Journal of Surgical Research最新文献_第8页

Manually Abstracted versus Electronic Health Record Data for Surgical Quality Improvement 人工提取与电子病历数据对手术质量提高的影响

IF 1.7 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2026-02-01 Epub Date: 2026-01-09 DOI: 10.1016/j.jss.2025.12.018

James L. Galloway MD , Vivi W. Chen MD, MPH , Jennifer Kramer PhD, MPH , Tracey Rosen MSPH , Yongquan Dong MS , Peter A. Richardson PhD , Nader N. Massarweh MD, MPH

Introduction

Manually abstracted variables are considered the gold standard within national surgical quality improvement (QI) programs. However, because of the resources associated with manual data abstraction, opportunities to automate data collection could have numerous benefits for surgical QI. The goal of this study is to describe the accuracy and concordance of Veterans Affairs (VA) Surgical Quality Improvement Program (VASQIP) electronic health record (EHR) variable correlates (derived using EHR data) when compared to manually abstracted VASQIP variables.

Methods

This was a national, cross-sectional analysis of VASQIP and VA Corporate Data Warehouse (i.e., EHR) data (2016-2020). EHR-derived VASQIP variable correlates were created from Corporate Data Warehouse and compared to manually abstracted VASQIP variables for the same cases. The primary measure of agreement was Cohen's kappa. Sensitivity, specificity, positive predictive value, and negative predictive value were also calculated for each variable with addition of exact match proportion for lab variables. Strong agreement was considered kappa ≥80%.

Results

Among 533,164 cases across 113 hospitals for 429,163 unique patients, data were evaluated for five variable domains (race and ethnicity, preoperative risk factors, intraoperative factors, labs, and postoperative complications). Kappa for race and ethnicity ranged from 91.1 to 99.5%, with a median of 98.1% (IQR, 95.3-99.5%). Preoperative risk factors ranged from −0.1 to 83.0%, with a median of 28.6% (interquartile range [IQR], 12.7-53.9%). Preoperative labs ranged from 72.2 to 95.9% with a median of 91.9% (IQR, 89.9–93.3%). Intraoperative factors ranged from 0.0 to 99.5%, with a median of 93.9% (IQR, 9.9-97.3%). Postoperative complications ranged from 3.9 to 53.2%, with a median of 15.1% (IQR, 7.1-29.6%).

Conclusions:

Apart from postoperative complications, data collection for many VASQIP variables could potentially be automated using EHR-derived correlates with a high level of accuracy. This could minimize the resources associated with manual data collection and increase the timeliness and robustness of surgical QI programs.

人工抽象变量被认为是国家手术质量改进（QI）计划的金标准。然而，由于与手工数据抽象相关的资源，自动化数据收集的机会可以为外科QI带来许多好处。本研究的目的是描述退伍军人事务（VA）外科质量改进计划（VASQIP）电子健康记录（EHR）变量相关（使用EHR数据导出）与手动提取VASQIP变量相比的准确性和一致性。方法：这是对VASQIP和VA企业数据仓库（即EHR）数据（2016-2020年）的全国性横断面分析。从企业数据仓库创建ehr衍生的VASQIP变量相关性，并将其与相同情况下手动抽象的VASQIP变量进行比较。衡量一致的主要标准是科恩的kappa。计算每个变量的敏感性、特异性、阳性预测值和阴性预测值，并添加实验室变量的精确匹配比例。kappa≥80%为高度一致。结果在113家医院的429163名独特患者的533,164例病例中，对五个可变领域（种族和民族、术前危险因素、术中因素、实验室和术后并发症）的数据进行了评估。种族和民族的Kappa范围为91.1 -99.5%，中位数为98.1% （IQR, 95.3-99.5%）。术前危险因素范围为- 0.1 ~ 83.0%，中位数为28.6%（四分位数间距[IQR]， 12.7 ~ 53.9%）。术前化验率为72.2 - 95.9%，中位数为91.9% （IQR, 89.9-93.3%）。术中因素范围为0.0 ~ 99.5%，中位数为93.9% （IQR, 9.9 ~ 97.3%）。术后并发症为3.9 ~ 53.2%，中位数为15.1% （IQR, 7.1 ~ 29.6%）。结论：除术后并发症外，许多VASQIP变量的数据收集可以使用ehr衍生的相关性进行自动化，并且具有高水平的准确性。这可以最大限度地减少与人工数据收集相关的资源，并增加手术QI程序的及时性和稳健性。

