00pages
526-33issue
6eissn
1931-7204issn
1878-7452pii
S1931-7204(11)00115-2journal_volume
68pub_type
杂志文章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:Teaching of basic open surgical skills like skin closure has been well established in medical schools' surgical curricula. The same cannot be said for basic arthroscopic skills even though the importance of arthroscopic surgery in Orthopaedics has been well documented. The goal of this study was to evaluate t...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.01.001
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:There is an extremely small proportion of female medical students choosing to specialize in orthopedic surgery. The aim of the study was to assess medical students' and interns' interests and perceptions of orthopedic surgery and explore why women are not interested in orthopedic surgery. SETTING:Questionnai...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2013.08.005
更新日期:2014-03-01 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:To determine 2020 residency cycle application practices and to model potential consequences in the 2021 cycle if (1) applicants scheduled an uncapped number of interviews; (2) applicants were capped to schedule 12 interviews; (3) residency programs kept their number of interview offers unchanged; and (4) prog...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.08.033
更新日期:2020-09-14 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:Compare characteristics of U.S. medical school graduates with U.S.-born and foreign-born international medical school (IMG) graduates. DESIGN:Retrospective analysis. SETTING:East Carolina University, a tertiary care teaching hospital. PARTICIPANTS:Demographic data, United States Medical Licensing Examinati...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2008.05.002
更新日期:2008-11-01 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: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: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: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: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 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: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: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:Each year, thousands of surgeons and other trauma health care providers participate in the American College of Surgeon's Advanced Trauma Life Support (ATLS) program, which historically has allowed trainees to practice cricothyroidotomy, chest tube insertion, pericardiocentesis, venous cutdown, and diagnostic...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.08.011
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:Complex vascular anatomy has always been a difficult point for medical students. Gastrocolic trunk (Henle trunk) has many branches and variations, involving the venous reflux of the stomach, right colon, and pancreas. This study investigated the effects of 3 dimensional (3D) printing technology on medical int...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.02.031
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Interest in international surgery among general surgery residents in the United States has been shown in several publications. Several general surgery residency programs have reported their experiences with international surgery rotations (ISRs). Learning to use limited resources more efficiently is often cit...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2011.10.009
更新日期:2012-05-01 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:INTRODUCTION:Despite recent changes to medical education, surgical training remains largely based on the apprenticeship model. However, after completing training, there are few structured learning opportunities available for surgeons in practice to refine their skills or acquire new skills. Personalized observation wit...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.01.007
更新日期:2020-01-01 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: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:OBJECTIVE:Compassion fatigue (CF) is the profound sense of emotional exhaustion that care providers can experience as the result of helping others in distress. CF can contribute to burnout (BO), depression, and stress-related illness. While surgeons and surgical trainees may be at high risk for developing CF, it has no...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2019.03.012
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Although good communication skills are essential for surgeons, there is no formal communication training during general surgery residency. OBJECTIVES:To implement a communication skills training program based on evidence-based teaching methods in general surgery residency. DESIGN:We developed a 2-hour comm...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2019.04.001
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:In academic settings, surgical residents often serve as co-surgeon in complex operations such as pancreatic resections. These operations are typically performed by fellowship-trained primary surgeons with extensive experience in the field. Our study aimed to evaluate how the participation of general surgery r...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.04.006
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVES:In an effort to move training programs toward competency-based education, the Accreditation Council for Graduate Medical Education (ACGME) introduced the Next Accreditation System (NAS), which organizes specific milestones regarding resident skills, knowledge, and abilities along a continuum. In order to fos...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2014.12.007
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Humanitarian surgeons face many ethical challenges. Despite increasing resident participation during humanitarian activities, minimal literature exists describing premission ethics training. METHODS:A systematic literature review was conducted to identify publications on humanitarian surgery. A 3-tiered rev...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2019.11.015
更新日期:2020-01-01 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:INTRODUCTION:Since the introduction of laparoscopic surgery for cholecystectomy in 1989, the growth of minimally invasive surgery (MIS) has increased significantly in the United States. There is a growing concern that the pendulum has now shifted too far toward MIS and that current general surgery residents' exposure t...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2013.09.002
更新日期:2013-11-01 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