Journal of Surgical Education最新文献

{"title":"Diversifying the Surgical Workforce: Understanding Barriers to Inform Solutions","authors":"Emily Y. Fan MD ,&nbsp;Olajumoke Megafu MD, MPH ,&nbsp;Jaeyoung Lee BA ,&nbsp;Sudie-Ann Robinson MD ,&nbsp;Emely Salazar Bernal ,&nbsp;Muriel Cleary MD ,&nbsp;Jessica P. Simons MD, MPH","doi":"10.1016/j.jsurg.2024.103418","DOIUrl":"10.1016/j.jsurg.2024.103418","url":null,"abstract":"<div><h3>OBJECTIVES</h3><div>Race and gender concordance between physicians and patients is associated with reductions in healthcare disparities. However, the diversity of the medical workforce does not mirror the population; some of the greatest deficiencies exist in the surgical workforce. We conducted a pilot study focused on early recruitment of diverse college students in our region, with a concurrent needs assessment of their specific barriers to entering the field of surgery.</div></div><div><h3>METHODS</h3><div>Local college students who self-identified as underrepresented in medicine (URiM) were recruited to attend a symposium hosted by an academic surgery department. Events included a specialty discussion panel, live OR streaming, simulation lab, and breakout sessions covering various topics. The primary aims were to 1: increase interest in surgical careers and 2: conduct a needs assessment to optimize strategies for overcoming perceived barriers to entering surgery. A mixed methods analysis was conducted to assess cohort characteristics, changes in impressions of pursuing a surgical career, barriers to pursuing such careers across five domains, and overall perceptions of the symposium.</div></div><div><h3>RESULTS</h3><div>Recruitment consisted of emails sent to local college pre-medical society advisors. Of 58 students who attended, 77% were from state universities or community colleges. There were 63.8% who identified as a racial/ethnic minority (38% Latino, 24% Black, 16% Asian, 14% Middle Eastern, 8% mixed), 34.5% as economically-disadvantaged, 34.5% as first-generation college, 25.9% as female, 12.1% as LGBTQ+, and 3.5% as other. Pre-symposium, 93% of attendees intended to apply to medical school, but only 25% had considered surgery as a profession. Post-symposium, this increased to 43% who indicated an intention to pursue surgery, with an additional 52% who were undecided but interested. Across all sections, the mean rating for attendees’ knowledge regarding surgical training and careers pre- and post-symposium increased significantly. The most frequently cited barriers were the lack of mentors (50%), concerns about MCAT scores (50%), overall costs (48%), and work/life balance (47%). Thematic analysis identified gratitude for the event and for opportunities to meet surgeons; ongoing needs included shadowing and mentorship matching. The direct costs of the event were approximately $500.</div></div><div><h3>CONCLUSION</h3><div>This pilot study demonstrated the avidity of an audience with the potential to diversify the surgical workforce. Participant interest in pursuing surgical careers nearly doubled and clear unmet needs were identified to support this group towards this goal. Furthermore, these results were achieved with very little funding or advertising. Work is ongoing to upscale these efforts and determine impact on our surgical workforce.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 3","pages":"Article 103418"},"PeriodicalIF":2.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018911","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":"Get Over It: Surgical Residents’ Responses to Simulated Harassment. A Multi Method Study","authors":"Myriam Johnson ,&nbsp;Byunghoon (Tony) Ahn ,&nbsp;Keerat Grewal ,&nbsp;Negar Matin ,&nbsp;Jean-Sébastien Pelletier ,&nbsp;Liane S. Feldman ,&nbsp;Gerald M. Fried ,&nbsp;Melina Tsiolis ,&nbsp;Jason M. Harley","doi":"10.1016/j.jsurg.2024.103397","DOIUrl":"10.1016/j.jsurg.2024.103397","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>This study examined the response strategies of Surgery residents as bystanders to harassment in a simulated clinical environment, their alignment with the bystander intervention model, and the motivations behind their actions.</div></div><div><h3>DESIGN</h3><div>Participants watched an educational video on harassment and ways to address it prior to undergoing a simulated clinical scenario where they witnessed a senior resident harassing a medical student. The study used audio-video recordings of the simulations to capture and analyze residents' verbal and nonverbal responses to harassment. Frequencies from deductive thematic analysis were used for descriptive analysis, and nonparametric chi-square tests. Audio recordings of debriefings following simulations were also analyzed using deductive thematic analysis to explore residents’ motivations behind their responses.