Journal of Surgical Education最新文献

{"title":"Patient Safety Reporting Systems and Surgical Safety Culture: One Culture to Rule Them All?","authors":"Morgan M. Sellers MD, MSHP ,&nbsp;Jennifer Fieber MD, MSCE ,&nbsp;Jennifer S. Myers MD ,&nbsp;Judy Shea PhD ,&nbsp;Rachel R. Kelz MD, MSCE ,&nbsp;Phillip M. Dowzicky MD, MSHP","doi":"10.1016/j.jsurg.2025.103769","DOIUrl":"10.1016/j.jsurg.2025.103769","url":null,"abstract":"<div><h3>Objective</h3><div>Safety event reporting is considered a marker of a positive safety culture, and many institutions have implemented efforts to increase reporting rates. Less is understood about the relationship between reporting behaviors and the surrounding safety culture. The aim of this study is to explore similarities and differences in the behaviors and attitudes expressed by surgical faculty, residents, and nurses regarding safety event reporting, thereby exploring the underlying safety culture in each group.</div></div><div><h3>Design</h3><div>Semi-structured interviews were conducted with 41 individuals involved in surgical care at a single high-volume academic center, distributed among surgical residents, faculty, and nurses. The in-depth, semi-structured interviews included open-ended questions with targeted follow-up probing. Interviews were audio-recorded, de-identified, and transcribed verbatim. Content analysis was used to identify relevant behaviors and attitudes.</div></div><div><h3>Results</h3><div>Residents, faculty, and nurses described distinct patterns of behaviors around the reporting system, with nurses describing the most consistent use and faculty the least. All 3 groups expressed mixed attitudes toward reporting, describing perceived conflict between the formal processes of reporting and a more traditional face-to-face approach to handling safety incidents. Residents described a wide range of attitudes, while nurses most consistently articulated how reporting could effect positive change.</div></div><div><h3>Conclusions</h3><div>Examination of subgroup behaviors and attitudes regarding patient safety reporting reveals substantive differences in underlying safety culture. Understanding these differences can help institutions interested in improving reporting behaviors as well as the underlying safety culture itself.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103769"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Implementation of a Surgeon-Tailored Serious Illness and Palliative Care Education Program","authors":"Xiaofan Zhong ,&nbsp;Alethea Yee ,&nbsp;Ye Min Lim ,&nbsp;Gillian Phua ,&nbsp;Sui An Lie ,&nbsp;Claramae Shulyn Chia ,&nbsp;Yu Guang Tan ,&nbsp;Gerald Tay ,&nbsp;Jin Yao Teo ,&nbsp;Jolene Si Min Wong","doi":"10.1016/j.jsurg.2025.103753","DOIUrl":"10.1016/j.jsurg.2025.103753","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To develop and implement a surgeon-tailored serious illness and palliative care education program</div></div><div><h3>DESIGN</h3><div>Fourteen surgeons from a single academic center were recruited and enrolled in a nontailored, general palliative care education program. Following the nontailored program, we conducted qualitative semi-structured interviews to examine learning needs that were unique to surgeons. Thematic analysis was performed to identify key learning needs. Using the Kern’s 6-step approach for curriculum development, we identified general and targeted learning needs, formulated goals and objectives, and using learning theories, developed and implemented a serious illness and palliative care education program that was tailored for surgeons.</div></div><div><h3>RESULTS</h3><div>We identified 3 key palliative care learning needs for surgeons. First, in pain and symptom management for patients with serious illness. Second, palliative surgery and the application of palliative concepts in routine surgical care. Finally, communication skills to improve engagement during difficult conversations on goals of care and prognoses with patients and their families near end-of-life. Adopting situated and adult learning theories, we developed and implemented an interactive 1.5-day surgeon-tailored serious illness and palliative care education (SPLICES) program in July 2024. The tailored program comprised of 3 key components: 1) Applied palliative care in surgery, 2) Palliative surgery and peri-operative considerations, and 3) Serious illness communication and shared-decision making in surgery.