Journal of Surgical Education最新文献

{"title":"Obstetrics and Gynecology Residency Geographic Match Location Patterns: Comparison of Pre and Post Virtual Interviews","authors":"Briana N. Mayberry MD,&nbsp;Shweta Patel MD,&nbsp;Sima Baalbaki MD,&nbsp;Audra Williams MD,&nbsp;Carlos A. Estrada MD, MS,&nbsp;Deepti Sharma MD","doi":"10.1016/j.jsurg.2024.08.012","DOIUrl":"10.1016/j.jsurg.2024.08.012","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To evaluate the impact of virtual interviews on geographic trends for applicants and programs in the obstetrics and gynecology (OBGYN) resident match.</div></div><div><h3>DESIGN</h3><div>Cross-sectional study of a random 50% sample of all OBGYN residency programs listed by the Accreditation Council for Graduate Medical Education (ACGME) for the 2023 to 2024 academic year. Data collected from each program included geographic location, number of residents per year, and total number of residents. Residents were categorized into 4 mutually exclusive geographic match categories: matched into the same institution, matched into same state (but different institution), matched into the same US Census region but a different state/institution, or matched into a different US Census region.</div></div><div><h3>RESULTS</h3><div>A total of 148 of 295 (50.2%) residency programs were included (known total number of residents = 2,928 from four US census regions and Puerto Rico). Most programs were considered small (≤16 residents; n = 52, 35.1%). In general, 43.9% (1148 of 2617) residents matched in a different region from their medical school training. For the primary outcome, no differences in the geographic placement in the previrtual (2020) and virtual application cycles (2021-2023) were observed (p = 0.51). When analyzed by program size or program region, there was no difference in the geographic placement in the previrtual and virtual application cycles.</div></div><div><h3>CONCLUSIONS</h3><div>This study suggests that the virtual interview process did not demonstrate an impact on geographical placement of OBGYN residents, regardless of the size of the residency program or the program's geographic region.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 11","pages":"Pages 1778-1783"},"PeriodicalIF":2.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311223","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":"Lack of Racial and Ethnic Diversity in Surgical Education, as Reflected by Skin Tone in General Surgery Textbooks","authors":"E. Ajmal BS ,&nbsp;T. Meyer MD ,&nbsp;G. Sobol MS ,&nbsp;M. Silver MS ,&nbsp;J. Nicastro MD","doi":"10.1016/j.jsurg.2024.07.029","DOIUrl":"10.1016/j.jsurg.2024.07.029","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>Disparity in healthcare is an important and timely topic. One example of such disparity appears to be the disproportionate use of lighter skin tone illustrations in medical and surgical educational material.<span><span>¹</span></span> Visual representation of pathology in instructional material is one key element that informs decision making in surgical disease and could contribute to disparity in outcomes in underrepresented tonal groups. Our hypothesis is that visual examples (illustrations) of clinical pathology in major surgical texts are biased in that they are heavily weighted to Caucasian skin tones and therefore fail to accurately represent the racial distribution of patients in the United States population.</p></div><div><h3>METHODS</h3><p>Images from 4 commonly used general surgery textbooks were screened independently by 2 reviewers from Maimonides Medical Center and SUNY (State University of New York) Downstate College of Medicine. Human photographic and cartoon images (where skin tone could be determined), with adequate skin shown, were included. These images were assigned a Fitzpatrick skin photo type (FP) score (1-6). The distribution of images among the 6 FP categories were compared to the expected distribution of images in the United States population, as described from a previous National Health and Nutrition Examination Survey (NHANES). Differences in distribution were compared using a chi-squared test, with p-value &lt;0.05 considered as statistically significant.</p></div><div><h3>RESULTS</h3><p>There were 556 total images deemed adequate for assessment from the 4 textbooks chosen. 