</div></div><div><h3>SETTING</h3><div>The study was conducted in a controlled environment at McGill University's Steinberg Centre for Simulation and Interactive Learning (Montreal, Canada).</div></div><div><h3>PARTICIPANTS</h3><div>Participants included 32 Surgery residents completing the simulation as part of their Objective Structured Clinical Examinations. 28 residents provided usable data for analysis.</div></div><div><h3>RESULTS</h3><div>Residents used passive responses significantly more frequently than other responses throughout the simulation, especially in reaction to harassment. Analysis revealed that residents often delayed intervention, opting to remain passive or reassuring the victim rather than confronting the harasser. Debriefing showed that some residents intervened to denounce the SR's behavior or support the MS, while others hesitated due to discomfort with power dynamics, fear of repercussions, or uncertainty about addressing the situation</div></div><div><h3>CONCLUSIONS</h3><div>The study found that Surgery residents exhibit a tendency towards passive bystander responses in the face of harassment highlighting the need for targeted educational strategies to address power dynamics, build confidence in bystander intervention, and promote proactive responses to harassment in clinical training. Future research should explore similar dynamics across different medical professionals and consider intersectional factors to enhance antiharassment initiatives in medical education.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 3","pages":"Article 103397"},"PeriodicalIF":2.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018914","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":"Utilizing the DiSC Assessment in Surgical Residency Leadership Training to Address Communication Skill Acquisition: A Kern Six-step Approach to Curriculum Development","authors":"Russell J. Pepe MD, MSCTS ,&nbsp;William A. Burns MD ,&nbsp;John L. Dutton MD ,&nbsp;Sorasicha Nithikasem BS ,&nbsp;Jenny Cai MD ,&nbsp;Nell Maloney Patel MD","doi":"10.1016/j.jsurg.2024.103413","DOIUrl":"10.1016/j.jsurg.2024.103413","url":null,"abstract":"<div><h3>Objective</h3><div>Effective communication is essential in delivering high-quality patient care, and in recent years, resident education has expanded to focus on nontechnical skills and communication training. The “Everything DiSC” model is a communication inventory tool used to help employers and employees gain insight into how an individual may communicate within a team and how others may perceive similarities and differences in communication styles, comprising of Dominance (D), Influence (i), Steadiness (S), and Conscientiousness (C). In this report, we describe our experience mapping the DiSC model to the Kern 6-step framework for curriculum development and summarize residents’ feedback several years following its implementation.</div></div><div><h3>Design</h3><div>A general needs assessment was conducted to identify the problem of a lack of a formalized communication and leadership education and performed a general needs assessment. A curriculum was developed for a single academic surgical residency program to address development of nontechnical skills. We designed the leadership curriculum to be given over 4 sessions, with topics including from leadership styles, working within groups, feedback, and wellness. We utilized the DiSC tool, which is a 79-question survey, to establish communication styles of each of our residents and to determine the DiSC style.</div></div><div><h3>Setting</h3><div>This study was conducted at a single academic institution within a surgical residency training program.</div></div><div><h3>Participants</h3><div>This study included surgical residents at a single academic surgical training program.</div></div><div><h3>Results</h3><div>The initial needs assessment survey was completed by 28 of 36 residents, with all residents surveyed (100%) agreeing that communication training was important. In contrast, only 21% agreed that they had received adequate training on communication during residency. 28 residents completed the DiSC Year-in-Review Survey, which indicated that overall, the residents felt that DiSC was useful throughout the year. The majority of residents listed learning and understanding other people's communication style as what they appreciated most about the DiSC sessions.