Journal of surgical education最新文献

{"title":"Profiling and Predicting Faculty Assessment Behavior in Surgical Education.","authors":"Ranish K Patel, Phillip D Jenkins, Emily Lee, James Nitzkorwski, Ramanathan Seshadri, Rebecca Rhee, Mackenzie Cook, Julia Shelton, Julie Doberne, Jonathan Jesneck, Ruchi Thanawala","doi":"10.1016/j.jsurg.2025.103737","DOIUrl":"https://doi.org/10.1016/j.jsurg.2025.103737","url":null,"abstract":"<p><strong>Objective: </strong>To study and profile the digital assessment behaviors of surgical faculty and residents, and to build a classifier to predict assessment completion, enhancing formative feedback initiatives.</p><p><strong>Background: </strong>As competency-based paradigms are integrated into surgical training, developing digital education tools for measuring competency and providing rapid feedback is crucial. Simply making assessments available is inadequate and results in disappointingly low user participation. To optimize engagement and efficacy of these tools, user assessment behaviors need to be studied.</p><p><strong>Methods: </strong>User data was aggregated from a HIPAA-compliant electronic health record (EHR)-integrated medical education platform. Faculty and resident behaviors were analyzed with respect to factors, such as time, day, device type, automated reminders, and EHR integration.</p><p><strong>Results: </strong>10,729 assessments were completed by 254 attendings for 428 residents across 22 institutions, from 2022 to 2024. 86% of assessments were completed by faculty on weekdays, were significantly influenced by automated platform triggers and EHR integration, and distinct faculty behavior profiles contingent upon time to completion and comment length were established. Residents opened assessments at a median of 1.5 hours of faculty assessment completion, with 96% of assessments viewed by 24 hours.</p><p><strong>Conclusions: </strong>Faculty assessment behaviors represent an actionable bottleneck which can be leveraged to optimize and tailor the design of digital education tools, to enhance formative feedback.</p>","PeriodicalId":94109,"journal":{"name":"Journal of surgical education","volume":"82 11","pages":"103737"},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260285","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":"Evaluating the Evolution of Neurosurgical Training in Sub-Saharan Africa: Trends and Insights From the Cosecsa Operative Logbook.","authors":"Lawa Shaban, Laston Chikoya, Poster Mutambo, Cecilia Musonda, Niraj Bachheta, Agabe Nkusi","doi":"10.1016/j.jsurg.2025.103709","DOIUrl":"https://doi.org/10.1016/j.jsurg.2025.103709","url":null,"abstract":"<p><strong>Introduction: </strong>The College of Surgeons of East, Central, and Southern Africa (COSECSA) addresses the severe shortage of neurosurgeons in Sub-Saharan Africa through its fellowship programs. Neurosurgical trainees record their operative experiences in e-logbooks, aligning with COSECSA's procedural bundles, to ensure comprehensive surgical training. However, limited resources and access to specialized procedures continue to challenge the quality of neurosurgical care in the region. This study evaluates the operative exposure and procedural diversity of COSECSA neurosurgical trainees and assesses the effectiveness of the original COSECSA bundles compared to a newly proposed ICD-10-PCS-based system.</p><p><strong>Methods: </strong>This retrospective analysis reviewed data from 15 neurosurgical trainees who completed their COSECSA training between 2015 and 2023, across 25 hospitals in 5 countries. Operative data were extracted from the COSECSA e-logbook, which was standardized using the ICD-10-PCS coding system. Procedures were categorized into both the original COSECSA bundles and the new ICD-10-PCS-based bundles. Descriptive statistics were used to evaluate the total number of operations performed, the diversity of procedures, and compliance with training requirements.</p><p><strong>Results: </strong>Trainees logged a total of 12,352 operations, exceeding the minimum required 400 cases. The original COSECSA bundles had variable completion rates (26%-64%), while the ICD-10-PCS-based bundles demonstrated higher and more consistent completion (76%-100%). Hospital participation was broader under the new system, but specialized procedures, such as cranial nerve and vertebral vessel surgeries, were still underrepresented in certain hospitals.</p><p><strong>Discussion: </strong>While COSECSA's volume-based requirements ensure adequate operative exposure, they fail to address the procedural diversity needed for comprehensive neurosurgical training. The ICD-10-PCS-based system better captures the full range of trainee experiences and offers a more adaptable framework for evaluating training quality, though regional disparities in procedural availability remain a challenge.