Journal of surgical education
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Comparative Study
Monitoring universal protocol compliance through real-time clandestine observation by medical students results in performance improvement.
To measure universal protocol compliance through real-time, clandestine observation by medical students compared with chart audit reviews, and to enable medical students the opportunity to become conscious of the importance of medical errors and safety initiatives. ⋯ Direct, real-time observation by medical students provides an accurate and granular assessment of compliance with specific components of the universal protocol and engages medical students in the quality improvement process, raises their awareness of the gravity of medical errors, and ensures appreciation of the importance of quality and safety initiatives.
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Learning portfolios have gained modest acceptance in graduate medical education because of challenges related to user satisfaction, time and resource commitment, and quality assessment. In 2001, the Department of Surgery implemented the Surgical Learning and Instructional Portfolio (SLIP) to help residents develop a case-based portfolio demonstrating practice-based learning. In 2008, the format was changed to a Web-based platform with open viewing of portfolios for all learners. This study was performed to evaluate the SLIP program using resident and faculty perspectives in the domains of satisfaction, compliance, and educational value. ⋯ The SLIP program allows residents to demonstrate practice-based learning and improvement of medical knowledge. The Web-based format provides transparency and ease of administration. Quality assessment of individual portfolio entries remains a challenge to the widespread adoption of portfolios.
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Portal vein gas (PVG) was described as an uncommon ominous radiologic sign usually harboring an intra-abdominal catastrophe. When accompanied by pneumatosis intestinalis (PI), it is more predictive of bowel ischemia. Since the wide use of computed tomography (CT), both signs could also be viewed as incidental findings during routine radiologic investigations. ⋯ PVG and PI are radiologic signs that can represent a wide range of pathology.
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Systematic reviews were performed to assess methods of teaching the evidence-based medicine (EBM) process and determine which format or what components of journal club appear to be most effective in teaching critical appraisal skills to surgical residents and have the highest user satisfaction. ⋯ There is some evidence that courses with or without the addition of journal clubs lead to improved knowledge of the EBM process although the impact on patient care is unknown. Journal clubs seem to be the preferred way of teaching critical appraisal skills but while some components of journal clubs are favored by participants, it remains unclear which elements are most important for resident learning.
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Simulation-based training provides a low-stress learning environment where real-life emergencies can be practiced. Simulation can improve surgical education and patient care in crisis situations through a team approach emphasizing interpersonal and communication skills. ⋯ High-stress situations simulated in a low-stress environment can improve team interaction and educational competencies. Providing simulation training as a tool for surgical education may enhance patient care.