Annals of Surgery Open最新文献

{"title":"Near-Peer Coaching to Enhance Operative Learning: An Educational Innovation for Surgical Training","authors":"Alexander J. Papachristos, Elizabeth Molloy, J. Chui, Monica Ghidinelli, Simon Kitto, Debra Nestel, Benjamin P. T. Loveday","doi":"10.1097/as9.0000000000000471","DOIUrl":"https://doi.org/10.1097/as9.0000000000000471","url":null,"abstract":"\u0000 \u0000 To design, implement, and evaluate a near-peer coaching model to enhance operative learning in general surgery training.\u0000 \u0000 \u0000 \u0000 There is an urgent need to maximize operative learning in surgical education. Trainees find barriers to operative learning difficult to navigate and often sacrifice educational opportunities for the sake of impression management.\u0000 \u0000 \u0000 \u0000 A prospective cohort study was conducted over a 6-month period following design and implementation of a trainee-led near-peer coaching model; “SPICE” (Set goals, Plan, Imagine, Comment and feedback, Evaluate and reflect). Semistructured interviews were conducted to explore trainees’ experiences of the model.\u0000 \u0000 \u0000 \u0000 Twelve trainees participated in the study. The near-peer coaching encounters provided trainees with the psychological safety to be honest about learning needs, validated insecurities, and mitigated the pressures associated with impression management that consistently shaped consultant–trainee relationships. Trainees described improved operative performance, increased self-confidence, and a greater ability to adapt to the unexpected. Trainees adapted the use of the SPICE model to conventional consultant–trainee dynamics, which facilitated learning conversations and negotiation of operative opportunities. On a broader scale, trainees noticed an improvement in the teaching culture of the unit, describing that the use of the model legitimized the importance of perioperative learning conversations and increased consultant enthusiasm for teaching.\u0000 \u0000 \u0000 \u0000 Near-peer coaching created a unique psychological safety that facilitated authentic reflection and goal setting and improved trainee confidence. The benefits of the SPICE model were translated to other contexts and facilitated entrustment in conventional consultant–trainee relationships.\u0000","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141648716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Alcohol Use, Alcohol-Related Problems, and Substance Use Following Adolescent Metabolic and Bariatric Surgery","authors":"Gretchen E. White, Richard E. Boles, A. Courcoulas, T. Inge, S. Yanovski, T. Jenkins, M. Zeller","doi":"10.1097/as9.0000000000000461","DOIUrl":"https://doi.org/10.1097/as9.0000000000000461","url":null,"abstract":"\u0000 \u0000 To identify factors associated with incident alcohol consumption, hazardous drinking, alcohol-related problems, and substance use up to 8 years following metabolic and bariatric surgery (MBS) during adolescence.\u0000 \u0000 \u0000 \u0000 In this cohort, nearly half of those who underwent MBS as adolescents screened positive for alcohol use disorder, symptoms of alcohol-related harm, or alcohol-related problems within 8 years post-surgery. Moreover, persistent or heavy marijuana use following MBS during adolescence is higher than national data.\u0000 \u0000 \u0000 \u0000 This study includes 217 adolescents (aged 13–19 years) enrolled in a 5-center prospective cohort study who underwent Roux-en-Y gastric bypass or vertical sleeve gastrectomy between 2007 and 2011 and were followed for up to 8 years. Participants self-reported alcohol use via the Alcohol Use Disorders Identification Test and substance use for up to 8 years.\u0000 \u0000 \u0000 \u0000 Female sex, pre-surgery lower body mass index, and pre-surgery substance use were independently associated with increased risk of incident post-surgery hazardous drinking. Pre-surgery psychiatric counseling was significantly associated with increased risk for new-onset substance use post-surgery. Starting substance use post-surgery or continuing pre- to post-surgery was independently associated with a higher risk of post-surgery hazardous drinking. Greater percent weight loss, starting post-surgery or continuing pre- to post-surgery psychiatric counseling, using alcohol, and hazardous drinking were independently associated with a higher risk of post-surgery substance use.\u0000 \u0000 \u0000 \u0000 Future research with a nonsurgical control group should be examined to further elucidate the relationships between MBS and alcohol and substance use following surgery during adolescence.