Journal of Surgical Education最新文献

{"title":"Building A Culturally Concordant Mentorship Program for Immigrant Premedical Students","authors":"Nazineen Kandahari MD, MS ,&nbsp;Nilufar Kayhani BA ,&nbsp;Fareha Moulana Zada BA ,&nbsp;Anisha Chandy MS","doi":"10.1016/j.jsurg.2025.103474","DOIUrl":"10.1016/j.jsurg.2025.103474","url":null,"abstract":"<div><h3>Objective</h3><div>To develop an intervention addressing the unique needs of Afghan premedical students in successfully applying to and preparing for medical school in the U.S.</div></div><div><h3>Design</h3><div>A year-long virtual mentorship program was developed using the principles of community-based participatory research and cultural humility. Mentees were self-identified Afghan premedical students and Mentors were self-identified Afghan medical students, residents, and attendings. Mentees committed to attending monthly group workshops organized by Mentors, and having individual meetings with their assigned Mentors for a year. A workshop curriculum was developed based on findings from separate focus groups conducted with Mentees and Mentors. Participants completed a survey before and after the year-long program to assess barriers in applying to medical school, confidence, self-efficacy, resilience, and mentorship experience.</div></div><div><h3>Setting</h3><div>The program was organized by Afghan Clinic, a refugee-founded nonprofit organization dedicated to promoting agency among marginalized communities. Program activities were conducted virtually to accommodate participants from across the United States (U.S.).</div></div><div><h3>Participants</h3><div>Afghan undergraduate students or graduates interested in becoming physicians (Mentees), and medical students and physicians who trained in the U.S. (Mentors).</div></div><div><h3>Results</h3><div>Forty Afghan premedical students and 26 medical students and physicians applied for the first cohort. Thirty-two Mentees (6 male, 26 female) and 26 Mentors (13 male, 13 female) were selected to participate. After a year-long virtual mentorship program created with community input and led by Afghan medical professionals, Afghan premedical students reported positive mentor relationships, effective mentorship, and decreased sense of barriers to getting into medical school.</div></div><div><h3>Conclusions</h3><div>A community-based mentorship program for Afghan students can be effective in decreasing barriers to careers in medicine. Further exploration of the unique needs of immigrant premedical students, and creation, evaluation, and support of novel programs led by immigrant communities is needed. Our culturally concordant approach to premedical mentorship can be expanded to other immigrant communities in the U.S.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103474"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628606","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 Resident Education on the Performance of Morbidity and Mortality Conference","authors":"Brendin R. Beaulieu-Jones MD, MBA, MBI ,&nbsp;Spencer Wilson MD ,&nbsp;Gordana Rasic MD ,&nbsp;Erica A. Brotschi MD ,&nbsp;Luise I. Pernar MD, MHPE","doi":"10.1016/j.jsurg.2025.103485","DOIUrl":"10.1016/j.jsurg.2025.103485","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>Surgical morbidity and mortality (M&amp;M) conference is a cornerstone of surgical education and quality improvement. Despite its prominence, there are no widely established guidelines for the completion of M&amp;M, nor training for surgical residents, who are frequently responsible for root cause analysis and case presentation.</div></div><div><h3>METHODS</h3><div>Based on a recently published systematic review and expert focus groups with experienced surgeons, we developed a series of 10 recommendations and/or best practices for surgical M&amp;M conference. A brief educational session was created to share the recommendations and best practices with resident presenters. Trained reviewers assessed the completion of aforementioned best practices before and after the educational session. Chi-square analysis was performed to evaluate changes after the educational initiative.