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https://www.readbyqxmd.com/read/29351677/use-of-risk-model-for-assessment-of-residents-perception-of-complexity-of-surgical-steps-example-of-modular-component-steps-of-lumbar-spinal-fusion-surgery
#1
Jeffrey S Raskin, Jesse J Liu, Katherine Holste, Sarah Brown, Fran Hardaway, Priscilla Pang, Ahmed M Raslan
BACKGROUND: Quality improvement projects increasingly emphasize standardization of surgical work flow to optimize operative room efficiency. Removing special cause variability resulting from nonsurgical waste is an obvious target; however, resident surgical education must be maintained, even in the setting of process improvement. OBJECTIVE: To describe the impact of resident-identified "risky" or "uncomfortable" procedural steps on operative time during transforaminal lumbar interbody fusion (TLIF)...
February 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29349544/interpretation-of-motion-analysis-of-laparoscopic-instruments-based-on-principal-component-analysis-in-box-trainer-settings
#2
Ignacio Oropesa, Fernando Pérez Escamirosa, Juan A Sánchez-Margallo, Silvia Enciso, Borja Rodríguez-Vila, Arturo Minor Martínez, Francisco M Sánchez-Margallo, Enrique J Gómez, Patricia Sánchez-González
BACKGROUND: Motion analysis parameters (MAPs) have been extensively validated for assessment of minimally invasive surgical skills. However, there are discrepancies on how specific MAPs, tasks, and skills match with each other, reflecting that motion analysis cannot be generalized independently of the learning outcomes of a task. Additionally, there is a lack of knowledge on the meaning of motion analysis in terms of surgical skills, making difficult the provision of meaningful, didactic feedback...
January 18, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29349426/development-of-a-pulsatile-tissue-based-versatile-vascular-surgery-simulation-laboratory-for-resident-training
#3
Brian Fletcher, Jaime De La Ree, James Drougas
Simulation in surgery is becoming an important component of surgical education. Training on bench top models has been demonstrated to improve technical skills. The objective of our project was to create a vascular surgery simulation model. The simulation model consists of a platform, artificial blood reservoir, artificial blood, inflow and outflow limbs, electric motor, battery, pulse generator, and cryopreserved vessel. Three different vascular surgery simulation stations were created: carotid endarterectomy with shunting and patch angioplasty, arterial bypass, and arteriovenous graft formation...
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29343150/eight-year-outcomes-of-a-competency-based-residency-training-program-in-orthopedic-surgery
#4
Markku T Nousiainen, Polina Mironova, Melissa Hynes, Susan Glover Takahashi, Richard Reznick, William Kraemer, Benjamin Alman, Peter Ferguson
BACKGROUND: The Division of Orthopaedic Surgery at the University of Toronto implemented a pilot residency training program that used a competency-based framework in July of 2009. The competency-based curriculum (CBC) deployed an innovative, modularized approach that dramatically intensified both the structured learning elements and the assessment processes. METHODS: This paper discusses the initial curriculum design of the CBC pilot program; the refinement of the curriculum using curriculum mapping that allowed for efficiencies in educational delivery; details of evaluating resident competence; feedback from external reviews by accrediting bodies; and trainee and program outcomes for the first eight years of the program's implementation...
January 18, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29342008/the-r2c2-model-in-residency-education-how-does-it-foster-coaching-and-promote-feedback-use
#5
Joan Sargeant, Jocelyn M Lockyer, Karen Mann, Heather Armson, Andrew Warren, Marygrace Zetkulic, Sophie Soklaridis, Karen D Könings, Kathryn Ross, Ivan Silver, Eric Holmboe, Cindy Shearer, Michelle Boudreau
PURPOSE: The authors previously developed and tested a reflective model for facilitating performance feedback for practice improvement, the R2C2 model. It consists of four phases: relationship building, exploring reactions, exploring content, and coaching. This research studied the use and effectiveness of the model across different residency programs and the factors that influenced its effectiveness and use. METHOD: From July 2014-October 2016, case study methodology was used to study R2C2 model use and the influence of context on use within and across five cases...
