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https://www.readbyqxmd.com/read/28225921/model-for-simulated-training-of-laparoscopic-gastroenterostomy
#1
Márcio Alencar Barreira, Delano Gurgel Siveira, Hermano Alexandre Lima Rocha, Luiz Gonzaga de Moura, Charles Jean Gomes de Mesquita, Gleydson Cesar de Oliveira Borges
Purpose: To develop a model of gastroenterostomy and to analyze the acquisition of skills after training by simulation. Methods: Experimental longitudinal study and of a quantitative character. The sample consisted of twelve general surgery residents from four hospitals. The training consisted of making ten anastomoses divided equally into five sessions and it took place over a period of six weeks. The evaluation of the anastomoses considered the time and the analysis of the operative technique through the global evaluation scale Objective Structured Assessment of Technical Skills (OSATS)...
January 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28219677/nsqip-based-quality-improvement-curriculum-for-surgical-residents
#2
Mary M Mrdutt, Claire L Isbell, Justin L Regner, Bonnie R Hodges, Yolanda Munoz Maldonado, J Scott Thomas, Harry T Papaconstantinou
BACKGROUND: General surgery training has historically lacked a standardized approach to resident Quality Improvement (QI) education aside from traditional Morbidity and Mortality conference. In 2013, the Accreditation Council for Graduate Medical Education (ACGME) formalized QI as a component of residency training. Our residency chose the National Surgical Quality Improvement Program (NSQIP) Quality In-Training Initiative (QITI) as the foundation for our QI training. We hypothesized that a focused curriculum based on outcomes would produce change in culture and improve quality of patient care...
February 17, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28219453/a-consult-is-just-a-page-away-a-prospective-observational-study-on-the-impact-of-jinxing-on-call-karma-in-neurosurgery
#3
Holger Joswig, Lauren Zarnett, David A Steven, Martin N Stienen
OBJECTIVE: Our aim was to assess the impact of jinxing on "call karma" in neurosurgery. METHODS: We conducted a prospective observational study on 15 residents on call for the neurosurgery service, recording the total number of admissions, consults, deaths encountered, surgeries performed, hours of sleep and subjective call rating on a numeric rating scale (NRS) of 0-10 in terms of general awfulness. RESULTS: Some 204 on-call nightshifts were analyzed, of which 61 (29...
February 21, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28209533/hospital-admission-after-gastric-bypass-a-nationwide-cohort-study-with-up-to-6-years-follow-up
#4
Gustaf Bruze, Johan Ottosson, Martin Neovius, Ingmar Näslund, Richard Marsk
BACKGROUND: Several studies have addressed short-term admission rates after bariatric surgery. However, studies on long-term admission rates are few and population based studies are even scarcer. OBJECTIVE: The aim of this study was to assess short- and long-term admission rates for gastrointestinal surgery after gastric bypass in Sweden compared with admission rates in the general population. SETTING: Swedish healthcare system. METHODS: The surgery cohort consisted of adults with body mass index≥35 identified in the Scandinavian Obesity Surgery Registry (n = 28,331; mean age 41 years; 76% women; Roux-en-Y gastric bypass performed 2007-2012)...
January 5, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28209152/municipal-resources-and-patient-outcomes-through-the-first-year-after-a-hip-fracture
#5
Sabine Ruths, Valborg Baste, Marit Stordal Bakken, Lars Birger Engesæter, Stein Atle Lie, Siren Haugland
BACKGROUND: Hip fractures represent major critical events for older people, and put huge demands on economic and personnel resources. Most hip fracture patients are in need of postoperative rehabilitation services. Through the Coordination Reform, the municipalities in Norway were given increased responsibility for community-based treatment and rehabilitation after surgery. The purpose of this study was to examine associations between municipal resources and patient outcomes through the first year after a hip fracture, focusing on survival and health-related quality of life...
February 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28203253/the-use-of-laparoscopy-simulation-to-explore-gender-differences-in-resident-surgical-confidence
#6
Rebecca L Flyckt, Eliza E White, Linnea R Goodman, Catherine Mohr, Sanjeev Dutta, Kristine M Zanotti
Background. The objective of this study was to determine whether female surgical residents underestimate their surgical abilities relative to males on a standardized test of laparoscopic skill. Methods. Twenty-six male and female general surgery residents and 25 female obstetrics and gynecology residents at two academic centers were asked to predict their score prior to undergoing the Fundamentals of Laparoscopic Surgery standardized skills exam. Actual and predicted score as well as delta values (predicted score minus actual score) were compared between residents...
