Journal of Surgical Education最新文献

{"title":"How I Do It: Teaching and Applying Qualitative Methods to Improve Surgical Simulation Design and Implementation","authors":"Lou Clark PhD, MFA ,&nbsp;Lauren Weaver MD ,&nbsp;Eugene Floersch MPH ,&nbsp;Mojca Remskar MD, PhD ,&nbsp;Melissa Brunsvold MD ,&nbsp;Anne Woll MS","doi":"10.1016/j.jsurg.2025.103481","DOIUrl":"10.1016/j.jsurg.2025.103481","url":null,"abstract":"<div><h3>Objective</h3><div>To propose a simulation-based learning curriculum for trainees to comprehend and apply qualitative methodology.</div></div><div><h3>Design</h3><div>After learning theoretical principles of qualitative methodology through assigned readings and meetings with an expert, a surgical simulation fellow practiced applying grounded theory principles to evaluate a piloted simulation curriculum teaching surgery residents de-escalation communication skills. The simulation consisted of a “just-in-time” de-escalation training, 2 simulated patient (SP) encounters, and 2 learner debrief sessions. All components were video recorded, then transcribed. The first authors performed first and second level coding yielding thematic data.</div></div><div><h3>Setting</h3><div>Single academic institution</div></div><div><h3>Participants</h3><div>One surgical simulation fellow.</div></div><div><h3>Results</h3><div>About 3 themes emerged describing key aspects of the pilot simulation. The first, <em>Escalation Spirals and SP case portrayal,</em> consisted of the SP assuming the role of an agitated patient, as trained, with escalating and de-escalating emotions based on learner interactions. The second theme, <em>Safety Codes,</em> identified critical safety issues in the simulation. Lastly, <em>Rule Confusion</em> included the learner not understanding simulation logistics. These themes informed the team of what to keep and change for the next simulation pilot of the de-escalation curriculum.</div></div><div><h3>Conclusions</h3><div>Teaching qualitative methods in a practice-based learning format is feasible and has simultaneous potential to improve educational content and safety simulation-based curricula.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103481"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455041","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 Interview Modality on Gender Disparities in Plastic and Reconstructive Surgery Residency Match Success","authors":"Anya Wang BA ,&nbsp;Nargiz Seyidova MD, MHQS ,&nbsp;Olachi Oleru MD ,&nbsp;Peter J. Taub MD, MS","doi":"10.1016/j.jsurg.2025.103464","DOIUrl":"10.1016/j.jsurg.2025.103464","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;INTRODUCTION&lt;/h3&gt;&lt;div&gt;The transition from in-person to virtual visits during the COVID-19 pandemic transformed the residency application process. Recognizing the gradual return to in-person interviews and the historical presence of gender disparities within medical fields, the present study sought to evaluate how interview modality influences the success rates of applicants to Plastic and Reconstructive Surgery (PRS) residency programs, with a focus on gender and applicant characteristics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;Data on PRS residency applicants to a single integrated Plastic and Reconstructive Surgery program from 2017 to 2021 (4 application cycles) were obtained from the Electronic Residency Application Service (ERAS), National Residency Matching Program databases, and public online sources. The dataset included demographics (gender, race, orphan status), academic and professional qualifications (research year participation, Alpha Omega Alpha [AOA] and Gold Humanism Honor Society [GHHS] memberships, USMLE Step 1 and 2 scores, reapplicant status, type of medical graduate, additional degrees), interview modality (virtual or in-person), and match results. Specifically, interviews in the 2017/18, 2018/19, and 2019/20 cycles were in-person and those that took place in the 2020/21 application cycle were virtual. Data analysis included univariate regression with chi-squared test and multivariate logistic regression to assess the impact of virtual interviews on match success across genders and other factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;A total of 1298 applicants (573 females, 724 males, 1 uncategorized) were included in the analysis; 985 (75.9%) underwent in-person interviews, and 313 (24.1%) had virtual interviews. There was a predominance of males with in-person interviews (58.2%) and females with virtual interviews (51.4%) (p = 0.002). The overall match success rate was 63.5%, with virtual interviews having a lower match rate (56.9%) compared to in-person (65.5%) (p = 0.004). Gender analysis revealed that female applicants had a higher overall match rate (67.2%) than males (60.5%) (p = 0.008). Notably, females had 37.9% higher odds of matching