Journal of Surgical Education最新文献

{"title":"Conflict Competence Among Resident Physicians: Knowledge and Perception","authors":"Chinedu Okoli MBBS, MSc ,&nbsp;Bridget Olsen MD, MPH ,&nbsp;Carolyne Falank PhD ,&nbsp;Amelia Denney ,&nbsp;Bryan Morse MD, MS ,&nbsp;Jaswin Sawhney MD","doi":"10.1016/j.jsurg.2024.103310","DOIUrl":"10.1016/j.jsurg.2024.103310","url":null,"abstract":"<div><h3>Background</h3><div>The hospital environment is a complex and unpredictable workplace where different providers share the responsibility of patient care. Differences in opinions, values, and experiences between resident physicians and other care team members may trigger conflicts that affect the safety and quality of patient care. Thus, developing conflict competencies may help to negotiate the complexities of different conflict situations and resolve these conflicts. However, the extent of the knowledge and perception of conflict competence among resident physicians remains to be determined.</div></div><div><h3>Methods</h3><div>A survey and qualitative semi-structured interviews of resident physicians were conducted. Participants were recruited voluntarily. Survey results were analyzed using SPSS 21, and MAXQDA 24 was used to evaluate the interview transcripts with thematic analysis.</div></div><div><h3>Results</h3><div>Sixty-five resident physicians completed the survey, and 15 resident physicians were interviewed. 61.5% of the survey respondents identified as female, 76.9% were Caucasian, 35.4% of the respondents were from surgical specialties, and 43.1% of the residents were in their second year of training. 53.8% of the participants reported witnessing or experiencing conflicts weekly, with 44.6% reporting resident physician-nurse conflicts. 63.1% of the conflicts were reported as unresolved, with 16.9% reporting that the conflict affected future working relationships, 25.5% of the conflicts were due to failure of communication, 75.4%residents did not have any form of prior training on conflict management, and 83.1% of them reported interest in conflict competence training. Conflicts mainly affected the quality of care (87.3%) compared to patient safety concerns (12.3%). Participants with prior training in conflict competence were more likely to resolve their reported conflict (p = 0.047). The interviews highlighted 5 main themes: sources of conflict, awareness of conflict resolution styles, addressing conflict and outcomes, and the effect on patient care. Sources of conflict included hierarchy and different priorities. 52.2% of the respondents did not know any style of conflict resolution. Addressing conflict included collaboration, avoidance, competition, and prevention. Avoidance was the most common style used by interviewees, followed by collaboration. While most felt that the conflicts affected the quality of patient care, 1 interviewee reported severe adverse events on the patient.</div></div><div><h3>Conclusion</h3><div>Conflicts are rife in the hospital environment and can affect patient care when unresolved. Resident physicians' knowledge of conflict competence is low and does not reflect the complexity of their working environment. Future training in conflict competence and resolution is warranted.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103310"},"PeriodicalIF":2.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549843","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":"Consequences of Legal Infractions on the General Surgery Residency Application Process","authors":"John T. McCarthy Med ,&nbsp;Brett H. Waibel MD ,&nbsp;Paul J. Schenarts MD","doi":"10.1016/j.jsurg.2024.103303","DOIUrl":"10.1016/j.jsurg.2024.103303","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Alcohol and drug-related legal infractions are common among college and medical students. The objective of this work is to quantify the influence of these legal infractions on program directors (PDs) when making decisions on applicants to general surgery residencies.</div></div><div><h3>DESIGN</h3><div>A convenience sample of 72 PDs with publicly accessible email addresses were electronically sent a previously piloted survey tool. Data collected included demographic information about the PD, and the legal status of recreational marijuana in their state. A 5-point Likert scale (No influence – Would not select) was used to quantify the influence of various alcohol and drug-related legal infractions on an applicants’ ability to match into their general surgery residency.</div></div><div><h3>SETTING</h3><div>American general surgery PDs</div></div><div><h3>PARTICIPANTS</h3><div>61 general surgery PDs.