Journal of Surgical Education最新文献

{"title":"Differential Attainment in Higher Surgical Training: A Systematic Review of Contributing Factors And Interventions","authors":"Jaspreet Kaur Seehra BSc(Hons), MBChB, MSc(Ed), MRCS(Ed),&nbsp;Tristan Boam FRCS(PaedSurg),&nbsp;Ricky Ellis MBChB, MRCS, PhD,&nbsp;Brett Doleman MBChB, PhD,&nbsp;Jonathan Lund PhD","doi":"10.1016/j.jsurg.2025.103829","DOIUrl":"10.1016/j.jsurg.2025.103829","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Differential attainment (DA) reflects persistent disparities in surgical training outcomes across gender, ethnicity, and socioeconomic status and has been increasingly recognized in surgical training. This systematic review aimed to synthesize existing evidence on contributory factors and evaluate interventions designed to mitigate DA in higher surgical training.</div></div><div><h3>METHODS</h3><div>systematic review was conducted in accordance with PRISMA guidelines and registered on the Open Science Framework (DOI: 10.17605/OSF.IO/RC54V). Inclusion criteria comprised studies focusing on causes or solutions to DA in higher surgical training. Exclusion criteria included studies not exploring causes/solutions, studies focused solely on faculty, and non-peer reviewed literature. MEDLINE, Embase and Scopus were searched (2004-2024). Eligible studies analyzing contributory factors or interventions targeting DA were included. Quality was appraised using CASP, Newcastle-Ottawa Scale, or MMAT tools. A thematic synthesis categorized findings at individual, institutional and systemic levels. No external funding was received for this study.</div></div><div><h3>RESULTS</h3><div>Forty-three studies met inclusion criteria, including 33 quantitative, 6 qualitative, and 4 mixed-methods studies. Common contributors to DA included gender and ethnic disparities, burnout, financial barriers, work-life balance, and workplace harassment. Interventions such as structured mentorship, financial support, competency-based assessment, and anti-harassment policies were frequently proposed. However, few were formally evaluated or co-designed with affected trainees. No studies provided conclusive evidence of reduction in DA outcomes.</div></div><div><h3>CONCLUSION</h3><div>Despite widespread recognition, DA in surgical training remains poorly addressed. Most interventions are unevaluated, under-theorized, and not co-designed with affected trainees. Systematic, evidence-based approaches are urgently needed to achieve equity in surgical education. This review provides actionable insights for surgical educators, policymakers, and training programs aiming to achieve equity.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 2","pages":"Article 103829"},"PeriodicalIF":2.1,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883959","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":"EQIP 2023-2025: Increased Usability and Sustainability","authors":"Amit R.T. Joshi MD ,&nbsp;Andrew Krumm PhD ,&nbsp;Daniel M. Relles MD ,&nbsp;Kristen Conrad-Schnetz DO ,&nbsp;Kyla Terhune MD, MBA ,&nbsp;Brian George MD ,&nbsp;Jennifer Choi MD ,&nbsp;David T. Harrington MD","doi":"10.1016/j.jsurg.2025.103822","DOIUrl":"10.1016/j.jsurg.2025.103822","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the collaborative efforts that improved the Educational Quality Improvement Program (EQIP) between 2023 and 2025.</div></div><div><h3>Design</h3><div>EQIP was formed by the Association of Program Directors in Surgery (APDS) in 2018 as a continuous educational quality improvement program. After a successful proof-of-concept completed in 2021 to 2022, EQIP’s underlying infrastructure was transitioned to the Society for Improving Medical Professional Learning (SIMPL). A data-ingestion process and reporting platform were iteratively developed over 2 years in collaboration with participating programs. User-centered design strategies were used to develop both data-ingestion and reporting tools.</div></div><div><h3>Setting &amp; Participants</h3><div>Ten surgical training programs provided design ideas and iterative feedback on data upload and reporting processes.