compared to males (p = 0.006). Specifically, the majority of applicants who successfully matched with in-person interviews were male (56.3%), and the majority of those who matched with virtual interviews were female (57.9%) (p = 0.001). Gender was not a significant determinant in match rates when considering other characteristics (p = 0.213). Race played a crucial role (p = 0.011), with Asian, Hispanic, and other race categories associated with overall lower match success (p = 0.004, p = 0.049, p = 0.045). Participation in a research year was positively correlated with match success (p &lt; 0.001). Being a previous graduate at the time of application (as opposed to being a senior medical student at the time of application) had a negative correlation (p &lt; 0.001). Reapplicant st","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103464"},"PeriodicalIF":2.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437798","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 Surgical Education Checklist: A Novel Tool to Improve the Use of Entrustable Professional Activities in Operative Training in Competence by Design","authors":"Yung Lee MD, MPH ,&nbsp;Jigish Khamar MD ,&nbsp;Yasith Samarasinghe BHSc ,&nbsp;Tyler McKechnie MD, MSc ,&nbsp;Bradley Petrisor MD ,&nbsp;Ilun Yang MD, MMEd","doi":"10.1016/j.jsurg.2025.103470","DOIUrl":"10.1016/j.jsurg.2025.103470","url":null,"abstract":"<div><h3>Objective</h3><div>Surgical residents face significant challenges in meeting Entrustable Professional Activity (EPA) assessment requirements under the Competence By Design (CBD) framework, potentially impacting their surgical training and readiness for practice. This study seeks to assess the effectiveness of the Surgical Education Checklist (SEC) in increasing the proportion of completed EPA assessments within the Division of General Surgery.</div></div><div><h3>Design</h3><div>This prospective cohort study implemented the SEC between January 1, 2023, and June 30, 2023. A pre and postchecklist survey collected experiences with the SEC and overall CBD framework. The primary outcome was the proportion of completed EPA assessments. Descriptive statistics were reported and subgroup analyses were performed based on resident postgraduate year (PGY).</div></div><div><h3>Setting</h3><div>About 5 tertiary academic-affiliated teaching hospitals with McMaster University (Hamilton, Ontario)</div></div><div><h3>Participants</h3><div>All general surgery residents and staff faculty were invited to utilize the survey, with an approximate sample size of 71 participants. The overall response rate was 34 (47.9%) for the prechecklist survey and 11 (15.5%) for the postchecklist survey.</div></div><div><h3>Results</h3><div>The number of EPA assessments triggered increased from 485 to 639, with a significant increase in the absolute number of EPA assessments completed (400 vs 477, p &lt; 0.01). There was an increase in the proportion of expired assessments (85 [17.5%] vs 162 [25.4%], p &lt; 0.01) after the implementation of the SEC. In the subgroup analysis based on resident PGY, PGY1 to 3 general surgery residents triggered significantly more EPA assessments after the implementation of the SEC.</div></div><div><h3>Conclusions</h3><div>The SEC demonstrated its effectiveness as a perioperative prompt for triggering EPA assessments, particularly amongst junior general surgery residents, indicating its potential to facilitate early engagement with essential surgical training tasks. However, there remains gaps in follow-through and completion of triggered EPA assessments.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103470"},"PeriodicalIF":2.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420138","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":"Cultivating Rural Surgeons: An Analysis of the Current Rural Surgery Graduate Medical Education Landscape and a Roadmap to Program Creation","authors":"Mustafa Abid MD ,&nbsp;Lori Rodefeld MS ,&nbsp;Mukesh Adhikari MPH ,&nbsp;Benjamin Jarman MD, FACS ,&nbsp;Laney McDougal MS-HSM ,&nbsp;Ann P. O'Rourke MD, MPH, FACS ,&nbsp;Farzad Amiri MD, FACS ,&nbsp;Emily M. Hawes PharmD","doi":"10.1016/j.jsurg.2025.103446","DOIUrl":"10.1016/j.jsurg.2025.103446","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of the study is to provide current data on the composition and prevalence of rural general surgery residency programs and describe new mechanisms and resources facilitating the creation of such programs.</div></div><div><h3>Design</h3><div>Training site and program data for general surgery residencies for the academic year 2022 to 2023 from the Accreditation Council for Graduate Medical Education (ACGME) were geocoded and analyzed. A literature search and iterative consensus process with graduate medical education (GME) experts was used to synthesize and describe new mechanisms and resources to grow rural general surgery training.