</div></div><div><h3>RESULTS</h3><div>Response rate was 84% or 18.4% of all accredited general surgery residencies. The consequences of legal infractions were more significant for medical students than college students, this included drunk and disorderly (p &lt; 0.001), driving under the influence (DUI) (p &lt; 0.001), possession of marijuana (p &lt; 0.001), cocaine (p &lt; 0.001), fentanyl (p = 0.003), and methamphetamine (p = 0.004). For both college and medical students, infractions distribute into 3 tiers of severity. The lowest tier is for drunk and disorderly and marijuana. These have minimal negative impact and are not different from each other. DUI is the second tier and is significantly more negative than the first tier infractions (p = 0.002, p &lt; 0.001). Infractions involving cocaine, fentanyl, and methamphetamine, have the most negative impact; with each being significantly worse than tier 1 offenses (p &lt; 0.001 for each) and DUI (p &lt; 0.001 for each). For residencies located in states where marijuana was illegal, arrest for possession of marijuana as a medical student has a greater negative influence (p = 0.033), than where it is legal.</div></div><div><h3>CONCLUSIONS</h3><div>Legal infractions occurring during college are less consequential than those in medical school. Regardless of the timing, being arrested for drunk and disorderly or marijuana possession had less impact than a DUI, possession of cocaine, methamphetamine or fentanyl.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 1","pages":"Article 103303"},"PeriodicalIF":2.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549845","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":"Emotional Intelligence in Medicine: An Investigation of the Significance for Physicians, Residents, and Medical Students – A Systematic Review","authors":"Mason J. Horne DPT ,&nbsp;Malena Allbright BS ,&nbsp;D'Nea A. Galbraith BS ,&nbsp;Ashit Patel MBChB","doi":"10.1016/j.jsurg.2024.103307","DOIUrl":"10.1016/j.jsurg.2024.103307","url":null,"abstract":"<div><h3>Objective</h3><div>Physicians, residents, and medical students consistently report higher levels of stress, anxiety, depression, burnout, and suicide compared to the general population. Emotional intelligence is a trait 1 possesses that has been shown to have associations with aspects of mental health specifically in the medical field. It has also been studied in business literature demonstrating multiple performance benefits. The purpose of this review is to investigate the relationship of emotional intelligence and mental health and well-being, clinical performance, and academic success with physicians, residents, and medical students.</div></div><div><h3>Methods</h3><div>A systematic review was conducted of studies investigating the associations of emotional intelligence on physicians, residents, or medical students between 2013 and 2023. Studies investigating the association of empathy within the study population were also included. Studies must have used a validated measure or reported a reliable method of measuring emotional intelligence or empathy.</div></div><div><h3>Results</h3><div>Thirty-nine articles were included. The trait emotional intelligence questionnaire short form was the most frequently used assessment tool (28%). Mental health and well-being was the most common study outcome (67%). Twenty articles reported lower levels of burnout in those with higher emotional intelligence levels. (p &lt; 0.05). Other protective associations of emotional intelligence included decreased levels of anxiety, stress, and depression (p &lt; 0.05). Emotional intelligence was associated with multiple clinical performance metrics including patient satisfaction, perceived communication ratings, patient information recall, and improved decision making under operational stress (p &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Emotional intelligence has beneficial associations for physicians at all levels of training. Those entering with higher levels of emotional intelligence may be better suited to handle the psychological effects described within the healthcare field. Emotional intelligence can also be improved through training. Using emotional intelligence as part of a holistic screening process may help predict and enhance the success of doctors, residents, and medical students, which can contribute to improving the healthcare system.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103307"},"PeriodicalIF":2.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549844","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":"Operative Performance and Autonomy Across Training Years: Does a Preliminary Year Matter?","authors":"Rebecca Moreci MD ,&nbsp;Kayla M. Marcotte MS ,&nbsp;Alyssa Pradarelli MD ,&nbsp;Chia Chye Yee PhD ,&nbsp;Tanvi Gupta MEng ,&nbsp;Stefanie S. Sebok-Syer PhD ,&nbsp;Andrew E. Krumm PhD ,&nbsp;Brian C. George MD, MAEd","doi":"10.1016/j.jsurg.2024.09.016","DOIUrl":"10.1016/j.jsurg.2024.09.016","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Preliminary surgery positions are associated with a negative stigma, and this stigma may persist for those residents who later go on to obtain a categorical position. However, it is currently unknown if general surgery residents who complete a preliminary year perform differently than their categorical peers throughout training. To examine these potential differences, we compared operative performance and autonomy across all 5 years of training for those who completed a nondesignated preliminary training year with those who did not.