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引用次数: 0

Efficacy of the Traditional Chinese Medicine “Seven-Step Method” With Sleep Support Braces in Managing Postoperative Upper Limb Lymphedema After Breast Cancer Surgery: A Randomized Trial 中医“七步法”配合睡眠支撑支架治疗乳腺癌术后上肢淋巴水肿的疗效：一项随机试验

IF 1.7 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2026-02-01 Epub Date: 2026-01-21 DOI: 10.1016/j.jss.2025.12.031

Chengwen Shao MMed , Hongmei LV MMed , Hengchang Liu MD , Liangyou Zhao MD , Na Zhang MD

Background

Postoperative upper limb lymphedema affects 32%-55% of breast cancer patients and impairs quality of life. Standard treatments, including education and exercise, are often insufficient. In 2014, the U.S. NIH recommended complex decongestive therapy. Recently, integrating traditional Chinese medicine (TCM) meridian theory into complex decongestive therapy has led to the “Seven-Step Method,” which shows encouraging outcomes. The objective of this study was to evaluate the efficacy of the TCM Seven-Step Method combined with sleep braces compared to conventional care in improving limb function and quality of life in breast cancer patients with postoperative upper limb lymphedema.

Methods

One hundred thirty-six patients randomized (n = 68 per arm) to conventional care or TCM “Seven-Step Method” + sleep braces applied daily over 6 wks. Outcomes included limb circumference, DASH, VRS pain, QOL-BREF scores, and satisfaction.

Results

At weeks 2, 4, and 6, the intervention group showed significantly greater reductions in limb circumference. DASH, VRS pain, and QOL-BREF scores also improved significantly, with higher satisfaction than controls.

Conclusions

The TCM Seven-Step Method combined with sleep braces significantly improves limb function, reduces pain, and enhances quality of life in breast cancer patients with lymphedema, offering an effective complementary therapy.

背景：术后上肢淋巴水肿影响32%-55%的乳腺癌患者，并影响生活质量。包括教育和锻炼在内的标准治疗往往是不够的。2014年，美国国立卫生研究院推荐了综合消血疗法。最近，将中医经络理论与复杂的消血疗法相结合，产生了“七步法”，并显示出令人鼓舞的效果。本研究的目的是评价中医七步法联合睡眠支架与常规护理相比，对乳腺癌术后上肢淋巴水肿患者的肢体功能和生活质量的改善效果。方法：136例患者随机分为常规护理组和中医“七步法”+睡眠支架组，每组68例。结果包括肢体围度、DASH、VRS疼痛、QOL-BREF评分和满意度。结果：在第2周、第4周和第6周，干预组的肢体围度明显减小。DASH、VRS疼痛和QOL-BREF评分也显著改善，满意度高于对照组。结论：中医七步法配合睡眠支架能明显改善乳腺癌淋巴水肿患者的肢体功能，减轻疼痛，提高生活质量，是一种有效的补充疗法。

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引用次数: 0

Liver Remnant Hypertrophy: A Model-Based Evaluation of Associated Liver Partition and Portal Vein Ligation for Staged Hepatectomy Versus Liver Venous Deprivation 残肝肥厚：基于模型的肝分割和门静脉结扎对肝切除术和肝静脉剥夺的评估

IF 1.7 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2026-02-01 Epub Date: 2026-01-28 DOI: 10.1016/j.jss.2025.12.043

Savannah R. Smith MD , Sarah M. Cheney MD , Juan M. Sarmiento MD, FACS

Introduction

Patients undergoing major hepatectomy require a future liver remnant (FLR) of at least 30%. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and liver venous deprivation (LVD) are hypertrophy techniques for inadequate FLR. We sought to evaluate the cost-effectiveness of these techniques in patients with FLR <30%.