</div></div><div><h3>Setting</h3><div>Programs were designated as either having a rural rotation or the majority of training in a rural location (i.e. greater than 50% of training). Two definitions of rural were incorporated: nonmetropolitan Core-Based Statistical Area (CBSA) counties and Federal Office of Rural Health Policy area (FORHP) rural counties or census tracts.</div></div><div><h3>Participants</h3><div>All listed general surgery residency programs reporting data to the ACGME.</div></div><div><h3>Results</h3><div>Less than 2% of ACGME-accredited general surgery programs spend the majority of their training in rural areas. Nearly 10% (<em>n</em> = 36) of programs have training sites in nonmetropolitan counties, and 13.30% (<em>n</em> = 48) of programs have sites in FORHP rural areas. Recent changes to GME funding policies and regulations have opened opportunities to expand rural GME programs. For example, existing residencies that increase their complement and establish a new rural site are eligible for Medicare GME funding.</div></div><div><h3>Conclusions</h3><div>Despite new funding opportunities for rural GME, program development remains low among existing or new general surgery programs. Rural general surgery residency training could play an important role in addressing current and future general surgeon workforce shortages. Recent state and federal financing and assistance can be accessed to bolster rural rotations and residencies.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 4","pages":"Article 103446"},"PeriodicalIF":2.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421229","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":"Nontechnical Coaching in Academic Surgical Practice–Where Do We Stand and What's Next?","authors":"Krishna Unadkat MS ,&nbsp;Patti M. Thorn PhD ,&nbsp;Mary Ann Djonne Med ,&nbsp;Shelley S. Noland MD","doi":"10.1016/j.jsurg.2025.103469","DOIUrl":"10.1016/j.jsurg.2025.103469","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the potential of nontechnical coaching (NC) as an intervention to enhance professional development, reduce burnout, and improve patient outcomes among attending academic surgeons (AS) in high-pressure surgical environments.</div></div><div><h3>Design</h3><div>A narrative review was performed using PubMed to identify and assess studies focused on NC in academic surgery. We evaluated articles addressing the impact, benefits, risks, and barriers associated with NC, with particular attention to coaching frameworks, training programs, and participant feedback.</div></div><div><h3>SETTING</h3><div>The review encompasses research conducted in various academic surgical settings.</div></div><div><h3>PARTICIPANTS</h3><div>Studies primarily involved attending academic surgeons across diverse surgical specialties, especially those experiencing high levels of burnout and decreased job satisfaction.</div></div><div><h3>Results</h3><div>Findings indicate that NC offers several benefits for AS. Pilot studies and qualitative surveys suggest that NC can reduce burnout, enhance intraoperative decision-making, and improve patient engagement. Surgeons who participated in NC reported better stress management, increased self-awareness, and improved leadership skills. Moreover, NC appears to foster enhanced team dynamics and, in some cases, may yield fiscal benefits by reducing surgical errors and increasing operational efficiency. However, significant barriers to NC adoption remain, including cultural resistance within surgical departments, time constraints, and concerns regarding the efficacy of NC compared to traditional technical coaching. Additionally, the current evidence is limited by small sample sizes, selection bias, and a lack of standardized, quantitative measures.</div></div><div><h3>Conclusion</h3><div>Preliminary evidence supports NC as a promising intervention for enhancing surgeon well-being and patient outcomes. Future research should focus on establishing standardized guidelines for coach training, addressing misconceptions about NC, and designing larger, methodologically robust studies using validated outcomes. Expanding NC could foster a more resilient surgical workforce, ultimately benefiting both surgeons and patients through improved engagement, satisfaction, and quality of care.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103469"},"PeriodicalIF":2.