</p><p><strong>Conclusion: </strong>The ICD-10-PCS-based bundle system provides a more effective method for tracking neurosurgical training, enhancing its relevance in resource-limited settings. To further improve training, COSECSA should focus on increasing access to specialised procedures and refining training requirements to ensure a more diverse and comprehensive surgical education.</p>","PeriodicalId":94109,"journal":{"name":"Journal of surgical education","volume":"82 11","pages":"103709"},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260338","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":"Whiteboard Time Out (WBTO) Improves Resident Operative Performance.","authors":"Yeonjoo Cho, Jonathan Jesneck, Ruchi Thanawala, Rebecca Rhee","doi":"10.1016/j.jsurg.2025.103711","DOIUrl":"https://doi.org/10.1016/j.jsurg.2025.103711","url":null,"abstract":"<p><strong>Objective: </strong>The Whiteboard Time Out (WBTO) is a resident-centered operative educational tool designed to improve resident knowledge and attending teaching, ultimately enhancing resident operative performance and autonomy. Prior study has demonstrated that both residents and attending perceive the WBTO as a valuable and effective educational tool. The present study aims to evaluate its impact on resident autonomy. Prior study has demonstrated that both residents and attending perceive the WBTO as a valuable and effective educational tool. The present study aims to evaluate its impact on resident autonomy. We hypothesized that residents were more likely to receive higher performance scores after the implementation of WBTO.</p><p><strong>Design: </strong>Residents prepared for cases focusing on indications, key steps, and possible complications. This was then outlined on a whiteboard in the operating room and discussed with the attending prior to the case. A picture of the WBTO was uploaded to an online platform. The resident and attending independently completed evaluations of the WBTO and the resident's operative performance. The Firefly Lab, a surgical educational platform, was used to keep track of resident evaluations and map their progression over time.</p><p><strong>Setting: </strong>WBTO was first implemented in July 2021 by the general surgery residency at Maimonides Medical Center (MMC), a 700-bed university-affiliated, academic, tertiary medical center in Brooklyn, New York.</p><p><strong>Participants: </strong>General surgery residents at MMC and the department's associated faculty participated in this study.</p><p><strong>Results: </strong>Residents were 1.5 times more likely to receive the highest rating (\"auto\") following the implementation of WBTO compared to before its initiation (95% CI: 1.516-1.523, p < 0.001). Residents who had a higher rating on their WBTO correlated to a higher level of operative autonomy.</p><p><strong>Conclusion: </strong>The implementation of the Whiteboard Time Out (WBTO) demonstrates a significant positive impact on resident operative autonomy. By integrating WBTO into intraoperative education, surgery residency programs may foster more consistent faculty engagement, optimize intraoperative teaching, and accelerate the development of surgical competency.</p>","PeriodicalId":94109,"journal":{"name":"Journal of surgical education","volume":" ","pages":"103711"},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260293","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":"Effect of Artificial Intelligence-Augmented Human Instruction on Feedback Frequency and Surgical Performance During Simulation Training.","authors":"Vanja Davidovic, Bianca Giglio, Abdulmajeed Albeloushi, Ahmad Kh Alhaj, Mohamed Alhantoobi, Rothaina Saeedi, Sabrina Deraiche, Recai Yilmaz, Trisha Tee, Ali M Fazlollahi, Matthew Ha, Abicumaran Uthamacumaran, Neevya Balasubramaniam, José A Correa, Rolando F Del Maestro","doi":"10.1016/j.jsurg.2025.103743","DOIUrl":"https://doi.org/10.1016/j.jsurg.2025.103743","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether personalized feedback from a human instructor receiving artificial intelligence (AI) error data will result in reduced feedback frequency and improvement of surgical skill compared to AI instruction. As feedback was only provided following AI error detection, a reduced feedback frequency is associated with fewer errors in performance. We hypothesized that AI-augmented personalized instruction would result in reduced feedback frequency and improvement in technical skill.