</div></div><div><h3>RESULTS</h3><div>During the pre-education period, 49 M&amp;M presentations were evaluated. Completion of best practice components ranged from 22.5% to 95.9%, with greater than 80% completion of 6 of 10 components. After the educational initiative, 45 additional presentations were evaluated. We observed a statistically significance increase in the number of presentations with a concise case presentation (baseline: 59.2%, posteducation: 88.9%, p = 0.002). Notable increases in completion were observed for 2 other components, although neither reached statistical significance: review of relevant, high-quality literature (baseline: 53.1%, posteducation: 66.7%, p = 0.116) and focused teaching point, with or without reference to literature (baseline: 63.3%, posteducation: 80.0%, p = 0.149). No clinically significant decreases were observed.</div></div><div><h3>DISCUSSION</h3><div>We used a mixed methods approach to design and evaluate an educational session to equip resident presenters with a series of evidence-based best practices for M&amp;M conference. The findings demonstrate the potential positive impact of a brief, educational initiative on aspects of M&amp;M conference at a single institution. The impact was ultimately limited, particularly in regard to scope and effect, which we postulate is due to the fact that the success of M&amp;M conference is dependent on a range of factors. Nonetheless, to advance the effectiveness of M&amp;M conference, we advocate for this initiative and related education for residents, given their principal role, as well as broader initiatives to increase the value of M&amp;M conference.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103485"},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620637","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":"Prediction of Basic Robotic Competence for Robotic Visceral Operations Using the O-Score within the “Robotic Curriculum for Young Surgeons” (RoCS)","authors":"Jessica Stockheim,&nbsp;Mihailo Andric,&nbsp;Maximilian Dölling,&nbsp;Aristotelis Perrakis,&nbsp;Roland S. Croner","doi":"10.1016/j.jsurg.2025.103500","DOIUrl":"10.1016/j.jsurg.2025.103500","url":null,"abstract":"<div><h3>Introduction</h3><div>Surgical residency programs lack structured assessments of robotic surgery. The validated O-Score is an assessment tool for tracking robotic operative proficiency consisting of 9 items on a 5 point Likert scale. Surgical autonomy is one comprehensive binary item. This study aimed to establish a benchmark for the number of procedures and the O-Score sum score to achieve surgical autonomy in robotic visceral procedures.</div></div><div><h3>Material and Methods</h3><div>This single-center prospective pilot cohort study assessed robotic procedures between 2020 and 2023. Bedside and console assistance performances were analyzed separately based on the O-Score and the calculated total numerical sum of the individual item values of the O-Score. Bedside assistance was conducted for upper gastrointestinal, hepatopancreatobiliary, and colorectal procedures, whereas console assistance referred to either one of the three areas. The study participants included inexperienced robotic surgeons who were evaluated by 2 robotic experts.</div></div><div><h3>Results</h3><div>In total, 273 procedures were included in this study. For 13 bedside assistants, 273 O-Score assessments were identified, and 62 O-Score assessments for six console assistants. Surgical autonomy was achieved in 50.9% for bedside assistance and in 11.3 % for assistance at the robotic console. Surgical autonomy was positively correlated with the O-Score sum for bedside (p = &lt; 0.001) and console assistance (p = 0.004). The positive prediction of surgical autonomy for bedside (console) assistance ranged from 74% (60%) to 93% (100%), correlated with a range of the O-Score sum between 37 (37) and 40 (40) and a robotic caseload between 19 (17) and 33 (24) procedures.</div></div><div><h3>Conclusions</h3><div>A significant improvement in the basic robotic performance was observed. Benchmarks regarding number of cases and O-Score sum were established for bedside assistance regardless of the type of visceral robotic operation. Currently, data on console assistance are limited. Monitoring robotic operative skills and skill progression is feasible in daily routine using the O-Score and O-Score sum.