</div></div><div><h3>DESIGN</h3><div>Faculty ratings of categorical general surgery residents were collected from the Society for Improving Medical and Professional Learning (SIMPL) application. Residents were categorized based on the completion of a nondesignated preliminary year (“Previous Prelim” [PP]) or not (“Traditional Categorical” [TC]). Operative performance and autonomy ratings were tracked over 5 training years and analyzed using generalized mixed effects models. Performance and autonomy outcomes were dichotomized: “not competent” or “competent” and “no meaningful autonomy” or “meaningful autonomy”, respectively. Fixed effects included cohort group, academic month, case complexity, resident level (junior [PGYs 1 and 2] vs senior [PGYs 3, 4, and 5] residents), and an interaction term between cohort group and resident level, while random effects included resident, faculty, program, and procedure.</div></div><div><h3>SETTING</h3><div>Operative performance and autonomy ratings were collected from the SIMPL application between 2015 and 2023.</div></div><div><h3>PARTICIPANTS</h3><div>A total of 89 general surgery residency programs, which encompassed 1,108 categorical general surgery residents.</div></div><div><h3>RESULTS</h3><div>A total of 42,416 evaluations were analyzed. Of these, 809 evaluations were from PP residents. Faculty ratings of PP vs TC residents revealed no significant differences in adjusted probabilities of achieving a “competent” rating as a junior (5.6%, 95% Confidence Interval [CI] 2.7%-11.1% vs 3.0%, 95% CI 2.4%-3.7%, p = 0.28) or senior (23.7%, 95% CI 12.2%-41% vs 34.1%, 95% CI 29.1%-39.5%, p = 0.59) resident. Similarly, no significant differences were identified in adjusted probabilities of achieving a “meaningful autonomy” rating between PP and TC junior (9.0%, 95% CI 5.4%-14.6% vs 8.1%, 95% CI 6.9%-9.5%, p = 0.97) or senior (42.3%, 95% CI 28.7%-57.1% vs 49.6%, 95% CI 44.9%-54.2%, p = 0.76) residents.</div></div><div><h3>CONCLUSIONS</h3><div>PP and TC residents may have similar operative performance and autonomy ratings throughout their residency training. Although further study of more senior residents is warranted, these initial findings could help combat the negative stigma associated with a preliminary year of training.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 1","pages":"Article 103297"},"PeriodicalIF":2.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549846","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":"Effect of Mindfulness Training on Skill Performance in Simulator-Based Knee Arthroscopy Training for Novice Residents—A Randomized Controlled Study","authors":"Wei Li ,&nbsp;Shangxing Wu ,&nbsp;Xiaobo Xie ,&nbsp;Weihao Yang ,&nbsp;Lei Feng ,&nbsp;Zhouwen Yang ,&nbsp;Oudong Xia ,&nbsp;Jing Tian","doi":"10.1016/j.jsurg.2024.103306","DOIUrl":"10.1016/j.jsurg.2024.103306","url":null,"abstract":"<div><h3>OBJECTIVES</h3><div>Negative emotions affect not only the physical health of residents but also the performance of surgical skills. Mindfulness training has been shown to be effective in improving mood. However, few studies have explored its effect on surgical skill performance. We aimed to investigate the effect of mindfulness training on knee arthroscopy skill performance.</div></div><div><h3>DESIGN</h3><div>We recruited 30 participants for knee arthroscopy skills training (Tasks 1-7) on a simulator, after which a pretest (Tasks 8 and 9) was conducted to test their skill performance and psychological states (including mindfulness state, anxiety, stress, and depression). Then, they were randomly assigned into 2 groups: the intervention group underwent 2 weeks of mindfulness training while the control group received no intervention. All participants were asked to retrain their skills 1 week after completing the initial arthroscopy skill training. After the 2-week mindfulness training intervention, a post-test was performed to detect the difference in skill performance and psychological states between 2 groups. We used the fNIRS device to record prefrontal cortex activation during the post-test.</div></div><div><h3>SETTING</h3><div>The study was carried out at the Zhujiang Hospital of Southern Medical University.</div></div><div><h3>PARTICIPANTS</h3><div>30 novice orthopedic residents.</div></div><div><h3>RESULTS</h3><div>A total of 30 residents completed all the study programs. We did not observe differences in arthroscopy skill performance at pretest. Compared with the control group, the intervention group showed significant improvement in total score of Task 8 (p = 0.034) and 9 (p = 0.002), as well as significant relief in anxiety (p = 0.037) and stress (p = 0.027) symptoms but no improvement in depression (p = 0.828). No statistical difference in 2 groups was observed on the activation of the left prefrontal cortex (p = 0.68).