Journal of Surgical Education最新文献

{"title":"Residency Wellness: A Historical Narrative Review","authors":"Jacob Leung BA ,&nbsp;Brian Tao BA ,&nbsp;Dhanesh D. Binda MD ,&nbsp;Maxwell B. Baker MSc ,&nbsp;Ansel Jhaveri MD ,&nbsp;Mark C. Norris MD","doi":"10.1016/j.jsurg.2024.09.013","DOIUrl":"10.1016/j.jsurg.2024.09.013","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>The structure of medical residency in the United States has experienced significant changes, paralleling advances in medical science and education. While these changes have enhanced medical training, they have introduced challenges, particularly in resident wellness. The well-being of residents is critical for patient care and the healthcare system. This review aims to provide an overview of the historical trends in medical residency, focusing on the evolution of resident wellness and its associated challenges.</div></div><div><h3>METHODS</h3><div>A narrative review was conducted, examining the evolution and challenges of medical residency with an emphasis on resident wellness. An exhaustive literature search on January 25, 2024 was conducted across PubMed, Web of Science, and Google Scholar. The search utilized keywords related to medical residency, wellness, and educational reforms. Articles were selected based on relevance and robust evidence, and information was organized into thematic categories for narrative synthesis.</div></div><div><h3>RESULTS</h3><div>The search yielded 57 publications that met the inclusion criteria. Historical trends revealed a shift from an apprenticeship model to formalized training programs, with each phase bringing unique challenges to resident wellness. The Flexner Report's influence on standardizing medical education, the rise of modern residency programs, and the recognition of burnout as a significant issue were key developments. Policy changes, technological impacts, and the COVID-19 pandemic have further shaped residency training and wellness. Studies highlight the need for interventions addressing burnout and promoting wellness, with varied approaches across specialties and institutions.</div></div><div><h3>CONCLUSION</h3><div>Residency burnout has been a growing concern since the 1970s, exacerbated by advancements in medicine, technology, and recent global events like the COVID-19 pandemic. Although awareness has increased, the need remains to address burnout and promote wellness during residency. Further research is warranted to develop effective interventions and adapt training to meet the evolving needs of residents.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103294"},"PeriodicalIF":2.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396384","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":"Autonomy and Competence in Cardiac Surgical Training: A Qualitative Analysis","authors":"Abigail White ,&nbsp;Hellmuth Ricky Muller Moran ,&nbsp;Zibdawi Rami ,&nbsp;Michael C. Moon ,&nbsp;Bin Zheng ,&nbsp;Simon R. Turner","doi":"10.1016/j.jsurg.2024.08.024","DOIUrl":"10.1016/j.jsurg.2024.08.024","url":null,"abstract":"<div><h3>Objective</h3><div>There is concern that current surgical residents are suboptimally prepared for autonomous practice. This qualitative study aimed to clarify perceptions of competency, autonomy and surgical training goals by Canadian cardiac surgery programs and trainees.</div></div><div><h3>Design</h3><div>This was a qualitative study using semistructured interviews. These were audio recorded and transcribed verbatim. We used thematic analysis and content analysis to deductively analyze interview transcripts. From this, we identified major themes describing competency, autonomy, and goals of surgical training.</div></div><div><h3>Setting</h3><div>All interviews were conducted online over Zoom.</div></div><div><h3>Participants</h3><div>We interviewed 16 individuals (7 trainees and 9 program directors) from 10 Canadian cardiac surgery training programs.</div></div><div><h3>Results</h3><div>Both trainees and staff agreed that the goal of surgical residency is to produce competent, not autonomous, surgeons. When defining competency, both faculty and trainees identified the importance of technical skills and nontechnical skills, such as surgical decision-making. Both groups believed autonomy and competency to be different, wherein autonomy assumes competency and is distinguished by the ability to make decisions independently. Importantly, 81% (n=13) believed that nontechnical skills were more important for independent practice than technical skills. Only 57% (n=4) of trainees and 33% (n=3) of staff surgeons felt that the current RCPSC competencies were reasonable to achieve during residency training.</div></div><div><h3>Conclusion</h3><div>We have identified several important discrepancies in the perceptions of competency, autonomy, and surgical training goals. The RCPSC (Royal College of Physicians and Surgeons of Canada) stated goal of producing trainees who are ready for independent practice is discordant with the perspective of Canadian cardiac surgery programs. Many staff and trainees do not feel that the currently espoused competencies are feasible to achieve by graduation. The results of our study will allow us to identify the barriers during training to produce trainees ready for independent practice.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103274"},"PeriodicalIF":2.