Journal of surgical education
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The Accreditation Council for Graduate Medical Education (ACGME) work-hour restrictions have prompted many surgical training programs to adopt a night-float resident coverage system (NF). Dissatisfaction with NF prompted us to transition to a rotating junior resident call model (Q4) with 24-hour call shifts at the outset of the 2007-2008 academic year. We performed a prospective study to determine the influence of this transition on resident education, morale, and quality of life, as well as on ACGME work rule compliance and American Board of Surgery In-Training Examination (ABSITE) scores. ⋯ Educational opportunities, compliance with ACGME work rules, and ABSITE scores can be preserved despite a transition from NF to Q4. Residents greatly prefer a rotating call schedule.
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Residency programs have been forced to curtail many educational activities to comply with duty-hour restrictions. We describe an "after hours" educational program as a forum to provide small-group education customized for each training level to compliment our formal curriculum. ⋯ There is enthusiasm among faculty and trainees to provide small-group, level-specific educational programs outside of the hospital setting and the 80-hour workweek. Such a program is easily implemented, highly effective, and well received. This format has the added benefit of improving interaction between faculty and residents and increasing the camaraderie of a surgical training program.
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Recently, the Accreditation Council for Graduate Medical Education (ACGME) has developed and enforced a complex set of regulations limiting resident duty hours (RDHs). One potential method to comply with these stringent regulations and better document resident work hours would be to use text message (TM)/short message service (SMS), allowing rapid, inexpensive, and interactive 2-way delivery of information. The purpose of this study was to document the successful implementation of TM to enhance compliance with the ACGME RDH regulations. ⋯ We were able to implement successfully a novel technique for ACGME RDH documentation and compliance in a general surgery residency program through the use of TM; this approach employed a state-of-the-art time-tracking method that was associated with high levels of resident work-hour compliance and overall satisfaction.
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Objective Structured Assessment of Technical Skills (OSATS) and Objective Structured Clinical Examinations (OSCE) are common tools used to objectively evaluate surgical residents. In 2005, our institution presented a novel hybrid OSATS/OSCE, which we renamed the Objective Structured Clinical Assessment (OSCA), encompassing all 6 core competencies regarding comprehensive care of the breast care patient. This study presents an analysis of the effects of a compulsory, comprehensive OSCA on our residents' competence in this index learning category. ⋯ Our data show consistent competence of residents in breast disease as evaluated by the OSCA, an increase in numbers of breast cases, and a decrease in incorrect responses on breast-related ABSITE questions. We believe a comprehensive, complete care OSCA represents a valuable learning tool for residents to increase their competence and improve their outcomes in breast care. We believe that comprehensive OSCAs will be necessary tools to evaluate resident competence and should be implemented in all areas of general surgery.
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Comparative Study
Visual learning: harnessing images to educate residents optimally.
Surgical educators are confronted with outdated models of education and less time for teaching. Digital images present an opportunity for a new method of education. ⋯ By incorporating surgical images into the teaching process, the teacher enhances insight and learning. In addition, by prompting the students to add creative elements to the thought process for diagnosis and management, the teaching format can be a dynamic and interactive process.