</div></div><div><h3>Conclusions</h3><div>The inclusion of behavioral assessment tools within surgical residency education can provide an opportunity for residents to evaluate their communication techniques and provide a gained awareness across various settings. Continued focus on communication skills, such as with the use of the DiSC model, can enhance patient care at any institution providing such training. This leadership curriculum aided our surgical residency program and can likely facilitate similar value within other training institutions.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 3","pages":"Article 103413"},"PeriodicalIF":2.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018966","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":"Best Practices in Formative Feedback in Resident Evaluations: A Narrative Review","authors":"Amy VanderStoep MD ,&nbsp;Kereen Constant MD ,&nbsp;Stephen M. Kavic MD, MSHPE","doi":"10.1016/j.jsurg.2024.103417","DOIUrl":"10.1016/j.jsurg.2024.103417","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Formative feedback is essential for the optimal development of a physician. The narrative portion of the evaluation is uniquely poised to help guide the resident. However, the quality of the feedback may be highly variable, and evaluators may be hampered by both a lack of formal training as well as time pressures.</div></div><div><h3>OBJECTIVE</h3><div>To determine best practices in providing narrative feedback for residents.</div></div><div><h3>METHODS</h3><div>We conducted a narrative review of the literature around formative feedback in residency using a Pubmed search of articles written in English over the 30 year span 1993-2023.</div></div><div><h3>RESULTS</h3><div>Several themes were identified. Comments should be specific, both to the task and to the individual. Commentary should also be actionable, rather than a statement of what cannot be changed by the learner. Ideally, the narration should be constructive, and strike the proper tone. There are additional operational items, such as the structure of the evaluation form itself, that may help optimize narrative commentary.</div></div><div><h3>CONCLUSIONS</h3><div>There is limited but compelling evidence that narrative commentary can be improved in educational value by being specific, actionable, constructive, and written with the proper tone. Changes in the evaluation form may optimize quality and improve timing of delivery.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 3","pages":"Article 103417"},"PeriodicalIF":2.6,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974113","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":"Doing Less Later: Seniorization of General Surgery Resident Operative Experience in the Entrustable Professional Activities at Veterans Affairs Hospitals","authors":"Tiffany K. Brocke MD, MHPE ,&nbsp;Daniel B. Eaton Jr MPH ,&nbsp;Cali E. Johnson MD, EdD ,&nbsp;Coen Klos MD ,&nbsp;Michael M. Awad MD, PhD, MHPE ,&nbsp;Kerri A. Ohman MD","doi":"10.1016/j.jsurg.2024.103403","DOIUrl":"10.1016/j.jsurg.2024.103403","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Identify changes in general surgery resident autonomy and resident postgraduate year (PGY) level in Entrustable Professional Activity (EPA) cases over time.</div></div><div><h3>DESIGN</h3><div>Retrospective cohort study.</div></div><div><h3>SETTING</h3><div>United States Veterans Affairs (VA) hospital system, 2004 to 2020.</div></div><div><h3>PARTICIPANTS</h3><div>All patients undergoing operations in any of the 12 general surgery EPAs with identifiable operative components captured by the VA Surgical Quality Improvement Project database from 2004 to 2020.</div></div><div><h3>RESULTS</h3><div>452,549 cases were identified. Between 2004 and 2020, there was a 61.4% decrease in resident-performed cases and a 14.3% decrease in attending-assisted cases, with a concomitant 51.8% increase in attending-performed cases. All EPAs experienced a statistically significant decrease in resident autonomy over the study period, and a net transfer of cases from resident-performed to attending-performed.</div><div>About 7 of 12 EPAs had significant increases in the resident PGY level of attending-assisted cases over the study period: abdominal wall hernia, benign/malignant breast, benign/malignant colon, cutaneous/subcutaneous neoplasm, gallbladder disease, inguinal hernia, and soft tissue infection. About 3 EPAs had significant increases in the resident PGY of resident-performed cases: abdominal wall hernia, benign/malignant breast, and inguinal hernia. Many of these changes represented seniorization of the operative experience by 3 to 12 months.