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https://www.readbyqxmd.com/read/28212590/the-july-effect-on-maternal-peripartum-complications-before-and-after-resident-duty-hour-reform-a-population-based-retrospective-cohort-study
#1
Ithan D Peltan, Crystal E Brown, Alson K Burke, Eric J Chow, Ali Rowhani-Rahbar, Matthew R Crull
Objective To compare maternal birth complications early versus late in the academic year and to evaluate the impact of resident work hour limitation on the "July effect." Study Design We conducted a retrospective, population-based cohort study of 628,414 singleton births in Washington State from 1987 to 2012 measuring the adjusted risk of maternal peripartum complications early (July/August) versus late (April/May) in the academic year. To control for seasonal outcome variation unrelated to trainees' involvement in care as well as long-term trends in maternal complications unrelated to variation in trainees' effect on outcomes across the academic year, we employed difference-in-differences methods contrasting outcomes at teaching to nonteaching hospitals for deliveries before and after restriction of resident work hours in July 2003...
February 17, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28196195/association-of-otolaryngology-resident-duty-hour-restrictions-with-procedure-specific-outcomes-in-head-and-neck-endocrine-surgery
#2
Aaron Smith, Lauren Braden, Jim Wan, Merry Sebelik
Importance: Graduate medical education has undergone a transformation from traditional long work hours to a restricted plan to allow adequate rest for residents. The initial goal of this restriction is to improve patient outcomes. Objective: To determine whether duty hour restrictions had any impact on surgery-specific outcomes by analyzing complications following thyroid and parathyroid procedures performed before and after duty hour reform. Design, Setting, and Participants: Retrospective cross-sectional analysis of the National Inpatient Sample (NIS)...
February 9, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28185560/inequalities-in-socio-economic-characteristics-and-health-and-wellbeing-of-men-with-and-without-disabilities-a-cross-sectional-analysis-of-the-baseline-wave-of-the-australian-longitudinal-study-on-male-health
#3
Anne M Kavanagh, Zoe Aitken, Eric Emerson, Sash Sahabandu, Allison Milner, Rebecca Bentley, Anthony D LaMontagne, Jane Pirkis, David Studdert
BACKGROUND: Internationally, men with disabilities have higher rates of social and economic disadvantage and poorer health and wellbeing than men without disabilities. No single study has provided comprehensive, population-level information about the magnitude of such differences among adult men using a well-validated instrument to measure disability. METHODS: We analysed baseline data from Ten to Men - an Australian longitudinal study of male health. Ten to Men used a stratified multi-stage cluster random sample design to recruit a national sample of males aged 10 to 55 years residing in private dwellings...
October 31, 2016: BMC Public Health
https://www.readbyqxmd.com/read/28185559/psychosocial-job-quality-mental-health-and-subjective-wellbeing-a-cross-sectional-analysis-of-the-baseline-wave-of-the-australian-longitudinal-study-on-male-health
#4
Anthony D LaMontagne, Allison Milner, Lauren Krnjacki, Marisa Schlichthorst, Anne Kavanagh, Kathryn Page, Jane Pirkis
BACKGROUND: Employment status and working conditions are strong determinants of male health, and are therefore an important focus in the Australian Longitudinal Study on Male Health (Ten to Men). In this paper, we describe key work variables included in Ten to Men, and present analyses relating psychosocial job quality to mental health and subjective wellbeing at baseline. METHODS: A national sample of males aged 10 to 55 years residing in private dwellings was drawn using a stratified multi-stage cluster random sample design...
October 31, 2016: BMC Public Health
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
#5
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/28118548/the-nasal-fracture-algorithm
#6
Alexander Lanigan, Joshua Lospinoso, Sarah N Bowe, Adrienne M Laury
Since the initiation of resident duty hour restrictions, significant controversy has arisen regarding its impact on surgical resident training. We reviewed a singular facet of the otolaryngology residency experience, nasal bone fracture management, to identify if treatment standardization would improve care and efficiency. For 1 year, otolaryngology consults for isolated nasal fractures were analyzed to assess consultation trends, rate of intervention, and resident work hour utilization. Following a review of the literature, an evidence-based algorithm for management of nasal fractures was developed...
January 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28118085/the-role-of-simulation-in-surgical-education
#7
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/28030417/a-resident-as-teacher-curriculum-using-a-flipped-classroom-approach-can-a-model-designed-for-efficiency-also-be-effective
#8
Binny D Chokshi, Heidi K Schumacher, Kristen Reese, Priti Bhansali, Jeremy R Kern, Samuel J Simmens, Benjamin Blatt, Larrie W Greenberg
PROBLEM: The Accreditation Council for Graduate Medical Education requires training that enhances resident teaching skills. Despite this requirement, many residency training programs struggle to implement effective resident-as-teacher (RAT) curricula, particularly within the context of the 80-hour resident workweek. APPROACH: In 2013, the authors developed and evaluated an intensive one-day RAT curriculum using a flipped classroom approach. Twenty-nine second-year residents participated in daylong RAT sessions...
December 27, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/27998549/patient-hand-off-initiation-and-evaluation-phone-study-a-randomized-trial-of-patient-handoff-methods
#9
Jesse Clanton, Aimee Gardner, Michael Subichin, Patrick McAlvanah, William Hardy, Amar Shah, Joel Porter
BACKGROUND: As residency work hour restrictions have tightened, transitions of care have become more frequent. Many institutions dedicate significant time and resources to patient handoffs despite the fact that the ideal method is relatively unknown. We sought to compare the effect of a rigorous formal handoff approach to a minimized but focused handoff process on patient outcomes. METHODS: A randomized prospective trial was conducted at a large teaching hospital over ten months...
February 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/27965068/pda-based-self-work-sampling-study-of-pediatric-interns-quantifies-workday-and-educational-value
#10
Joyce K Campbell, Michael V Ortiz, Mary C Ottolini, Sarah Birch, Dewesh Agrawal
OBJECTIVE: Optimizing clinical proficiency and education of residents has become more important with restricted residency duty hours. Our objective was to investigate how interns spend their time on inpatient rotations and the perceived educational value of workday activities. METHODS: A descriptive, self-work sampling study using a personal digital assistant (PDA) to randomly query interns on inpatient rotations in real time as to their activity and the perceived educational value of that activity on a 4-point Likert scale...
December 10, 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/27903015/neurosurgical-resident-training-in-germany
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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...
January 2017: 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
#19
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...
July 13, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27314271/3-d-imaging-and-simulation-for-nephron-sparing-surgical-training
#20
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
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