169 from Sabiston, 61 from Mulholland and Greenfield, 177 from Schwartz, and 149 from ACS. About 539 of these images (96.9%) were depictions of patients with light skin tone (FP scores 1-3.) while less than 4% of images were of dark-skinned individuals (FP score between 4 and 6.) An FP score 1 accounted for most images, comprising 477 images (86.1%). There was a 1.8% analytical discrepancy noted between the textbook reviewers. The distribution on the general US population (NHANES) is: FP score 1: 1.6%, FP score 2: 33.1%, FP score 3: 47.8%, FP score 4: 4.9%, FP score 5: 3.6%, FP score 6: 9.0%.</p></div><div><h3>CONCLUSIONS</h3><p>Screening of commonly used general surgery textbooks showed a significant lack of diversity in image-based skin tone representation when compared to the United States population at large. The overwhelming majority of images were of light skin tones. Improving diversity of imagery in educational material, such as basic textbooks, might help reduce observed disparities in outcomes among surgical patients in the future.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 11","pages":"Pages 1772-1777"},"PeriodicalIF":2.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271810","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 Film Room: Using Artificial Intelligence to Facilitate Video Review for Urology Trainees","authors":"Grant M. Henning,&nbsp;Bridget L. Findlay,&nbsp;Tal D. Cohen,&nbsp;Aaron M. Potretzke,&nbsp;Tobias S. Kohler,&nbsp;Sevann Helo,&nbsp;Candace F. Granberg,&nbsp;Stephen A. Boorjian,&nbsp;Abhinav Khanna,&nbsp;Brian J. Linder,&nbsp;Boyd R. Viers","doi":"10.1016/j.jsurg.2024.08.019","DOIUrl":"10.1016/j.jsurg.2024.08.019","url":null,"abstract":"<div><p>Video-based educational programs offer a promising avenue to augment surgical preparation, allow for targeted feedback delivery, and facilitate surgical coaching. Recently, developments in surgical intelligence and computer vision have allowed for automated video annotation and organization, drastically decreasing the manual workload required to implement video-based educational programs. In this article, we outline the development of a novel AI-assisted video forum and describe the early use in surgical education at our institution.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 11","pages":"Pages 1743-1747"},"PeriodicalIF":2.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271813","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":"Validation of Checklists and Evaluation of Clinical Skills in Cases of Abdominal Pain With Simulation in Formative, Objective, Structured Clinical Examination With Audiovisual Content in Third-Year Medical Students' Surgical Clerkship","authors":"JJ Ruiz-Manzanera PhD ,&nbsp;J Almela-Baeza PhD ,&nbsp;A Aliaga MD ,&nbsp;G Ádanez PhD ,&nbsp;F Alconchel PhD ,&nbsp;JM Rodríguez PhD ,&nbsp;F Sánchez-Bueno ,&nbsp;P Ramírez ,&nbsp;B Febrero PhD","doi":"10.1016/j.jsurg.2024.08.016","DOIUrl":"10.1016/j.jsurg.2024.08.016","url":null,"abstract":"<div><h3>OBJECTIVES</h3><p>The objective of this study was to develop and validate 6 checklists for evaluating abdominal pain in clinical simulation scenarios; to assess student competencies in managing 6 clinical cases using OSCE, based on faculty evaluations; and to analyze discrepancies between faculty and student evaluations.</p></div><div><h3>DESIGN</h3><p>A practical workshop was designed to address 6 clinical scenarios of abdominal surgical conditions. Four scenarios employed medium fidelity simulators, while 2 scenarios employed standardized patient methodology. Prior to the workshop, students received theoretical audiovisual material. At the conclusion of the workshop, students were evaluated using checklists that assessed communication, privacy, anamnesis, and technical skills. Ten workshops were conducted over 3 years, using the OSCE (Objective Structured Clinical Examination) format for evaluation.</p></div><div><h3>SETTING</h3><p>In the statistical analysis, t-Student tests or ANOVA were employed to ascertain whether there were any significant differences between the groups. In the process of validating checklists for clinical scenarios, 6 experts were asked to evaluate each item on a scale of 1 to 9. To assess the degree of agreement among experts, the intraclass correlation coefficient (ICC) was employed.</p></div><div><h3>PARTICIPANTS</h3><p>The study involved a total of 670 third-year medical students from the University of Murcia (UMU), Spain, who participated in the subject \"Medical-Surgical Skills.