</div></div><div><h3>CONCLUSION</h3><div>A surgeon-tailored serious illness and palliative care education program is feasible and has the potential to improve engagement and application of palliative care concepts in surgical care.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103753"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Medical Students’ Negative Perceptions of Surgical Training","authors":"Sophia Dittrich MD ,&nbsp;Parnika Telagi MD ,&nbsp;Robert Treat PhD ,&nbsp;Andrew Kastenmeier MD ,&nbsp;Sophie Dream MD, MPH","doi":"10.1016/j.jsurg.2025.103740","DOIUrl":"10.1016/j.jsurg.2025.103740","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To combat students’ perceived barriers of surgery, studies have mainly focused on offering electives and one-on-one mentorship. Our objective is to determine medical students’ perceived barriers to pursuing surgery and determine if a Question and Answer (Q&amp;A) event will increase students’ interest in surgical specialties.</div></div><div><h3>DESIGN</h3><div>A prepanel survey was distributed among first- and second-year medical students that asked questions related to student perceived barriers about surgery. A 60-minute Q&amp;A panel event with 3 attendings and 2 residents from multiple surgery specialties was then held that addressed these barriers on the survey based on personal experiences. Following the panel, the same survey was distributed to both attendees and non-attendees.</div></div><div><h3>SETTING</h3><div>Private Medical College in the Midwest.</div></div><div><h3>PARTICIPANTS</h3><div>All first- and second-year medical students were eligible to complete the pre- and postpanel surveys.</div></div><div><h3>RESULTS</h3><div>This study categorized survey responses into 3 groups (prepanel, post–attended panel, and post–did not attend panel survey) and found significant decreases, using the Holm-Bonferroni method, in 8 of 14 perceived barriers to a surgical career among panel attendees. These included concerns regarding poor work-life balance, difficulty maintaining a family life, malignant culture, unpredictable schedules, and long working hours. Panel attendees also demonstrated increased interest in pursuing a surgical career and greater ability to envision themselves as surgical residents or attendings.</div></div><div><h3>CONCLUSION</h3><div>A brief student-organized panel with surgical attendings and residents can dispel many negative perceptions about surgery and increase surgical interest early on in medical school.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103740"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Piloting a Nationwide Survey of General Surgery Residents Investigating Their Experience with Obtaining Procedural Consent","authors":"Ethan Angle BS ,&nbsp;Linda Peng BA ,&nbsp;Jasmine Peterson MD ,&nbsp;Brian Longbottom MD ,&nbsp;Adrienne Davis MD ,&nbsp;Hassan Aziz MD, FACS","doi":"10.1016/j.jsurg.2025.103792","DOIUrl":"10.1016/j.jsurg.2025.103792","url":null,"abstract":"<div><h3>Objective</h3><div>There remains a lack of multi-center nationwide data that examine residents’ self-reported level of comfort with obtaining informed consent. Our study sought to acquire these data and discover relationships affecting the subjective experiences of general surgery residents during consent acquisition so that general surgery residency programs can better understand their trainees’ needs.</div></div><div><h3>Design</h3><div>We internally developed a 22-item survey assessing the demographics of general surgery residents who commonly obtain consent, the amount of formal informed consent training provided in residency, and residents’ comfort level with the consent process.</div></div><div><h3>Setting</h3><div>The study originated from the University of Iowa Health Care Department of Surgery. Our survey was distributed nationally via mass electronic-mailing to recruit participants.</div></div><div><h3>Participants</h3><div>The survey was iteratively sent to 323 ACGME-accredited general surgery residency programs across the United States via program leadership. Eight weeks were allowed for response accumulation from May to June 2025. There were 140 total survey responses (1.4% response rate) with a likely unrepresentative national sample.