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Impact of continuous medical education on the skills of Surgeons

Russell J Merritt, Valeria Cohran, Bram P Raphael, Timothy Sentongo, Diana Volpert, Brad W Warner, Praveen S Goday
Intestinal failure is a rare, debilitating condition that presents both acute and chronic medical management challenges. The condition is incompatible with life in the absence of the safe application of specialized and individualized medical therapy that includes surgery, medical equipment, nutritional products, and standard nursing care. Intestinal rehabilitation programs are best suited to provide such complex care with the goal of achieving enteral autonomy and oral feeding with or without intestinal transplantation...
November 2017: Journal of Pediatric Gastroenterology and Nutrition
Patricia L Hardré, Mikio Nihira, Edgar L LeClaire
Research in medical education does not provide a clear understanding of how professional expertise develops among surgeons and what experiential factors contribute to that development. To address this gap, the researchers interviewed 16 international experts in female pelvic medicine and reconstructive surgery to assess their reflective perceptions of what specific opportunities and experiences initiated and supported their development toward expertise in their field. Characteristics and influences explaining the speed and quality of expertise development were sorted into the following themes: the dynamic process of expertise development, internal and personal characteristics, general aptitudes and preparatory skills, role modeling and interpersonal influences, opportunities to learn and practice, and roles and reference points...
2017: Psychology Research and Behavior Management
Kyle J Jeray, Steven L Frick
Residency education continues to evolve. Several major changes have occurred in the past several years, including emphasis on core competencies, duty-hour restrictions, and call. The Accreditation Council for Graduate Medical Education (ACGME) Next Accreditation System (NAS) implemented educational milestones in orthopaedic surgery in July 2013. Additionally, the Residency Review Committee for orthopaedic surgery published suggested surgical case minimums in 2012, which overlap with several of the milestones...
December 3, 2014: Journal of Bone and Joint Surgery. American Volume
Ricardo B V Fontes, Nathan R Selden, Richard W Byrne
INTRODUCTION: Incorporation of the 6 ACGME core competencies into surgical training has proven a considerable challenge particularly for the two primarily behavioral competencies, professionalism and interpersonal and communication skills. We report on experience with two specific interventions to foster the teaching and continuous evaluation of these competencies for neurosurgery residents. MATERIAL AND METHODS: In 2010, the Society of Neurological Surgeons (SNS) organized the first comprehensive Neurosurgery Boot Camp courses, held at six locations throughout the US and designed to assess and teach not only psychomotor skills but also components of all six Accreditation Council for Graduate Medical Education (ACGME) core competencies...
November 2014: Journal of Surgical Education
Ritesh Agrawal, Saroj Kanta Mishra, Anjali Mishra, Gyan Chand, Gaurav Agarwal, Amit Agarwal, Ashok Kumar Verma
INTRODUCTION: This retrospective study was designed to assess the outcome of telemedicine technology supportive of educational collaboration among endocrine surgery peers and its impact on knowledge and skill development. MATERIALS AND METHODS: The study was carried out in the Department of Endocrine Surgery in collaboration with School of Telemedicine and Biomedical Informatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, during October 1999-December 2012...
September 2014: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Kyrollis Attalla, Syed Johar Raza, Shabnam Rehman, Rakeeba Din, Andrew Stegemann, Erinn Field, Leslie Curti, Sandra Sexton, Marlene Bienko, Mahendra Bhandari, Khurshid A Guru
INTRODUCTION: Robot-assisted surgery (RAS) has been integrated into the surgical armamentarium and generated wide-spread interest among practicing, non-robotic surgeons (NRS). While methods for training novice non-robotic surgeons have emerged, the effectiveness of these training programs has endured minimal scrutiny. This study aims to establish effectiveness of the RAST training program. MATERIALS AND METHODS: A formal RAST program was established at Roswell Park Cancer Institute (RPCI) in 2008...