Methods

Via Markov modeling, we assessed clinical and economic outcomes of ALPPS and LVD. Quality-adjusted life years (QALYs), costs (2022 USD), and incremental cost-effectiveness ratios (ICERs) were assessed. We conducted sensitivity analyses to evaluate the robustness of our model to changes in input parameters.

Results

LVD resulted in 0.60 QALYs and $42,500; ALPPS accumulated 0.58 QALYs and $126,500. LVD was therefore preferred in the base case. Though LVD reduced costs, fewer simulated patients achieved hepatectomy due to disease progression while awaiting hypertrophy. If time to adequate hypertrophy for LVD was <30 d, LVD substantially increased QALYs compared to ALPPS.

Conclusions

LVD and ALPPS are both acceptable techniques. LVD is preferred from a cost-effectiveness standpoint; however, if time to adequate hypertrophy were reduced or patient selection optimized to ensure at least 90% of LVD patients achieve hepatectomy, LVD would substantially improve QALYs while still saving costs compared to ALPPS.

接受大肝切除术的患者要求未来肝残余（FLR）至少为30%。分阶段肝切除术（ALPPS）和肝静脉剥夺（LVD）相关联的肝分区和门静脉结扎是治疗FLR不足的肥厚技术。我们试图评估这些技术在FLR <；30%患者中的成本-效果。方法通过马尔可夫模型评估ALPPS和LVD的临床和经济效果。评估了质量调整生命年（QALYs）、成本（2022美元）和增量成本-效果比（ICERs）。我们进行了敏感性分析，以评估我们的模型对输入参数变化的稳健性。结果slvd产生0.60个qaly和42,500美元；ALPPS累计获得了0.58个QALYs和126,500美元。因此，在基本情况下首选LVD。虽然LVD降低了成本，但较少的模拟患者在等待肥厚时因疾病进展而实现肝切除术。如果LVD达到充分肥厚的时间为30天，与ALPPS相比，LVD显著增加了QALYs。结论slvd和ALPPS都是可行的方法。从成本效益的角度来看，LVD是首选；然而，如果减少到足够肥厚的时间或优化患者选择以确保至少90%的LVD患者实现肝切除术，LVD将大大改善QALYs，同时与ALPPS相比仍节省成本。

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引用次数: 0

Expanding the Methodology Toolkit for Surgical Research in a Data-Rich Era 在数据丰富的时代扩展外科研究的方法论工具包

IF 1.7 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2026-02-01 Epub Date: 2026-01-17 DOI: 10.1016/j.jss.2025.12.037

Kanhua Yin MD, MPH , Lakshika Tennakoon MD, MPhil, DrPH , Amro M. Abdelrahman MBBS, MS

Introduction

The volume and variety of available data sources in surgical research continue to expand. While these advances enable increasingly sophisticated analyses, they also introduce substantial methodological complexity, which often exceeds the training in biostatistics and data science for surgeon investigators. Inefficiencies in collaboration between surgeons and methodological experts further compound these challenges.

Methods

This special edition was developed to address these gaps by providing clear, introductory, and clinically grounded explanations of emerging research methodologies, each illustrated with surgery-relevant examples.

Results

The included articles cover high-impact topics, such as cost-effectiveness analysis, causal inference, spatial analysis, natural language processing, and modern survival analysis. Together, they aim to improve methodological literacy and promote more effective interdisciplinary collaboration in surgical research.

Conclusions

By making modern research methods more accessible, understandable, and clinically relevant, this issue seeks to support rigorous study design, sound interpretation, and evidence-based decision making within the surgical community.