</div></div><div><h3>CONCLUSIONS</h3><div>Two weeks of mindfulness training can improve arthroscopy skill performance while alleviating anxiety and reducing stress in novice residents. Mindfulness training may be an effective adjunct to surgical skill training.</div><div>Trial Registration: Chinese Clinical Trial Registry, Number: ChiCTR2200058144.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103306"},"PeriodicalIF":2.6,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142537892","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":"Critical Thinking in the Texting Age","authors":"Riley Brian MD, MAEd ,&nbsp;Jacquelyn Alexandra Knox MD ,&nbsp;Aileen Gozali ,&nbsp;Brandon Cowan MD ,&nbsp;Patricia O'Sullivan EdD ,&nbsp;Shareef Syed MBChB, MAEd","doi":"10.1016/j.jsurg.2024.103309","DOIUrl":"10.1016/j.jsurg.2024.103309","url":null,"abstract":"<div><h3>Objectives</h3><div>Though texting has become a preferred way for clinicians to discuss patient care, surgeons report that texting detracts from trainees’ education. Little research has explored how texting relates to education and more specifically to critical thinking – the problem-solving and decision-making processes central to safe patient care. As such, we aimed to identify how trainees perceived the effect of texting on critical thinking.</div></div><div><h3>Design</h3><div>We undertook a qualitative study using a constructivist paradigm. Through interviews, we explored the relationship between texting and critical thinking. We approached interview data with a directed content analysis, generated themes in discussion with the study team, and corroborated findings through member checking.</div></div><div><h3>Setting</h3><div>We conducted this study at the University of California San Francisco.</div></div><div><h3>Participants</h3><div>Thirty surgical residents from multiple surgical specialties participated.</div></div><div><h3>Results</h3><div>We identified four themes: a new technocultural norm, altered practice patterns and demands, de-emphasis of critical thinking, and methods to promote critical thinking skills. A new technocultural norm has fundamentally changed communication. Furthermore, broader changes in medicine have affected the setting in which teams work, leading to altered practice patterns and demands. Together, certain aspects of the new technocultural norm combined with altered practice patterns have de-emphasized critical thinking, shifting the balance in team relationships towards communication and away from critical thinking. After establishing the de-emphasis of critical thinking in the setting of texting, participants posited possible methods to promote critical thinking skills. These methods centered on changing feedback and team culture and providing structured education to junior and senior residents.</div></div><div><h3>Conclusions</h3><div>Although texting has become an enduring fixture in clinical communication, it may detract from critical thinking in certain scenarios. Educators can harness this study's findings to build structured education and change the culture around text-based communication to allow for efficient clinical care without sacrificing critical thinking.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103309"},"PeriodicalIF":2.6,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resident Operative Autonomy in Robotic Surgery Training: Unpacking Gender Disparities and Training Trends","authors":"Maisa Nimer MD ,&nbsp;Andres A. Abreu MD ,&nbsp;Lauren A. Tyler MD,&nbsp;Kareem R. AbdelFattah MD,&nbsp;Patricio M. Polanco MD,&nbsp;Sneha G. Bhat MD","doi":"10.1016/j.jsurg.2024.103312","DOIUrl":"10.1016/j.jsurg.2024.103312","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>This study evaluated resident and program-level factors associated with resident-reported robotic operative autonomy at our institution.</div></div><div><h3>DESIGN</h3><div>This retrospective cohort study evaluates self-reported residents’ robotic case logs detailing case type, console time, and portions of the case completed. The analysis included three procedures: pancreaticoduodenectomies, hernia repairs, and low anterior resection. Each procedure was divided into four key portions. Outcomes measured included minutes at the console and High Resident Autonomy (HRA), defined as &gt;50% resident case participation. Independent variables included graduation cohort, pursued fellowship type, attending gender, underrepresented minority status, and hospital type. Univariable and multivariable logistic regression were performed.</div></div><div><h3>SETTING</h3><div>This study took place at the University of Texas Southwestern Medical Center General Surgery Residency between 2021 and 2023.</div></div><div><h3>PARTICIPANTS</h3><div>Twenty-nine chief residents (postgraduate year 5).