</p><p><strong>Design: </strong>This cross-sectional cohort study was a follow-up of a randomized controlled trial, which utilized the NeuroVR, an immersive virtual reality neurosurgical simulator. Participants were stratified by year in medical school and block randomized to receive one of 3 educational interventions as they performed simulated procedures on the NeuroVR: AI tutor instruction, scripted human instruction, and AI-augmented personalized instruction. Performance was assessed by the feedback frequency and technical skill performance metrics.</p><p><strong>Clinicaltrials: </strong>gov ID: NCT06273579.</p><p><strong>Setting: </strong>Neurosurgical Simulation and Artificial Intelligence Learning Centre, McGill University, Montreal, Canada.</p><p><strong>Participants: </strong>Volunteer sample of medical students from 4 Quebec universities in preparatory, first, or second year without prior use of the NeuroVR. Eighty-eight students participated in the study with 87 included in the final analysis; 1 was excluded due to technical issues.</p><p><strong>Results: </strong>By the third repetition, the AI-augmented personalized instruction group received significantly fewer total instructions (incidence rate ratio [IRR], 1.50 [95% CI, 1.16-1.94] instructions; p < 0.001), and high aspirator force instructions (IRR, 1.71 [95% CI, 1.15-2.55] instructions; p = 0.002), compared to the second repetition. Compared to AI tutor instruction, AI-augmented personalized instruction resulted in a significantly lower rate of healthy tissue removal (p = 0.01), instrument tip separation distance (mean ratio, 1.25 [95% CI, 1.05-1.50] mm; p = 0.008), and aspirator force (mean ratio, 1.68 [95% CI, 1.23-2.31] N; p < 0.001). AI-augmented personalized instruction showed a significant improvement from baseline in all subsequent repetitions for all performance metrics.</p><p><strong>Conclusions: </strong>This cohort study demonstrated that AI-augmented personalized instruction resulted in less frequent feedback, indicating fewer errors in trainee performance, and an improvement in simulated surgical skills.</p>","PeriodicalId":94109,"journal":{"name":"Journal of surgical education","volume":"82 11","pages":"103743"},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260380","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":"Preference Signaling in General Surgery: A Qualitative Study of Program Director Perspectives.","authors":"Pooja M Varman, Nicole E Brooks, Judith C French, Jeremy M Lipman","doi":"10.1016/j.jsurg.2025.103714","DOIUrl":"https://doi.org/10.1016/j.jsurg.2025.103714","url":null,"abstract":"<p><strong>Objective: </strong>Although large-scale surveys have gathered some data on the use of preference signals by general surgery programs, little is known about how program directors (PDs) interpret and apply these signals in practice. This study aims to gather in-depth insights from PDs regarding their perspectives on preference signaling and its impact on the resident selection process.</p><p><strong>Design, setting, and participants: </strong>Semi-structured, virtual interviews were conducted with 14 PDs, representing a mix of university-based (57.1%), community-based university-affiliated (21.4%), and community-based (21.4%) programs of varying sizes (3-9 residents per year) from all US regions. Interviews explored PDs' perceptions of preference signals, their impact on the selection process, associated benefits/challenges, and recommendations for applicants. Transcripts were de-identified, coded, and analyzed for thematic trends.</p><p><strong>Results: </strong>Analysis yielded 314 codes and 6 major themes: (1) signals reflect genuine applicant interest; (2) signals help applicants stand out, particularly borderline candidates; (3) signals do not always imply alignment with program values; (4) 5 signals were viewed as meaningful but limited in impact; (5) increasing the number of signals could reduce overapplication and enhance signal utility; and (6) both PD and advisor understanding of signals is evolving. PDs used signals during interview selection but not for postinterview ranking. While signals were useful for mid-tier applicants and helped programs identify unexpected candidates, their absence was not necessarily interpreted as a lack of interest. PDs supported increasing the number of signals, predicting shifts in how signals are used and interpreted.</p><p><strong>Conclusions: </strong>Preference signaling can support a more intentional and applicant-centric review process, especially for less competitive applicants. However, variability in PDs' use and interpretation of signals poses challenges for equitable advising. As general surgery transitions to 15 signals, further efforts are needed to promote transparency, standardize guidance, and evaluate long-term impact on application behavior and match outcomes.