Journal of Surgical Education最新文献

{"title":"Mental Imagery as a Formal Educational Adjunct for Surgical Skills Development in Medical Students: A Scoping Review","authors":"Khang Duy Ricky Le ,&nbsp;Jessica Ferdinands ,&nbsp;Kaylah Fink","doi":"10.1016/j.jsurg.2025.103472","DOIUrl":"10.1016/j.jsurg.2025.103472","url":null,"abstract":"<div><h3>Background</h3><div>The development of surgical skills is a key component of the medical education curriculum. While simulation-based medical education approaches are increasingly adopted to facilitate skills development in a safe, standardized and realistic manner, mental imagery (MI) has been considered as an emerging approach for surgical skills development. MI is defined as the mental rehearsal of tasks without motor performance and has demonstrated effective skills development in industries such as elite sport and aviation. However, its benefit has yet to be explored and utilized in the medical school curriculum. This scoping review seeks to evaluate the current literature to characterize efficacy of MI interventions for the surgical skills development of medical students.</div></div><div><h3>Methods</h3><div>A scoping review was performed following a comprehensive search of Medline, Embase, CINAHL and Emcare databases. Articles evaluating the outcomes related to the impact of MI interventions on the development of technical and nontechnical surgical skills among medical students were included.</div></div><div><h3>Results</h3><div>MI-based programs among medical students improve certain areas of technical and nontechnical surgical skills performance such as in laparoscopic performance, fluidity and with co-benefits of improved stress management and low cost. However, inconsistencies were observed in findings across studies, with mixed results across the technical and nontechnical surgical skills assessed. This was largely attributed to significant study heterogeneity of the underlying evidence.</div></div><div><h3>Conclusions</h3><div>Despite the emerging evidence suggesting MI-based programs as an effective adjunct to the current surgical skills development, there are important limitations to the quality of the evidence. Our scoping review highlights the need for prospective research with standardized MI programs assessing surgical skills at the expected scope of competency for medical students to further characterize the utility of MI-based programs in the Accreditation Council for Graduate Medical Education (ACGME) surgical skills curriculum, particularly in areas of medical knowledge, professionalism, interpersonal and communication skills.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103472"},"PeriodicalIF":2.6,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465291","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":"Identifying Recent Trends in the Prevalence of International Medical Graduates Entering the Surgical Workforce in the United States","authors":"Jason Silvestre MD ,&nbsp;John W. Moore BS ,&nbsp;Mallory Williams MD ,&nbsp;Harris S. Slone MD","doi":"10.1016/j.jsurg.2025.103473","DOIUrl":"10.1016/j.jsurg.2025.103473","url":null,"abstract":"<div><h3>Objective</h3><div>The objectives of this study were to 1.) determine recent trends in the prevalence of international medical graduates (IMGs) in the US surgical workforce, and 2.) understand differences in match rates between IMGs, allopathic, and osteopathic graduates.</div></div><div><h3>Design</h3><div>Data from the American Medical Association (2008-2022) and National Resident Match Program (2018-2023) were analyzed for eight surgical subspecialties including vascular surgery, thoracic surgery, general surgery, plastic surgery, orthopedic surgery, neurosurgery, otolaryngology, obstetrics and gynecology.</div></div><div><h3>Setting</h3><div>Accreditation Council for Graduate Medical Education (ACGME)-accredited surgical residency training programs.</div></div><div><h3>Participants</h3><div>Surgical residents (2018-2023) and active surgeons (2008-2022) in the United States.</div></div><div><h3>Results</h3><div>Over the study period, the prevalence of IMGs in the US surgical workforce decreased for all surgical specialties except vascular surgery. Among surgical residents, allopathic graduates constituted the majority (82%) followed by osteopathic graduates (12%) and IMGs (6%). The annual prevalence of IMGs was highest in thoracic (10%) and general surgery (10%), and lowest in orthopedic surgery (1%). Allopathic graduates had the highest match rates followed by osteopathic graduates and then IMGs (p &lt; 0.001) across all surgical specialties. Match rates for IMGs were lowest in thoracic surgery and vascular surgery (4%) and highest in obstetrics and gynecology (12%). Most surgical residency program directors reported never or seldomly interviewing (range, 73%-100%) or ranking (range, 77%-100%) IMGs.</div></div><div><h3>Conclusions</h3><div>The prevalence of IMGs in the US surgical workforce is decreasing. IMGs have lower match rates than US allopathic and osteopathic graduates and most surgical residency programs report rarely interviewing or ranking IMGs. Strategies that support IMGs enter surgical residency training may help promote diversity and inclusion in the US surgical workforce.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103473"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Applicant Signaling on the General Surgery Match Process: A Single Institution Experience","authors":"Peyton Murdock MD,&nbsp;Juyeon Park MD,&nbsp;Eric Heidel PhD,&nbsp;Ginger Miya-Hildebrand,&nbsp;Andrew Russ MD,&nbsp;Catherine McKnight MD,&nbsp;Tanaz Vaghaiwalla MD","doi":"10.1016/j.jsurg.2025.103476","DOIUrl":"10.1016/j.jsurg.2025.103476","url":null,"abstract":"<div><h3>Objective</h3><div>This single-institution study examined both the outcomes of signaling on the general surgery match and the perceptions of signaling by the applicants and the interviewers at an academic residency program.</div></div><div><h3>Design</h3><div>A retrospective review was performed using prospective data collected at a single institution over 2 application cycles that spanned 2022 to 2024. Applications were submitted through the Electronic Residency Application Service (ERAS). Statistical analysis was performed using Chi to square and logistic regression.</div></div><div><h3>Setting</h3><div>A tertiary academic medical center in the South.</div></div><div><h3>Participants</h3><div>Study participants were drawn from a pool of applicants in the general surgery residency program 2022 to 2024 application cycles. During this period, 2,421 candidates applied to this program and 155 (6.4%) signaled. Additionally, voluntary surveys were electronically distributed to the current and immediate past program directors, the chief residents involved in the interview process during this period, and the applicants who matched in 2024.</div></div><div><h3>Results</h3><div>Among applicants who signaled, those who were and were not interviewed exhibited no statistically significant differences in the United States Medical Licensing Exam (USMLE) Step 1 pass rate, gender, race/ethnicity, or medical school geographic region. Applicants who signaled were more likely to be interviewed, with a significantly higher interview rate, X2(1) = 187.42, p &lt; 0.001, and 8.3 times higher odds of interviewing (95% CI 5.88-11.84). These applicants were also more likely to match at the program, with a significantly higher rate of matching, X2(1) = 38.25, p &lt; 0.001, and 15.2 times higher odds of matching (95% CI 4.83-47.6). Lastly, among the applicants who signaled, multiple regression analysis was used to show that completion of a fourth-year rotation increased the odds of interviewing by 25 times (95% CI 2.73-228.44).</div></div><div><h3>Conclusion</h3><div>At this studied institution, the odds of interviewing and matching to this program were significantly higher for applicants who signaled. Multi-institutional studies are needed to validate the study findings.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103476"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465290","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 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}