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103500"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591538","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 Current State of Diversity, Equity, and Inclusion (DEI) in Orthopedics at the Medical Student Level: A Systematic Review","authors":"Nicolette Ann Schurhoff BS ,&nbsp;Hannah Mosher BS ,&nbsp;Hallie B. Remer BS,&nbsp;Camila Sacher BS,&nbsp;Jenna Adalbert MD, MPH,&nbsp;Giselle M. Hernandez MD","doi":"10.1016/j.jsurg.2025.103496","DOIUrl":"10.1016/j.jsurg.2025.103496","url":null,"abstract":"<div><h3>Introduction</h3><div>Females and individuals underrepresented in medicine currently comprise 50.5% and 23.8% of all medical student matriculates in the United States, respectively. However, orthopedic surgery remains the least diverse specialty with 18.3% female and 17.3% URiM residents. There has been an increasing amount of effort to increase diversity, equity, and inclusion (DEI) and remedy these representation gaps; however, there remains a gap in the literature summarizing the effectiveness of DEI initiatives at the medical student level and their impact on the future diversity of the orthopedic workforce. Thus, the purpose of this systematic review is to analyze the progress and current state of DEI efforts within orthopedics at the medical student level to inform future efforts focused on diversifying this specialty.</div></div><div><h3>Methods</h3><div>A systematic review of the English literature was performed according to PRISMA guidelines using the following databases: PubMed, Web of Science, Embase, Scopus, Cochrane from inception to October 20, 2023, using a combination of search terms. Eligible full text articles reported on various domains of DEI at the medical student level in the United States such as demographics, initiatives, and perspectives.</div></div><div><h3>Results</h3><div>A total of 3,184 studies were screened and 26 full-text articles met inclusion criteria. Eight articles discussed trends in diversity demographics application, and match with orthopedics (30.8%), 10 articles discussed initiatives detailing methods and results of how to increase DEI in orthopedics (38.4%), and 8 articles discussed perspectives on where to focus future outreach endeavors (30.8%).</div></div><div><h3>Conclusion</h3><div>Enhancing DEI in orthopedic surgery at the level of medical students requires a multifaceted approach which fosters early engagement and supports outreach and sustained mentorship. Medical specialties that seek to diversify their field may benefit from similarly structured initiatives.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103496"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591513","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":"Pilot Implementation of a Simulation-Based Surgical Curriculum for Rwandan Medical Interns","authors":"Michael Kirsch MD, MSCR ,&nbsp;Christophe Mpirimbanyi MD, MMed ,&nbsp;Songnan Wang BS ,&nbsp;Grace Kansayisa MD, MMed ,&nbsp;Miguel Gasakure MD, MMed ,&nbsp;Faustin Ntirenganya MD, MMed ,&nbsp;Yihan Lin MD, MPH","doi":"10.1016/j.jsurg.2025.103475","DOIUrl":"10.1016/j.jsurg.2025.103475","url":null,"abstract":"<div><h3>Objectives</h3><div>Develop and implement a standardized surgical training curriculum for Rwandan medical interns to better prepare them for general practice at district hospitals. Assess the curriculum's impact on participants surgical knowledge and technical skills and identify areas for iterative improvement.</div></div><div><h3>Design</h3><div>A 2-day surgical curriculum combining theory-based didactics and hands-on, simulation-based skills training was developed and implemented. Rwandan medical interns were surveyed before and after participation to evaluate their comfort with various core surgical topics and skills.</div></div><div><h3>Setting</h3><div>The study was conducted in Kigali, Rwanda.</div></div><div><h3>Participants</h3><div>35 participated, Rwandan medical interns who had completed or were completing their surgical rotations were enrolled in the study.</div></div><div><h3>Results</h3><div>Significant improvements were observed in participants’ confidence in both surgical knowledge and techniques after completing the curriculum. Participants identified simulation as a valuable training technique but reported barriers such as limited access to simulation resources. Most participants reported that the curriculum was beneficial, realistic, and something they would recommend to others.</div></div><div><h3>Conclusions</h3><div>Rwanda faces a shortage of surgical specialists necessitating an expanded scope of practice for general practitioners, including performing common surgical procedures. Our pilot surgical skills curriculum for Rwandan interns demonstrates potential in addressing this need. Future iterations will refine the curriculum and expand its implementation to all Rwandan medical interns to enhance the surgical care that they will provide as general practitioners.