外科研究中可用数据源的数量和种类不断扩大。虽然这些进步使分析变得越来越复杂，但它们也引入了大量的方法复杂性，这往往超出了外科医生调查员在生物统计学和数据科学方面的培训。外科医生和方法学专家之间的合作效率低下进一步加剧了这些挑战。方法：本特别版旨在通过对新兴研究方法提供清晰、介绍性和临床基础的解释来解决这些差距，每种方法都配有与手术相关的例子。结果纳入的文章涵盖了成本效益分析、因果推理、空间分析、自然语言处理和现代生存分析等高影响主题。他们的共同目标是提高方法素养，促进外科研究中更有效的跨学科合作。通过使现代研究方法更容易获得、理解和临床相关，本问题旨在支持外科社区严格的研究设计、合理的解释和基于证据的决策。

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引用次数: 0

Spontaneous Splenic Ruptures: A Contemporary Systematic Review 自发性脾破裂：当代系统回顾。

IF 1.7 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2026-02-01 Epub Date: 2026-01-20 DOI: 10.1016/j.jss.2025.12.029

Marti Pastak , Sten Saar MD, PhD , Edgar Lipping MD, PhD , Peep Talving MD, PhD

Introduction

Spontaneous splenic rupture (SSR) is a rare, life-threatening condition. The current study aims to provide a comprehensive recent overview of SSR.

Methods

A comprehensive search was performed in PubMed (MEDLINE), Google Scholar, and Scopus to identify relevant case reports and case series published during the last decade (January 1, 2015-July 1, 2025).

Results

We identified 351 eligible studies with 400 cases of SSR. The two most common etiologies for SSR were infectious (25.6%) and neoplastic (22.9%) conditions. Drug- or treatment-related etiologies were reported in 19% of cases, and noninfectious inflammatory conditions in 14.6%. Idiopathic SSRs accounted for 4.1% of the cases. Other less frequent, noncategorized etiologies accounted for the remaining 13.7% of the cases. Abdominal pain was the most common symptom, reported in 94.6% of the patients. Overall, 74.4% of the patients were subjected to splenectomy, followed by conservative management in 12.3%, angioembolization in 10.8%, and spleen-preserving surgery in 1.3%. The overall SSR-related mortality rate was 8.7% (95% confidence interval: 6.2%–12.1%).

Conclusions

Infectious and neoplastic causes comprise the most common etiologies of SSR. Compared with previous studies the rate of drug- or treatment-related etiologies has evolved, which may be related to the wider use of antiplatelet and anticoagulant drugs, particularly novel direct oral anticoagulants. The rate of angioembolization has significantly increased, whereas splenectomy numbers have declined. Neoplastic etiology and age over 50 years were associated with higher mortality on multivariate analysis. Overall, SSR-related mortality has decreased.

自发性脾破裂（SSR）是一种罕见的危及生命的疾病。本研究的目的是提供一个全面的SSR的最新概况。方法：综合检索PubMed （MEDLINE）、谷歌Scholar和Scopus，确定近十年（2015年1月1日- 2025年7月1日）发表的相关病例报告和病例系列。结果：共筛选到351份符合条件的研究，其中SSR病例400例。SSR最常见的两种病因是感染性（25.6%）和肿瘤性（22.9%）。19%的病例报告了药物或治疗相关的病因，14.6%的病例报告了非感染性炎症。特发性SSRs占4.1%。其他不常见的、未分类的病因占其余13.7%的病例。腹痛是最常见的症状，占94.6%。总体而言，74.4%的患者行脾切除术，12.3%的患者行保守治疗，10.8%的患者行血管栓塞，1.3%的患者行保脾手术。ssr相关的总死亡率为8.7%（95%可信区间：6.2%-12.1%）。结论：感染性和肿瘤性原因是SSR最常见的病因。与以往的研究相比，与药物或治疗相关的病因率发生了变化，这可能与抗血小板和抗凝药物，特别是新型直接口服抗凝药物的广泛使用有关。血管栓塞的比例显著增加，而脾切除术的数量下降。多变量分析显示，肿瘤病因和50岁以上的年龄与较高的死亡率相关。总体而言，与ssr相关的死亡率有所下降。

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引用次数: 0

Letter Regarding: Impact of Etiology on Predictive Models for Acute Pancreatitis Severity: A Retrospective Study 关于“病因学对急性胰腺炎严重程度预测模型的影响：一项回顾性研究”的信函。

