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https://www.readbyqxmd.com/read/27903015/neurosurgical-resident-training-in-germany
#1
Martin N Stienen, Jens Gempt, Oliver P Gautschi, Andreas K Demetriades, David Netuka, Dominique E Kuhlen, Karl Schaller, Florian Ringel
Introduction Efficient neurosurgical training is of paramount importance to provide continuing high-quality medical care to patients. In this era of law-enforced working hour restrictions, however, maintaining high-quality training can be a challenge and requires some restructuring. We evaluated the current status of resident training in Germany. Methods An electronic survey was sent to European neurosurgical trainees between June 2014 and March 2015. The responses of German trainees were compared with those of trainees from other European countries...
November 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27900775/pilot-testing-of-a-novel-surgical-simulator-for-endoscopic-zenker-s-diverticulotomy
#2
Nathan D Wiebracht, John P Giliberto, Charles Myer, Keith Casper, Kaalan E Johnson
OBJECTIVES/HYPOTHESIS: Restrictions on resident work hours and the increasing purview of otolaryngology reduce the efficacy of the traditional surgical training model. With limited case volumes at many institutions and the unique instrumentation of endoscopic Zenker's diverticulotomy (EZD), simulation may be useful to improve training. In this study, a novel surgical simulator for EZD is developed and validated. STUDY DESIGN: Simulation model development. METHODS: An EZD model was designed using an intubation trainer and disposable diverticulum inserts...
November 30, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27886972/the-resident-run-minor-surgery-clinic-a-pilot-study-to-safely-increase-operative-autonomy
#3
REVIEW
Brandon M Wojcik, Zhi Ven Fong, Madhukar S Patel, David C Chang, Emil Petrusa, John T Mullen, Roy Phitayakorn
OBJECTIVE: General surgery training has evolved to align with changes in work hour restrictions, supervision regulations, and reimbursement practices. This has culminated in a lack of operative autonomy, leaving residents feeling inadequately prepared to perform surgery independently when beginning fellowship or practice. A resident-run minor surgery clinic increases junior resident autonomy, but its effects on patient outcomes have not been formally established. This pilot study evaluated the safety of implementing a resident-run minor surgery clinic within a university-based general surgery training program...
November 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27817764/supplementary-educational-models-in-canadian-neurosurgery-residency-programs
#4
Won Hyung A Ryu, Sonny Chan, Garnette R Sutherland
BACKGROUND: The proposed implementation of work hour restrictions has presented a significant challenge of maintaining the quality of resident education and ensuring adequate hands-on experience that is essential for novice surgeons. To maintain the level of resident surgical competency, revision of the apprentice model of surgical education to include supplementary educational methods, such as laboratory and virtual reality (VR) simulations, have become frequent topics of discussion...
November 7, 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/27803179/physicians-attentional-performance-following-a-24-hour-observation-period-do-we-need-to-regulate-sleep-prior-to-work
#5
P Smyth, K Maximova, J D Jirsch
BACKGROUND: The tradition of physicians working while sleep deprived is increasingly criticised. Medical regulatory bodies have restricted resident physician duty-hours, not addressing the greater population of physicians. We aimed to assess factors such as sleep duration prior to a 24-hour observation period on physicians' attention. METHODS: We studied 70 physicians (mean age 38 years old (SD 10.8 years)): 36 residents and 34 faculty from call rosters at the University of Alberta...
November 1, 2016: Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/27788923/evaluating-handoffs-in-the-context-of-a-communication-framework
#6
Hani Hasan, Fadwa Ali, Paul Barker, Robert Treat, Jacob Peschman, Matthew Mohorek, Philip Redlich, Travis Webb
BACKGROUND: The implementation of mandated restrictions in resident duty hours has led to increased handoffs for patient care and thus more opportunities for errors during transitions of care. Much of the current handoff literature is empiric, with experts recommending the study of handoffs within an established framework. METHODS: A prospective, single-institution study was conducted evaluating the process of handoffs for the care of surgical patients in the context of a published communication framework...
October 24, 2016: Surgery
https://www.readbyqxmd.com/read/27766758/training-in-hepato-pancreato-biliary-surgery-during-residency-past-present-and-future-perspectives
#7
REVIEW
Martin de Santibañes, Eduardo de Santibañes, Juan Pekolj
The paradigm introduced by William Halsted for surgical residency training has been considered the most appropriate educational system to acquire the knowledge and surgical skills required to become a competent general surgeon. Hepato-pancreato-biliary (HPB) surgery is considered an important part of general surgery training because of its high prevalence and complexity. Nowadays, we are faced with a worldwide shortage of general surgeons candidates, restrictive working hours and less surgical exposure, situations that can undermine the objectives of training in HPB surgery during residency...