</p>","PeriodicalId":94109,"journal":{"name":"Journal of surgical education","volume":" ","pages":"103714"},"PeriodicalIF":2.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254267","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":"Educational Equity in Obstetric Training: Procedural Disparities in the Ob/Gyn Clerkship.","authors":"Melissa R Rosen, Brooke E Schroeder, Katherine A Lambert, Norma Davis, Lena Fried, Deborah Engle, Melody Baldwin, Sarah K Dotters-Katz","doi":"10.1016/j.jsurg.2025.103614","DOIUrl":"10.1016/j.jsurg.2025.103614","url":null,"abstract":"<p><strong>Objective: </strong>To assess for differences in obstetric procedural experiences on the obstetrics and gynecology (OB/GYN) clerkship based on medical student race and gender.</p><p><strong>Design: </strong>IRB-approved retrospective cohort study of medical student case logs on their OB/GYN clerkship between 2014 and 2022.</p><p><strong>Setting: </strong>Single United States allopathic medical school, with clinical rotations at a tertiary care center-Duke University School of Medicine, Durham, North Carolina PARTICIPANTS: 918 medical students who completed their OB/GYN clerkship between 2014 and 2022. Students with missing race or gender data from the information shared by the Assistant Dean of Education were excluded, resulting in a total of 869 students included in the analysis.</p><p><strong>Results: </strong>Among 869 students included in the study, 59.0% were female and 23.9% identified as underrepresented minorities in medicine (URM). There were no significant differences in \"hands-on\" experience in vaginal or cesarean deliveries based on medical student race or gender. However, URM male students participated in 0.74 fewer vaginal deliveries (95% CI: -1.35 to -0.12) and 1 less total delivery (95% CI: -1.91 to -0.07) than non-URM female students, while non-URM male students participated in 0.45 fewer vaginal deliveries (95% CI: -0.87 to -0.03) than non-URM female peers. These results were obtained while controlling for differences based on academic year and clerkship timing within the academic year.</p><p><strong>Conclusions: </strong>No differences were noted in \"hands-on\" delivery experience during the OB/GYN clerkship based on medical student gender or URM status, however subgroup analyses revealed that URM and non-URM male students participated in fewer vaginal deliveries compared to non-URM female peers. These differences, although modest, highlight potential disparities in clinical exposure and inclusion in the learning environment, warranting further investigation and underscoring the need for continued efforts to ensure equitable learning opportunities for all students.</p>","PeriodicalId":94109,"journal":{"name":"Journal of surgical education","volume":"82 10","pages":"103614"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812731","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":"Workplace-Based Assessment in Emergency Surgical Education Improves the Clinical Core Competency of Residents.","authors":"Wuchao Liu, Jie Ding, Xinhui Zhang, Xueqian Ma, Junchi Yang, Panyu Zhou, Xiaojun Shen","doi":"10.1016/j.jsurg.2025.103644","DOIUrl":"10.1016/j.jsurg.2025.103644","url":null,"abstract":"<p><strong>Objective: </strong>While numerous studies exist on Workplace-Based Assessment (WPBA) methodologies, their application in surgical education remains underexplored. This study implemented WPBA within Emergency General Surgery (EGS) residency standardized training, with the aim to evaluate its efficacy in enhancing clinical core competencies.</p><p><strong>Design: </strong>For this prospective study, a multimodal assessment framework incorporating WPBA tools, namely, Mini-Clinical Evaluation Exercise (Mini-CEX), Directly Observed Practical Skills (DOPS), Subjective, Objective, Assessment, and Plan (SOAP), an assessment recording, and Multisource Feedback (MSF); and competency evaluation metrics were employed. Comparative analysis of core competency scores and exit assessment performance was conducted between experimental and control groups. Data were analyzed using the chi-squared test or Fisher's exact test.</p><p><strong>Setting: </strong>The First Affiliated Hospital of Naval Medical University, located in Shanghai, China.</p><p><strong>Participants: </strong>Sixty three residents undergoing standardized EGS training from January to March, 2024, at the First Affiliated Hospital of Naval Medical University, were recruited. These trainees were allocated into either experimental or control groups, using monthly randomization principles.