American journal of surgery
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Randomized Controlled Trial
Polyethylene glycol versus sodium phosphate mechanical bowel preparation in elective colorectal surgery.
The type of mechanical bowel preparation (MBP) used before elective colorectal surgery remains controversial. ⋯ SP, coupled with ertapenem antibiotic prophylaxis, may improve outcomes and reduce SSIs in patients undergoing elective colorectal surgery when compared with PEG coupled with cefotetan antibiotic prophylaxis.
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Intraoperative decision making requires both knowledge and experience. The script concordance test (SCT), based on cognitive psychology script theory, is a new tool of clinical-reasoning assessment that may be used to evaluate a candidate's approach to ill-defined problems encountered in the operating room. ⋯ SCT, applied to the assessment of intraoperative clinical judgment, can discriminate successfully between junior and senior residents. Results from an SCT test must be compared with the present gold standard, the oral examination, to better determine its place as an assessment tool.
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Randomized Controlled Trial
Virtual-reality training improves angled telescope skills in novice laparoscopists.
Based on prior success of virtual-reality (VR) trainers in imparting surgical skills, a randomized and controlled study was designed to determine whether VR training improves angled-telescope operative performance. ⋯ VR training in angled laparoscope use improves operative performance of novices. These data support growing evidence that VR training is highly effective in improving surgical skills outside of the clinical setting.