IF 1.7 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2026-02-01 Epub Date: 2026-01-20 DOI: 10.1016/j.jss.2025.11.070

Xingyu Huang MD

引用次数: 0

Single-Arm Phase Ⅱ Study About a Tissue Oxygen Saturation Monitor in Gastric Tube Reconstruction 单臂期Ⅱ组织氧饱和度监测仪在胃管重建中的应用研究

IF 1.7 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2026-02-01 Epub Date: 2025-12-30 DOI: 10.1016/j.jss.2025.12.002

Kenjiro Ishii MD, PhD , Yasuhiro Tsubosa MD, PhD , Shuhei Mayanagi MD, PhD , Keita Mori PhD , Masazumi Inoue MD, PhD , Kazunori Tokizawa MD , Ryoma Haneda MD

Introduction

Insufficient blood flow at the cervical anastomosis site can cause anastomotic leakage following radical esophagectomy. Previously, we reported the use of a tissue oxygen saturation monitor in a case series study, and we aimed to present the results of the prospective study.

Methods

This single-arm phase Ⅱ study involved patients who underwent radical esophagectomy with gastric tube reconstruction and cervical site anastomosis. Regional tissue oxygen saturation (rSO2) was measured at the tip and 2, 4, and 6 cm on the caudal side of the tip before gastric tube elevation through the retrosternal route. After elevating the gastric tube, rSO2 was measured at the same points: 3 cm above the edge of the sternal bone and the chest skin. The primary endpoint was the rate of having rSO2 > 45% 3 cm above the edge of the sternal bone, which was the anastomotic site. The secondary endpoint was the relationship between anastomotic leakage and the rate of change in rSO2 before and after gastric tube elevation. Based on the calculated sample size, 42 patients were enrolled.

Results

The rate of having rSO2 > 45% 3 cm above the edge of the sternal bone was 83.3%. Anastomotic leakage was found in seven patients. Only the rSO2 at the tip after gastric tube elevation was significantly lower in patients with anastomotic leakage.

Conclusions

Monitoring tissue oxygen saturation was a feasible indicator of blood flow insufficiency in the gastric tube during radical esophagectomy.

食管根治性切除术后，吻合口血流不足可引起吻合口漏。之前，我们报道了在一个病例系列研究中使用组织氧饱和度监测仪，我们的目的是呈现前瞻性研究的结果。方法单臂期Ⅱ研究纳入行根治性食管切除术合并胃管重建和颈部吻合的患者。在经胸骨后途径提升胃管前，在尖端和尖端尾侧2、4和6 cm处测量区域组织氧饱和度（rSO2）。抬高胃管后，在胸骨和胸部皮肤边缘以上3cm处测量rSO2。主要终点为吻合口胸骨边缘以上3cm处rSO2 >； 45%。次要终点为胃管抬高前后吻合口漏与rSO2变化率的关系。根据计算的样本量，纳入42例患者。结果胸骨缘以上3cm处病变发生率为83.3%；吻合口瘘7例。吻合口瘘患者只有胃管抬高后尖端的rSO2明显降低。结论监测组织血氧饱和度是根治性食管切除术中胃管血流不足的一个可行指标。

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引用次数: 0

Robotic-Assisted Simultaneous Bilateral Native Nephrectomy and Living Donor Kidney Transplantation 机器人辅助双侧自体肾切除术和活体供肾移植

IF 1.7 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2026-02-01 Epub Date: 2026-01-17 DOI: 10.1016/j.jss.2025.12.015

Rodrigo Vianna MD, PhD , Mahmoud Morsi MD , Armando Salim Munoz-Abraham MD, MBEE , Giselle Guerra MD , Gaetano Ciancio MD, MBA

Introduction

Simultaneous bilateral nephrectomy and living donor kidney transplantation (LDKT) is often indicated for autosomal dominant polycystic kidney disease (ADPKD) with end-stage kidney disease (ESKD). Robotic-assisted surgery offers a minimally invasive alternative to open approaches and may reduce perioperative morbidity and length of stay.