December 2013: Canadian Journal of Urology
Alexander F Arriaga, Atul A Gawande, Daniel B Raemer, Daniel B Jones, Douglas S Smink, Peter Weinstock, Kathy Dwyer, Stuart R Lipsitz, Sarah Peyre, John B Pawlowski, Sharon Muret-Wagstaff, Denise Gee, James A Gordon, Jeffrey B Cooper, William R Berry
OBJECTIVE: To test the feasibility of implementing a standardized teamwork training program with full operating room teams in multiple institutions, driven by malpractice insurer support and incentives. BACKGROUND: Failures in intraoperative teamwork are among the leading causes of preventable patient injury and death in surgical patients. Teamwork training, particularly using simulation, can be an effective intervention but is difficult to scale. METHODS: A malpractice insurer convened a collaborative with 4 Harvard-affiliated simulation programs to develop a standardized operating room teamwork training curriculum, including principles of communication, assertiveness, and use of the World Health Organization Surgical Safety Checklist...
March 2014: Annals of Surgery
Iryna Atamanyuk, Olivier Ghez, Imran Saeed, Mary Lane, Judith Hall, Tim Jackson, Ajay Desai, Margarita Burmester
OBJECTIVES: To develop an affordable realistic open-chest extracorporeal membrane oxygenation (ECMO) model for embedded in situ interprofessional crisis resource management training in emergency management of a post-cardiac surgery child. METHODS: An innovative attachment to a high-fidelity mannequin (Laerdal Simbaby) was used to enable a cardiac tamponade/ECMO standstill scenario. Two saline bags with blood dye were placed over the mannequin's chest. A 'heart' bag with venous and arterial outlets was connected to the corresponding tubes of the ECMO circuit...
January 2014: Interactive Cardiovascular and Thoracic Surgery
Peter Shah, Vinette Cross, Freda Sii
INTRODUCTION: The potential for "discontinuities in care" arising from the turbulent transition from specialist trainee to consultant specialist presents risks to patient safety. But it is easy to lose sight of the affective needs of individuals facing the burden of keeping patients safe. This article describes a 2-day program focused on new and prospective consultant specialist ophthalmic surgeons entitled "Sailing a Safe Ship" (SASS). The purpose was to facilitate understanding and analysis of their personal holistic learning needs and enhance individual agency in optimizing learning during the transition period...
2013: Journal of Continuing Education in the Health Professions
Victoria A Roach, Michael G Brandt, Corey C Moore, Timothy D Wilson
The process of learning new surgical technical skills is vital to the career of a surgeon. The acquisition of these new skills is influenced greatly by visual-spatial ability (VSA) and may be difficult for some learners to rapidly assimilate. In many cases, the role of VSA on the acquisition of a novel technical skill has been explored; however, none have probed the impact of a three-dimensional (3D) video learning module on the acquisition of new surgical skills. The first aim of this study is to capture spatially complex surgical translational flaps using 3D videography and incorporate the footage into a self-contained e-learning module designed in line with the principles of cognitive load theory...
May 2012: Anatomical Sciences Education
Saurabh Khandelwal, Andrew S Wright, Edgar Figueredo, Carlos A Pellegrini, Brant K Oelschlager
BACKGROUND: Single-incision laparoscopy is an emerging technique that brings new challenges to laparoscopy and introduces new skills that a surgeon must learn. The learning needs for single-incision skills acquisition are unknown and no current guidelines exist for training or for its safe adoption. METHODS: We developed an approach to adoption of new surgical techniques and applied it to single-incision laparoscopy. It is based on the following principles: a defined training algorithm, dry and wet-laboratory practice, a graded clinical introduction, and careful review of early outcomes...
October 2011: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Ajit K Sachdeva
Major imperatives regarding quality of patient care and patient safety are impacting surgical care and surgical education. Also, significant emphasis continues to be placed on education and training to achieve proficiency, expertise, and mastery in surgery. Simulation-based surgical education and training can be of immense help in acquiring and maintaining surgical skills in safe environments without exposing patients to risk. Opportunities for repetition of tasks can be provided to achieve pre-established standards, and knowledge and skills can be verified using valid and reliable assessment methods...
2011: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
D Schreiter, H-D Saeger
BACKGROUND: The creation of a center for interdisciplinary operative intensive care through the fusion of several smaller intensive care units from various specialties is mainly driven by economic reasons. To specify some conditions for making such a fusion less expensive and to identify the impact of larger intensive care units on the quality of patients' treatment and on surgical training are the subjects of this study. MATERIALS AND METHODS: Based on a review of the literature and on our own experience in this field, the influence of the size of the unit should be analysed not just regarding the economic aspects but also concerning the medical and surgical training issues...