</div></div><div><h3>CONCLUSIONS</h3><div>There has been a continual decrease in resident operative autonomy across all general surgery EPAs at the VA. Furthermore, many EPA cases have shifted to more senior residents over time, delaying or deferring autonomous completion of these cases during training. Although these data were drawn from the VA system, the results likely reflect a continued decrease in autonomy for resident surgeons in other settings as well. As general surgery adapts to a competency-based educational model, action is needed to stabilize these changes for sustainable graduate surgical education.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 3","pages":"Article 103403"},"PeriodicalIF":2.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974123","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":"Gender Gap? A Survey among Plastic Surgeons in Germany","authors":"Shaghayegh Gorji MD ,&nbsp;Maximilian Kueckelhaus MD ,&nbsp;Britta Pehlke MSc ,&nbsp;Tobias Hirsch MD ,&nbsp;Filipa Almeida Oliveira MD","doi":"10.1016/j.jsurg.2024.103402","DOIUrl":"10.1016/j.jsurg.2024.103402","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>There is an ongoing increase in the percentage of females in the field of Plastic Surgery in Germany. Currently, 29,1% of fellows and 46% of residents in Germany are female. Several studies have pointed out the various obstacles that female doctors, especially female plastic surgeons, are confronted with in their professional life. The aim of this study is to examine gender parity among plastic surgeons in Germany. Furthermore, we aim to evaluate the opinion of both women and men on gender-specific discrimination.</div></div><div><h3>METHODS</h3><div>In a nonrandomized, cross-sectional study an anonymous questionnaire covering various subjects such as education/training, career path, the compatibility of family and career, as well as the subjective perception of gender equality in Plastic Surgery was distributed among members of the German Association of Plastic, Reconstructive and Aesthetic Surgery (DGPRÄC) as well as through social media. Data was collected with Google Docs.</div></div><div><h3>RESULTS</h3><div>The sample group (n = 285) composition was 162 female (56,8%), 122 (42,9%) male and 1 nonbinary (0,4%). The majority of women (54.3%) and men (49.1%) rated work-life balance as \"difficult\". In 82.1% of women and 44.3% of men, family planning was influenced by the profession. Most of the respondents work in hospitals (62.9% of women and 50.0% of men). The main motivation of 61.4% of women to go to in private practice was family reasons, 51.8% of men gave financial reasons. 64.1% of women and 54.1% of men have a doctoral degree, whereas 6.9% of women and 13.3% of the men have a postdoctoral degree.</div><div>While 33.6% of the men believe that their own gender had no influence on their respective career decision, career progress or success, only 4.9% of women had the same opinion. In addition, 43.8% of women and 22.1% of men reported having experienced sexual harassment in their professional lives.</div></div><div><h3>CONCLUSION</h3><div>This study reveals significant gender differences in career development in Plastic Surgery. Family planning, motivations for establishment and academic careers, as well as the experience of sexual harassment, are of primary concern. Actively helping to shape the work environment of career development opportunities in light of this study may help to reduce gender disparities in Plastic Surgery in the future.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 3","pages":"Article 103402"},"PeriodicalIF":2.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974124","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":"The Operating Room and Learning Environment for US-Based Muslim Women in Medicine","authors":"Shadi Mehrabi MD ,&nbsp;Asmaa Rimawi MD ,&nbsp;Asmaa El-Ghazali MD ,&nbsp;Deena Kishawi MD ,&nbsp;Hawa Ali MD ,&nbsp;Kendalle Cobb MD","doi":"10.1016/j.jsurg.2024.103399","DOIUrl":"10.1016/j.jsurg.2024.103399","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>As the number of women in medical training rises, there has been increased interest in understanding the perspectives of minority women. Although Muslim women face unique challenges in pursuing medical training, there are no current studies dedicated to understanding the experience of Muslim women as healthcare professionals. This study aims to present insight into perspectives of United States-based Muslim women physicians, residents, and medical students on discrimination and allyship, the operating room environment, mentorship, and institutional resources.