Abstract:
PURPOSE:We developed a system of resident-driven, evidence-based standardization of care in our trauma-surgical intensive care unit (TSICU). Our main purposes are to improve patient care and outcomes and to help the residents develop practical competency in practice-based learning and improvement and in systems-based practice. DEVELOPMENT OF THE ACTIVITY:Since October 2006, each rotating TSICU resident has chosen a topic to research the available evidence and has developed a guideline, which the resident then presents to the TSICU faculty and residents for discussion, amendments, and acceptance or reevaluation. EVALUATION COMPONENT:Evaluation of proposed guidelines is based on the quality of information presented in support of the recommendations. Ultimately, acceptance of a guideline requires consensus among the TSICU faculty. Immediate feedback is given to the presenting resident by the faculty. The residents evaluate the program via a Web-based evaluation tool. PROPOSED OUTCOME MEASURES:We have qualitative data from residents that indicate this experience is positive. We are developing a tool to use both qualitative and quantitative means to evaluate resident, faculty, and nursing staff satisfaction with the process. We will use our clinical database to evaluate whether improved patient outcomes have resulted from standardization of care. IMPLEMENTATION DATES AND EXPERIENCE TO DATE:We implemented this methodology in October 2006 and have thus far implemented 20 guidelines and 2 standardized order sets. CONCLUSION AND OR NEXT STEPS: We believe competency is achieved and demonstrated by actively participating in a process such as development of care guidelines. Researching and developing standardized guidelines for our TSICU seems to be an effective and practical way for residents to use multiple sources for practice-based learning and improvement. It also requires the resident to advocate for quality patient care and optimal patient care systems. We plan to use outcome and qualitative data to validate this method.
journal_name
J Surg Educjournal_title
Journal of surgical educationauthors
Marinaro J,Tawil I,Nelson MTdoi
10.1016/j.jsurg.2008.01.003subject
Has Abstractpub_date
2008-03-01 00:00:00pages
109-11issue
2eissn
1931-7204issn
1878-7452pii
S1931-7204(08)00004-4journal_volume
65pub_type
杂志文章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: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:PURPOSE:As laparoscopy continues to permeate general surgery, there is an increased need for residents to acquire advanced laparoscopic skills during a surgical training program. To underscore its importance, the Accreditation Council of Graduate Medical Education (ACGME) recently increased the requirements for laparos...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2007.06.013
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:To determine the effect of the 80-hour work week restrictions on general surgery resident operative volume in a large, community-based, university-affiliated, general surgery residency program. METHODS:We performed a retrospective review of Accreditation Council for Graduate Medical Education (ACGME) operati...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2010.05.007
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:The Luke Commission, a provider of comprehensive mobile health outreach in rural Swaziland, focuses on human immunodeficiency virus testing and prevention, including the performance of over 100 circumcisions weekly. Educational objectives for medical student global health electives are essential. Learning re...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2017.09.015
更新日期:2018-01-01 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: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:To conduct a needs assessment to identify gaps in communication skills training in ophthalmology residency programs and to use these results to pilot a communication workshop that prepares residents for difficult conversations. DESIGN:A mixed-methods design was used to perform the needs assessment. A pre-and...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2017.08.011
更新日期:2018-01-01 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:INTRODUCTION:The aim of this study was to ascertain whether the University of Texas, Southwestern (UTSW) open skills curriculum (Goova et al.(13)) could be successfully implemented in the University of Minnesota (UMN) multisite training program. We posed 4 questions: (1) Is the curriculum feasible? (2) Did residents' s...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2014.08.001
更新日期:2014-11-01 00:00:00
abstract:INTRODUCTION:Medical students have typically received relatively modest training in approaches for engaging the concerns of patients and families facing life-threatening situations and terminal illnesses. We propose that medical students would perceive benefits to their communication skills, understanding of the role o...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2013.07.001
更新日期:2014-01-01 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::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:BACKGROUND:Patient safety is a critical issue in healthcare services particularly in surgical units and operation rooms because of the high prevalence and risk of medical errors in such settings. This study was conducted to determine whether a 1-day educational intervention can change the attitude and behavior of surgi...