\u0000","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141647298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics Associated with Successful Residency Match in General Surgery","authors":"Reagan A. Collins, Kaitlyn Nimmer, Salma A. Sheriff, Tania K. Arora, Anai N. Kothari, Carrie E Cunningham, C. Clarke","doi":"10.1097/as9.0000000000000469","DOIUrl":"https://doi.org/10.1097/as9.0000000000000469","url":null,"abstract":"\u0000 \u0000 To evaluate characteristics of matched and unmatched general surgery residency (GSR) applicants.\u0000 \u0000 \u0000 \u0000 Given the recent change of the United States Medical Licensing Exam Step 1 grading to pass/fail, understanding the factors that influence GSR match success is integral to identifying potential interventions to improve match rates for diverse medical students.\u0000 \u0000 \u0000 \u0000 Retrospective review of GSR National Residency Matching Program (NRMP) applicant and Accreditation Council for Graduate Medical Education (ACGME) active resident data between 2011 and 2022. Data included application characteristics for United States (“US”) and “independent” applicants, factors cited by program directors in the interview and ranking process, paths pursued if applicants went unmatched, and racial/ethnic representation.\u0000 \u0000 \u0000 \u0000 A total of 9149 US and 3985 independent applicants applied to GSR between 2011 and 2021. Matched versus unmatched applicants had higher step 1 scores (US: 236 vs 218, P = 0.005; independent: 237 vs 228, P = 0.001), higher step 2 scores (US: 248 vs 232, P = 0.006; independent: 245 vs 234, P < 0.001), more likely to belong to alpha omega alpha (US: 17.1% vs 1.6%, P = 0.002) or to attend a top 40 National Institutes of Health-funded school (US: 31.0% vs 19.4%, P = 0.002) compared to unmatched applicants. Program directors heavily factored step 1 and step 2 scores, letters of recommendation, interactions with faculty and trainees, and interpersonal skills when interviewing and ranking applicants. The proportion of active general surgery residents versus applicants was lower for Asians (12.3% vs 20.9%, P < 0.001), Black/African American (5.0% vs 8.8%, P < 0.001), Hispanic/Latino (5.0% vs 9.4%, P = 0.001), and underrepresented in medicine students (10.3% vs 19.1%, P < 0.001).\u0000 \u0000 \u0000 \u0000 In the pass/fail step 1 era, factors including step 2 score and other subjective metrics may be more heavily weighted in the GSR match process.\u0000","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141655942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Find Your Perfect Match for Surgical Residency: Six Steps to Building your BRANDD from the Collaboration of Surgical Education Fellows","authors":"John M. Woodward, Sarah Lund, Riley Brian, Ananya Anand, Rebecca Moreci, Sergio M. Navarro, Jorge Zarate Rodriguez, Ariana Naaseh, Katrina Tate, Joshua Roshal, Caitlin Silvestri, Connie Y. Gan, Tejas S. Sathe, Steven W. Thornton, Madeline R. Cloonan, Lauren Weaver, Mary H. Oh, Frederick Godley, Joseph C. L'Huillier","doi":"10.1097/as9.0000000000000466","DOIUrl":"https://doi.org/10.1097/as9.0000000000000466","url":null,"abstract":"","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning Outcomes and Educational Effectiveness of Social Media as a Continuing Professional Development Intervention for Practicing Surgeons: A Systematic Review and Narrative Synthesis","authors":"Arashk Ghasroddashti, Fatimah Sorefan-Mangou, R. D. Fernandes, Erin Williams, Ken Choi, B. Zevin","doi":"10.1097/as9.0000000000000470","DOIUrl":"https://doi.org/10.1097/as9.0000000000000470","url":null,"abstract":"\u0000 \u0000 The objective of this systematic review was to assess the learning outcomes and educational effectiveness of social media as a continuing professional development intervention for surgeons in practice.\u0000 \u0000 \u0000 \u0000 Social media has the potential to improve global access to educational resources and collaborative networking. However, the learning outcomes and educational effectiveness of social media as a continuing professional development (CPD) intervention are yet to be summarized.\u0000 \u0000 \u0000 \u0000 We searched MEDLINE and Embase databases from 1946 to 2022. We included studies that assessed the learning outcomes and educational effectiveness of social media as a CPD intervention for practicing surgeons. We excluded studies that were not original research, involved only trainees, did not evaluate educational effectiveness, or involved an in-person component. The 18-point Medical Education Research Study Quality Instrument (MERSQI) was used for quality appraisal. Learning outcomes were categorized according to Moore’s Expanded Outcomes Framework (MEOF).