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https://www.readbyqxmd.com/read/28742711/readiness-of-us-general-surgery-residents-for-independent-practice
#1
Brian C George, Jordan D Bohnen, Reed G Williams, Shari L Meyerson, Mary C Schuller, Michael J Clark, Andreas H Meier, Laura Torbeck, Samuel P Mandell, John T Mullen, Douglas S Smink, Rebecca E Scully, Jeffrey G Chipman, Edward D Auyang, Kyla P Terhune, Paul E Wise, Jennifer N Choi, Eugene F Foley, Justin B Dimick, Michael A Choti, Nathaniel J Soper, Keith D Lillemoe, Joseph B Zwischenberger, Gary L Dunnington, Debra A DaRosa, Jonathan P Fryer
OBJECTIVE: This study evaluates the current state of the General Surgery (GS) residency training model by investigating resident operative performance and autonomy. BACKGROUND: The American Board of Surgery has designated 132 procedures as being "Core" to the practice of GS. GS residents are expected to be able to safely and independently perform those procedures by the time they graduate. There is growing concern that not all residents achieve that standard. Lack of operative autonomy may play a role...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28734949/the-program-evaluation-committee-in-action-lessons-learned-from-a-general-surgery-residency-s-experience
#2
Shanley B Deal, Heather Seabott, Lily Chang, Adnan A Alseidi
OBJECTIVE: To evaluate the success of the annual program evaluation process and describe the experience of a Program Evaluation Committee for a General Surgery residency program. DESIGN: We conducted a retrospective review of the Program Evaluation Committee's meeting minutes, data inputs, and outcomes from 2014 to 2016. We identified top priorities by year, characterized supporting data, summarized the improvement plans and outcome measures, and evaluated whether the outcomes were achieved at 1 year...
July 19, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28734557/-conversational-advice-a-mixed-methods-analysis-of-medical-residents-experiences-co-managing-primary-care-patients-with-behavioral-health-providers
#3
Patrick Hemming, R B Levine, Joseph J Gallo
OBJECTIVE: When integrated behavioral health clinicians (IBHCs) and residents co-manage patients, residents may learn new approaches. We aimed to understand the effect of co-management on residents' behavioral health (BH) management learning. METHODS: Residents completed a web-based survey enquiring: whether co-management included a shared visit and/or face-to-face meeting with an IBHC, whether residents received feedback from the IBHC, and what they learned. Qualitative responses were coded thematically using a constant comparative method...
July 14, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28734046/effect-of-a-community-based-service-learning-experience-in-geriatrics-on-internal-medicine-residents-and-community-participants
#4
Rachel K Miller, Jennifer Michener, Phyllis Yang, Karen Goldstein, Jennine Groce-Martin, Gala True, Jerry Johnson
Community-based service learning (CBSL) provides an opportunity to teach internal medicine residents the social context of aging and clinical concepts. The objectives of the current study were to demonstrate the feasibility of a CBSL program targeting internal medicine residents and to assess its effect on medical residents and community participants. internal medicine residents participated in a CBSL experience for half a day during ambulatory blocks from 2011 to 2014. Residents attended a senior housing unit or center, delivered a presentation about a geriatric health topic, toured the facility, and received information about local older adult resources...
July 22, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28733672/trainee-surgeons-affect-operative-time-but-not-outcome-in-minimally-invasive-total-hip-arthroplasty
#5
Markus Weber, Achim Benditz, Michael Woerner, Daniela Weber, Joachim Grifka, Tobias Renkawitz
Training of young surgeons in total hip arthroplasty (THA) is crucial, but might affect operative time and outcome especially in minimally invasive (MIS) THA. We asked whether the learning curve of orthopaedic residents trained on MIS THA has an impact on (1) operative time (2) complication rates and (3) early postoperative outcome. In a retrospective analysis of over 1000 MIS THAs from our institutional joint registry, operative time, complication rates, patient reported outcome measures (Western Ontario and McMaster Universities Arthritis Index [WOMAC] and Euro-Qol 5D-5L [EQ-5D]) within the first year and responder rates for positive outcome as defined by the Outcome Measures in Rheumatology and Osteoarthritis Research Society International consensus responder (OMERACT-OARSI) criteria were compared between trainee and senior surgeons...
July 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28733142/deprescribing-for-frail-older-people-learning-from-the-case-of-mrs-hansen
#6
Anne Gerd Granas, Marit Stendal Bakken, Sabine Ruths, Katja Taxis
Drug treatment is often an essential part in treatment and prevention of diseases in older people, but there is much concern about inappropriate medication use. This paper aims to describe the complexity of medication safety issues and clinical judgments when optimizing prescribing in older individuals. It uses the case of Mrs. Hansen, an aged nursing home resident, to illustrate the facilitators and barriers of this process. With decreasing life expectancy, medication use should shift from cure to care, focusing on symptomatic treatment to increase the patient's well-being...