Methods

Four adults with ADPKD/ESKD underwent fully robotic-assisted simultaneous bilateral nephrectomy/LDKT (RASBN/LDKT) at a single high-volume transplant center. All procedures used an intra-abdominal approach with a Pfannenstiel incision and GelPort for native kidney extraction and allograft introduction. Clinical, perioperative, and functional outcomes were recorded prospectively and analyzed retrospectively.

Results

Median total operative time was 462.5 min (range, 401-544 min). Median length of stay was 3.5 days (range, 3-5 d). There were no intraoperative or postoperative vascular, urological, or surgical complications, and no conversions or hand assistance were required. All recipients had immediate graft function without delayed graft function (no hemodialysis in the first postoperative week). Kidney allograft function remained stable through 12 mo after transplant.

Conclusions

Robotic-assisted simultaneous bilateral nephrectomy/LDKT is feasible and safe in carefully selected ADPKD/ESKD recipients, providing excellent early clinical outcomes and expanding the role of minimally invasive techniques for complex scenarios.

常染色体显性多囊肾病（ADPKD）合并终末期肾病（ESKD）常适用于双侧肾切除术和活体供体肾移植（LDKT）。机器人辅助手术为开放性手术提供了一种微创选择，并可减少围手术期的发病率和住院时间。方法4例成人ADPKD/ESKD患者在同一大容量移植中心接受全机器人辅助双侧肾切除术/LDKT （RASBN/LDKT）。所有手术均采用腹腔内入路Pfannenstiel切口和GelPort进行原生肾脏取出和同种异体移植。前瞻性记录临床、围手术期和功能结果并回顾性分析。结果总手术时间中位数为462.5 min（范围401 ~ 544 min）。中位住院时间为3.5天（范围3-5天）。术中或术后无血管、泌尿或外科并发症，不需要手术或手辅助。所有受者均有立即移植功能，无延迟移植功能（术后第一周无血液透析）。同种异体肾移植后12个月功能保持稳定。结论机器人辅助双侧肾切除术/LDKT在精心选择的ADPKD/ESKD受者中是可行和安全的，提供了良好的早期临床结果，扩大了微创技术在复杂情况下的作用。

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引用次数: 0

Improving College Readiness Through a High School Surgery Exposure Program 通过高中手术曝光计划提高大学准备

IF 1.7 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2026-02-01 Epub Date: 2026-01-17 DOI: 10.1016/j.jss.2025.12.025

Kevin T. Mutore MD , Katalina Acevedo BA, MS , Phillip Taboada BS , Munir Buhaya MD, Geli Kane BA, Anthony Froix MD, Thomas Shoultz MD

Introduction

Racial and ethnic minorities remain significantly underrepresented in the health care workforce. Despite ongoing efforts, gains in representation have been limited and the disparity widens across successive stages of medical training. Early interventions are essential to empower underrepresented minority students interested in health care with the tools to navigate the educational path toward health careers. This study evaluated whether a three-session college preparatory course could influence the attitudes and perceived preparedness for college among high school students enrolled in a medical and surgical exposure program.

Methods

Seventy-nine 10th grade students participated in a three-session workshop. Preintervention and postintervention surveys were administered using a modified version of the validated College-Going Self-Efficacy Scale and College Planning Behaviors Scale. Paired presurvey and postsurvey data were analyzed using student's t-tests and Fisher's exact tests, with statistical significance defined as P < 0.05.

Results

Forty-four students (56%) completed both surveys. Postintervention, more students had researched the college application process (P = 0.02), college costs (P < 0.01), and identified someone to answer their college-related questions (P < 0.01). Students also reported increased confidence in choosing a good college (P = 0.01) and belief in their academic ability to finish college (P = 0.02).

Conclusions

This is the first study to assess and improve college planning attitudes and behaviors in high school students participating in a surgery exposure program. This suggests that integrating college preparation into health care exposure programs may better support students' educational advancement. Future work should examine whether these improvements lead to increased college application and matriculation rates.