\u0000 \u0000 \u0000 \u0000 A total of 830 unique studies revealed 14 studies for inclusion. The mean MERSQI score of the included studies was 9.0 ± 0.8. In total, 3227 surgeons from 105 countries and various surgical specialties were included. Twelve studies (86%) evaluated surgeons’ satisfaction (MEOF level 2), 3 studies (21%) evaluated changes in self-reported declarative or procedural knowledge (MEOF levels 3A and 3B), 1 study (7%) evaluated changes in self-reported competence (MEOF level 4), and 5 studies (36%) evaluated changes in self-reported performance in practice (MEOF level 5). No studies evaluated changes in patient or community health (MEOF levels 6 and 7).\u0000 \u0000 \u0000 \u0000 The use of social media as a CPD intervention among practicing surgeons is associated with improved self-reported declarative and procedural knowledge, self-reported competence, and self-reported performance in practice. Further research is required to assess whether social media use for CPD in surgeons is associated with improvements in higher level and objectively measured learning outcomes.\u0000","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141664797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental Sustainability Initiatives in the Operating Room: A Scoping Review","authors":"Emre Gorgun, Sumudu Dehipawala, Matthew O’Hara, Elena Naoumtchik, Gaurav Gangoli, Crystal Ricketts, Giovanni A. Tommaselli","doi":"10.1097/as9.0000000000000451","DOIUrl":"https://doi.org/10.1097/as9.0000000000000451","url":null,"abstract":"The global healthcare industry has a substantial environmental footprint and therefore has a responsibility to decrease its impact. Changes to increase sustainability will only occur if healthcare providers (HCPs) and decision-makers understand and incorporate environmentally conscious practices in the operating room (OR). This scoping review aimed to assess hospital initiatives undertaken to support environmental sustainability in the OR, with a focus on HCP and hospital decision-maker beliefs and perceptions related to sustainability. A scoping review was conducted using Embase and PubMed. Searches were performed to identify relevant studies published between January 2011 and November 2022. A total of 163 publications were included: 10 systematic literature reviews and 153 original research articles. Most studies reported department-wide sustainability measures (waste reduction, staff education, etc), which were evaluated by the reduction in generated waste and energy, emission of greenhouse gasses, and costs. Despite up to 97% of HCPs noting willingness to improve sustainability within practices, up to 80.9% of HCPs stated that they lacked the necessary training and information. In conclusion, this research highlights a recent increase in interest about sustainability initiatives in the OR and that HCPs and surgical staff are not only willing to participate but also have suggestions on how to minimize the environmental impact of the OR.","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141666154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Questionnaire to Survey Cosmetic Outcomes in Laparoscopic Surgery for Colorectal Cancer","authors":"Masaaki Miyo, Ichiro Takemasa, K. Okuya, Tatsuya Ito, Emi Akizuki, Tadashi Ogawa, Ai Noda, Masayuki Ishii, Ryo Miura, Momoko Ichihara, Maho Toyota, Akina Kimura, Mitsugu Sekimoto","doi":"10.1097/as9.0000000000000443","DOIUrl":"https://doi.org/10.1097/as9.0000000000000443","url":null,"abstract":"\u0000 \u0000 There has been a steady increase in the use of minimally invasive surgery, including conventional multiport laparoscopic surgery (MLS) and single-site laparoscopic surgery (SLS) for colorectal cancer. We aimed to evaluate how important the cosmetic outcome, one of the advantages of SLS, is to patients and whether SLS reflects social needs.\u0000 \u0000 \u0000 \u0000 We used a web-based questionnaire to survey nonmedical and medical workers for what factors were considered on the assumption that respondents undergo colorectal cancer surgery and that the most important person for them undergoes. Five items (curability, safety, pain, length of hospital stay, and cosmetic outcomes) were compared. After paired photographs before and after SLS and MLS were shown, perceptions of body image and cosmesis were assessed using a visual analog scale.