</div></div><div><h3>RESULTS</h3><div>Of the 541 cases, 61% were hernia repairs, 26% were low anterior resections, and 13% were pancreaticoduodenectomies. Female residents were present in 60% of the cases. Male residents reported more HRA (76% vs. 54%) and longer console times (150 vs 120 minutes; p &lt; 0.01). Multivariable analysis indicated female gender was associated with 74% lower odds of HRA (95% CI: 0.15 - 0.45; p &lt; 0.001) and 18 fewer minutes of console time versus males (p &lt; 0.01). The 2023 cohort had significantly higher odds of HRA than the 2021 cohort (OR: 4.46, 95% CI: 2.34 - 8.51; p &lt; 0.001) and 15 more console minutes. Residents with aligned fellowships spent 37 more console minutes than those without (p &lt; 0.001). No significant differences were found between attending gender, hospital, and minority status.</div></div><div><h3>CONCLUSIONS</h3><div>Our findings reveal significant gender disparities in self-reported operative autonomy and console time. The recent cohort showed improved training outcomes, and fellowship alignment with the case positively impacted console time. This suggests a need to refine training approaches, ensuring equity and optimizing training efficacy.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103312"},"PeriodicalIF":2.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impromptu Speaking: Teaching an Essential Leadership Skill","authors":"Valeda Yong MD, MSEd ,&nbsp;Allyson Saccomandi MEd ,&nbsp;Kristine Chin BS ,&nbsp;Lynde Lutzow MD, MPH ,&nbsp;Joseph P. DuCette PhD ,&nbsp;Raphael Bueno MD ,&nbsp;Cherie P. Erkmen MD","doi":"10.1016/j.jsurg.2024.103313","DOIUrl":"10.1016/j.jsurg.2024.103313","url":null,"abstract":"<div><h3>Objective</h3><div>Clinical leaders are frequently asked to assert an opinion or message spontaneously in a public forum. We aimed to measure the effectiveness of structured leadership training in impromptu speaking.</div></div><div><h3>Design</h3><div>This prospective study examined trainees who participated in a 3-hour workshop consisting of didactic instruction on impromptu speaking followed by small group practice. The workshop ended in a large group where participants were selected randomly to speak on various topics. Pre- and postsurveys were administered to measure participants' comfort with impromptu speaking, organization, integration of the audience's perspective, and ability to portray a central message. Data were analyzed using paired t-tests and two-way repeated measures ANOVA.</div></div><div><h3>Setting</h3><div>This study occurred at a tertiary academic institution during protected surgical resident education time.</div></div><div><h3>Participants</h3><div>Medical students, surgical residents, and surgical fellows participated in the study. Fifty-four trainees completed the workshop and surveys.</div></div><div><h3>Results</h3><div>Of the 54 trainees who participated, 74.1% (n=40) had no previous leadership training. Perceived comfort with impromptu speaking improved (p &lt; 0.001), especially among those with no previous leadership training (p = 0.013). Perceived ability to adapt communication to the audiences improved after the workshop (p &lt; 0.001). Participant's perception of their ability to deliver a central message also improved (p &lt; 0.001), especially among those without previous leadership training (p = 0.001). Participants did not feel the workshop improved their organization with impromptu speaking (p = 0.572). 90.7% (n=49) would like additional educational opportunities to improve their communication as a leader, and 88.9% (n=48) thought formal leadership training was beneficial.</div></div><div><h3>Conclusions</h3><div>A 3-hour workshop on the essential leadership skill of impromptu speaking is a feasible way to increase surgical trainees’ comfort with speaking, as well as their perceived ability to integrate the audience's perspective and deliver a central message. Dedicated leadership training for surgical trainees focused on specific skills, such as impromptu speaking, is both desired and effective within a residency program's existing protected educational time.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103313"},"PeriodicalIF":2.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515444","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":"Improving Medical Student Performance With Unsupervised Simulation and Remote Asynchronous Feedback","authors":"Julián Varas MD, MSc ,&nbsp;Francisca Belmar MD ,&nbsp;Javiera Fuentes MMedEd, MSc ,&nbsp;Javier Vela MD, MSc ,&nbsp;Caterina Contreras MD ,&nbsp;Luz M Letelier MD ,&nbsp;Arnoldo Riquelme MD, MMedEd ,&nbsp;Domenech Asbun MD ,&nbsp;Eduardo F. Abbott MD ,&nbsp;Gabriel Escalona MD ,&nbsp;Adnan Alseidi MD, MMedEd ,&nbsp;Patricia O'Sullivan EdD ,&nbsp;Ignacio Villagrán MSc","doi":"10.1016/j.jsurg.2024.103302","DOIUrl":"10.1016/j.jsurg.2024.103302","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to assess the effectiveness of training medical students to perform two clinical procedures using unsupervised simulation with remote asynchronous feedback, compared to an intensive workshop with in-person feedback.