Abstract:
PURPOSE:To evaluate the effect of the 30-hour restriction on resident operative participation and assess whether the 30-hour restriction can be extended in certain cases to enhance educational experience and continuity of care without being detrimental to the 80-hour limit. METHODS:In September 2006, we administered a 10-item Likert scale survey to 41 general surgery residents to assess their experience with the 30-hour work restriction. We also reviewed the operative reports from the busiest general surgery service in April 2003 and April 2005 to assess surgical participation before and after the 30-hour restriction. RESULTS:Twenty-three (56%) residents reported missed operations each month because of the 30-hour restriction. Thirty-four (83%) reported occasions where participating in an operation would require only an additional 1-4 hours. Thirty-six (88%) residents reported a better educational experience when operating on patients whom they had evaluated and a preference to operate on patients whom they had evaluated. The operative log review revealed that in April 2003, the resident assigned to the service participated in 47 out of 134 (35%) total operations and 11 out of 30 (37%) operations beginning after noon. In April 2005, the resident assigned to the service participated in 49 out of 109 (45%) total operations and 20 out of 45 (44%) of the operations beginning after noon. CONCLUSION:The difference in the amount of operations involving resident participation before and after the 30-hour restriction, including afternoon cases that would be most affected by the work restriction, was minimal. However, we identified occasions when the 30-hour work restriction could be extended to provide continuity of care and a better educational operative experience while maintaining weekly duty hours within the approved limit. Extensions beyond the 30 hours should be limited to providing unique and comprehensive experiences for residents where the additional time or episodes would not cause resident fatigue.
journal_name
J Surg Educjournal_title
Journal of surgical educationauthors
Izu BS,Johnson RM,Termuhlen PM,Little AGdoi
10.1016/j.jsurg.2007.08.006subject
Has Abstractpub_date
2007-11-01 00:00:00pages
361-4issue
6eissn
1931-7204issn
1878-7452pii
S1931-7204(07)00214-0journal_volume
64pub_type
杂志文章abstract:BACKGROUND:Human factors are important causes of error, but little is known about their possible effect during objective structured clinical examinations (OSCE). We have previously identified stress and pressure in OSCE examiners in the postgraduate intercollegiate Membership of the Royal College of Surgeons (MRCS) exa...
journal_title:Journal of surgical education
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jsurg.2016.12.013
更新日期:2017-01-01 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:Quality improvement (QI) activities are an integral part of residency training. We started the process to implement team-based, multilevel QI project streams within our academic surgical residency by studying resident perceptions. OBJECTIVE:Our residency carried out 6 QI projects in line with the American C...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.10.006
更新日期:2019-01-01 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: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: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:OBJECTIVE:The purpose of this study was to identify academic differences between male and female candidates applying to our obstetrics and gynecology (OBGYN) residency. METHODS:We reviewed the Electronic Residency Application Service applications of candidates applying to our residency program from 2005 to 2009. Acade...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2013.03.012
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVES:The American Board of Surgery Certifying Examination (ABSCE) is an oral examination designed to evaluate a resident׳s ability to apply their cognitive knowledge to manage a broad range of clinical problems. In this study, we analyze our 5-year experience with a Philadelphia-wide mock oral examination (PMOE)....
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2014.06.019
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:The purpose of the study was to determine the optimal number of throws to ensure knot security. STUDY DESIGN:Knots were tied with 3, 4, 5, or 6 square throws with 0-gauge coated polyester, polydioxanone, polypropylene, and polyglactin 910. The suture was soaked in 0.9% sodium chloride and subsequently transf...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2010.11.001
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:Explore the methods used and costs necessary for the creation and maintenance of a surgical video library with an emphasis on its applications in surgical education and scholarship. DESIGN:A methodology paper highlighting how to develop and utilize a surgical video library for trainee operative preparation, ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.10.011
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this article is to discuss a surgical resident's experience in Kenya as a component of a custom-designed dedicated year. The academic value, clinical experience, and lessons learned will be described. Hopefully, these insights will be useful to those planning to take a similar course or for tho...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2008.07.009
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:To conduct focus group interviews with operating room (OR) personnel to determine components of effective teamwork to inform a revision of a teamwork assessment instrument. DESIGN:Qualitative research study targeting OR personnel using semi-structured focus group interviews of interprofessional OR personnel....
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.09.019
更新日期:2020-11-04 00:00:00
abstract:OBJECTIVE:Given limitations in surgical educational resources, more efficient teaching methods are needed. We sought to evaluate 3 strategies for improving skills in subcuticular suturing-practice with an instructional video, practice with expert instructor supervision, and independent practice. DESIGN:Fifty-eight med...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2011.04.006
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:Few tasks are more ingrained within the minds of practicing surgeons than the dictation of the narrative report of an operation. However, the construct of these reports varies widely among surgeons and is rarely formally taught and not tested formally during surgical training or board certification. DESIGN:A...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2011.06.015
更新日期:2011-11-01 00:00:00
abstract:INTRODUCTION:Surgical care contributes significantly to the fiscal challenges facing the US health care system. Multiple studies have demonstrated surgeons' lack of awareness of the costs associated with individual portions of surgical care, namely operating room supplies. We sought to assess surgeon and trainee awaren...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.11.001
更新日期:2019-01-01 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: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:OBJECTIVE:The Accreditation Council for Graduate Medical Education (ACGME) established duty-hour regulations for accredited residency programs on July 1, 2003. It is unclear what changes occurred in the national incidence of medication errors in surgical patients before and after ACGME regulations. DESIGN:Patient and ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2015.05.013
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:Clerkship students feel increased anxiety and lack of confidence when it comes to surgery. This study assessed whether participation in Surgical Exploration And Discovery (SEAD), a 2-week intensive surgical program that includes career information, simulation workshops, and operating room observerships, would...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.03.010
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::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: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: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:OBJECTIVES:During the last 2 decades, the advent of new technologies in trauma patient care may have resulted in a decreased number of diagnostic peritoneal lavage (DPL) evaluations. In this study, it is hypothesized that fewer DPL are being performed at a midwestern trauma center. Such negative trends may make the inc...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2011.02.003
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Anatomy education has long been considered fundamental to the medical profession. Recently, Australasian medical schools have favored prosected human material, models and medical imaging in their anatomy curriculum with only 3 medical schools offering whole-body dissection. The aim of this study was to explo...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.07.041
更新日期:2020-09-18 00:00:00
abstract::Congenital agenesis of the gallbladder and cystic duct represents a rare anomaly of the biliary system. It likely results from an embryologic mishap in the development of the hepatobiliary bud and can occur with other associated malformations. We report the case of congenital absence of the gallbladder and cystic duct...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2012.07.001
更新日期:2013-01-01 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:OBJECTIVE:A fundamental premise of establishing collaborative relationships between residents and nurses is a basic understanding of the attributes of each group. The intent of this study was to determine what surgical nurses know about surgical residents. DESIGN:A piloted survey tool was administered to a cross-secti...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2009.08.001
更新日期:2009-11-01 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:OBJECTIVE:The aim of this systematic review was to identify studies on hysteroscopic training and assessment. DESIGN:PubMed, Excerpta Medica, the Cochrane Library, and Web of Science were searched in January 2015. Manual screening of references and citation tracking were also performed. Studies on hysteroscopic educat...
journal_title:Journal of surgical education
pub_type: 杂志文章,评审
doi:10.1016/j.jsurg.2016.04.006
更新日期:2016-09-01 00:00:00