</p><p><strong>Results: </strong>Baseline characteristics showed no statistically significant intergroup differences in gender, training grade, educational background, standardized training source, or standardized training base (p > 0.05). The experimental group demonstrated significant post-training improvements across all competency domains (p < 0.05), whereas the control group exhibited marginal improvement (p > 0.05). While theoretical knowledge and medical documentation scores were marginally higher in the experimental group (p > 0.05), clinical skills assessment scores showed statistically significant superiority (p < 0.05).</p><p><strong>Conclusion: </strong>WPBA implementation effectively enhances clinical core competencies in EGS residents, and optimizes standardized training outcomes, suggesting its value as a pedagogical innovation in surgical education.¹.</p>","PeriodicalId":94109,"journal":{"name":"Journal of surgical education","volume":"82 10","pages":"103644"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812732","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":"A Scoping Review of Trainees With Motor and Sensory Disabilities in Surgical Specialties: Barriers, Representation, and Inclusive Solutions.","authors":"Raeesa Kabir, Shannon Y Zhou, Minh-Doan Nguyen","doi":"10.1016/j.jsurg.2025.103640","DOIUrl":"10.1016/j.jsurg.2025.103640","url":null,"abstract":"<p><strong>Objective: </strong>To highlight the experiences of trainees with disabilities in surgical and procedural specialties to encourage the development of inclusive training opportunities within surgical specialties.</p><p><strong>Design: </strong>PRISMA guidelines were used to search PubMed, Medline, Embase, and Cochrane databases in October 2024. Studies that focused on trainees with motor or sensory disabilities (MSD) in medical school or graduate medical training were included. Studies not specifying learners' experience navigating training were excluded. Data extraction included trainee level, specialty, type of disability, and solutions implemented.</p><p><strong>Setting: </strong>This review includes research conducted in academic settings.</p><p><strong>Participants: </strong>Participants in the included studies were medical students, residents, and fellows in various specialties.</p><p><strong>Results: </strong>Of 621 initial studies, 5 met inclusion criteria. Total number of trainees included 4 medical students, and 1 resident. Three (66.7%) learners had spinal cord injuries, one (16.7%) had Osteogenesis Imperfecta, and one (16.7%) had severe bilateral sensorineural hearing loss. Three studies (50%) described medical students' and a resident's experience in surgical fields of OBGYN and Surgery clerkship, and Neurosurgery residency respectively. One study (16.7%) described a student's experience in Emergency Medicine, and the final study (16.7%) described a student's experience navigating medical school and all clerkships. All 4 medical students passed their clerkships, with honors awarded for those in Emergency Medicine and Surgery. The resident in Neurosurgery successfully completed the program.</p><p><strong>Conclusion: </strong>Trainees with disabilities in surgical fields remain underrepresented. This review highlights the capacity for resilience among trainees in surgical and procedural fields, showing that students with disabilities can excel in surgical training. These findings emphasize the need for surgical programs to adopt practices that accommodate diverse needs among trainees and foster a more accessible and supportive learning environment for all aspiring surgeons.</p>","PeriodicalId":94109,"journal":{"name":"Journal of surgical education","volume":"82 10","pages":"103640"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818908","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":"\"Distanced Traveled\" Program Increases Interest in Orthopedics in Title I High School Students.","authors":"Omar Taha, Matthew Weintraub, Ritt Givens, Matan Malka, Grace Plassche, Avonley Nguyen, Christen M Russo","doi":"10.1016/j.jsurg.2025.103628","DOIUrl":"10.1016/j.jsurg.2025.103628","url":null,"abstract":"<p><strong>Objectives: </strong>The Distance Traveled program aims to increase access to orthopedic education by increasing early exposure, knowledge, and interest in musculoskeletal (MSK) medicine among title 1 high school students. Title 1 high schools are a federal designation for schools serving a high percentage of students from low-income families. The program focuses on addressing barriers such as limited field exposure, lack of role models, misconceptions about physical demands, and negative stereotypes.