</div></div><div><h3>DESIGN</h3><div>A cross-sectional survey was distributed between November 2020 and March 2021 to US-based Muslim women in medical training. The survey was designed to query perspectives across four domains: discrimination and allyship, the operating room environment, mentorship, and institutional resources. Respondents completed a series of 32 questions and were invited to provide free-form comments at the end of the survey. Two-sided tests of significance were used, with a 0.05 threshold. Analyses were performed using R, Version 1.3.</div></div><div><h3>SETTING</h3><div>Online cross-sectional survey distributed from a major academic medical center.</div></div><div><h3>PARTICIPANTS</h3><div>117 Muslim women in the United States in medical training (MD/DO pathways) (n = 117).</div></div><div><h3>RESULTS</h3><div>Respondents reported high levels of discrimination, significant barriers to reporting discrimination, unique challenges in the operating room, and limited institutional support. The majority reported satisfaction with the mentorship available to them, with gender concordance deemed more important than religion concordance.</div></div><div><h3>CONCLUSIONS</h3><div>In this report of survey results, we present insight into perspectives of US-based Muslim women in medicine on mentorship, discrimination &amp; allyship, the operating room environment, and institutional resources. A unique area of focus that emerged within the survey was the culture regarding wearing hijab in the operating room, as well as multiple areas in which institutions can better support their Muslim members.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 3","pages":"Article 103399"},"PeriodicalIF":2.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974126","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":"Sewing the SEAMs: Surgical Education in the Art Museum","authors":"Stephanie M. Cohen MD ,&nbsp;Brooke DiGiovanni-Evans MA ,&nbsp;Ingrid M. Ganske MDMPA ,&nbsp;Joel T. Katz MD ,&nbsp;Tara S. Kent MD","doi":"10.1016/j.jsurg.2024.103401","DOIUrl":"10.1016/j.jsurg.2024.103401","url":null,"abstract":"<div><h3>Objective</h3><div>The field of surgery is highly visual and technical. Yet, there is a paucity of data evaluating how a mandatory visual arts-based workshop may benefit surgical trainees. We report upon the feasibility of and short-term outcomes of a novel, visual art-based curriculum for surgery residents.</div></div><div><h3>Design</h3><div>A validated survey was administered at the end of each visual art workshop to measure resident self-reported skills in problem-solving, interpersonal skills, and wellness. All questionnaire items were measured on a 4-point Likert scale (0-3) with added responses that were analyzed qualitatively.</div></div><div><h3>Setting</h3><div>3-hour singular workshops were hosted at The Museum of Fine Arts, Boston.</div></div><div><h3>Participants</h3><div>General and vascular surgery residents in their first and second postgraduate year were required to participate in the new curriculum.</div></div><div><h3>Results</h3><div>Moderate to great improvement was reported for most questionnaire items. The greatest improvement was reported for making intentional observations (2.46), attentiveness to detail (2.42), viewing others as multidimensional people (2.57), and forming connections with colleagues (2.5). When asked how the workshop would impact their future practice, many residents described setting goals to: slow down when thinking through clinical problems, to consider alternative diagnoses, work on perspective taking, and paraphrase back to patients to enhance their relationships and accuracy of communication.</div></div><div><h3>Conclusions</h3><div>Required workshops for surgery residents early in their training at an art museum is feasible and beneficial. Future studies to measure the long-term impact such session and the ideal content and timing (e.g., PGY 1-5) are required to better understand the potential of this methodology.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 3","pages":"Article 103401"},"PeriodicalIF":2.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974125","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":"Orthopedic Resident Intern Foundations: A Cross-Institutional, Month-Long Skills Training Boot Camp for PGY-1 Residents","authors":"Tanios Dagher BSE ,&nbsp;Tessa Balach MD ,&nbsp;Jason Strelzow MD","doi":"10.1016/j.jsurg.2024.103406","DOIUrl":"10.1016/j.jsurg.2024.103406","url":null,"abstract":"<div><h3>Objective</h3><div>Orthopedic residents are tasked with rapidly acquiring clinical and surgical skills, especially during their PGY-1 year. However, resource constraints and other factors frequently cause skills training to fall short of established guidelines. We aimed to design and evaluate a cross-institutional, month-long curriculum aimed at pooling resources to optimize training.