December 2016: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/27697404/comparison-of-canadian-and-swiss-surgical-training-curricula-moving-on-toward-competency-based-surgical-education
#8
Henry Hoffmann, Daniel Oertli, Robert Mechera, Salome Dell-Kuster, Rachel Rosenthal, Richard Reznick, Hugh MacDonald
OBJECTIVE: Quality of surgical training in the era of resident duty-hour restrictions (RDHR) is part of an ongoing debate. Most training elements are provided during surgical service. As exposure to surgical procedures is important but time-consuming, RDHR may affect quality of surgical training. Providing structured training elements may help to compensate for this shortcoming. DESIGN: This binational anonymous questionnaire-based study evaluates frequency, time, and structure of surgical training programs at 2 typical academic teaching hospitals with different RDHR...
September 30, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27411835/resident-duty-hour-modification-affects-perceptions-in-medical-education-general-wellness-and-ability-to-provide-patient-care
#9
Andrew Moeller, Jordan Webber, Ian Epstein
BACKGROUND: Resident duty hours have recently been under criticism, with concerns for resident and patient well-being. Historically, call shifts have been long, and some residency training programs have now restricted shift lengths. Data and opinions about the effects of such restrictions are conflicting. The Internal Medicine Residency Program at Dalhousie University recently moved from a traditional call structure to a day float/night float system. This study evaluated how this change in duty hours affected resident perceptions in several key domains...
2016: BMC Medical Education
https://www.readbyqxmd.com/read/27314271/3-d-imaging-and-simulation-for-nephron-sparing-surgical-training
#10
REVIEW
Hamed Ahmadi, Jen-Jane Liu
Minimally invasive partial nephrectomy (MIPN) is now considered the procedure of choice for small renal masses largely based on functional advantages over traditional open surgery. Lack of haptic feedback, the need for spatial understanding of tumor borders, and advanced operative techniques to minimize ischemia time or achieve zero-ischemia PN are among factors that make MIPN a technically demanding operation with a steep learning curve for inexperienced surgeons. Surgical simulation has emerged as a useful training adjunct in residency programs to facilitate the acquisition of these complex operative skills in the setting of restricted work hours and limited operating room time and autonomy...
August 2016: Current Urology Reports
https://www.readbyqxmd.com/read/27216301/national-orthopedic-residency-attrition-who-is-at-risk
#11
Jennifer M Bauer, Ginger E Holt
BACKGROUND: National U.S. orthopedic resident attrition rates have been historically low, but no literature exists as to the characteristics of those who leave nor the circumstance of the departure. We aimed to determine factors that may place a resident at higher risk for attrition. Additionally, we planned to determine whether the 2003-work hour restriction affected attrition rate. MATERIALS AND METHODS: All orthopedic surgery residency program directors in the United States were surveyed on demographic data for their current resident class, the number of residents who left the program, as well as demographic description for each of the residents who left their program from 1998 to 2013...
September 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27182471/the-effects-of-the-80-hour-workweek-on-occupational-hazards
#12
Doniel Drazin, Lutfi Al-Khouja, Chaim Colen
BACKGROUND : The most recent work-hour restrictions were implemented in July 2011 for training physicians. The impact of these regulations on workplace injuries is not yet fully understood. Our goal is to determine the effect of the work-hour limitation on the rates of needlestick and eyesplash injuries. METHODS : Approximately 1200 neurosurgery residents and fellows in the United States were emailed a survey, several times, Sept 2013-February 2014. There were 212 responses across postgraduate years 1-7 and fellowship regarding the rate of needlestick and eyesplash injuries experienced or witnessed before and after July 2011...
2016: Curēus
https://www.readbyqxmd.com/read/27178510/resident-fatigue-in-otolaryngology-residents-a-web-based-survey
#13
Andrew M Nida, Benjamin J Googe, Andrea F Lewis, Warren L May
IMPORTANCE: Resident fatigue has become a point of emphasis in medical education and its effects on otolaryngology residents and their patients require further study. OBJECTIVE: The purpose of our study was to evaluate the prevalence and nature of fatigue in otolaryngology residents, evaluate various quality of life measures, and investigate associations of increased fatigue with resident safety. STUDY DESIGN: Anonymous survey. SETTING: Internet based...