2017: Obstetrics and Gynecology International
https://www.readbyqxmd.com/read/28203055/resident-surgeon-efficiency-in-femtosecond-laser-assisted-cataract-surgery
#7
Andrew C Pittner, Brian R Sullivan
PURPOSE: Comparison of resident surgeon performance efficiencies in femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification. PATIENTS AND METHODS: A retrospective cohort study was conducted on consecutive patients undergoing phacoemulsification cataract surgery performed by senior ophthalmology residents under the supervision of 1 attending physician during a 9-month period in a large Veterans Affairs medical center. Medical records were reviewed for demographic information, preoperative nucleus grade, femtosecond laser pretreatment, operative procedure times, total operating room times, and surgical complications...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/28194616/impact-of-fellow-versus-resident-assistance-on-outcomes-following-pancreatoduodenectomy
#8
Rosalie A Carr, Catherine W Chung, Christian M Schmidt, Andrea Jester, Molly E Kilbane, Michael G House, Nicholas J Zyromski, Attila Nakeeb, C Max Schmidt, Eugene P Ceppa
BACKGROUND: Participation by surgical trainees in complex procedures is key to their development as future practicing surgeons. The impact of surgical fellows versus general surgery resident assistance on outcomes in pancreatoduodenectomy (PD) has not been well studied. The purpose of this study was to determine differences in patient outcomes based on level of surgical trainee. METHODS: Consecutive cases of PD (n = 254) were reviewed at a single high-volume institution over a 2-year period (July 2013-June 2015)...
February 13, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28178918/global-health-training-among-u-s-residency-specialties-a-systematic-literature-review
#9
Duncan K Hau, Luke R Smart, Jennifer I DiPace, Robert N Peck
BACKGROUND: Interest in global health training during residency is increasing. Global health knowledge is also becoming essential for health-care delivery today. Many U.S. residency programs have been incorporating global health training opportunities for their residents. We performed a systematic literature review to evaluate global health training opportunities and challenges among U.S. residency specialties. METHODS: We searched PubMed from its earliest dates until October 2015...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28178577/operative-and-diagnostic-hysteroscopy-a-novel-learning-model-combining-new-animal-models-and-virtual-reality-simulation
#10
Alfred Bassil, Chrystèle Rubod, Yves Borghesi, Yohan Kerbage, Elie Servan Schreiber, Henri Azaïs, Charles Garabedian
CONTEXT: Hysteroscopy is one of the most common gynaecological procedure. Training for diagnostic and operative hysteroscopy can be achieved through numerous previously described models like animal models or virtual reality simulation. We present our novel combined model associating virtual reality and bovine uteruses and bladders. STUDY DESIGN: End year residents in obstetrics and gynaecology attended a full day workshop. The workshop was divided in theoretical courses from senior surgeons and hands-on training in operative hysteroscopy and virtual reality Essure(®) procedures using the EssureSim™ and Pelvicsim™ simulators with multiple scenarios...
February 1, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28169925/hospital-teaching-status-and-medicare-expenditures-for-complex-surgery
#11
Jason C Pradarelli, Christopher P Scally, Hari Nathan, Jyothi R Thumma, Justin B Dimick
OBJECTIVE: To evaluate the relationship between hospital teaching intensity, Medicare payments, and perioperative outcomes. BACKGROUND: Several emerging payment policies penalize hospitals for low-value healthcare. Teaching hospitals may be at a disadvantage given the perception that they deliver care less efficiently. METHODS: Using Medicare Provider and Analysis Review files, we studied patients from age 65 to 100 years who underwent abdominal aortic aneurysm (AAA) repair (n = 71,422), pulmonary resection (n = 93,056), or colectomy (n = 277,619) from 2009 to 2012...
March 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28164320/perception-of-point-of-care-ultrasound-performed-by-emergency-medicine-physicians
#12
Whitney Hansen, Carl E Mitchell, Bikash Bhattarai, Napatkamon Ayutyanont, Jeffrey R Stowell
PURPOSE: Point-of-care ultrasound (POCUS) is integral to the practice of emergency medicine (EM). Furthermore, EM-performed POCUS (EM-POCUS) offers consultants the opportunity to avoid delays in care due to wait times for confirmatory imaging studies. This study is the first to describe the perception of POCUS to consulting services at a single institution where EM-POCUS is routinely performed. METHODS: This study was conducted as a survey distributed to residents from consultant specialties (internal medicine [IM], general surgery [GS], and obstetrics and gynecology [OB-GYN])...
February 6, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28159560/are-bariatric-operations-performed-by-residents-safe-and-efficient
#13
Piotr Major, Michał Wysocki, Jadwiga Dworak, Michał Pędziwiatr, Piotr Małczak, Andrzej Budzyński
BACKGROUND: The growing need for surgeons who are educated and trained in bariatric surgery has raised many issues related to training in this field. OBJECTIVES: This study was performed to evaluate the safety and efficacy of laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) performed by doctors-in-training during their residency in general surgery. SETTING: Tertiary referral university teaching hospital, Poland...