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103475"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591514","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":"Changes in Matches into Surgical Residencies and Fellowships Following the ACGME Merger","authors":"Sara S. Soliman ,&nbsp;Gabrianna Andrews ,&nbsp;Salma Emara ,&nbsp;Naomi Watkins-Granville ,&nbsp;Alicia Podwójniak ,&nbsp;Iman Hasan ,&nbsp;Jha Stuti ,&nbsp;Alissa Brotman","doi":"10.1016/j.jsurg.2025.103466","DOIUrl":"10.1016/j.jsurg.2025.103466","url":null,"abstract":"<div><h3>Objective</h3><div>In 2015, a transition was initiated among the Accreditation Council for Graduate Medical Education (ACGME), American Osteopathic Association (AOA), and American Association of Colleges of Osteopathic Medicine (AACOM), resulting in a single accrediting body for residencies and fellowships as of 2020. This study aims to elucidate whether this had an impact on osteopathic students' matching into general surgery residencies, integrated surgery residencies, and surgical fellowships.</div></div><div><h3>Design, Setting, and Participants</h3><div>Using the Results and Data Residency Match data file and the Results and Data: Specialties Matching Service data from the National Resident Matching Program from 2015 to 2024, data was extracted regarding osteopathic and allopathic match rates into general surgery residency and surgical fellowships, respectively. Applicants were grouped on matching in 2015-2019 (premerger) or 2020-2024 (postmerger). Statistical analysis using the Chi-Square test was performed to determine if there was a significant difference in the mean number of matches in the pre and postmerger groups (p &lt; 0.05).</div></div><div><h3>Results</h3><div>Postmerger, the proportion of osteopathic students matching into general surgery residency increased significantly (DO, 5.77% vs 14.25%, p = 0.032). However, the proportion of osteopathic students who matched into integrated residencies, such as thoracic, plastic, and thoracic surgery, did not increase (p &gt; 0.05). For surgical fellowships, there was no significant increase in the proportion of osteopathic students matching (DO, 6.36% vs 9.59%, p = 0.389). Independently, an increase was seen in osteopathic matches across fellowships; however, it was only significant for vascular (8.16% vs 14.17%, p = 0.013) and hand surgery (3.79% vs 5.86%, p = 0.019).</div></div><div><h3>Conclusions</h3><div>Postmerger, there was an increase in osteopathic students and physicians filling general surgery residency, vascular, and hand surgery fellowship positions. However, the proportion of osteopathic students who matched into integrated surgery residencies remained the same.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103466"},"PeriodicalIF":2.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591625","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":"Comparing Behavioral and Neural Activity Changes During Laparoscopic and Robotic Surgery Trainings","authors":"Mehmet Emin Aksoy MD, PHD ,&nbsp;Kurtulus Izzetoglu PHD ,&nbsp;Nihat Zafer Utkan MD ,&nbsp;Atahan Agrali MS ,&nbsp;Serhat Ilgaz Yoner MS ,&nbsp;Ashley Bishop MS ,&nbsp;Patricia A. Shewokis PHD","doi":"10.1016/j.jsurg.2025.103486","DOIUrl":"10.1016/j.jsurg.2025.103486","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to compare the cognitive workload levels of general surgery residents by measuring prefrontal cortex hemodynamic activity while performing a similar task using robotic-assisted surgery (RAS) and laparoscopic surgery simulators.</div></div><div><h3>Design</h3><div>The study was conducted with 22 general surgery residents who completed a peg transfer task in simulated laparoscopic and RAS training environments. Participants' performance and neurophysiological data were collected over a 1-month period.</div></div><div><h3>Setting</h3><div>The study was conducted at Acibadem Mehmet Ali Aydinlar University- CASE (Center of Advanced Simulation and Education), utilizing a laparoscopic training simulator (CAE Lap VR) and robotic surgery simulator (Da Vinci Surgical System Si console with Backpack).