</div></div><div><h3>Results</h3><div>Across all respondent training levels, first-year residents (interns) were identified as the most frequent consenters. Only 14.3% of interns felt “very comfortable” obtaining surgical consent. Although most senior residents reported receiving consent training during their PGY1 year, 73.3% of interns reported not receiving any formal instruction during residency. Interns made up 60% of respondents who reported being “very dissatisfied” with their formal consent training. Furthermore, 64.3% of interns were either very dissatisfied (21.4%) or slightly dissatisfied (42.9%) with consent training. Nearly half of interns reported “usually” obtaining consent for procedures they felt would be more appropriate for senior residents, and 57.1% reported acquiring consent for unfamiliar procedures “about half the time.”</div></div><div><h3>Conclusions</h3><div>These findings suggest a possible disconnect between expectations and preparation among surgical trainees who are expected to obtain informed consent. This self-reported lack of preparation may represent a lapse in patient safety standards and supports our continued research into the necessity of developing a standardized informed consent curriculum for all general surgery residents with a revamped participant recruitment strategy.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103792"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concerning Trends in Acute Care Surgeries Among General Surgery Trainees","authors":"Sameh Yousef MD ,&nbsp;Jin Park MD ,&nbsp;Franklin Burg MD ,&nbsp;Tul Maya Gurung MD ,&nbsp;Pooja Shah MD ,&nbsp;Awinita Barpujari ,&nbsp;Raj Lingnurkar MD ,&nbsp;Jeremy Jen MD ,&nbsp;Kanika Trehan MD ,&nbsp;Mark Seamon MD ,&nbsp;Aley Tohamy MD ,&nbsp;Karen Kish MD ,&nbsp;Prashanth Ramachandra MD","doi":"10.1016/j.jsurg.2025.103776","DOIUrl":"10.1016/j.jsurg.2025.103776","url":null,"abstract":"<div><h3>Background</h3><div>Surveys of residents, program directors, and fellowship leaders have raised concerns about general surgery graduates’ readiness for independent practice. Evolving practice patterns, particularly the rise of laparoscopic surgery, advanced endoscopy, and interventional radiology, have altered residents’ exposure to traditional open procedures. However, the impact of these changes on operative experience in acute care surgery (ACS) has not been well quantified.</div></div><div><h3>Objective</h3><div>This study assessed temporal trends in the operative experience of general surgery trainees in the acute care surgery component.</div></div><div><h3>Design</h3><div>We analyzed publicly available ACGME operative case logs for graduating general surgery trainees from 2000 to 2023. Procedures categorized under acute care surgery were identified. Temporal trends were assessed using the Mann-Kendall trend test and visualized with line plots.</div></div><div><h3>Results</h3><div>The average total case volume increased from 903 cases per trainee in 2006 to 1,062 in 2023. Despite the overall increase in case volume, exposure to multiple key ACS operations has declined to critically low levels. Notably, average case numbers per trainee for procedures such as splenectomy, duodenal perforation repair, open common bile duct exploration, choledochoenteric anastomosis, pancreatic abscess drainage, and esophageal perforation repair have fallen to fewer than 1 per trainee. The laparoscopic approach has largely supplanted the open approach across various procedures.</div></div><div><h3>Conclusion</h3><div>Although the total operative volume for general surgery trainees has increased over time, exposure to essential open ACS procedures has markedly declined. This trend raises concerns about the adequacy of operative experience in foundational emergency surgeries and may contribute to ongoing perceptions of insufficient preparedness among graduates.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103776"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Oncology Breast Fellowship Websites: A Critical Analysis of Accessibility and Content for Society of Surgical Oncology (SSO)-Approved Program Websites","authors":"Sandra Tomlinson-Hansen MD ,&nbsp;Julia Rozenberg MD ,&nbsp;Jessica Bilz MD ,&nbsp;Yancey E. Warren MD ,&nbsp;Rachel S. Handelsman MD ,&nbsp;Jennifer S. Gass MD ,&nbsp;Ashley R. Stuckey MD ,&nbsp;Micaela A. Weaver DO ,&nbsp;Stephanie Ng MD, MPH ,&nbsp;David A. Edmonson MD","doi":"10.1016/j.jsurg.2025.103715","DOIUrl":"10.1016/j.jsurg.2025.103715","url":null,"abstract":"<div><h3>Background</h3><div>Residents applying for surgical breast fellowships increasingly rely on the internet – a change that sets this generation of applicants apart from previous. Data on surgical breast fellowship websites (SBFW) is limited and content is variable among program websites.