Abstract：
OBJECTIVE:We aimed to identify potential variables predictive of a resident achieving faculty future entrustment as a way to enhance attending surgeons' planning of teaching in the operating room leading to improved resident operative autonomy in practice. METHODS:We reviewed 273 resident performance evaluations from 91 surgical cases that were collected from 11 general surgery chief residents and 16 attending surgeons between April 2018 and June 2019 using a validated evaluation instrument. The primary outcome measure was prospective resident entrustment estimated by the rater for future similar cases. We used descriptive statistics and the boosted tree analysis model to find potential predictors for the outcome measure and examine test-retest reliability by procedure. RESULTS:Step-specific guidance (r = 0.77, p < 0.0001) was the variable most highly associated with prospective resident entrustment in bivariate linear analysis. The boosted tree analysis demonstrated step-specific guidance was the strongest predictor for prospective resident entrustment in the OR, and its predictive importance was much higher than the overall guidance (0.64 > 0.18). Test-retest reliability was from 0.93 to 0.98 across procedures, indicating the likelihood that attending surgeons granted future autonomy complied with their evaluation of prospective resident entrustment was high. CONCLUSIONS:By assessing step-specific guidance, attending surgeons can reliably judge residents' future entrustment and potentially better plan for operative teaching/supervision that may lead to granting a surgical resident operative autonomy on similar cases in the future. Our findings provide insight into prospective faculty development of surgical teaching aimed at improving resident readiness for independent practice.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Chen XP,Cochran A,Harzman AE,Ellison ECdoi
10.1016/j.amjsurg.2021.01.020subject
Has Abstractpub_date
2021-01-19 00:00:00eissn
0002-9610issn
1879-1883pii
S0002-9610(21)00038-6pub_type
杂志文章abstract：:A genetic study of hybrid Baltimore blacks in relation to the presence of cancer may be timely since the mortality rate in blacks compared with the mortality rate in whites has increased considerably. The appearance of white genes in black persons may provide some help in such a study. A positive relationship was not ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90302-1
更新日期：1983-11-01 00:00:00
abstract：:A significant impairment in the intestinal absorption of D-xylose and vitamin A was observed in the first weeks after preservation and transplantation of the whole small bowel. Functional recovery was only observed in long-term survivors, usually transplanted dogs that lived more than five weeks. There was no impairme...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90297-4
更新日期：1975-02-01 00:00:00
abstract：BACKGROUND:The aim of this analysis is to compare the postoperative outcomes of resection and enucleation of small pancreatic neuroendocrine tumors (PNETs). METHODS:The 2014-17 American College of Surgeons-NSQIP dataset was queried. Patients undergoing pancreatoduodenectomy (N = 297) or distal pancreatectomy (N = 712)...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.12.013
更新日期：2020-12-08 00:00:00
abstract：:The results of a pathologic study of 42 colorectal cancers have been presented. Of the 42 lesions, only 2 demonstrated intramural spread. The maximum extent of intramural spread was 2 cm. In one case, intramural spread was in the distal direction. Thirty-six percent of the lesions were in the rectum or rectosigmoid, 1...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90320-3
更新日期：1983-12-01 00:00:00
abstract：:The clinical efficacy and safety of cefotetan was assessed in two multicenter clinical trials involving 335 evaluable patients hospitalized with obstetric and gynecologic infections. In Study I, cefotetan was compared with moxalactam and in Study II, cefotetan was compared with cefoxitin. The clinical response rate in...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(88)80214-9
更新日期：1988-05-31 00:00:00
abstract：:The presentation, surgical management, and clinical outcome in 153 patients with biliary pancreatitis has been reviewed. Only 37 percent of our patients demonstrated any of Ranson's 11 prognostic signs of severe pancreatitis, and only 3 percent had 3 or more signs. Fourteen patients underwent emergency operation withi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90028-0
更新日期：1986-01-01 00:00:00
abstract：BACKGROUND:Transduodenal sphincterotomy (TS) has fallen into disuse since endoscopists developed techniques to treat sphincter problems nonsurgically. However, some patients experience recurrent sphincter strictures after endoscopic sphincterotomy (ES), with the ampulla endoscopically inaccessible, and pancreas divisum...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.08.048
