Journal of surgical education
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Airway management occupies a crucial component of surgical education. As such, it can be difficult to provide adequate training within the hospital setting alone. To be facile in all aspects of nonsurgical airway management, the surgical resident must have thorough cognitive understanding of the process as well as technical mastery. The Department of Surgery at the Methodist Hospital in Houston has developed a curriculum for nonsurgical airway management that uses multiple modalities for education, reinforcement, and testing. Didactic lectures based on established national guidelines are provided as a foundation. This method is supplemented by hands-on group scenarios that use inanimate models. Throughout the course, faculty leaders provide guidance and skills assessment. Residents are tested for competency using core value checklists based on knowledge and technical proficiency. During its pilot year, the curriculum has proven its need and success in residency education. Future improvements include development of specific clinical scenarios as well as integration of more advanced educational equipment and models for use in nonsurgical airway management. ⋯ Our preliminary experience with a nonsurgical airway management training module for surgical residents has shown that a need for training exists in this critical area. Correct procedural adoption occurred rapidly after a didactic and procedural hands-on experience. Time intervals needed for review to maintain competence will also be studied. Improvements to the proficiency criteria and simulations are underway.
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The scope of patient management increasingly crosses the defined lines of multiple medical specialties and services to meet patient needs. Concurrently, many hospitals and health-care systems have adapted new multidisciplinary team structures that provide patient-centric care as opposed to the more traditional discipline-centered delivery of care. As health care continues to evolve, the use of teams becomes even more critical in allowing interdependence between multiple disciplines to provide excellent care delivery and ongoing patient management. ⋯ Most importantly, we wish to emphasize that health care, both philosophically and practically, is delivered best through high-performance teams. For such teams to perform properly, the organizational environment must support the team concept tangibly. In concert, we believe the best manner in which to cultivate knowledge and performance of the health-care organizational mission and goals is by using such teams.
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Although penetrating gluteal injuries rarely are life-threatening, the risk for concomitant injury to regional anatomic structures warrants additional evaluation. We analyzed factors affecting the management and outcomes of these injuries. ⋯ Penetrating gluteal injuries are associated with significant damage to local structures. Gunshot wounds carry a higher risk of injury to the rectum and stoma placement, whereas blast injuries are associated with less local injury and more multisystem trauma.
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To demonstrate that a surgery "educational" chief resident can develop a resident-centered, evidence-based, surgical basic/clinical science curriculum that will improve American Board of Surgery In-Training Examination (ABSITE) scores. ⋯ An educational chief resident designed surgical curriculum, including weekly reading assignments, weekly ABSITE-styled questions, monthly chief resident problem-based conferences, and an ABSITE remediation course, may augment a basic/clinical science lecture series and may improve ABSITE performance.