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403337","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":"Opportunities to Overcome Barriers to Lactation—Recommendations for Best Practices","authors":"Rida Mitha MD ,&nbsp;Rohit Prem Kumar BA ,&nbsp;Nitin Agarwal MD ,&nbsp;Peter C. Gerszten MD, MPH ,&nbsp;D. Kojo Hamilton MD ,&nbsp;Robert M. Friedlander MD ,&nbsp;Roberta Sefcik MD, MSCR","doi":"10.1016/j.jsurg.2025.103445","DOIUrl":"10.1016/j.jsurg.2025.103445","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>Women represent over 50% of graduating medical students in the United States and approximately 20% of current neurosurgical residents in training. An increase in female representation requires an increase in advocacy efforts related to pregnancy. Although there is extensive literature on pregnancy in neurosurgical residents, the postpartum period, sometimes referred to as the “fourth trimester”, is frequently overlooked. This study was performed in order to characterize the lactation experiences of female neurosurgeons and neurosurgical trainees and compare their experiences to their peers in other medical specialties.</div></div><div><h3>METHODS</h3><div>A 62-question survey examining lactation experiences was developed and electronically disseminated to members of Women In Neurosurgery, the social media group Dr. MILK, and to neurosurgical residency Program Directors throughout the United States.</div></div><div><h3>RESULTS</h3><div>Seventy-eight responses were received (neurosurgery: 10, other surgical specialty: 19, nonsurgical specialty: 49). When asked if respondents met their goal for lactation duration, 26 nonsurgical, 13 other surgical, and 8 neurosurgery respondents responded affirmatively (p = 0.059). A significantly greater proportion of neurosurgery respondents reported that expression of breastmilk at work caused anxiety compared to nonsurgical respondents (p = 0.02). Overall, 59% of respondents felt that they did not have adequate time to express breastmilk at work, and 69% had to stop expressing breastmilk at work prior to completely emptying. Fifty-three percent of respondents were fearful of being unable to feed their baby secondary to the inability to express breastmilk. Twenty percent reported never being able to consume sufficient liquid at work, and 17% reported never being able to consume sufficient calories at work. Additional cited barriers included limited mentorship (68%), inconvenient lactation spaces (58%), perceived discrimination (32%), and breast pump malfunction (28%).</div></div><div><h3>CONCLUSION</h3><div>Women residents across medical specialties face significant barriers to successful lactation experiences. With limited mentorship in lactation across medical specialties, advocacy efforts and lactation support are vitally needed for the protection of the health of physician mother and baby.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 4","pages":"Article 103445"},"PeriodicalIF":2.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394598","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":"Essential Competencies for the Success of International Medical Graduates in Surgical Training: A Comparative Study of Trainee and Faculty Perspectives","authors":"Carolina Torres Perez-Iglesias MD ,&nbsp;Fleming Mathew MBBS ,&nbsp;Brendha Cacao Coimbra MD ,&nbsp;Gopika SenthilKumar PhD ,&nbsp;Raunak Goyal MBBS ,&nbsp;Sidharta P. Gangadharan MD","doi":"10.1016/j.jsurg.2024.103419","DOIUrl":"10.1016/j.jsurg.2024.103419","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND&lt;/h3&gt;&lt;div&gt;International Medical Graduates (IMGs) occupy a third of all non-designated preliminary general surgery training positions in the United States, but fewer than half complete surgical training. Previous research has shown discrepancies between evaluators and trainees on various aspects of medical training, impacting educational outcomes. Understanding any potential divergence in perceptions between faculty and trainees on essential competencies could help trainees improve their clinical performance and their chances of obtaining categorical training positions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;To assess differences in perceptions between IMGs and evaluators on essential competencies during general surgery training.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;DESIGN&lt;/h3&gt;&lt;div&gt;Cross-sectional, survey-based using a nonvalidated electronic survey instrument, with 13 questions aimed to assess the competencies considered essential for IMGs in preliminary PGY-1 or PGY-2 training positions to succeed in general surgery residency. Responses were collected using a snowball sampling method.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;SETTING&lt;/h3&gt;&lt;div&gt;The survey was distributed via X (formerly known as Twitter), WhatsApp, the American College of Surgeon Online Communities, and email between June and August 2023. Responses were captured in RedCap.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PARTICIPANTS&lt;/h3&gt;&lt;div&gt;The first group (“the evaluatees\") comprises IMGs and medical students applying for general surgery residency positions in the U.S. and IMGs in PGY-1 and PGY-2 preliminary general surgery training positions in the U.S. The second group (“the evaluators”) included faculty in general surgery programs in the U.S. and senior general surgery residents in the U.S.