November 23, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28149219/levels-of-evidence-for-hand-questions-on-the-orthopaedic-in-training-examination
#14
Louis C Grandizio, James C Huston, Stephanie S Shim, Jove Graham, Joel C Klena
Background: Although analyses of the Orthopaedic In-Training Examination (OITE) subspecialty content domains have been performed, few studies have analyzed the levels of evidence (LoEs) for journal articles used as references to create OITE questions. We present an analysis of reference characteristics and question taxonomy for the hand surgery content domain on the OITE. We aim to determine whether level of evidence (LoE) for hand surgery questions have increased over a 15-year period. Methods: All questions and references in the hand surgery content domain on the OITE from 1995-1997 and 2010-2012 were reviewed...
December 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28131325/mistreatment-and-the-learning-environment-for-medical-students-on-general-surgery-clerkship-rotations-what-do-key-stakeholders-think
#15
Manuel Castillo-Angeles, Ammara A Watkins, Danilo Acosta, Julia L Frydman, Lydia Flier, Alejandro Garces-Descovich, Michael J Cahalane, Sidharta P Gangadharan, Katharyn M Atkins, Tara S Kent
BACKGROUND: Mistreatment has potential downstream effects on students. General surgery rotations tend to have a higher incidence of mistreatment reports. This study was undertaken to identify dominant themes contributing to a negative learning environment. METHODS: A qualitative study was performed using Delphi consensus technique to develop a discussion guide. Four focus groups were performed (n = 30 participants) with medical students, residents, nurses, and attending surgeons...
February 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28128705/assessing-residents-operative-skills-for-external-ventricular-drain-placement-and-shunt-surgery-in-pediatric-neurosurgery
#16
Guillermo Aldave, Daniel Hansen, Valentina Briceño, Thomas G Luerssen, Andrew Jea
OBJECTIVE The authors previously demonstrated the use of a validated Objective Structured Assessment of Technical Skills (OSATS) tool for evaluating residents' operative skills in pediatric neurosurgery. However, no benchmarks have been established for specific pediatric procedures despite an increased need for meaningful assessments that can either allow for early intervention for underperforming trainees or allow for proficient residents to progress to conducting operations independently with more passive supervision...
January 27, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28120274/advanced-gi-surgery-training-a-roadmap-for-the-future-the-white-paper-from-the-ssat-task-force-on-advanced-gi-surgery-training
#17
Matthew M Hutter, Kevin E Behrns, Nathaniel J Soper, Fabrizio Michelassi
There is the need for well-trained advanced GI surgeons. The super specialization seen in academic and large community centers may not be applicable for surgeons practicing in other settings. The pendulum that has been swinging toward narrow specialization is swinging the other way, as many trained subspecialists are having a harder time finding positions after fellowship, and if they do find a position, the majority of their practice can actually be advanced GI surgery and not exclusively their area of focused expertise...
January 24, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28118787/learning-curve-associated-with-an-automated-laparoscopic-suturing-device-compared-with-laparoscopic-suturing
#18
Steven G Leeds, Lizzy Wooley, Ganesh Sankaranarayanan, Yahya Daoud, James Fleshman, Sanket Chauhan
BACKGROUND: Laparoscopic suturing has proved to be a challenging skill to master which may prevent surgical procedures from being started, or completed, in a minimally invasive fashion. The aim of this study is to compare the learning curves between traditional laparoscopic techniques with a novel suturing device. METHODS: In this prospective single blinded nonrandomized controlled crossover study, we recruited 19 general surgery residents ranging from beginner (PGY1-2, n = 12) to advanced beginner (PGY3-5, n = 7)...
January 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28118085/the-role-of-simulation-in-surgical-education
#19
Ben Schwab, Eric Hungness, Katherine Ann Barsness, William Craig McGaghie
The current healthcare environment demands optimization of patient outcomes in addition to maximal cost efficiency. Restrictions on resident work hours have placed limitations on the amount of time that trainee physicians can spend on patient care. For the surgery resident, the consequence is less time spent in the operating room under the supervision of a senior surgeon, the cornerstone of Halsted's approach to resident surgeon education. The use of simulation in graduate medical education has gained significant traction as a way to provide trainees with exposure to various techniques and procedures before use on the general patient population...
January 24, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28098712/business-education-for-plastic-surgeons-a-systematic-review-development-and-implementation-of-a-business-principles-curriculum-in-a-residency-program
#20
Bahar Zarrabi, Karen K Burce, Stella M Seal, Scott D Lifchez, Richard J Redett, Kevin Frick, Amir H Dorafshar, Carisa M Cooney
BACKGROUND: Rising healthcare costs, decreasing reimbursement rates, and changes in American healthcare are forcing physicians to become increasingly business-minded. Both academic and private plastic surgeons can benefit from being educated in business principles. We conducted a systematic review to identify existing business curricula and integrated a business principles curriculum into residency training. METHODS: We anonymously surveyed our department regarding perceived importance of business principles and performed a systematic literature review from 1993-2013 using PubMed and Embase to identify residency training programs that had designed/implemented business curricula...
January 13, 2017: Plastic and Reconstructive Surgery
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