January 16, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29341035/when-an-unexpected-diagnosis-occurs-a-vaginal-premenopausal-sarcoma
#6
Pedro Marcos-Figueiredo, Diana de Sousa da Costa Moreira, Manuel Gonçalves Morim, Júlia Leite Pereira, Lurdes Silva Salgado
Vaginal cancer is a rare entity. The evidence on its management resides mostly in clinical cases or small case series. Of the histological types, the most frequent is the squamous cell carcinoma, followed by adenocarcinoma. But what to do when identifying an even more infrequent sarcoma in a premenopausal woman? In this study, we describe the case of a 53-year-old woman presenting with metrorrhagia for two months, who was evaluated after an intense episode. A necrotic and ulcerative vaginal swelling was documented and then submitted to biopsy, which revealed a vaginal sarcoma...
January 2018: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29339299/is-there-a-difference-in-the-outcome-of-mid-urethral-sling-operations-performed-by-urogynecologists-as-compared-to-supervised-residents
#7
Osnat Elyashiv, Noa Mevorach Zussman, Masha Ben-Zvi, Jacob Bar, Ron Sagiv, Alexander Condrea, Shimon Ginath
STUDY OBJECTIVE: To compare the operative results of midurethral sling (MUS) surgeries for stress urinary incontinence (SUI) performed by residents under the guidance of an attending specialist in urogynecology, to those done by attendings. DESIGN: Retrospective chart review DESIGN CLASSIFICATION: Canadian Task Force classification II-2 SETTING: University hospital PATIENTS: A retrospective analysis of all MUS's performed between January 2009 to December 2013, in a single public tertiary medical center, was carried out...
January 12, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29337447/-geriatric-medicine
#8
Gabriel Gold, Christophe Büla, Pierre Olivier Lang, Philippe Chassagne
2017 highlights benefits of prevention. Better control of cardiovascular risk reduces the incidence of dementia and monthly high-dose vitamin D the incidence of respiratory infections in nursing home. Pre-operative geriatric assessment lowers by 20% the rate of delirium after hip-fracture surgery and complications in vascular surgery. Deleterious effects are also reported. High-dose vitamin D triples the rate of falls in supplemented residents and doesn't improve gait speed in sedentary men. Widely used in cardiovascular prevention, antithrombotic therapy is associated with an astonishing risk of subdural bleeding that further increases with the number of drugs combined together...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29337170/virtual-cerebral-aneurysm-clipping-with-real-time-haptic-force-feedback-in-neurosurgical-education
#9
Matthias Gmeiner, Johannes Dirnberger, Wolfgang Fenz, Maria Gollwitzer, Gabriele Wurm, Johannes Trenkler, Andreas Gruber
OBJECTIVE: Realistic, safe and efficient modalities for simulation-based training are highly warranted to enhance the quality of surgical education and should be incorporated in resident training. The aim of this study was to develop a patient-specific virtual cerebral aneurysm-clipping simulator with haptic force-feedback and real-time deformation of the aneurysm and vessels. METHODS: A prototype simulator was developed from 2012-2016. Evaluation of virtual clipping by blood flow simulation was integrated in this software and the prototype was evaluated by 18 neurosurgeons...
January 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29337090/the-clinical-impact-of-resident-attending-discrepancies-in-on-call-radiology-reporting-a-retrospective-assessment
#10
Sebastian R McWilliams, Christopher Smith, Yaseen Oweis, Kareem Mawad, Constantine Raptis, Vincent Mellnick
RATIONALE AND OBJECTIVES: The purpose of this study is to quantify the clinical impact of resident-attending discrepancies at a tertiary referral academic radiology residency program by assessing rates of intervention, discrepancy confirmation, recall rate, and management change rate; furthermore, a discrepancy categorization system will be assessed. MATERIALS AND METHODS: Retrospective review of the records was performed for n = 1482 discrepancies that occurred in the 17-month study period to assess the clinical impact of discrepancies...