种族和少数民族在卫生保健工作人员中的代表性仍然严重不足。尽管不断作出努力，但在代表性方面取得的进展有限，而且在医疗培训的各个阶段差距越来越大。早期干预对于赋予对卫生保健感兴趣的代表性不足的少数民族学生权力，使其具备在通往卫生事业的教育道路上导航的工具至关重要。本研究评估了三期大学预备课程是否会影响参加医学和外科接触计划的高中生对大学的态度和感知准备。方法79名10年级学生参加了三次研讨会。干预前和干预后调查采用改良版的大学自我效能量表和大学计划行为量表进行。对调查前后数据进行配对分析，采用学生t检验和Fisher精确检验，统计学意义定义为P <； 0.05。结果44名学生（56%）完成了两项调查。干预后，更多的学生研究了大学申请程序（P = 0.02），大学费用（P < 0.01），并确定了有人回答他们的大学相关问题（P < 0.01）。此外，学生们对选择好大学的信心（P = 0.01）和对完成大学学业的能力的信心（P = 0.02）也有所增加。这是第一个评估和改善高中学生参加手术暴露计划的大学计划态度和行为的研究。这表明，将大学准备纳入医疗保健暴露计划可能更好地支持学生的教育进步。未来的工作应该研究这些改进是否会导致大学申请和入学率的提高。

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引用次数: 0

Blending Life and the Scalpel: A Financial Literacy Workshop for the Transition Beyond Training 融合生活和手术刀：一个超越培训过渡的金融知识研讨会

IF 1.7 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2026-02-01 Epub Date: 2026-01-23 DOI: 10.1016/j.jss.2025.12.039

Martha Godfrey MD , Ming-Li Wang MD

Although surgical training programs have formalized curricula for professional knowledge and skills acquisition, there is still a gap in nonclinical knowledge that surgical trainees suffer when transitioning to practice (TTP). Financial literacy is one topic that has been identified by both trainees and program directors as a high-yield topic for TTP. Traditionally, surgical trainees relied on formative experience, self-motivated learning, or one-off local institutional efforts. Due to the high demands of time in surgical training and the frequent accumulation of large amounts of educational debt during this process, financial well-being may be neglected, which can lead to professional and personal stress and burnout. The paucity of formal education on this TTP topic causes surgical graduates to rely on informal mentorship during contract negotiation or expensive legal advice. This situation jeopardizes long-term recruitment and retention of surgeons from nonprivileged backgrounds who are less likely to have access to robust informal financial literacy resources. Financially literate surgeons are more likely to enjoy careers that have longevity and high overall career satisfaction. The topic of financial literacy was the focus of a Hot Topic session during the 2025 Academic Surgical Congress. This article covers the content included in that session, including TTP challenges, employment contract basics, negotiation, compensation models, and insurance. This serves as a real-world guide for those who are preparing for TTP or those interested in supporting the recruitment and retention of the next generation of surgical trainees.

尽管外科培训项目已经为专业知识和技能的获取提供了正式的课程，但外科培训生在向实践过渡时所需要的非临床知识（TTP）仍然存在差距。金融知识是一个被学员和项目主管认定为TTP高收益的话题。传统上，外科培训生依赖于形成性经验、自我激励学习或一次性的当地机构努力。由于外科手术训练对时间的要求很高，并且在此过程中经常积累大量的教育债务，财务健康可能被忽视，这可能导致专业和个人的压力和倦怠。由于缺乏这方面的正规教育，导致外科毕业生在合同谈判或昂贵的法律咨询期间依赖非正式的指导。这种情况危及非特权背景的外科医生的长期招聘和保留，他们不太可能获得强大的非正式金融知识资源。懂得理财的外科医生更有可能从事寿命长、整体职业满意度高的职业。在2025年学术外科大会期间，金融知识是一个热门话题会议的焦点。本文涵盖了该会议的内容，包括tpp挑战、雇佣合同基础、谈判、薪酬模式和保险。对于那些正在为TTP做准备或有兴趣支持招募和保留下一代外科培训生的人来说，这是一个现实世界的指南。

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