更新日期：2010-08-01 00:00:00
abstract：BACKGROUND:To evaluate the clinical and laboratory characteristics of patients submitted to subtotal splenectomy during the immediate and late postoperative period. METHODS:The study was conducted on 34 patients, 25 of whom were submitted to subtotal splenectomy (group I), and 9 to total splenectomy without preservati...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01407-1
更新日期：2003-04-01 00:00:00
abstract：:A retrospective study of 316 patients with a diagnosis of intestinal obstruction admitted to the University of Benin Teaching Hospital over a 5 year period is presented. The overall mortality was 10.6 percent. Attention is called to the unacceptably high morbidity and mortality associated with volvulus in this and oth...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90300-1
更新日期：1980-03-01 00:00:00
abstract：:Two hundred six consecutive patients were followed from 5 to 15 years after a distal splenorenal shunt operation. Nonalcoholic patients demonstrated nearly twice the survival rate when compared with alcoholic patients. The mean duration of life for the surviving nonalcoholics was 10 years and for the alcoholics, 9 yea...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80250-2
更新日期：1988-01-01 00:00:00
abstract：:Although the incidence of anastomotic false aneurysms decreased precipitously with the cessation of usage of silk sutures for vascular anastomoses, the prevalence of these aneurysms has undoubtedly increased in keeping with an ever-increasing volume of peripheral vascular operations. Most aneurysms occur at femoral an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90338-0
更新日期：1983-12-01 00:00:00
abstract：:Significant salvage of patients with a wide variety of cysts and benign tumors of the liver and of some patients with biliary strictures can be achieved by hepatic resection in carefully selected clinical situations with a low operative mortality rate and an acceptable postoperative complication rate. Still to be dete...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90123-5
更新日期：1979-04-01 00:00:00
abstract：BACKGROUND:Based on current evidence, the benefit of intraoperative nerve monitoring (IONM) in thyroid surgery is equivocal. METHODS:All patients who underwent planned thyroid surgery in the 2016-2018 ACS NSQIP procedure-targeted thyroidectomy dataset were included. Multivariable regression analyses were performed to ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.10.013
更新日期：2020-10-16 00:00:00
abstract：BACKGROUND:Trastuzumab has been found to have potent antiproliferative effects in human epidermal growth factor receptor 2 (HER-2)-overexpressing human breast tumors. Inhibition of vascular endothelial growth factor receptor (VEGFR), a protein often overexpressed in breast carcinoma, has been shown to induce apoptosis....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.10.009
更新日期：2009-03-01 00:00:00
abstract：:The records of 46 immunocompromised patients who presented with diffuse pulmonary infiltrates were reviewed to determine the role of open lung biopsy in their management. Fifty-two percent of these patients had underlying hematologic malignancies and 54 percent had received chemotherapy within 3 months prior to biopsy...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90246-7
更新日期：1987-12-01 00:00:00
abstract：:Access to the peroneal artery as well as to the anterior tibial artery can be accomplished by a lateral approach with fibular resection. The technic is described as well as the use of the glutaraldehyde-tanned human umbilical cord vein as a vascular prosthesis. The results using the latter have been extremely gratifyi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90343-9
更新日期：1977-08-01 00:00:00
abstract：:Despite the advantages of aseptic nonoperative intubation of the small intestine for decompression of obstructed loops, 48% of the attempts lead to failure to pass the tube through the pylorus. The difficulty and inconvenience of passage beyond the stomach have been overcome by the development of a special tube attach...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90427-x
更新日期：1976-01-01 00:00:00
abstract：:Despite the very high accuracy rate of imaging studies (ultrasound, computed tomography, liver-lung-spleen scans and gallium-67 scans) in detecting intraabdominal abscesses, our experience with 80 recent cases indicate that these techniques have not significantly altered traditional methods of decision-making about wh...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90195-7
更新日期：1982-04-01 00:00:00
