Journal of surgical education
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Wrong-site surgery (WSS) is considered a sentinel event by the Joint Commission. The education of spine surgery fellows on WSS is unknown. Our objective was to evaluate North American spine surgery fellows' education, awareness, and experience with WSS. ⋯ This is the first study evaluating spine surgery fellowship education on WSS. Among the spine surgery fellows, 30% had already experienced WSS and only 33% had formal fellowship didactics on WSS. Owing to the significant patient care and medicolegal ramifications from WSS, spine surgery fellowships should consider adding WSS prevention didactics to their curriculum.
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"Global surgery" is becoming an increasingly popular concept not only for new trainees, but also for established surgeons. The need to provide surgical care in low-resource settings is laudable, but the American surgical training system currently does not impart the breadth of skills required to provide quality care. We propose one possible model for a surgical fellowship program that provides those trainees who desire to practice in these settings a comprehensive experience that encompasses not only broad technical skills but also the opportunity to engage in policy and programmatic development and implementation. ⋯ Global surgery is a key word these days in attracting young trainees to academic surgical residency programs, yet they are subsequently inadequately trained to provide the required surgical services in these low-resource settings. Dedicated programmatic changes are required to allow those who choose to practice in these settings to obtain the full breadth of training needed to become safe, competent surgeons in such environments.
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To define the operations performed by surgical residents at a tertiary referral hospital in Rwanda to help guide development of the residency program. ⋯ The operative experience of surgery residents at CHUK primarily involves emergency and trauma procedures. Although this likely reflects the demographics of surgical care within Rwanda, more focus should be placed on elective procedures to ensure that surgical residents are broadly trained.
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The Accreditation Council for Graduate Medical Education (ACGME) established duty-hour regulations for accredited residency programs on July 1, 2003. It is unclear what changes occurred in the national incidence of medication errors in surgical patients before and after ACGME regulations. ⋯ After ACGME duty-hour reform, medication error rates increased in teaching hospitals, which diminished over time. This decrease in errors may be related to changes in training program structure to accommodate duty-hour reform.
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During surgical residency, trainees are expected to master all the 6 competencies specified by the ACGME. Surgical training programs are also evaluated, in part, by the residency review committee based on the percentage of graduates of the program who successfully complete the qualifying examination and the certification examination of the American Board of Surgery in the first attempt. Many program directors (PDs) use the American Board of Surgery In-Training Examination (ABSITE) as an indicator of future performance on the qualifying examination. Failure to meet an individual program's standard may result in remediation or a delay in promotion to the next level of training. Remediation is expensive in terms of not only dollars but also resources, faculty time, and potential program disruptions. We embarked on an exploratory study to determine if residents who might be at risk for substandard performance on the ABSITE could be identified based on the individual resident's behavior and motivational characteristics. If such were possible, then PDs would have the opportunity to be proactive in developing a curriculum tailored to an individual resident, providing a greater opportunity for success in meeting the program's standards. ⋯ Behavioral, motivational, and acumen characteristics can be useful to identify residents "at risk" for substandard performance on the ABSITE. Armed with this information, PDs have the opportunity to intervene proactively to offer these residents a greater chance for success. The NN was capable of developing a model that explained performance on the examination for both the junior and the senior examinations. Subsequent testing is needed to determine if the NN is a good predictive tool for performance on this examination.