</div></div><div><h3>Design</h3><div>The O.R.I.F. (Orthopaedic Resident Intern Foundations) Boot Camp was created to teach foundational residency skills and knowledge through daily didactic and simulation-based training covering 6 domains: orthopedic knowledge, orthopedic skills, nonorthopedic clinical knowledge (e.g. radiology), day-to-day hospital tasks, academic research, and social aspects of medicine. Content was based on ACGME milestones and core competencies. The program ran 8 hours each weekday throughout November 2022 and 2023. Before and after the curriculum, participants were administered a 65-question orthopedic knowledge assessment and self-reported competency surveys. Additionally, graduates from the O.R.I.F. 2022 class and a cohort of peer residents from nonparticipating institutions were administered a follow-up survey 1 year after Boot Camp. Comparative testing was performed using Wilcoxon signed-rank analysis (α = 0.05).</div></div><div><h3>Setting</h3><div>The curriculum was hosted at a Level 1 urban trauma center.</div></div><div><h3>Participants</h3><div>Over the study period 40 residents from the Chicagoland institutions participated in Bootcamp: 25 PGY-1 residents from 5 programs in 2022 and15 residents from 3 programs in 2023.</div></div><div><h3>Results</h3><div>Orthopedic assessment scores increased from 45.7 (SD = 8.3) precurriculum to 60.1 (SD = 7.6) postcurriculum (p &lt; 0.001). Additionally, self-rated competence increased in 5/6 domains—all except the social aspects of medicine. One year after O.R.I.F. 2022, a higher proportion of graduates reporting that skills training provided good or very good preparation for intern year and allowed them to network with peers at other institutions compared to non-Boot Camp residents.</div></div><div><h3>Conclusions</h3><div>The O.R.I.F. Boot Camp improves PGY-1 clinical knowledge and skills in a resource-efficient model while also providing an environment that cultivates cross-institutional camaraderie.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 3","pages":"Article 103406"},"PeriodicalIF":2.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962487","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":"Is Specific Consent for Educational Sensitive Exams on Anesthetized Patients Necessary? Arguments for and Against From Canadian Medical Students","authors":"Phoebe Friesen PhD ,&nbsp;Wan-Li Sun BSc ,&nbsp;Sarah Towle MSc ,&nbsp;Zoe Hyman-Levy MSSW, MPH","doi":"10.1016/j.jsurg.2024.103349","DOIUrl":"10.1016/j.jsurg.2024.103349","url":null,"abstract":"<div><h3>Objective</h3><div>Discussions related to the importance of seeking specific consent for sensitive (e.g., pelvic, rectal) exams performed on anesthetized patients by medical students have been growing. The perspectives of Canadian medical students on this topic have never been sought.</div></div><div><h3>Design</h3><div>An anonymous questionnaire related to experiences and beliefs regarding consent and sensitive exams under anesthesia (EUAs) within medical training was distributed to medical students across Canada.</div></div><div><h3>Setting</h3><div>Of 17 medical schools in Canada, 6 confirmed distribution, 8 schools expressed an intention to distribute but did not confirm whether distribution had occurred, and 3 did not share the questionnaire.</div></div><div><h3>Participants</h3><div>134 respondents answered at least 1 question. Canadian medical students who had begun clerkship or previous students enrolled within the last 5 years were eligible.</div></div><div><h3>Results</h3><div>Our data indicates that, of Canadian medical students surveyed, the majority (72%) believe that specific consent for educational sensitive EUAs is a moral requirement, while 20% are unsure, and 8% do not share this belief. Respondents offered a variety of reasons why specific consent is necessary, including patient rights, autonomy, respect, and integrity, as well as concerns related to nonconsensual exams being abusive or constituting assault. Some respondents noted that consent is already implied, is unnecessary because of clinical benefit, or requiring it could lead to missed educational opportunities, especially for male and/or racialized medical students.</div></div><div><h3>Conclusion</h3><div>These results indicate that while most respondents support specific consent for educational EUAs, confusion regarding the purpose of these exams and the moral basis of specific consent exists in training.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 3","pages":"Article 103349"},"PeriodicalIF":2.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962449","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}