abstract：:The application of systems analysis and flow charting technics to abdominal incision and closure allow a complete display of objectives and alternatives. A route of alternatives has been chosen and supported by the best available principles in the surgical literature. The choices include an unconventional large bite m...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90160-4
更新日期：1976-04-01 00:00:00
abstract：:One hundred seventeen patients with threatened limb loss were evaluated. Seventy-three of these patients underwent vascular reconstruction. Diabetics had a significantly higher incidence of ischemic ulceration and gangrene when compared with nondiabetics. Nondiabetics typically presented with rest pain. The outcome of...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80534-8
更新日期：1988-12-01 00:00:00
abstract：BACKGROUND:Patients with radiographically-identified traumatic brain injury are often transferred to our regional trauma center for neurosurgical evaluation, yet few injuries require neurosurgical intervention. Transfer is costly, inconvenient, and potentially risky in inclement weather. We propose that previously-publ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.09.002
更新日期：2017-12-01 00:00:00
abstract：:Surgical experience with adrenal disease from 1970 to 1979 was reviewed in 315 patients. The pathologic conditions that were encountered were hypercortisolism (74 patients), hyperaldosteronism (46 patients), adrenocortical carcinoma (35 patients), pheochromocytoma (77 patients), and nonfunctioning adenoma (47 patients...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90571-2
更新日期：1982-11-01 00:00:00
abstract：BACKGROUND:The results and advantages of laparoscopic cholecystectomy in the geriatric population have received minimal attention. Several early reports related high conversion rates complications and mortality. This case series review is focused on the results of laparoscopic cholecystectomy in the geriatric populatio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.11.031
更新日期：2004-06-01 00:00:00
abstract：:Between 1982 and 1985, 83 patients with hypopharyngeal or extensive laryngeal cancers underwent pharyngoesophagectomy (48 patients), circumferential pharyngectomy (8 patients), and partial pharyngectomy (27 patients), depending on the site and extent of tumor involvement. The resultant hypopharyngeal defects were reco...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90007-x
更新日期：1987-10-01 00:00:00
abstract：:Eighty-two femoropopliteal reconstructions were performed on sixty-six consecutive patients. Of seventeen late failures, thirteen were secondarily reconstructed. Clinical and angiographic studies demonstrated the reasons for failure in all patients except one. Seven patients were improved and six unimproved by reopera...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90107-1
更新日期：1978-02-01 00:00:00
abstract：OBJECTIVES:The OX-40 receptor (OX-40R/CD134) is expressed primarily on activated CD4(+) ("helper") T cells. We have previously reported the presence of OX-40(+) T cells in head and neck cancer and melanoma, where they appear to be restricted to tumor compartments (primary tumor infiltrating lymphocytes [TILs] and drain...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00361-5
更新日期：2000-05-01 00:00:00
abstract：:Twenty-three consecutive patients who had persistent respiratory symptoms of unexplained etiology were evaluated to determine the presence of gastroesophageal reflux (GER) and its relationship to their respiratory complaints. Lower esophageal sphincter (LES) and upper esophageal sphincter (UES) pressures and the chara...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(92)90041-o
更新日期：1992-04-01 00:00:00
abstract：BACKGROUND:Previous evaluations of endoscopic hernia surgery mostly are based on small prospectively documented series or on a few randomized comparative studies. In the following, results of a large single-institution experience concerning the transabdominal preperitoneal patch (TAPP) technique with regard to the deve...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00074-9
更新日期：1998-06-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to determine the utility of breast-imaging studies in identifying cancer and high-risk lesions among patients with spontaneous, single-duct, nipple discharge (SSND). METHODS:The medical records of 168 cases with SSND treated with duct excision between June 1998 and May 2004 wer...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.06.032
更新日期：2005-10-01 00:00:00
abstract：BACKGROUND:An ideal treatment method for the widely prevalent pilonidal sinus disease is not yet available. The most commonly practiced technique is simple closure following resection of the effected tissue. However, high recurrence rates in some series have led to the search for other methods. One of these methods is ...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2008.12.030
更新日期：2010-02-01 00:00:00