\"</p></div><div><h3>RESULTS</h3><p>High levels of appropriateness were observed for the checklist items, with mean scores above 7.5 points, as well as high levels of inter-expert agreement. Students obtained a mean score of 8 points in the evaluation of each clinical scenario. No significant differences were found between faculty and student scores (p &lt; 0.05).</p></div><div><h3>CONCLUSIONS</h3><p>The learning method focused on clinical scenarios of abdominal surgical diseases effectively enhanced the clinical skills of third-year medical students. It used pre-existing audiovisual materials, hands-on workshops with medium-fidelity simulators, and standardized patients. Consistent evaluations from students and faculty confirmed the efficacy of these strategies.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 11","pages":"Pages 1756-1763"},"PeriodicalIF":2.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S193172042400391X/pdfft?md5=a0834c6283947dbd2aade95137c7ecae&pid=1-s2.0-S193172042400391X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272001","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":"Post Night Shift Education for Interns: A Pilot Program","authors":"Rachael C. Acker MD ,&nbsp;Jeffrey L. Roberson MD ,&nbsp;Sarah Landau MD ,&nbsp;Cary B. Aarons MD, MSEd ,&nbsp;Rachel R. Kelz MD, MSCE, MBA ,&nbsp;Major Kenneth Lee IV MD, PhD","doi":"10.1016/j.jsurg.2024.08.026","DOIUrl":"10.1016/j.jsurg.2024.08.026","url":null,"abstract":"<div><h3>BACKGROUND</h3><p>Night float rotations are associated with decreased feedback, educational conference attendance, and operative time. Interns are also more isolated and spend less time on teams. We therefore developed a novel post night shift initiative to address these shortcomings and examined its impact on the educational experience and sense of belonging among interns.</p></div><div><h3>METHODS</h3><p>A program of weekly senior resident-led post night shift sessions was instituted at a university-based general surgery residency program for the first quarter of the academic year. Four interns and one senior resident participated in each session. Feedback surveys were administered. A previously validated Belonging in Surgery survey was also administered to all general surgery interns at the end of the quarter.</p></div><div><h3>RESULTS</h3><p>Eleven interns had night float rotations within the first 3 months of the academic year. The intern feedback survey response rate was 93% (10/11). All intern respondents attended at least 3 sessions. Interns felt that the sessions increased familiarity with each other (85%) and senior residents (92%), improved clinical decision making (77%), and provided a safe space for discussion (69%). The senior resident survey response rate was 86% (n = 14). All senior residents enjoyed teaching the sessions and felt that they improved their familiarity with interns. The intern belonging survey response rate was 84% (16/19). Categorical interns had significantly higher belonging scores than preliminary interns at the end of the first quarter (mean 48.1 vs 41.6, p = 0.009). There was a trend toward decreased belonging scores for interns who had night float rotations early in the year which did not meet statistical significance (42.9 vs 47.4, p = 0.059).</p></div><div><h3>CONCLUSION</h3><p>This novel program improved intern decision-making, familiarity with other residents, and comfort calling senior residents for assistance overnight. There was no statistically significant difference in belonging between interns who started residency on night float versus those who did not. Similar programs may help address concerns regarding missed learning opportunities and decreased sense of community during these rotations.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 11","pages":"Pages 1764-1771"},"PeriodicalIF":2.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271812","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":"A Team-Based American Board of Surgery In-Training Examination (ABSITE) Competition Improves Exam Performance","authors":"Graham J. Spurzem MD,&nbsp;J. Jeffery Reeves MD,&nbsp;Jennifer A. Berumen MD,&nbsp;Garth R. Jacobsen MD,&nbsp;Allison E. Berndtson MD","doi":"10.1016/j.jsurg.2024.08.021","DOIUrl":"10.1016/j.jsurg.2024.08.021","url":null,"abstract":"<div><h3>OBJECTIVE</h3><p>The American Board of Surgery In-Training Examination (ABSITE) is an important factor in general surgery resident career development. The use of practice question banks for ABSITE preparation improves exam scores and completing more practice questions results in higher scores. The objective of this study is to describe the design of a novel, team-based ABSITE competition implemented into our residency program and analyze its effect on exam performance.