journal_title:Journal of surgical education
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jsurg.2019.03.002
更新日期:2019-01-01 00:00:00
abstract::Giant colonic diverticulum is a rare complication of diverticular disease of the colon and is thought to result, in most cases, from a "ball-valve" effect. The presentation and clinical course can be variable and confusing. The most common symptoms are abdominal pain and a palpable abdominal lump, with many patients p...
journal_title:Journal of surgical education
pub_type: 杂志文章,评审
doi:10.1016/j.jsurg.2006.10.007
更新日期:2007-03-01 00:00:00
abstract:INTRODUCTION:Entrustment is a key component connecting to resident preparedness for surgical practice in the operating room (OR). Residents' self-entrustment of their surgical competencies closely associates with their OR training experience and granted autonomy. Some recent studies have investigated how attending surg...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.07.019
更新日期:2021-01-01 00:00:00
abstract::In the beginning of the academic year, medical errors are often attributed to inexperienced medical staff. This potential seasonal influence on health care outcomes is termed the "July effect." No study has demonstrated the July effect in liver transplantation. We reviewed retrospectively collected data from the Unite...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2013.04.012
更新日期:2013-09-01 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::Intracardiac foreign bodies may be caused by direct penetrating trauma, embolization from injury to another area of the body, or iatrogenically from fragments of intravascular access devices. Penetrating cardiac trauma commonly presents with a hemodynamically unstable patient necessitating emergent life-saving procedu...
journal_title:Journal of surgical education
pub_type: 杂志文章,评审
doi:10.1016/j.jsurg.2009.04.002
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:To determine, given a fixed amount of training, the optimal distribution of sessions needed to acquire intracorporeal endoscopic suturing skills and to retain said skills for 1 to 6 months. DESIGN:A randomized controlled trial consisted of 6 study groups who received identical laparoscopic suturing training ...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2013.01.005
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVES:Smartphones have become the most important personal technological device. M-learning is learning through mobile device educational technology. We aim to assess the acceptability of a smartphone learning experience among the vascular trainees and determine if results could inform formal teaching efforts. MET...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2016.12.006
更新日期:2017-01-01 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: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:OBJECTIVE:This study attempts to assess the association between surgeon personality factors (measured by the Myers-Briggs Type Indicator personality inventory (MBTI(®))) and risk tolerance (measured by the Revised Physicians' Reactions to Uncertainty (PRU) and Physician Risk Attitude (PRA) scales). DESIGN:Instrument a...
journal_title:Journal of surgical education
pub_type: 杂志文章,评审
doi:10.1016/j.jsurg.2013.07.014
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:To investigate the current rate of attrition in general surgery residency, assess the risk factors, and identify prevention strategies. DESIGN:A literature review of the PubMed and MEDLINE databases, from January 1, 1980 to February 1, 2016, for relevant articles. The calculated attrition rate and the statis...
journal_title:Journal of surgical education
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jsurg.2017.07.015
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:Few medical school programs in Canada address challenges related to the significant increase in responsibility for patient care between medical school and residency. This is particularly important in surgery and anesthesia due to the high-acuity care required during the perioperative period. The purpose of th...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2017.08.022
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:Attrition rates in general surgery training are higher than other surgical disciplines. We sought to determine the prevalence with which Canadian general surgery residents consider leaving their training and the contributing factors. DESIGN, SETTING, AND PARTICIPANTS:An anonymous survey was administered to a...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2015.11.008
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:To investigate whether preclinical laparoscopy training offers a benefit over standard apprenticeship training and apprenticeship training in combination with simulation training. DESIGN:This randomized controlled trial consisted of 3 groups of first-year surgical registrars receiving a different teaching me...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2013.04.001
更新日期:2013-09-01 00:00:00
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 t...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2012.07.002
更新日期:2013-01-01 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