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396380","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":"Exploring the Scientific Conversation Regarding Live Tissue Training in Trauma Surgery: A Bibliometric Analysis","authors":"C.S. Swain ,&nbsp;H.M.L. Cohen ,&nbsp;G. Helgesson ,&nbsp;R.F. Rickard ,&nbsp;K. Karlgren","doi":"10.1016/j.jsurg.2024.09.014","DOIUrl":"10.1016/j.jsurg.2024.09.014","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>Live tissue training (LTT), use of a living anaesthetized animal to practice surgical skills, is a continuing practice, despite controversy and ethical concern. The scientific literature appears polarized in terms of supporting or refuting the practice. This bibliometric analysis of the literature maps and explores the academic conversation regarding LTT including potential influences associated with authorship.</div></div><div><h3>METHOD</h3><div>Literature identified via the process conducted during a previously published systematic review was used for analysis. 84 literature sources were included. Bibliometric data were manually extracted for analysis, and visually mapped.</div></div><div><h3>RESULTS</h3><div>The scientific conversation about LTT use in trauma is centered on surgery, trauma and emergency medicine specialties, published in clinical journals, with significant influence noted from military authors and organizations. Few authors published work in simulation or education-based journals. Publications are considered to be generally supportive of, or ambivalent to, the use of LTT; those with notable objections to LTT tended to be affiliated to animal activist organizations.</div></div><div><h3>CONCLUSION</h3><div>There is academic conversation apparent within the literature, in the form of citations, although this is used to affirm or rebuke a given perspective, rather than engage with, or learn from, the content. There is potential benefit to increased interactivity between researchers. The conversation could also be informed by authors broadening the outlook to wider medical educational literature and other disciplines, rather than focusing on application to clinical training, to improve trauma education for all, regardless of modality.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103295"},"PeriodicalIF":2.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396381","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":"Table of Contents & Bacode","authors":"","doi":"10.1016/S1931-7204(24)00443-4","DOIUrl":"10.1016/S1931-7204(24)00443-4","url":null,"abstract":"","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 11","pages":"Pages ii-iv"},"PeriodicalIF":2.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417220","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":"Resident Self-Efficacy in Grantsmanship Lags Behind Key Funding Deadlines","authors":"Jeffrey L. Roberson MD, MBA,&nbsp;Jesse E. Passman MD, MPH,&nbsp;Major Kenneth Lee IV MD, PhD,&nbsp;Sunil Singhal MD,&nbsp;Rachel Kelz MD, MSCE, MBA,&nbsp;Jon B. Morris MD,&nbsp;Lillias H. Maguire MD","doi":"10.1016/j.jsurg.2024.08.030","DOIUrl":"10.1016/j.jsurg.2024.08.030","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Extramural funding is critical to career success and advancement in academic surgery, and surgical residents can apply for both societal and federal funding. Many federal funding mechanisms require proposals to be submitted before residents’ formal research years.</div></div><div><h3>METHODS</h3><div>To better understand the resident experience with grantsmanship, we distributed a validated grantsmanship self-efficacy assessment inventory for voluntary completion at our academic general surgery training program with 2 years of dedicated research. The survey covers 3 domains: conceptualizing, designing and analyzing, and funding a study. All questions are scored 0 to 10 with 0 indicating no confidence and 10 indicating complete confidence. Median scores for the 3 domains were calculated for all respondents and compared between training years using Kruskal-Wallis with post-hoc Dunn testing.</div></div><div><h3>RESULTS</h3><div>Forty-four surveys were completed with a response rate of 84%. Resident self-efficacy in grantsmanship improved throughout the training years with the greatest changes being in their comfort with conceptualizing and funding a study. Dunn testing identified specific differences between PGY2 and PGY7 comfort with conceptualizing studies (median 5 vs. 7.5, p = 0.003) and understanding of funding mechanisms (median 2.0 vs. 7, p = 0.003).</div></div><div><h3>CONCLUSIONS</h3><div>While comfort with conceptualizing and funding studies does increase throughout the training years, this often develops after critical funding deadlines have already passed and can disadvantage surgical residents interested in academic careers. A curriculum that emphasizes familiarity with the grant writing and funding processes may better facilitate long term career success.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103280"},"PeriodicalIF":2.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396385","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":"Impact of COVID-19 on Confidence and Anxiety in Medical Students Related to Procedural Skills","authors":"Sloane Kowal ,&nbsp;Owen Kolasky ,&nbsp;Andrea Winthrop MD ,&nbsp;Steve Mann MD, MMEd","doi":"10.1016/j.jsurg.2024.09.009","DOIUrl":"10.1016/j.jsurg.2024.09.009","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>During the COVID-19 pandemic, opportunities for hands-on surgical and procedural skills training and practice were significantly reduced, as many curricular activities were deferred or converted to a virtual format. This study focused on whether these changes contributed to increased anxiety and decreased confidence for medical students performing these skills.