January 12, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29336769/processes-of-health-care-delivery-education-and-provider-satisfaction-in-acute-care-surgery-a-systematic-review
#11
DeGirolamo Kristin, Patrick B Murphy, Karan D'Souza, Jacques X Zhang, Neil Parry, Elliott Haut, W Robert Leeper, Ken Leslie, Kelly N Vogt, S Morad Hameed
In recent years, significant workload, high acuity, and complexity of emergency general surgery conditions have led hospitals to replace the traditional on-call model with dedicated acute care surgery (ACS) service models. A systematic search of Ovid, EMBASE, and MEDLINE was undertaken to examine the impact of ACS services on health-care delivery processes and cost, education, and provider satisfaction. From 1827 papers, reviewers identified 22 studies that met inclusion criteria and subsequently used The Evidence-Based Practice for Improving Quality method and Newcastle-Ottawa Scale to score quality and level of evidence...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336337/-training-program-in-endourological-surgery-future-perspectives
#12
Federico Soria, Felipe Villacampa, Alvaro Serrano, Jesús Moreno, Jorge Rioja, Francisco Miguel Sánchez
Current training in urological endoscopy lacks a specific training program. However, there is a clear need for a specific and uniform program, which will ensure the training, regardless of the unit where it is carried out. So, the goal is to first evaluate the current model and then bring improvements for update. The hospital training accreditation programme are only the adjustment of the official program of the urology specialty to the specific circumstances of each center, which causes variability in training of residents...
January 2018: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/29335101/outcomes-and-complication-rates-of-primary-resident-performed-cataract-surgeries-at-a-large-tertiary-care-county-hospital
#13
Cameron Clarke, Shazia F Ali, Michael Murri, Saagar N Patel, Li Wang, Marie Tuft, Mitchell P Weikert, Zaina Al-Mohtaseb
PURPOSE: To identify the preoperative risk factors, intraoperative events, and postoperative complications increasing the risk for poor visual outcomes in resident-performed cataract surgeries at a tertiary-care county hospital. SETTING: Ben Taub General Hospital, Houston, Texas, USA. DESIGN: Retrospective case series. METHODS: Resident-performed cataract surgeries were analyzed for risk factors, comorbidities, and intraoperative and postoperative complications...
December 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/29330861/validity-evidence-as-a-key-marker-of-quality-of-technical-skill-assessment-in-otl-hns
#14
Mathilde Labbé, Meredith Young, Lily H P Nguyen
OBJECTIVE: Quality monitoring of assessment practices should be a priority in all residency programs. Validity evidence is one of the main hallmarks of assessment quality and should be collected to support the interpretation and use of assessment data. Our objective was to identify, synthesize, and present the validity evidence reported supporting different technical skill assessment tools in otolaryngology-head and neck surgery (OTL-HNS). METHODS: We performed a secondary analysis of data generated through a systematic review of all published tools for assessing technical skills in OTL-HNS (n = 16)...
January 13, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29325763/clinical-experience-with-three-dimensional-printing-techniques-in-orthopedic-trauma
#15
Ji Wan Kim, Yongkoo Lee, Joonho Seo, Jai Hyung Park, Yong Min Seo, Sung Soo Kim, Hyun Chul Shon
BACKGROUND: To report our experiences with the use of three-dimensional (3D) printing in the field of orthopedic trauma. METHODS: This retrospective study enrolled 24 patients from three university teaching hospitals in whom 3D printing technique was applied: 14 patients with acetabular fractures and 10 patients with clavicular shaft fractures. We summarized our experiences with 3D printed bone models. RESULTS: Three-dimensional printed acetabular models improved understanding of complex acetabular anatomy and fracture pattern to plan the optimal positioning of a reduction clamp and the trajectory of screws...