April 2011: Zentralblatt Für Chirurgie
Alice Miller, Julian Archer
OBJECTIVE: To investigate the literature for evidence that workplace based assessment affects doctors' education and performance. DESIGN: Systematic review. DATA SOURCES: The primary data sources were the databases Journals@Ovid, Medline, Embase, CINAHL, PsycINFO, and ERIC. Evidence based reviews (Bandolier, Cochrane Library, DARE, HTA Database, and NHS EED) were accessed and searched via the Health Information Resources website. Reference lists of relevant studies and bibliographies of review articles were also searched...
September 24, 2010: BMJ: British Medical Journal
Mark V Schaverien
Surgical training is currently undergoing many changes. Moves toward an outcomes-based education based on achievement of core competencies will have a significant impact on how trainees are taught and evaluated. New strategies must therefore be sought to enhance surgical training to achieve outstanding resident education and safe patient care. An extensive body of literature is available concerning the attributes of experts and the development of expertise. It is increasingly apparent that the extent and nature of practice, as well as the practice structure, are critical to the development of complex motor skills...
January 2010: Journal of Surgical Education
Allan Okrainec, Lloyd Smith, Georges Azzie
INTRODUCTION: The use of laparoscopy in resource-restricted countries has increased in recent years. Although simulation is now considered an important adjunct to operating-room-based training for learning laparoscopic skills, there is very little literature assessing the use of simulation in resource-restricted countries. The purpose of this study was to determine the feasibility and impact of a 3-day Fundamentals of Laparoscopic Surgery (FLS) course in Botswana, Africa. METHODS: A total of 20 surgeons and trainees participated in a 3-day FLS course...
November 2009: Surgical Endoscopy
Hans-Christoph Pape, Roman Pfeifer
BACKGROUND: Work-hour limitations have been implemented by the Accreditation Council for Graduate Medical Education (ACGME) in July 2003 in order to minimize fatigue related medical adverse events. The effects of this regulation are still under intense debate. In this literature review, data of effects of limited work-hours on the quality of life, surgical education, and patient care was summarized, focusing on surgical subspecialities. METHODS: Studies that assessed the effects of the work-hour regulation published following the implementation of ACGME guidelines (2003) were searched using PubMed database...
2009: Patient Safety in Surgery
Mischel G Neill, Charles C Chabert, David A Merrilees, Christopher G Eden
OBJECTIVE: To address concerns about the impact of training on patient outcomes during the 'learning curve' for laparoscopic radical prostatectomy (LRP), we compare the results of our patients undergoing LRP with and without trainees performing a substantial proportion of the cases. PATIENTS AND METHODS: In all, 771 consecutive cases of LRP were performed or supervised by one surgeon during a 7.5-year period, of which 114 (15%) were training cases. A five-port transperitoneal technique was used in the first 111 patients and an extraperitoneal approach in the remaining 660...
May 2009: BJU International
Aldrin Joseph R Gamboa, Rosanne T Santos, Eric R Sargent, Michael K Louie, Geoffrey N Box, Kevin H Sohn, Hung Truong, Rachelle Lin, Amanda Khosravi, Ricardo Santos, David K Ornstein, Thomas E Ahlering, Darren R Tyson, Ralph V Clayman, Elspeth M McDougall
PURPOSE: Robot assisted laparoscopic prostatectomy has stimulated a great deal of interest among urologists. We evaluated whether a mini fellowship for robot assisted laparoscopic prostatectomy would enable postgraduate urologists to incorporate this new procedure into clinical practice. MATERIALS AND METHODS: From July 2003 to July 2006, 47 urologists participated in the robot assisted laparoscopic prostatectomy mini fellowship program. The 5-day course had a 1:2 faculty-to-attendee ratio...
February 2009: Journal of Urology
Daniel J Scott
Despite its relatively short track record, simulation has been successfully introduced into the surgical arena in an effort to augment training. Initially a fringe endeavor at isolated centers, simulation has now become a mainstream component of surgical education. The surgical community is now aware that the old adage, "see one, do one, and teach one" is no longer acceptable from the ethical standpoint of practicing procedures on patients. Moreover, financial and time constraints have made teaching outside of the operating room an attractive proposition...
2006: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
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