</div></div><div><h3>METHODS</h3><div>The Surgical Skills Technology Elective Program (SSTEP) is an annual five-day intensive procedural skills program after second-year medical school. Surveys assessing anxiety and confidence with respect to procedural skills were distributed and completed before and after SSTEP in 2016 and 2022.</div></div><div><h3>RESULTS</h3><div>Pre-SSTEP scores were higher for anxiety and lower for confidence in the 2022 cohort compared to the prepandemic group. Post-SSTEP scores for anxiety and confidence were comparable between cohorts.</div></div><div><h3>CONCLUSIONS</h3><div>Curricular changes and restrictions during the pandemic likely played a major role in the 2022 cohort having more anxiety and less confidence in their skills than prepandemic cohorts. However, these changes were effectively mitigated after participation in SSTEP. Medical schools should consider using and expanding on in-person bootcamps to support those with decreased exposure to surgical and procedural skills related to resource constraints and/or curricular changes.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103290"},"PeriodicalIF":2.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396383","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":"Ethical Approaches in General Surgery Residency Training: A Blended Learning Module Trial","authors":"Ali Kagan Coskun MD, PhD ,&nbsp;Irem Budakoglu MD, MSc ,&nbsp;Ozlem Coskun MD, PhD ,&nbsp;Canan Uluoglu MD, PhD","doi":"10.1016/j.jsurg.2024.09.010","DOIUrl":"10.1016/j.jsurg.2024.09.010","url":null,"abstract":"<div><h3>AIM</h3><div>This study aimed to develop a blended training module focusing on ethical approaches within general surgery residency training and to assess the impact of this training on participants.</div></div><div><h3>METHODS</h3><div>Based on the literature review and input from both general surgery residents and trainers, 14 topics were identified, and corresponding learning objectives were formulated. The training was conducted through a blended learning module, which encompassed online video presentations alongside face-to-face sessions involving real-life cases. Assessment of the training involved administering test-formatted exams both before and after the training, which assessed the learning objectives of the 14 topics. These exams comprised multiple-choice questions and true/false inquiries based on case-based propositions. Additionally, feedback regarding the training was solicited from the residents.</div></div><div><h3>RESULTS</h3><div>The study involved 20 general surgery residents. Assessment revealed a statistically significant increase in exam success among the residents after the training (p&lt;0.001). Additionally, feedback indicated that the training model was effective.</div></div><div><h3>CONCLUSIONS</h3><div>Developing a blended learning module that combines online and face-to-face education, supplemented with real-life case studies, and incorporating discussions on ethical dilemmas during face-to-face sessions, along with assessment through exams, will significantly enhance the proficiency of residents in surgical ethics.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103291"},"PeriodicalIF":2.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383032","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":"Shared Music Experiences During Bedside Neurosurgical Procedures: An ACGME-Sponsored Pilot Study on Fostering Patient-Clinician Alliance Through Music","authors":"Collin M. Labak MD ,&nbsp;Michael J. Mann ,&nbsp;Michael D. Shost ,&nbsp;Mandy Wong ,&nbsp;Eric Z. Herring MD ,&nbsp;Martha Sajatovic MD ,&nbsp;Alan Hoffer MD","doi":"10.1016/j.jsurg.2024.07.006","DOIUrl":"10.1016/j.jsurg.2024.07.006","url":null,"abstract":"<div><h3>Background</h3><div>Bedside procedures represent a substantial proportion of the neurosurgical resident's responsibilities. Although music interventions in healthcare have classically been employed for the benefit of the patient, there is evidence in support of its positive effects on healthcare workers as well.</div></div><div><h3>Objectives</h3><div>We aimed to create a novel framework-the shared music experience (SME)-which allows for patient and provider to discuss and mutually select a musical playlist during bedside procedural interventions.</div></div><div><h3>Methods</h3><div>A single-center prospective pilot study with nested design was carried out during a 6-month period. One sample was neurosurgery residents at our institution, while the other was patients undergoing nonemergent bedside procedures. Primary endpoints included change in neurosurgery residents' and patients' perception of patient-provider alliance. Secondary endpoints include quantitative and qualitative analysis of feedback from residents and patients about the SME framework.</div></div><div><h3>Results</h3><div>Twelve out of 13 (92.3%) eligible neurosurgery residents were enrolled. Twenty-eight SMEs were carried out. Twenty-six of 28 patients (92.9%) replied that they did enjoy the SME. Patients who partook in SMEs had a significant increase in metrics of patient-clinician alliance as measured by the mARM-5. All 7 residents who participated in at least 1 SME reported having enjoyed performing procedures within the framework and affirmed they would either ''often'' (2/7, 28.6%) or ''always'' (5/7, 71.4%) implement SME in future practice.