</p></div><div><h3>DESIGN</h3><p>For the 2023 to 2024 academic year (AY), residents were randomly sorted into teams. The number of TrueLearn (TL) practice questions completed by each team during the 6-month period preceding the 2024 ABSITE was monitored at regular intervals. Paired sample t-test was used to compare total questions completed and ABSITE percent scores from the prior AY. Simple linear regression was performed to determine if total completed questions predicted ABSITE percent scores, and if the change in total completed questions predicted a change in ABSITE percent scores for unique residents.</p></div><div><h3>SETTING</h3><p>University-affiliated general surgery residency program.</p></div><div><h3>PARTICIPANTS</h3><p>About 34 clinical and research general surgery residents.</p></div><div><h3>RESULTS</h3><p>Mean total TL questions completed per resident increased by 175.2, with a difference trending toward statistical significance (1037.9 ± 583.6 vs 1213.1 ± 596.0, p = 0.08). Mean ABSITE percent scores significantly increased by 4.6% (68.2 ± 8.7 vs 72.8 ± 5.7, p &lt; 0.001). Total completed questions positively correlated with ABSITE percent scores (R² = 0.21, F (1,66) = 17.04, p &lt; 0.001). Among individual residents, completing more questions than the prior AY predicted improvement in ABSITE percent scores (R² =.18, F (1,32) = 7.02, p = 0.01). Our model predicts that by completing 300 additional practice questions (e.g. 10 more questions/day for 1 month) a resident's ABSITE percent score will increase by 4.8 percentage points.</p></div><div><h3>CONCLUSION</h3><p>Implementation of a team-based ABSITE competition is a straightforward and effective intervention that increases general surgery resident question bank utilization and significantly improves ABSITE percent scores.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 11","pages":"Pages 1691-1698"},"PeriodicalIF":2.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1931720424004033/pdfft?md5=178ad17562914ae58596518e936db607&pid=1-s2.0-S1931720424004033-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241437","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":"How Do I Match? A Survey Study on the Impact of Step 1 Becoming Pass/Fail","authors":"Benjamin J. Lichtbroun MD ,&nbsp;Aravind Rajagopalan MSc ,&nbsp;Kevin Chua MD ,&nbsp;Alexandra Tabakin MD ,&nbsp;John Pfail MD ,&nbsp;Chrystal Chang MD ,&nbsp;Danielle Velez MD ,&nbsp;Ji Hae Park MD ,&nbsp;Vignesh T. Packiam MD ,&nbsp;Thomas L. Jang MD, MPH ,&nbsp;Saum Ghodoussipour MD","doi":"10.1016/j.jsurg.2024.08.013","DOIUrl":"10.1016/j.jsurg.2024.08.013","url":null,"abstract":"<div><h3>BACKGROUND</h3><p>Step 1 has historically been a major criterion to evaluate students for residency match. With Step 1 now being pass/fail (P/F), students are uncertain how to distinguish their applications. We aim to understand student's opinions surrounding the scoring change as this is the first class of students applying to residency in the P/F era.</p></div><div><h3>MATERIALS AND METHODS</h3><p>An electronic survey was sent to 3rd and 4th year American medical students.</p></div><div><h3>RESULTS</h3><p>Of the 255 students surveyed, 61.6% prefer Step 1 in the P/F format. Students applying for highly competitive specialties (HCS) preferred numerical scoring (55.6%). On a 5-point Likert scale, students entering HCS believed more strongly that they would have a better chance at matching if Step 1 was graded numerically (3.47 vs 2.71) and creates an unfair advantage for those who can afford to pursue a research year (3.46 vs 2.95). Students entering HCS felt finances played a significant role in whether they took a research year and felt added pressure to engage in research. Respondents believe that students from prestigious medical schools, well-connected students, and MD students will benefit most.