Journal of surgical education
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The time it takes to complete an operation is important. Operating room (OR) time is costly and directly associated with infectious complications and length of stay. Intuitively, procedures take longer when a surgical resident is operating. How much extra time should we take to train residents? We examined the relationship between laparoscopic inguinal hernia repair (IHR) procedure duration and resident participation and its impact on the development of complications and hospital stay. ⋯ Laparoscopic IHR is performed faster by staff surgeons without residents. There was no difference in the complication rate when residents were involved. Teaching and mentoring residents in the OR for laparoscopic IHR is safe and laudable.
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Comparative Study
General surgery vs fellowship: the role of the Independent Academic Medical Center.
To compare career choices of residency graduates from Independent Academic Medical Center (IAMC) and University Academic Medical Center (UAMC) programs and evaluate program directors' perceptions of residents' motivations for pursuing general surgery or fellowships. ⋯ Most general surgery residents undergo fellowship training. Graduates from IAMC and UAMC programs pursue similar specialties, but UAMC programs report more first choice acceptance. IAMC programs may graduate proportionately more general surgeons. Further studies directly evaluating surgical residents' career choices are warranted to understand the influence of independent and university programs in shaping these choices and to develop strategies for reducing the general surgeon shortage.
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The purpose of this study was to explore the relationship between qualifying examination (QE) and certifying examination (CE) results and to determine whether an appropriate cut-point on the QE would predict success on the CE. ⋯ While a moderate relationship between QE scores and CE performance is evident, correlations suggest that the 2 examinations measure different abilities. The low AUC value on the ROC analysis, along with poor predictability at all possible cut-points, show that no appropriate cut-point on the QE predicts success on the CE. These data add to the validity of both tests by providing evidence that distinct latent traits are being measured by both tests.
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There is a growing need for effective surgical simulators to train the novice resident with a core skill set that can be later used in advanced operating room training. The most common simulator-based laparoscopic skills curriculum, the Fundamentals of Laparoscopic Skills (FLS), has been demonstrated to effectively teach basic surgical skills; however, a key deficiency in current surgical simulators is lack of validated training for force-based or haptic skills. In this study, a novel haptic simulator was examined for construct validity by determining its ability to differentiate between the force skills of surgeons and novices. ⋯ The haptic simulator successfully differentiated between novice and surgeon force skill level at specific ranges for all 3 salient haptic tasks, establishing initial construct validity of the haptic simulator. Based on these results, force-based simulator metrics may be used to objectively measure haptic skill level and potentially train residents. Haptic simulator development should focus on the 3 salient haptic skills (grasping, probing, and sweeping) where precise force application is necessary for successful task outcomes.
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Randomized Controlled Trial Comparative Study
Comparing video games and laparoscopic simulators in the development of laparoscopic skills in surgical residents.
The video game industry has become increasingly popular over recent years, offering photorealistic simulations of various scenarios while requiring motor, visual, and cognitive coordination. Video game players outperform nonplayers on different visual tasks and are faster and more accurate on laparoscopic simulators. The same qualities found in video game players are highly desired in surgeons. Our investigation aims to evaluate the effect of video game play on the development of fine motor and visual skills. Specifically, we plan to examine if handheld video devices offer the same improvement in laparoscopic skill as traditional simulators, with less cost and more accessibility. ⋯ Studies have shown that residents who engage in video games have better visual, spatial, and motor coordination. We showed that over 6 weeks, residents who played video games improved in their laparoscopic skills more than those who practiced on laparoscopic simulators. The accessibility of gaming systems is 1 of the most essential factors making these tools a good resource for residents. Handheld games are especially easy to use and offer a readily available means to improve visuospatial and motor abilities.