May 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27103047/patient-outcomes-when-housestaff-exceed-80-hours-per-week
#14
David Ouyang, Jonathan H Chen, Gomathi Krishnan, Jason Hom, Ronald Witteles, Jeffrey Chi
BACKGROUND: It has been posited that high workload and long work hours for trainees could affect the quality and efficiency of patient care. Duty hour restrictions seek to balance patient care and resident education by limiting resident work hours. Through a retrospective cohort study, we investigated whether patient care on an inpatient general medicine service at a large academic medical center is impacted when housestaff work more than 80 hours per week. METHODS: We identified all admissions to a housestaff-run general medicine service between June 25, 2013 and June 29, 2014...
September 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27073829/twelve-tips-for-improving-the-general-surgery-resident-night-float-experience
#15
Rebecca M Rentea, Jared A Forrester, Nathan W Kugler, Anahita Dua, Travis P Webb
Restriction of resident duty hours has resulted in the implementation of night float systems in surgical and medical programs. Many papers have examined the benefits and structure of night float, but few have addressed patient safety issues, quality patient care, and the impact on the residency education system. The objective of this review is to provide practical tips to optimize the night float experience for resident training while continuing to emphasize patient care. The tips provided are based on the experiences and reflections of residents, supervising staff, group discussions, and the available literature in a hospital-based general surgery residency program...
June 2015: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/27068844/operative-variability-among-residents-has-increased-since-implementation-of-the-80-hour-workweek
#16
Ralph C Quillin, Alexander R Cortez, Timothy A Pritts, Dennis J Hanseman, Michael J Edwards, Bradley R Davis
BACKGROUND: The ACGME instituted duty hour restrictions in 2003. This presents a challenge for surgical residents who must acquire a medical and technical knowledge base during their training. Although the effect of work hour limitations on operative volume has been examined, no study has examined whether duty hour reform has had an effect on operative volume variability. STUDY DESIGN: The ACGME operative log data of graduating general surgery residents from 1992 to 2015 were examined...
June 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/26956034/paediatric-cardiology-fellowship-training-effect-of-work-hour-regulations-on-scholarly-activity
#17
Christina Ronai, Peter Lang
BACKGROUND: In 2003, work-hour regulations were implemented by the Accreditation Council for Graduate Medical Education. Much has been published regarding resident rest and quality of life as well as patient safety. There has been no examination on the effect of work-hour restrictions on academic productivity of fellows in training. Paediatric subspecialty fellows have a scholarly requirement mandated by the American Board of Pediatrics. We have examined the impact of work-hour restrictions on the scholarly productivity of paediatric cardiology fellows during their fellowship...
March 9, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/26954746/a-time-study-of-plastic-surgery-residents
#18
Frank H Lau, Indranil Sinha, Wei Jiang, Stuart R Lipsitz, Elof Eriksson
BACKGROUND: Resident work hours are under scrutiny and have been subject to multiple restrictions. The studies supporting these changes have not included data on surgical residents. We studied the workday of a team of plastic surgery residents to establish prospective time-study data of plastic surgery (PRS) residents at a single tertiary-care academic medical center. METHODS: Five trained research assistants observed all residents (n = 8) on a PRS service for 10 weeks and produced minute-by-minute activity logs...
May 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/26880315/allocation-of-residency-training-positions-in-spain-contextual-effects-on-specialty-preferences
#19
Jeffrey E Harris, Beatriz G Lopez-Valcarcel, Patricia Barber, Vicente Ortún
In Spain's 'MIR' system, medical school graduates are ranked by their performance on a national exam and then sequentially choose from the available residency training positions. We took advantage of a unique survey of participants in the 2012 annual MIR cycle to analyze preferences under two different choice scenarios: the residency program actually chosen by each participant when it came her turn (the 'real') and the program that she would have chosen if all residency training programs had been available (the 'counterfactual')...
February 16, 2016: Health Economics
https://www.readbyqxmd.com/read/26836467/a-novel-mammoplasty-part-task-trainer-for-simulation-of-breast-augmentation-description-and-evaluation
#20
Roy Kazan, Brigitte Courteau, Shantale Cyr, Thomas M Hemmerling, Mirko Gilardino
INTRODUCTION: Since the introduction of competency-based education and the restriction of residents' working hours, simulator-aided training has obtained increasing attention for its role in teaching and assessing resident surgical skills. Within plastic surgery training, such simulators would be particularly useful for aesthetic surgery procedures such as augmentation mammoplasty where residents have fewer opportunities for hands-on experience. The aims of this study were to develop a part-task trainer that allows plastic surgery trainees to acquire skills necessary for augmentation mammoplasty and to assess its potential value as a training tool...
February 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
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