</div></div><div><h3>Participants</h3><div>Twenty-two general surgery residents (mean [SD] age, 29.45 [2.40] years; 18 [81.82%] male) volunteered for the study. None of the participants had prior experience with RAS or RAS simulators, whereas most had varying degrees of laparoscopic surgery experience.</div></div><div><h3>Results</h3><div>Significant differences were observed between RAS and laparoscopic simulations in terms of performance time and neural activity. Peg transfer times were shorter in RAS simulations compared to laparoscopic simulations (χ2(3) = 134.805, p &lt; 0.001). Mean oxygenated hemoglobin (ΔHbO) levels in the prefrontal cortex were lower in RAS simulations (χ2(3) = 20.695, p &lt; 0.001), indicating reduced cognitive workload. Relative Neural Efficiency (RNE) and Relative Neural Involvement (RNI) scores were higher in RAS tasks (χ2(1) = 55.765, p &lt; 0.001), suggesting greater efficiency and involvement during robotic-assisted procedures.</div></div><div><h3>Conclusions</h3><div>The findings indicate that RAS tasks are associated with lower cognitive workload and improved efficiency compared to laparoscopic tasks. Incorporating neural indices alongside performance metrics may enhance training assessments and provide deeper insights into trainees’ experiences in simulation-based surgical education.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103486"},"PeriodicalIF":2.6,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578268","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 Should Laparoscopic Surgery Training be Planned in a Resource-Limited Environment?","authors":"Huseyin Kilavuz MD ,&nbsp;Abdirahman Burale Ahmed MD ,&nbsp;Abdinasir Mohamed Mohamud MD ,&nbsp;Badri Omer MD ,&nbsp;Fikret Ezberci MD ,&nbsp;Suleyman Salman MD ,&nbsp;Veli Mihmanlı MD ,&nbsp;Suat Turgut MD","doi":"10.1016/j.jsurg.2025.103483","DOIUrl":"10.1016/j.jsurg.2025.103483","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Laparoscopic surgeries (LSs) are underperformed in low-income countries with inadequate health infrastructure due to many restrictive factors. In this study, we aimed to present the process and results of the first bilateral collaboration protocol (BCP) for LS in an African university hospital where laparoscopic surgery had not been performed before.</div></div><div><h3>DESIGN</h3><div>A 3-stage BCP was implemented between the University of Health Sciences (Turkey) and Jigjiga University Hospital (Somali State, Ethiopia) between January and June 2024. In the first stage, training was received in Turkey for 3-6 months. In the second stage, 2 general surgery, 2 gynecology and obstetrics, and one ear-nose-throat (ENT) clinic training officers from the University of Health Sciences went to Jigjiga University Hospital and provided the installation of laparoscopic devices, on-site training of surgeons and other operating room personnel, and the initiation of the first laparoscopic and minimally invasive surgeries for a week. In the third stage, LS performed in the first 30 days after the end of the program were connected via video call.</div></div><div><h3>SETTING</h3><div>This training was held at Jigjiga University Hospital, the only university hospital in the Somali state of Ethiopia.</div></div><div><h3>PARTICIPANTS</h3><div>The first stage of this training was attended by the teaching staff of the surgical clinics at Jigjiga University Hospital. The second stage of the program was attended by all surgeons, clinical assistants, operating room nurses and staff at Jigjiga University Hospital.</div></div><div><h3>RESULTS</h3><div>In the second stage of the program, a total of 25 patients underwent the first laparoscopic and minimally invasive surgeries in the state in 1 week. 13 (52%) were performed by general surgery, 7 (28%) by gynecology and 5 (20%) by ENT. In the third stage, 24 laparoscopic procedures were performed in the first 30 days.</div></div><div><h3>CONCLUSIONS</h3><div>In low-income countries with limited resources, laparoscopic surgeries can be introduced with the right training programs and appropriate bilateral collaboration programs.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103483"},"PeriodicalIF":2.