</p></div><div><h3>CONCLUSIONS</h3><p>While students mostly prefer P/F scoring, there were differences of opinion between those going into HCS and LCS. Students indicated that those who have financial means are at a distinct advantage as they can afford to utilize a research year to distinguish their applications. Future efforts should be made to address student concerns and unintended consequences of the scoring change to create an equitable system.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 11","pages":"Pages 1735-1742"},"PeriodicalIF":2.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1931720424003921/pdfft?md5=4c4451fa3a31c742052c93608e8a74fa&pid=1-s2.0-S1931720424003921-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272000","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":"Serious Illness Communication Training for Surgical Critical Care Fellows: A Pilot Implementation Study","authors":"Nikhil R. Shah MD ,&nbsp;Sarah D. King DO ,&nbsp;Michael P. Mendez MD ,&nbsp;Pauline K. Park MD ,&nbsp;Laura Taylor MD ,&nbsp;Arul S. Thirumoorthi MD","doi":"10.1016/j.jsurg.2024.08.027","DOIUrl":"10.1016/j.jsurg.2024.08.027","url":null,"abstract":"<div><h3>OBJECTIVE</h3><p>Effective communication about serious illness is pivotal in delivering surgical palliative care—a crucial component of comprehensive surgical critical care (SCC). However, limited educational strategies exist for fellow-level trainees, who are often directing clinical decision-making and building mutual trust with patients and families. This pilot study assess implications of a novel serious illness communication training opportunity tailored specifically for SCC fellows.</p></div><div><h3>DESIGN</h3><p>Prospective implementation of a multimodal training session (1 hour–didactic lecture, 2 hours–live-action simulation), using pre- and postcourse surveys to assess self-perceived confidence.</p></div><div><h3>SETTING</h3><p>University of Michigan in Ann Arbor, Michigan.</p></div><div><h3>PARTICIPANTS</h3><p>Eleven ACGME-accredited SCC fellows during the 2023 to 2024 academic year participated and completed all 3 survey assessments.</p></div><div><h3>RESULTS</h3><p>Following the course, 6 of 7 confidence domains showed improvement, with 2 reaching statistical significance—communication skills to discuss goals of care and/or code status (3.73 vs. 4.36, p = 0.018) and end-of-life care or transition to comfort-focused care (3.36 vs. 4.18, p = 0.023) with a patient or family member. At 6-month follow up, fellows reported further increases in all queried domains, though changes were nonsignificant. Greatest absolute increases were noted in delivering serious news (4.18 vs. 4.55, p = 0.143) and expressing nonverbal empathy (4.09 vs. 4.50, p = 0.197). The majority (91%) of respondents felt more comfortable having serious illness conversations with patients and families due to their training course experience.</p></div><div><h3>CONCLUSION</h3><p>Implementation of a 3-hour training course tailored for SCC fellows significantly boosted both the immediate and long-term confidence in their serious illness communication skills and ability to manage complex care scenarios.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 11","pages":"Pages 1730-1734"},"PeriodicalIF":2.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272002","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":"Evaluating the Validity of National Multiassessment System in Postgraduate Surgical Training: A Retrospective Cohort Study","authors":"Dara A. O'Keeffe MHPE ,&nbsp;Oscar Traynor MD ,&nbsp;Ara Tekian PhD ,&nbsp;Yoon Soo Park PhD","doi":"10.1016/j.jsurg.2024.08.008","DOIUrl":"10.1016/j.jsurg.2024.08.008","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this study was to evaluate the validity evidence supporting the use and interpretation of a multifaceted assessment system in the early years of surgical training.</p></div><div><h3>Design</h3><p>This was a national retrospective cohort study analyzing the validity and reliability of an assessment process for surgical residents over a 2-year period. Data from all elements of the assessment process was evaluated using Messick's unified validity framework. Assessments were categorized as Workplace-based, Structured assessment performed in the academic center and Multiple Mini Interview.</p></div><div><h3>Setting</h3><p>Our Institution is a health sciences university and the body responsible for the training and certification of all surgeons in our national program. Residents on the Core Surgical Training program undergo multiple assessments over the first 2 years of postgraduate training, both in the workplace and the academic training center, which inform their progression into higher surgical training in their chosen specialty.