</div></div><div><h3>Methods</h3><div>All 63 American SSO-approved breast surgical oncology fellowship programs available for the 2023 match were included. SBFW were evaluated by 2 residents interested in breast fellowship for 41 categories of content, which were subdivided into 6 broad categories: program description, education, research, recruitment, alumni/current fellows/faculty and fellow lifestyle/DEI initiatives.</div></div><div><h3>Results</h3><div>Of the 63 approved programs, 54 had breast fellowship-specific program websites (85.7%) and some form of program description. Of the programs, 60.3% had educational information, 68.3% had research initiative information, 22.2% had resident recruitment information, 52.4% had information on alumni, current fellows and/or faculty, and 23.8% described fellow lifestyle/experience. Four websites (6.3%) listed diversity/equity/inclusivity information.</div><div>After reviewing SBFW, the residents evaluated that 33 (61.1%) and 53 (84.1%) of the programs met applicant needs. They rated that 12 (22.2%) and 32 (50.8%) of the websites provided complete information for an interested applicant.</div></div><div><h3>Conclusion</h3><div>SBFW provide limited information across programs and fail to convey important program information to applicants. Improving websites may improve the ability of the Match to align the most ideal programs to applicants.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103715"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Student Performance Evaluations for International Medical Graduates: Variability in Content and Standardization","authors":"Michelle L. Shui MD ,&nbsp;Said S. Saab MD, MEd, MPhil ,&nbsp;Marie Altendahl MD ,&nbsp;Rini B. Ratan MD ,&nbsp;Anthony Shanks MD, MEd ,&nbsp;Shireen M. Sims MD ,&nbsp;Weronika A. Armstrong MD","doi":"10.1016/j.jsurg.2025.103768","DOIUrl":"10.1016/j.jsurg.2025.103768","url":null,"abstract":"<div><h3>Objective</h3><div>The Medical Student Performance Evaluation (MSPE) could be a standard objective measure to evaluate international medical graduates (IMGs) in the residency application. The purpose of this study was to evaluate whether international MSPEs are compliant with best-practice guidelines and whether the content allows for meaningful comparisons with other candidates.</div></div><div><h3>Design</h3><div>This was a retrospective cohort study of applications submitted in 2023 from 117 international medical schools to the obstetrics &amp; gynecology (OB/GYN) residency program at a single institution. One representative MSPE for each school was reviewed for page length, sections included, and section content as outlined in the 2016 MSPE Task Force Guidelines. Results were analyzed and descriptive statistics were reported.</div></div><div><h3>Setting</h3><div>OB/GYN residency program at New York Presbyterian Hospital – Columbia Campus</div></div><div><h3>Participants</h3><div>IMG applications to the OB/GYN residency program as identified by an Educational Commission for Foreign Medical Graduates annotation</div></div><div><h3>Results</h3><div>Of the 117 international medical schools, 105 (90%) included an MSPE. The median page length was 6 (range 2-13). Recommended MSPE sections were represented as follows: Identifying Information (99%), Noteworthy Characteristics (94%), Academic History (98%), Academic Progress (100%), Summary (98%), Medical School Information (72%). Within the Academic Progress section, 57% reported preclinical grades, and 79% reported clinical grades. When final grades were reported, comparative data were available only about half the time (preclinical 50%, clinical 51%). A summative rating was included in the Summary section in 50% of MSPEs; only 75% of these were accompanied by comparative data.</div></div><div><h3>Conclusions</h3><div>The international MSPEs follow the structure outlined by the guidelines. However, the inconsistent reporting of final grades, summative ratings, and associated comparative data within these sections makes it difficult to interpret IMG performance and use the international MSPE as an objective measure to compare applicants.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103768"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Flipped Classroom Effect: Improving Faculty and Resident Engagement and Satisfaction in Ophthalmology Residency","authors":"Suma K. Thareja PhD ,&nbsp;Brandon Kennedy MD ,&nbsp;Rachel Simpson MD ,&nbsp;Katherine Hu MD ,&nbsp;Rachel Patel MD ,&nbsp;Griffin Jardine MD ,&nbsp;Marissa Larochelle MD ,&nbsp;Ariana Levin MD ,&nbsp;Tara Hahn MD ,&nbsp;Rachels R. Codden MPH ,&nbsp;Jeff Pettey MD, MBA ,&nbsp;Sravanthi Vegunta MD","doi":"10.1016/j.jsurg.2025.103745","DOIUrl":"10.1016/j.jsurg.2025.103745","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the longitudinal impact and sustainability of a flipped classroom model (MOLE) on faculty and resident satisfaction, engagement, and educational outcomes within an ophthalmology residency over 3 years.