</div></div><div><h3>Conclusions</h3><div>The SME is a novel intervention that can be employed to help patients and providers find common ground through music and foster the patient-clinician relationship during bedside procedures.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103224"},"PeriodicalIF":2.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383033","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":"Implementation of a Urologic Surgery Skills Fair for Medical Students","authors":"Shayan Smani BS ,&nbsp;Mursal Gardezi MD ,&nbsp;Folawiyo Laditi MD, MBA ,&nbsp;Vinaik M. Sundaresan BS ,&nbsp;Victoria Kong BS ,&nbsp;Olamide Olawoyin MD ,&nbsp;Marianne Casilla-Lennon MD","doi":"10.1016/j.jsurg.2024.103300","DOIUrl":"10.1016/j.jsurg.2024.103300","url":null,"abstract":"<div><h3>Objectives</h3><div>To increase the proportion of applicants to urology residencies, we created a surgical skills fair to introduced urology early in undergraduate medical education.</div></div><div><h3>Design</h3><div>Funded by the Department of Urology, the fair was designed to have student rotations through 12 hands-on practice stations supervised by faculty and an advanced care practitioner or resident physicians. At conclusion, medical students completed a voluntary survey about their experience.</div></div><div><h3>Setting</h3><div>Surgical skills fairs were organized at Yale School of Medicine (New Haven, CT) in 2022 and 2023.</div></div><div><h3>Participants</h3><div>The fair was designed to encourage interaction between medical students, urology residents, and urology faculty by highlighting common urologic procedures and skills.</div></div><div><h3>Results</h3><div>The fair was well received by medical students at all levels of training. Over 2 years, 155 medical students attended, including 67 (43%) first-year and 60 (39%) second-year medical students. Eighty-two medical students completed the survey. An average of 19 attendings, advanced care practitioners and residents attended each event. Of the survey respondents, 42.7% reported prior interest in a surgical specialty but had not considered urology. Students reported increased interest in urology and greater confidence in urologic skills after the event (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>We demonstrate that creating a surgical fair in urology is feasible and enhances early exposure and interest in urology. For students who do not pursue urology, the fair provides knowledge of urological pathologies and valuable skills for all physicians.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103300"},"PeriodicalIF":2.6,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378682","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":"Exploring Gender Diversity in Canadian Surgical Residency Leadership","authors":"Kaitlyn G. Harding MD ,&nbsp;A.J. Lowik PhD ,&nbsp;Caroline A. Guinard MD ,&nbsp;Sam M. Wiseman MD, FRCSC","doi":"10.1016/j.jsurg.2024.09.001","DOIUrl":"10.1016/j.jsurg.2024.09.001","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Studies in the United States demonstrate a low proportion of cisgender women in medical leadership. No research exists about the prevalence of transgender people in medical leadership. The objective of this study was to evaluate gender representation within Canadian surgical training leadership.</div></div><div><h3>DESIGN</h3><div>This study represents a survey based exploratory analysis and literature review. Associations between gender and leadership position, surgical subspecialty, years in practice and leadership role, province of work, and age were calculated using Chi squared goodness of fit and independence tests.</div></div><div><h3>SETTING</h3><div>The study was based out of the University of British Columbia in Vancouver and included all Canadian surgical training programs.</div></div><div><h3>PARTICIPANTS</h3><div>Participants were identified using the Canadian Resident Matching Service and program websites. All prospective respondents (359) were emailed an encrypted survey link.</div></div><div><h3>RESULTS</h3><div>The survey response rate was 65/359 responses (18%). The overall gender distribution was cis men (n = 36, 56.5%), cis women (n = 26, 40%), nonbinary (n = 1, 1.5%), agender (n = 1, 1.5%) and nonresponse (n = 1, 1.5%). Sixty-three percent of program directors were cis men, 33% were cis women and 4% were agender. Sixty-seven percent of associate program directors were cis women and 33% were cis men. Sixty-five percent of division leads were cis men, 29% were cis women, and 6% were nonbinary. There were more cis women in general surgery leadership than expected (df = 1, N = 20, x² = 11.05, p ≤ 0.001). No statistically significant associations between gender identity/modality, leadership role, province, or age were found using chi squared tests.</div></div><div><h3>CONCLUSIONS</h3><div>Cis men continue to outnumber all others in surgical training leadership. More cis women than expected work in general surgery training leadership. However, these findings must be interpreted with caution considering the low survey response rate and the greater proportion of cis women respondents compared to cis women surgeons. There is a marked absence of binary-identified trans people in surgical training leadership in Canada, however a small number of nonbinary and agender people are present.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 12","pages":"Article 103282"},"PeriodicalIF":2.6,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378681","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}