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;There were 196 respondents, including 70 “evaluators” and 126 “evaluatees”. Most evaluators identified as male (78.5%), whereas 65.1% of evaluatees identified as female. Ethnic diversity varied widely between groups. Evaluators identified mainly as white (67.1%), while evaluatees were mostly Asian/South Asian (46%) or Hispanic/Latino (30.1%). Most evaluators worked at university-affiliated hospitals (61.4%). Both groups ranked “Knowledge Application/Critical Thinking Skills” as the most essential competency for preliminary IMG residents to do well in training. “Research Skills” followed by “Technical Skills” were rated as the least essential. The highest concordance (&gt;80%) between groups for mandatory competencies was found for “Interpersonal and Communication Skills”, “Professionalism,” and “Learning, Teaching, and Teamwork”. Significant differences were found between the groups' perceptions of clinical, research, and technical skills (p &lt; 0.01).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSIONS&lt;/h3&gt;&lt;div&gt;The value of nontechnical skills in surgical training transcends cultural and educational backgrounds. IMGs place greater importance on clinical and technical skills. Future educational initiatives must bridge ","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 4","pages":"Article 103419"},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387365","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":"Benchmarking Vision Capabilities of Large Language Models in Surgical Examination Questions","authors":"Jean-Paul Bereuter MD ,&nbsp;Mark Enrik Geissler MS ,&nbsp;Anna Klimova PhD ,&nbsp;Robert-Patrick Steiner MD ,&nbsp;Kevin Pfeiffer ,&nbsp;Fiona R. Kolbinger MD ,&nbsp;Isabella C. Wiest MD ,&nbsp;Hannah Sophie Muti MD ,&nbsp;Jakob Nikolas Kather MD","doi":"10.1016/j.jsurg.2025.103442","DOIUrl":"10.1016/j.jsurg.2025.103442","url":null,"abstract":"<div><h3>Objective</h3><div>Recent studies investigated the potential of large language models (LLMs) for clinical decision making and answering exam questions based on text input. Recent developments of LLMs have extended these models with vision capabilities. These image processing LLMs are called vision-language models (VLMs). However, there is limited investigation on the applicability of VLMs and their capabilities of answering exam questions with image content. Therefore, the aim of this study was to examine the performance of publicly accessible LLMs in 2 different surgical question sets consisting of text and image questions.</div></div><div><h3>Design</h3><div>Original text and image exam questions from 2 different surgical question subsets from the German Medical Licensing Examination (GMLE) and United States Medical Licensing Examination (USMLE) were collected and answered by publicly available LLMs (GPT-4, Claude-3 Sonnet, Gemini-1.5). LLM outputs were benchmarked for their accuracy in answering text and image questions. Additionally, the LLMs’ performance was compared to students’ performance based on their average historical performance (AHP) in these exams. Moreover, variations of LLM performance were analyzed in relation to question difficulty and respective image type.</div></div><div><h3>Results</h3><div>Overall, all LLMs achieved scores equivalent to passing grades (≥60%) on surgical text questions across both datasets. On image-based questions, only GPT-4 exceeded the score required to pass, significantly outperforming Claude-3 and Gemini-1.5 (GPT: 78% vs. Claude-3: 58% vs. Gemini-1.5: 57.3%; p &lt; 0.001). Additionally, GPT-4 outperformed students on both text (GPT: 83.7% vs. AHP students: 67.8%; p &lt; 0.001) and image questions (GPT: 78% vs. AHP students: 67.4%; p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>GPT-4 demonstrated substantial capabilities in answering surgical text and image exam questions. Therefore, it holds considerable potential for the use in surgical decision making and education of students and trainee surgeons.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 4","pages":"Article 103442"},"PeriodicalIF":2.6,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143369737","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":"Virtual Reality Simulation as a Tool for ENT Training: An Autoethnographic Study","authors":"Thomas W. Binnersley MBChB ,&nbsp;Emma Richards MRCS (ENT) ,&nbsp;Joshua D. Whittaker MRCS (ENT) ,&nbsp;C. Lucy Dalton FRCS (ORL-HNS)","doi":"10.1016/j.jsurg.2025.103439","DOIUrl":"10.1016/j.jsurg.2025.103439","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To investigate the factors influencing a novice trainee's surgical skill acquisition using virtual reality (VR) temporal bone (TB) drilling simulation as a training tool. This study is the first application of autoethnography in the surgical simulation literature.