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562718","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":"Rural General Surgeons’ Perspectives Regarding the Provision of Surgical Care to Children","authors":"Gopika SenthilKumar PhD ,&nbsp;Katherine T. Flynn-O'Brien MD MPH FACS ,&nbsp;Mary Fallat MD FACS ,&nbsp;Kyle J. Van Arendonk MD PhD FACS","doi":"10.1016/j.jsurg.2025.103471","DOIUrl":"10.1016/j.jsurg.2025.103471","url":null,"abstract":"<div><h3>Objective</h3><div>The volume of surgical care provided to children by general surgeons has decreased over time, which disproportionally impacts rural children. This study aimed to understand factors that influence rural general surgeons’ decisions regarding provision of surgical care to children.</div></div><div><h3>Design</h3><div>Cross-sectional survey of 55 items conducted between February 2023 and March 2024</div></div><div><h3>Setting</h3><div>Survey distributed at meetings, ACS communities, social media.</div></div><div><h3>Participants</h3><div>162 nonpediatric surgery trained general surgeons practicing in rural communities across North America.</div></div><div><h3>Results</h3><div>Among respondents, median age was 58 years, and 75.9% identified as male and 87.7% as White/Caucasian. While a majority of respondents operated on children, most performed &lt; 20 surgeries per year. Factors reported by surgeons to be most influential regarding their decision to operate on children were personal experience/expertise/training. Availability of a pediatric inpatient unit and proximity to a children's hospital/pediatric surgeons were the next most influential factors. The amount of pediatric surgery exposure during training, feeling this training was adequate, and a greater number of years in practice since completion of training all significantly correlated with comfort in operating on younger patients. The amount of pediatric surgery exposure during training also correlated with the number of surgeries performed per year in children. &gt; 90% of respondents reported that they would have completed additional training in pediatric surgery if it had been available during or after completion of residency. About 3 to 6 months was reported by most respondents as the optimal duration of additional pediatric surgery exposure.</div></div><div><h3>Conclusions</h3><div>New training paradigms that increase exposure to pediatric surgery during residency may facilitate rural surgeons’ provision of routine surgical care to children and minimize the travel burden currently experienced by rural children who require surgical care.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103471"},"PeriodicalIF":2.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562717","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":"Training and Assessment of Nontechnical Skills in Cardiothoracic Surgery: Current Literature Review","authors":"Chinedu C. Okoli MBBS, MSc ,&nbsp;Obieze C. Nwanna-Nzewunwa MBBS, MS ,&nbsp;Scott Buchanan MD","doi":"10.1016/j.jsurg.2025.103480","DOIUrl":"10.1016/j.jsurg.2025.103480","url":null,"abstract":"<div><h3>Background</h3><div>This review explores the surgical and psychological literature on cardiothoracic (CT) surgeons’ intraoperative nontechnical skills (NTS). Successful task performance depends on the seamless integration of technical skills (TS) and NTS. This paper aims to identify the training and assessment modalities for NTS in cardiothoracic surgery (CTS).</div></div><div><h3>Methods</h3><div>PubMed, Cochrane Library, BioMed Central, Medline, EDINA BIOSIS, Web-of-Knowledge, PsychINFO, and ScienceDirect were searched through to December 2023. Additionally, a manual search of the referenced work of each included article and relevant reviews in PubMed were performed to avoid missing any important data. Original research articles were included if they described NTS training modalities and their assessment in cardiac or thoracic surgeries. Exclusion criteria included any study without full-text availability, non–peer-reviewed publications, studies without extractable data, and duplicates. Retrieved articles were screened, and data extracted in duplicate by 2 independent reviewers.</div></div><div><h3>Results</h3><div>The literature search found 371 relevant references related to cardiothoracic surgery, 17 articles were included in this literature review, and 12 training tools were identified.</div></div><div><h3>Conclusions</h3><div>This review demonstrates the need for additional work to create reliable training and assessment methods for NTS in CTS.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 5","pages":"Article 103480"},"PeriodicalIF":2.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550590","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}