Journal of surgical education
-
Multicenter Study Comparative Study
Resident Operative Experience at Independent Academic Medical Centers-A Comparison to the National Cohort.
Independent Academic Medical Centers (IAMCs) comprise one-third of U.S. general surgery training programs. It is unclear whether IAMCs offer qualitatively or quantitatively different operative experiences than the national cohort. We analyzed a large representative sample of IAMCs to compare operative volume and variety, with a focus on low-volume procedures. ⋯ The IAMCs studied appear to provide equivalent exposure to specific subcategories mandated by the Accreditation Council for Graduate Medical Education and American Board of Surgery. Graduates of IAMCs gain similar operative experience in low-volume, defined categories when compared to the national cohort. Certain specific cases subject to regionalization pressure are less well represented among IAMCs. This has important implications for medical students applying to surgery residency.
-
Comparative Study
Training Surgical Residents With a Haptic Robotic Central Venous Catheterization Simulator.
Ultrasound guided central venous catheterization (CVC) is a common surgical procedure with complication rates ranging from 5 to 21 percent. Training is typically performed using manikins that do not simulate anatomical variations such as obesity and abnormal vessel positioning. The goal of this study was to develop and validate the effectiveness of a new virtual reality and force haptic based simulation platform for CVC of the right internal jugular vein. ⋯ A virtual reality haptic robotic simulator for CVC was successfully developed. Surgical residents training on the simulation improved to near expert levels after three robotic training sessions. This suggests that this system could act as an effective training device for CVC.
-
The surgical community commonly perceives a decline in surgical and patient care skills among residents who take dedicated time away from clinical activity to engage in research. We hypothesize that residents perceive a decline in their skills because of dedicated research time. ⋯ Most residents who dedicate time for research perceive a decline in their overall clinical aptitude and surgical skills. This can have a dramatic effect on the confidence of these residents in caring for patients and leading a care team once they re-enter clinical training. Residents who engaged in 2 or more years of research were significantly more likely to perceive these problems. Further research should determine how to keep residents who are interested in academics from losing ground clinically while they are pursuing research training.
-
Multicenter Study Comparative Study
Two-Year Experience Implementing a Curriculum to Improve Residents' Patient-Centered Communication Skills.
Surgery milestones from The Accreditation Council for Graduate Medical Education have encouraged a focus on training and assessment of residents' nontechnical skills, including communication. We describe our 2-year experience implementing a simulation-based curriculum, results of annual communication performance assessments, and resident evaluations. ⋯ The simulation-based SP-CAT has shown initial evidence of usability, content validity, relationships to observed communication behaviors and residents' skills confidence. Evaluations of different scenarios may not be correlated for individuals over time. The communication curriculum paralleled improvements in patient experience concerning surgeons' clear explanations. An ongoing surgery resident communication curriculum has numerous educational, assessment, and institutional benefits.
-
The American College of Surgeons (ACS) appointed a committee of leaders from the ACS, Association of Program Directors in Surgery, Accreditation Council for Graduate Medical Education, and American Board of Surgery to define key challenges facing surgery resident training programs and to explore solutions. The committee wanted to solicit the perspectives of surgery resident program directors (PDs) given their pivotal role in residency training. ⋯ Information regarding the valuable perspectives of PDs gathered through these surveys should help in implementing important changes in residency training and faculty development. These efforts will need to be pursued collaboratively with involvement of key stakeholders, including the organizations represented on this ACS committee.