July 13, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28732336/using-machine-learning-to-identify-air-pollution-exposure-profiles-associated-with-early-cognitive-skills-among-u-s-children
#7
Jeanette A Stingone, Om P Pandey, Luz Claudio, Gaurav Pandey
Data-driven machine learning methods present an opportunity to simultaneously assess the impact of multiple air pollutants on health outcomes. The goal of this study was to apply a two-stage, data-driven approach to identify associations between air pollutant exposure profiles and children's cognitive skills. Data from 6900 children enrolled in the Early Childhood Longitudinal Study, Birth Cohort, a national study of children born in 2001 and followed through kindergarten, were linked to estimated concentrations of 104 ambient air toxics in the 2002 National Air Toxics Assessment using ZIP code of residence at age 9 months...
July 18, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28730111/cumulative-sum-analysis-score-and-phacoemulsification-competency-learning-curve
#8
Gustavo Vedana, Filipe G Cardoso, Alexandre S Marcon, Licio E K Araújo, Matheus Zanon, Daniella C Birriel, Guilherme Watte, Albert S Jun
AIM: To use the cumulative sum analysis score (CUSUM) to construct objectively the learning curve of phacoemulsification competency. METHODS: Three second-year residents and an experienced consultant were monitored for a series of 70 phacoemulsification cases each and had their series analysed by CUSUM regarding posterior capsule rupture (PCR) and best-corrected visual acuity. The acceptable rate for PCR was <5% (lower limit h) and the unacceptable rate was >10% (upper limit h)...
2017: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/28729882/breastfeeding-is-associated-with-enhanced-learning-abilities-in-school-aged-children
#9
Johanna Inhyang Kim, Bung-Nyun Kim, Jae-Won Kim, Soon-Beom Hong, Min-Sup Shin, Hee Jeong Yoo, Soo-Churl Cho
OBJECTIVE: The majority of studies on the associations between breastfeeding and cognitive functioning have focused on IQ, with only a few investigating learning skills, and none of the latter adjusting for maternal IQ. We examined the association between breastfeeding and learning abilities in school-aged children using a cross-sectional design. METHODS: We recruited 868 children, aged 8-11 years and parents completed the Learning Disability Evaluation Scale (LDES)...
2017: Child and Adolescent Psychiatry and Mental Health
https://www.readbyqxmd.com/read/28729189/the-quality-in-training-initiative-giving-residents-data-to-learn-clinical-effectiveness
#10
Morgan M Sellers, Matt Fordham, Craig W Miller, Clifford Y Ko, Rachel R Kelz
BACKGROUND: Training programs are expected to provide clinical outcomes data to residents. Few systems have the necessary infrastructure. We evaluated initial adoption and use of the Quality In-Training Initiative (QITI) platform linking National Surgical Quality Improvement Program (NSQIP) data to trainees. STUDY DESIGN: Proportions of Accreditation Council for Graduate Medical Education general surgery residency programs with differing levels of NSQIP and QITI affiliation were calculated and program characteristics were compared...
July 17, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28727316/primary-inguinal-hernia-the-open-repair-today-pros-and-cons
#11
REVIEW
Giampiero Campanelli, Piero Giovanni Bruni, Andrea Morlacchi, Francesca Lombardo, Marta Cavalli
Open anterior repair for inguinal hernia offers several distinct advantages over endoscopic repair, especially when real-world effectiveness is taken into account. The learning curve for endoscopic techniques is long, whereas the Lichtenstein and other open tension-free techniques are easier to teach and replicate at all levels. The outcomes of Lichtenstein repairs for primary inguinal hernia as performed by non-experts and supervised residents are comparable to those of experts. Moreover, open tension-free repair does not require expensive instruments or dedicated equipment, other than the prosthetic mesh...
August 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28725788/pathology-residents-comprise-inspection-team-for-a-cap-self-inspection
#12
Stacy G Beal, Jesse L Kresak, Anthony T Yachnis
We report our experience at the University of Florida in which residents and fellows served as the inspection team for a College of American Pathologists (CAP) self-inspection. We aimed to determine whether the CAP self-inspection could serve as a learning opportunity for pathology residents and fellows. To prepare for the inspection, we provided a series of 4 lunchtime seminars covering numerous laboratory management topics relating to inspections and laboratory quality. Preparation for the inspection began approximately 4 months prior to the date of the inspection...
January 2017: Acad Pathol
https://www.readbyqxmd.com/read/28724154/mapping-residency-global-health-experiences-to-the-acgme-family-medicine-milestones
#13
Maureen O Grissom, Tochi Iroku-Malize, Rita Peila, Marco Perez, Neubert Philippe
BACKGROUND AND OBJECTIVES: Global health (GH) experiences are a unique part of family medicine (FM) training that offer an opportunity for residents to demonstrate development across a multitude of the milestones recently implemented by the Accreditation Council for Graduate Medical Education (ACGME). The GH experience presents an opportunity for resident development, and including a component of written reflection can provide tangible evidence of development in areas that can be difficult to assess...