</div></div><div><h3>Design</h3><div>This prospective, longitudinal, pre- post intervention study used anonymous surveys (5-point Likert scales) administered to faculty and residents preimplementation (baseline), and at 1- and 3-years postimplementation of the MOLE curriculum. Assessed metrics included satisfaction, learning preferences, perceived barriers, attendance, and preparation time.</div></div><div><h3>Setting</h3><div>The study was conducted at the ophthalmology residency of the (University of Utah's John A. Moran Eye Center), a tertiary care academic institution in Salt Lake City, Utah.</div></div><div><h3>Participants</h3><div>All ophthalmology residents and teaching faculty were invited. At baseline, 1-year, and 3-year surveys, resident response rates were 100% (n = 12/12), 100% (n = 12/12), and 78.6% (n = 11/14), respectively. Faculty response rates were 70.6% (n = 24/34), 71.4% (n = 25/35), and 51.4% (n = 18/35), respectively, for the same time points.</div></div><div><h3>Results</h3><div>Baseline satisfaction with traditional lectures was moderate (faculty mean = 3.1/5; resident mean = 2.5/5). One-year post–MOLE, preference for the flipped format was high (faculty 88%; residents 100%), faculty satisfaction increased (mean = 4.1/5), and resident didactic attendance improved (from 61.7% to 84.2%). At 3 years, faculty preference for the flipped format persisted (83.3%), while resident preference declined to 63.6%, particularly among junior residents desiring more didactic structure. Ophthalmic Knowledge Assessment Program (OKAP) percentile scores increased from a pre-MOLE average of 51.8 (2017–2019) to 70.1 (2021–2023).</div></div><div><h3>Conclusions</h3><div>A flipped classroom model initially improved satisfaction and engagement in this surgical residency. Longitudinal data underscore the need for ongoing adaptation, responsive to evolving learner needs across training levels. These findings are pertinent for surgical education programs considering or implementing similar active learning curricula.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103745"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hernia Repair Approaches Vary: A Case for Including Private Surgeons in Residency Training","authors":"Ian Kim BS ,&nbsp;Galinos Barmparas MD ,&nbsp;Shirin Towfigh MD","doi":"10.1016/j.jsurg.2025.103749","DOIUrl":"10.1016/j.jsurg.2025.103749","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Hernia repair is the most common general surgical operation, and new surgical techniques continue to advance the field. Surgical residency would benefit from exposing residents to various surgical techniques and practice patterns in hernia repair during their training..&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To compare inguinal (IHR) and ventral (VHR) hernia repair practice patterns among surgeons with academic (AA), private-with-academic (PWA), and private (PA) affiliations, to plan residency rotations that maximize breadth of training in hernia care.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A retrospective cohort analysis of 108,137 hernia repairs was performed, as captured by the Abdominal Core Health Quality Collaborative (ACHQC) from 2013 to 2023 (ACHQC). Outcomes included operative approach (open, laparoscopic, robotic), mesh placement (VHR), defect size (VHR), ASA class, and urgency (elective vs non-elective). Group comparisons used χ² tests with Cramér’s V for categorical variables and 1-way ANOVA with η² for continuous variables; α = 0.01. Time trends display the annual share of robotic approach by setting; to avoid unstable estimates, year–setting points with total &lt;em&gt;n&lt;/em&gt; &lt; 50 were excluded from the figures.