\u0000 \u0000 \u0000 \u0000 This study included a total of 1352 respondents (990 nonmedical and 362 medical). Curability had the highest score (49.9–53.7 points), followed by safety (23.8–24.7 points). The scores for cosmetic outcomes (6.2–7.1 points) were almost equal to those of the length of hospital stay (6.2–7.1 points), which was associated with medical costs and pain (10.0–11.1 points), one of the main reasons for fear of surgery. Participants who were female, younger, and in the nonmedical group placed great importance on cosmetic outcomes. For all questions regarding body image and cosmesis, SLS had superior scores compared with MLS.\u0000 \u0000 \u0000 \u0000 Understandably, curability, and safety were most important in colorectal cancer surgery. However, medical workers should consider cosmetic outcomes, even in malignant cases.\u0000","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141666638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus for Operating Room Multimodal Data Management: Identifying Research Priorities for Data-Driven Surgery","authors":"A. García Vázquez, J. Verde, Hernandez Lara Ariosto, D. Mutter, L. Swanstrom","doi":"10.1097/as9.0000000000000459","DOIUrl":"https://doi.org/10.1097/as9.0000000000000459","url":null,"abstract":"\u0000 \u0000 This study aimed to identify research areas that demand attention in multimodal data-driven surgery for improving data management in minimally invasive surgery.\u0000 \u0000 \u0000 \u0000 New surgical procedures, high-tech equipment, and digital tools are increasingly being introduced, potentially benefiting patients and surgical teams. These innovations have resulted in operating rooms evolving into data-rich environments, which, in turn, requires a thorough understanding of the data pipeline for improved and more intelligent real-time data usage. As this new domain is vast, it is necessary to identify where efforts should be focused on developing seamless and practical data usage.\u0000 \u0000 \u0000 \u0000 A modified electronic Delphi approach was used; 53 investigators were divided into the following groups: a research group (n=9) for problem identification and a narrative literature review, a medical and technical expert group (n=14) for validation, and an invited panel (n=30) for two electronic survey rounds. Round 1 focused on a consensus regarding bottlenecks in surgical data science areas and research gaps, while round 2 prioritized the statements from round 1, and a roadmap was created based on the identified essential and very important research gaps.\u0000 \u0000 \u0000 \u0000 Consensus panelists have identified key research areas, including digitizing operating room (OR) activities, improving data streaming through advanced technologies, uniform protocols for handling multimodal data, and integrating AI for efficiency and safety. The roadmap prioritizes standardizing OR data formats, integrating OR data with patient information, ensuring regulatory compliance, standardizing surgical AI models, and securing data transfers in the next generation of wireless networks.\u0000 \u0000 \u0000 \u0000 This work is an international expert consensus regarding the current issues and key research targets in the promising field of data-driven surgery, highlighting the research needs of many operating room stakeholders with the aim of facilitating the implementation of novel patient care strategies in minimally invasive surgery.\u0000","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141686319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Impact of the Surgical Approach for Neoadjuvantly Treated Gastroesophageal Junction Type II Tumors: A Multinational, High-Volume Center Retrospective Cohort Analysis”","authors":"Arnar B. Ingason, Mitchell C. Norotsky","doi":"10.1097/as9.0000000000000446","DOIUrl":"https://doi.org/10.1097/as9.0000000000000446","url":null,"abstract":"","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141109606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on Portal Hemodynamics in Liver Transplantation: Do not Shunt The Large-For-Flow!","authors":"Xavier Muller, G. Rossignol, K. Mohkam, J. Mabrut","doi":"10.1097/as9.0000000000000447","DOIUrl":"https://doi.org/10.1097/as9.0000000000000447","url":null,"abstract":"","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141112013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}