</p><p><strong>Design: </strong>A pipeline initiative utilizing hands-on simulations, mock surgeries, expert lectures, and Q&A sessions. The program employed pre- and postprogram surveys to assess changes in participants' interest, career orientation, and knowledge of orthopedics. Data were analyzed using within-subject T-tests (alpha = 0.05).</p><p><strong>Setting: </strong>Implemented in Title I public high schools across New York City, targeting communities traditionally underrepresented in medicine and orthopedics.</p><p><strong>Participants: </strong>In its inaugural year, the program reached 160 students through 5 events. Survey responses were collected from 100 participants before the program and 66 after its completion. The cohort was notably diverse: 36% identified as Black or African American, 65% as Hispanic, and 72% as female.</p><p><strong>Results: </strong>Participants showed statistically significant improvements in several areas: increased interest in orthopedics (p = 0.003), Greater inclination toward pursuing medical school (p = 0.014) and orthopedic careers (p = 0.02), Improved perceptions of orthopedic surgeons (p = 0.012), Enhanced familiarity with orthopedic terminology and overall confidence in understanding the field (p = 0.001) CONCLUSIONS: The Distance Traveled program is a promising model for increasing access to orthopedic surgery amongst a diverse group of students. By improving early exposure and interest in the field among underrepresented high school students, this initiative has the potential to contribute to a more representative physician workforce.</p>","PeriodicalId":94109,"journal":{"name":"Journal of surgical education","volume":"82 10","pages":"103628"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144801366","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":"Not All EPAs Are Created Equal: Fixing Sampling Bias With Utility Modeling.","authors":"Phillip Jenkins, Ali Oran, Carolyn C Chang, Jonathan Jesneck, Julie Doberne, Ruchi Thanawala","doi":"10.1016/j.jsurg.2025.103708","DOIUrl":"https://doi.org/10.1016/j.jsurg.2025.103708","url":null,"abstract":"<p><strong>Background: </strong>Entrustable professional activities (EPAs) are foundational for understanding resident progress towards practice readiness. Unfortunately, when EPAs were initiated manually, EPA assessment completion has been uneven, creating biases from assessment variability across individuals, specialties, and institutions. Therefore, we introduce EPA assessment utility modeling, which can retrospectively correct for and prospectively avoid these biases by informing each attending of the usefulness of each EPA assessment opportunity and highlighting when EPA assessments are most needed.</p><p><strong>Methods: </strong>We performed a longitudinal analysis of general surgery EPA assessments using an EHR-integrable medical-education platform across 37 institutions. EPA assessment counts were fitted with power law curves to measure skewing. Raw EPA assessment ratings, combined with historical case logs and OR schedules, were analyzed with the platform's large-scale Bayesian network model to quantify each EPA assessment's impact on entrustment learning curves. Lastly, we used Monte Carlo simulations to develop an assessment utility score, as an intuitive label for the predicted benefit of each EPA assessment opportunity, in order to prompt faculty members to complete the most highly useful assessments.</p><p><strong>Results: </strong>From 6/2023 to 5/2025, 444 faculty assessed 532 residents with 17,245 EPA assessments. EPA assessment counts showed substantial skewing across several factors. By EPA type, 52.8% of EPA assessments were of the top 4 (22.2%) types (power law α = 0.27, 2 p ≈ 0). By faculty, 33.5% of EPA assessments were from the most active 15 (4.3%) faculty members (α = 0.15, 2 p ≈ 0). By faculty specialty, 31.0% were from the most active 2 (9.5%) specialties (α = 0.24, 2 p ≈ 0). By resident, 20.1% were received by the 20 (4.5%) most assessed residents (α = 0.21, 2 p ≈ 0).</p><p><strong>Conclusion: </strong>EPA assessments were heavily skewed with sampling biases, misrepresenting entrustment levels. To fix these biases and provide a data-driven approach to CBE measurement, we propose an assessment utility framework to optimize EPA assessment timing, assessor, and prioritization.</p>","PeriodicalId":94109,"journal":{"name":"Journal of surgical education","volume":" ","pages":"103708"},"PeriodicalIF":2.1,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180693","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}