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Significant differences were observed among AA, PWA, and PA surgeons. PA were most likely to use a robotic approach for both IHR and VHR (39.9% and 37.3%, respectively; p &lt; 0.01) and to perform tissue-based (non-mesh) IHR (7.5%; p &lt; 0.01). IHR urgency differed by setting (elective: AA 64.9%, PWA 82.6%, PA 83.8%; p &lt; 0.001; Cramér’s &lt;em&gt;V&lt;/em&gt; = 0.210, small), and IHR defects were larger at AA than at PWA/PA (length 4.41 ± 6.10 vs 2.87 ± 4.45–3.75 ± 5.31 cm; width 3.16 ± 3.91 vs 2.21 ± 2.67-2.75 ± 3.18 cm; η² ≈ 0.011, small). AA managed sicker patients and performed more complex VHR with larger defects (mean width 7.05 cm; p &lt; 0.01). For VHR, AA most frequently placed retrorectus mesh (43.2%), whereas private practice surgeons more commonly used intraperitoneal mesh (p &lt; 0.01). Robotic utilization increased across all settings: for IHR, absolute gains from 2017 to 2023 were 31.2% (AA), 27.6% (PWA), and 18.6% (PA); for VHR, the 2023 robotic share was 32.5% (AA), 58.5% (PWA), and 49.2% (PA). Overall, PA adopted robotic technique the earliest, and PWA had the highest VHR share in the most recent year.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Practice setting is strongly associated with hernia care patterns. This is an important fact that can help residency programs as they prioritize training goals in hernia care for the residents. By including private practice surgeons in residency training, residents can be exposed to a wider breadth of hernia repair techniques, including open tissue-based IHR and various robotic repair techniques for both IHR and VHR. As hernia repairs are the most common operation in surgical practice, including private practice surg","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103749"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing High and Low Faculty EPA Assessment Completers: Insights to Improve EPA Implementation","authors":"Alyssa D. Murillo MD, MA.Ed ,&nbsp;Camilla Gomes MD ,&nbsp;Ye Lim S. Lee BS ,&nbsp;Kara L. Faktor MD ,&nbsp;Riley J. Brian MD, MA.Ed ,&nbsp;Olle Ten Cate PhD ,&nbsp;Adnan A. Alseidi MD, MA.Ed ,&nbsp;Patricia S. O’Sullivan EdD ,&nbsp;Lan T. Vu MD","doi":"10.1016/j.jsurg.2025.103630","DOIUrl":"10.1016/j.jsurg.2025.103630","url":null,"abstract":"<div><h3>Comparing High and Low Faculty EPA Assessment Completers</h3><div>Insights to Improve EPA Implementation</div></div><div><h3>Objective</h3><div>Despite the widespread use of Entrustable Professional Activities (EPA) assessments, faculty completion rates vary significantly. Understanding the motivations behind faculty participation is crucial for improving these rates. Utilizing the Theory of Planned Behavior (TPB), this study explores the factors influencing EPA assessment completion by examining high- and low-completing faculty.</div></div><div><h3>Design</h3><div>Using EPA assessments from 2023-2024, we calculated the percentage of assessments completed to total resident cases generated from resident case logs. Faculty were classified as high-users (at or above the median EPA assessments-to-case percentage) or low-users (below the median). Participants completed 15-minute semi-structured Zoom interviews. Qualitative codes were generated deductively from the transcripts guided by the TPB looking for intention to complete assessments based on their attitude, who influences their behavior (subjective norm), and perceived control of their behavior. We also inductively identified codes. Using a directed content analysis we identified themes.</div></div><div><h3>Setting</h3><div>Three institutions affiliated with a single general surgery residency program: a large academic quaternary referral center, a private community hospital, and a major Health Maintenance Organization (HMO) hospital</div></div><div><h3>Participants</h3><div>Seventy-seven surgical faculty participated in EPA assessments, with a median completion rate of 4.32% of total resident cases (range: 0.43%-100%).</div></div><div><h3>Results</h3><div>Interviews with 15 faculty members (9 high-users, 6 low-users) revealed differences in attitudes towards EPA assessments and perceived behavioral control. Both groups agreed on the influence of subjective norms, the importance of feedback quality, and incongruency between the Entrustment-Supervision (ES) scale and surgical training. High users were more confident in the value of EPA assessments and integrated them into their workflow. Low users, however, were uncertain of the impact and preferred residents to initiate assessments.</div></div><div><h3>Conclusions</h3><div>To increase faculty participation, targeted development programs should clarify the benefits of EPA assessments, streamline their integration into clinical workflows, and address challenges with the ES scale.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 12","pages":"Article 103630"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}