January 8, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29325183/validation-of-the-modified-surgeon-periorbital-rating-of-edema-and-ecchymosis-spree-questionnaire-a-prospective-analysis-of-facial-plastic-and-reconstructive-surgery-procedures
#16
Jeremie D Oliver, Deanna Menapace, Ahmed Younes, Chelsey Recker, Grant Hamilton, Oren Friedman
Although periorbital edema and ecchymosis are commonly encountered after facial plastic and reconstructive surgery procedures, there is currently no validated grading scale to qualify these findings. In this study, the modified "Surgeon Periorbital Rating of Edema and Ecchymosis (SPREE)" questionnaire is used as a grading scale for patients undergoing facial plastic surgery procedures. This article aims to validate a uniform grading scale for periorbital edema and ecchymosis using the modified SPREE questionnaire in the postoperative period...
January 11, 2018: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/29323794/skills-transfer-to-sinus-surgery-via-a-low-cost-simulation-based-curriculum
#17
R Alex Harbison, Jennifer Dunlap, Ian M Humphreys, Greg E Davis
BACKGROUND: Surgical skill development outside the operating room aims to improve technique and subsequent patient safety. The purpose of this study was to evaluate the correlation between technical and cognitive skills with cadaveric endoscopic sinus surgery (ESS) performance and change in ESS performance before and after implementation of a dedicated ESS simulation-based and knowledge-based curriculum. METHODS: A before-after study design was implemented among 10 medical students and 10 junior otolaryngology residents...
January 11, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29322173/association-of-surgical-practice-patterns-and-clinical-outcomes-with-surgeon-training-in-university-or-nonuniversity-based-residency-program
#18
Morgan M Sellers, Luke J Keele, Catherine E Sharoky, Christopher Wirtalla, Elizabeth A Bailey, Rachel R Kelz
Importance: Important metrics of residency program success include the clinical outcomes achieved by trainees after transitioning to practice. Previous studies have shown significant differences in reported training experiences of general surgery residents at nonuniversity-based residency (NUBR) and university-based residency (UBR) programs. Objective: To examine the differences in practice patterns and clinical outcomes between surgeons trained in NUBR and those trained in UBR programs...
January 10, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29316598/s-orthopaedic-department-teaching-status-associated-with-adverse-outcomes-of-primary-total-knee-arthroplasty
#19
Dean C Perfetti, Nipun Sodhi, Anton Khlopas, Assem A Sultan, Suela Lamaj, Mathew R Boylan, Jared M Newman, Qais Naziri, William A Cantrell, Aditya V Maheshwari, Carl B Paulino, Michael A Mont
INTRODUCTION: Although resident physicians have a critical role in the daily management of patients, based on their limited experiences, they are thought to potentially create inefficiencies in the hospital. With changes set forth by the Comprehensive Care for Joint Replacement (CJR) program, both teaching and non-teaching hospitals are directly compared on efficiency and outcomes. Therefore, the purpose of this study was to compare outcomes between teaching and non-teaching hospitals in the state of New York...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29313124/development-of-a-train-to-proficiency-curriculum-for-the-technical-skills-component-of-the-fundamentals-of-endoscopic-surgery-exam
#20
Susan Gearhart, Michael Marohn, Saowanee Ngamruengphong, Gina Adrales, Oluwafemi Owodunni, Kim Duncan, Emil Petrusa, Pamela Lipsett
BACKGROUND: The demonstration of competency in endoscopy is required prior to obtaining American Board of Surgery Certification. To demonstrate competency, the resident must pass a national high-stakes cognitive test and a technical skills exam on a virtual reality simulator. The purpose of this preliminary study was to design a proficiency-based endoscopy simulation curriculum to meet this competency requirement. METHODS: This is a mixed methods prospective cohort study at a single academic medical institution...
January 8, 2018: Surgical Endoscopy
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