</div></div><div><h3>Design, Setting, and Participants</h3><div>Third-year medical students were recruited and randomized into 2 groups: Thoracentesis or paracentesis. Within each group, participants were further randomized into either unsupervised simulation with remote asynchronous feedback (experimental group; EG) or a 2-hour workshop (control group; CG). The EG underwent two unsupervised 20-minute training sessions and received remote asynchronous feedback. The CG had a 2-hour workshop where they received in-person feedback. After training, students were assessed using the objective structured assessment of technical skills (OSATS) scale. Twenty students in thoracentesis and 23 in paracentesis training completed the 2 training sessions with remote and asynchronous feedback, and 30 students for both thoracentesis and paracentesis groups completed the 2-hour workshop.</div></div><div><h3>Results</h3><div>The EG achieved a significantly higher passing rate than the CG on both procedures (thoracentesis 80% vs. 43%, paracentesis 91% vs. 67%, p-value&lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The asynchronous educational method allowed EG students to achieve higher performance than CG students. This novel modality allowed students and instructors to train and assess at their own pace.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103302"},"PeriodicalIF":2.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515445","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 Impact of Mentoring on Academic Career Success in Surgical Subspecialties: A Systematic Review","authors":"Madeline Case BA ,&nbsp;Marcela Herrera BS ,&nbsp;Mia V. Rumps MS ,&nbsp;Mary K. Mulcahey MD","doi":"10.1016/j.jsurg.2024.09.011","DOIUrl":"10.1016/j.jsurg.2024.09.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;INTRODUCTION&lt;/h3&gt;&lt;div&gt;As of 2019, women comprise 52.4% of medical school matriculants, make up more than one-third of the active physician workforce, and nearly half of residents and fellows. Although the number of women physicians continues to increase, many surgical subspecialities, including orthopaedic surgery, have not seen a substantial increase in the percentage of women physicians. This may be due to a lack of mentorship. Efforts within the medical community to decrease the burden of gender bias on women include attempts to increase access to mentorship opportunities. Effective mentoring is a critical aspect of any resident physician's training. The purpose of this study was to analyze the most important aspects of mentorship in the academic advancement of female surgical subspecialists.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;A systematic review of the literature was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in July 2022 using the electronic databases PubMed, EMBASE, Cochrane Database, Scopus, and Web of Science.&lt;span&gt;&lt;span&gt;&lt;sup&gt;10&lt;/sup&gt;&lt;/span&gt;&lt;/span&gt; Search terms can be found in Appendix 1. An initial abstract screen of each article was conducted by 3 authors. Studies were included if they focused on mentorship of women in academic surgery, were published from 2000-2023, were peer-reviewed articles in the English language, and conducted in the United States. Two reviewers screened each article based on the criteria; the remaining studies were then reviewed in full text. After the full text screen, the eligible articles underwent data extraction and quality assessment using AXIS tool or CASP checklist. The results were then analyzed and synthesized. Additionally, risk of bias was assessed using the 2018 version of the Mixed Methods Appraisal Tool (MMAT).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Several common themes among the 10 studies were identified. Six (60%) studies discussed the impact of mentorship on career success. One of the most important ways that mentors assist mentees is by serving as positive role models. Two (20%) studies noted that goal-setting assistance is one of the most helpful ways mentors can provide guidance. Guidance with academic politics (such as funding and research priorities) was identified as a major contribution by mentors in two (20%) studies. The second most common theme was female mentors (6; 60%). Most studies (9; 90%) agree that it's important for women surgeons to have female mentors. The importance of multiple mentors was explored in 4 (40%) papers. Three (30%) studies addressed the issue of balancing work and life responsibilities among female surgeons.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSION&lt;/h3&gt;&lt;div&gt;This review suggests that female surgical subspecialists value mentorship in regard to career development, managing work-life balance, and academic productivity. Although many studies found that female physicians were more likely to express ","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103292"},"PeriodicalIF":2.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515458","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}