</p></div><div><h3>Participants</h3><p>Data was collected from 2 cohorts of the entire population of postgraduate trainees nationally (N = 114).</p></div><div><h3>Results</h3><p>Best practice standards for educational testing aligned with the results supporting the use of this assessment process. Findings indicate a robust assessment system, demonstrating validity evidence in content, response process, internal structure, relations to other variables, and consequences. Composite score reliability of the assessment was 0.89 which demonstrates a highly reliable process. Correlation between workplace-based assessments and standardized tests performed in the simulation setting was also very high (0.93).</p></div><div><h3>Conclusions</h3><p>The Core Training Assessment System (CTAS) provides a psychometrically rigorous system to measure trainee competence during the initial years of training. Residency programs of all sizes can replicate the methods described here to demonstrate the validity of their assessment processes, thereby being able to stand over decisions on surgical competency.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 11","pages":"Pages 1709-1719"},"PeriodicalIF":2.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1931720424003866/pdfft?md5=6a90ed2ea6df3b72af4d09c7f390cae2&pid=1-s2.0-S1931720424003866-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241433","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":"Decreasing Resident Vascular Case Volumes Have Not Changed National Numbers of Vascular Fellowship Applications in US General Surgery Residents Over the Past Twenty Years","authors":"Richa Kalsi MD ,&nbsp;Brigitte Anderson MD ,&nbsp;Qingwen Kawaji MD, MSc ,&nbsp;R. Gregory Conway MD ,&nbsp;Ace St. John MD ,&nbsp;Shahab Toursavadkohi MD ,&nbsp;Khanjan Nagarsheth MD ,&nbsp;Stephen M. Kavic MD","doi":"10.1016/j.jsurg.2024.08.031","DOIUrl":"10.1016/j.jsurg.2024.08.031","url":null,"abstract":"<div><h3>Objectives</h3><p>With an aging workforce and high prevalence of vascular disease, the US is expected to face a pronounced shortage of vascular surgeons over the next 2 decades. This has driven initiatives to expand vascular surgery training positions leading to the rise of integrated residency programs (0 + 5) and the expansion of traditional fellowships (VSFs, 5 + 2). Given the increase in dedicated vascular surgery training positions, there has been a growing concern that general surgery residents (GSRs) are experiencing decreased vascular case volumes. We aim to evaluate trends in vascular surgery specialty choice relative to vascular case volumes for US GSRs over the last 20 years.</p></div><div><h3>Design</h3><p>Using the Accreditation Council for Graduate Medical Education (ACGME) Case Log Graduate Statistics National Report, a retrospective analysis of ACGME-accredited GSR vascular case volumes was performed from academic year 1999-2000 to 2021-2022. Fellowship data was retrospectively reviewed using the available National Resident Matching Program (NRMP) Fellowship Match Data &amp; Reports for 2004-2023.</p></div><div><h3>Results</h3><p>Graduating GSRs logged increasing numbers of major cases between AY 1999-2000 and AY 2021-2022 (p &lt; 0.001) with 2022 graduates logging on average 98 more cases per resident compared to 2000 graduates. Mean total vascular cases decreased (p = 0.005) with 2022 graduates logging approximately 78 fewer vascular cases on average compared to the 2000 graduates, a 40% decrease in vascular case volume. Despite the decrease, US GSRs have applied to VSF at a relatively consistent rate: 8.5% in 2001-2002, 8% in 2011-2012, and 6% in 2021-2022. 2023 demonstrated an increase to 8.3%.</p></div><div><h3>Conclusion</h3><p>Over the past 2 decades, GSRs have experienced a substantial decrease in exposure to vascular surgery cases during their training; however, residents continue to apply for VSF at a relatively constant rate suggesting that interest in the specialty may be related to factors other than exposure to vascular cases.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"81 11","pages":"Pages 1699-1708"},"PeriodicalIF":2.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241435","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}