July 2017: Family Medicine
https://www.readbyqxmd.com/read/28721169/investigating-an-outbreak-of-measles-in-margibi-county-liberia-october-2015
#14
Joseph Asamoah Frimpong, Maame Pokuah Amo-Addae, Peter Adebayo Adewuyi, Meeyoung Mattie Park, Casey Daniel Hall, Thomas Knue Nagbe
The emergence and re-emergence of infectious diseases highlights the need to have well-trained field epidemiologists who will be at the forefront in the fight against these diseases, especially during an outbreak. Training for outbreak investigation is most effective when participants can develop their competencies in a practical exercise. To that end, this case study was based on a measles outbreak investigation conducted in Liberia during October 2015 by Liberia Frontline Field Epidemiology Training Program (FETP) residents, simulating steps to perform outbreak investigation in a real-life situation as a field epidemiologist...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28720087/resident-perceptions-of-the-impact-of-duty-hour-restrictions-on-resident-attending-interactions-an-exploratory-study
#15
Kristen A Gerjevic, Marcy E Rosenbaum, Manish Suneja
BACKGROUND: The institution of duty hour reforms by the Accreditation Council for Graduate Medical Education in 2003 has created a learning environment where residents are consistently looking for input from attending physicians with regards to balancing duty hour regulations and providing quality patient care. There is a paucity of literature regarding resident perceptions of attending physician actions or attitudes towards work hour restrictions. The purpose of this study was to identify attending physician behaviors that residents perceived as supportive or unsupportive of their compliance with duty hour regulations...
July 18, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28716383/nonspecialist-raters-can-provide-reliable-assessments-of-procedural-skills
#16
Oria Mahmood, Julia Dagnæs, Sarah Bube, Malene Rohrsted, Lars Konge
BACKGROUND: Competency-based learning has become a crucial component in medical education. Despite the advantages of competency-based learning, there are still challenges that need to be addressed. Currently, the common perception is that specialist assessment is needed for evaluating procedural skills which is difficult owing to the limited availability of faculty time. The aim of this study was to explore the validity of assessments of video recorded procedures performed by nonspecialist raters...
July 14, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28716337/physical-models-and-virtual-reality-simulators-in-otolaryngology
#17
REVIEW
Luv Javia, Maya G Sardesai
The increasing role of simulation in the medical education of future otolaryngologists has followed suit with other surgical disciplines. Simulators make it possible for the resident to explore and learn in a safe and less stressful environment. The various subspecialties in otolaryngology use physical simulators and virtual-reality simulators. Although physical simulators allow the operator to make direct contact with its components, virtual-reality simulators allow the operator to interact with an environment that is computer generated...
July 14, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28712902/design-based-comparison-of-spine-surgery-simulators-optimizing-educational-features-of-surgical-simulators
#18
Won Hyung A Ryu, Ahmed E Mostafa, Navjit Dharampal, Ehud Sharlin, Gail Kopp, W Bradley Jacobs, R John Hurlbert, Sonny Chan, Garnette R Sutherland
BACKGROUND: Simulation-based education has made its entry into surgical residency training, particularly as an adjunct to hands-on clinical experience. However, one of the ongoing challenges to wide adoption is the capacity of simulators to incorporate educational features required for effective learning. The aim of this study was to identify strengths and limitations of spine simulators to characterize design elements that are essential in enhancing resident education. METHODS: We performed a mixed qualitative and quantitative cohort study with focused survey and interviews of stakeholders in spine surgery pertaining to their experiences on three spine simulators...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28712688/the-role-of-the-operating-room-in-medical-student-education-differing-perspectives-of-learners-and-educators
#19
Rebecca O'Neill, Michael Shapiro, Aziz Merchant
OBJECTIVE: The surgical clerkship is an integral part of third-year medical student education. The operating room (OR) is a heavily used setting, but it is unclear whether this setting is as effective as possible. To determine the role of the OR and potential improvements, it is necessary to analyze the perspectives of those involved, including surgeons, residents, and medical students. DESIGN: An electronic survey was distributed to the surgeons, surgical residents, and third-year medical students associated with Rutgers New Jersey Medical School...
July 13, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28712686/using-touch-surgery-to-improve-surgical-education-in-low-and-middle-income-settings-a-randomized-control-trial
#20
Gisele Juru Bunogerane, Kathryn Taylor, Yihan Lin, Ainhoa Costas-Chavarri
BACKGROUND/OBJECTIVE: There is a severe surgical workforce shortage in Rwanda. Innovative educational tools must be introduced to train more residents and increase surgical capacity. Touch Surgery (TS) is a smartphone application that offers trainees the opportunity to practice operations; however, its effect is unknown in low- and middle-income countries. Our objectives were to determine the training effect of TS and its feasibility for use in surgery education in a low-resource setting...
July 13, 2017: Journal of Surgical Education
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