</div></div><div><h3>DESIGN</h3><div>This study uses autoethnography to examine the factors underpinning simulated surgical skill acquisition using VR TB drilling (ethnography) through systematically documenting and analyzing the researcher's reflections over a prolonged period of time (autobiography). The primary researcher undertook 16 3-hour sessions learning to perform a virtual cortical mastoidectomy on the Voxel-Man TempoSurg (VMT) simulator over 8 months. Data collected comprised qualitative field notes and reflective journal logs, and quantitative scores from formative assessments. Data were coded using NVivo12 and analyzed using inductive thematic analysis.</div></div><div><h3>SETTING</h3><div>University Hospitals Birmingham ENT Simulation Dry Lab, Queen Elizabeth Hospital, Birmingham, United Kingdom.</div></div><div><h3>PARTICIPANTS</h3><div>The primary researcher, a surgical novice, was responsible for the study design and execution, with supervision from a consultant ENT surgeon and 2 simulation fellows.</div></div><div><h3>RESULTS</h3><div>The study yielded 6 themes: About 3 themes highlight new insights: 1) VMT as a surgical learning tool, 2) overcoming technological issues, 3) and physical impacts of simulated surgery; About 3 themes support existing evidence relating to surgical skill acquisition: 4) rushing leading to inaccuracy, 5) reflections and feedback, and 6) overcoming demotivation.</div></div><div><h3>CONCLUSION</h3><div>The application of autoethnography to the study of surgical skill acquisition is new. Our results enable a deeper insight into surgical skill acquisition using VR TB simulation, with 6 specific themes identified as impacting learning with this tool. An understanding of these factors will facilitate future research in this area, and enable constructive adjustments to the learning experience, ultimately improving training program delivery and outcomes going forward.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 4","pages":"Article 103439"},"PeriodicalIF":2.6,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143338085","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 Survey Assessment of Psychological Safety in Colon and Rectal Surgery Residents and Comparison to General Surgery Residents","authors":"Saher-Zahra Khan MD ,&nbsp;Alexander Loftus MD ,&nbsp;John B. Ammori MD ,&nbsp;Michael Valente DO ,&nbsp;Ronald Charles MD ,&nbsp;Jennifer L. Miller-Ocuin MD ,&nbsp;Emily Steinhagen MD","doi":"10.1016/j.jsurg.2025.103448","DOIUrl":"10.1016/j.jsurg.2025.103448","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Psychological safety (PS) is the shared belief that the team is safe for interpersonal risk-taking. Although some research has been conducted regarding PS in healthcare settings, there is minimal research in surgical training programs. Our objective was to study PS levels in colorectal surgery (CRS) residents.</div></div><div><h3>DESIGN</h3><div>Our survey was adapted from Amy Edmonson's psychological safety scale and the Maslach Burnout Inventory for the surgical work environment. Questions regarding interactions with attending surgeons (AS) and program directors (PD) and regarding burnout were asked. Each question was scored on a 1-9 Likert Scale. Total PS scores for questions targeting AS or PD ranged from 3 (low) to 126 (high) and the overall PS score ranged from 6 (low) to 252 (high). Burnout scores ranged from 0 (low) to 32 (high). Descriptive statistics including medians and interquartile ranges (IQR) are used to present the data.</div></div><div><h3>SETTING</h3><div>The survey was distributed to CRS residents in-person at the 2023 Colorectal Career Course in November, 2023.</div></div><div><h3>PARTICIPANTS</h3><div>Of the 87 CRS residents in attendance, 50 completed the survey (57%).</div></div><div><h3>RESULTS</h3><div>CRS residents had overall high psychological safety overall (median score 228, IQR 198-247) with 92% of CRS residents having PS scores in the top third of the range. CRS residents had low burnout scores (median score 6, IQR 3-11) with 80% having burnout scores in the lowest third of the range.</div></div><div><h3>CONCLUSION</h3><div>CRS residents generally have high PS levels and low burnout levels. This high level of PS could stem from the consistency of working with the same attendings, the shared interest in 1 subspecialty, and/or more frequent high-quality feedback. Further research to determine the mediators of high PS in surgical residency and CRS can be used to foster PS in other healthcare fields.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 4","pages":"Article 103448"},"PeriodicalIF":2.6,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143338081","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}