</div></div><div><h3>Results</h3><div>EQIP was sustainably strengthened in the 2023 to 2025 academic years. Data from the Accreditation Council of Graduate Medical Education (ACGME), the American Board of Surgery (ABS), and the Electronic Resident Application Service (ERAS) were merged with manually entered data for 36 programs. Feedback from participating programs emphasized the ease of the data upload process. Previously documented challenges with identifying trainees across different transition points (e.g., UME to GME) and between organizations were experienced. Lastly, an additional emphasis around allowing program directors to explore their own data was identified. While a founding premise of EQIP was to generate benchmark data that individual programs could use to set goals, additional data analysis and reporting needs around understanding trainees across multiple data points were identified.</div></div><div><h3>Conclusions</h3><div>The APDS, in partnership with SIMPL, demonstrated that a secure database to support continuous quality improvement in surgical education can be successfully deployed. EQIP will continue to improve and hopes to increase the number of programs who can participate in iterative, collaborative improvement work.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 2","pages":"Article 103822"},"PeriodicalIF":2.1,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884519","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":"Complete Organ Laparoscopic Training System: A Novel Ex-Vivo Laparoscopic Simulator","authors":"Bo Tang MD ,&nbsp;Zhe Zhang ,&nbsp;Shibo Pang ,&nbsp;Hongbo Yang ,&nbsp;Yuanhong Nie ,&nbsp;Yaoxing Ren ,&nbsp;Shanpei Wang PhD ,&nbsp;Feng Ma PhD ,&nbsp;Nana Zhang PhD ,&nbsp;Yi Lv PhD ,&nbsp;Dinghui Dong PhD","doi":"10.1016/j.jsurg.2025.103831","DOIUrl":"10.1016/j.jsurg.2025.103831","url":null,"abstract":"<div><h3>Background</h3><div>Previous <em>ex vivo</em> laparoscopic simulators have presented limitations in mimicking the thoracic and abdominal environment and lacked a teaching component. Therefore, we developed a complete organ laparoscopic training system (COLTS).</div></div><div><h3>Methods</h3><div>The COLTS consists of complete clusters of living organs representing abdomen and thorax, a training platform, a specific circulation solution, and a teaching module. Twelve experts assessed the COLTS in terms of its simulation of the surgical environment and intervention using a Likert scale questionnaire. Twelve residents were randomly assigned groups with or without the teaching module. Trainees assessed COLTS and underwent performance evaluations based on operating time, blood loss, adverse events, and economy of movement.</div></div><div><h3>Results</h3><div>Experts confirmed the ability of the COLTS to simulate the surgical environment and vessel pulse. All trainees positively evaluated the educational value of the COLTS. With the help of the teaching module, the trainees were more confident in the use of instruments (4.83 ± 0.41 vs. 3.83±0.98, p <em>=</em> 0.044) and positioning of trocars (4.67 ± 0.52 vs. 3.50 ± 0.84, p <em>=</em> 0.016) than were the trainees in the control group. Additionally, the teaching module group obtained better performance scores in terms of operation time (p <em>=</em> 0.008), reduced blood loss (p <em>=</em> 0.035), adverse events (p <em>=</em> 0.019), and economy of movement (p <em>=</em> 0.040), compared with the control group.</div></div><div><h3>Conclusions</h3><div>The COLTS is a useful and promising laparoscopic training system that simulates the thoracic and abdominal region. Furthermore, the teaching module can significantly improve the performance and participation of trainees.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 2","pages":"Article 103831"},"PeriodicalIF":2.1,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879892","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":"Warm-up in Surgery: Impact on Operative Performance: A Systematic Review, Meta-analysis, and Trial Sequential Analysis","authors":"Vergilius José Furtado de Araujo Neto ,&nbsp;Rodrigo Marcus Cunha Frati ,&nbsp;Breno Cordeiro Porto ,&nbsp;Everson Luiz de Almeida Artifon ,&nbsp;José Pinhata Otoch ,&nbsp;José Arnaldo Shiomi da Cruz","doi":"10.1016/j.jsurg.2025.103818","DOIUrl":"10.1016/j.jsurg.2025.103818","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To evaluate the effect of surgical warm-up on operative performance through a systematic review, meta-analysis, and trial sequential analysis of randomized controlled trials.</div></div><div><h3>DESIGN</h3><div>This is a systematic review and meta-analysis of prospective randomized controlled trials, and it was prospectively registered in PROSPERO (CRD420251127516).</div></div><div><h3>SETTING</h3><div>Academic and teaching hospitals worldwide, involving surgical training environments with simulation and real procedures.</div></div><div><h3>PARTICIPANTS</h3><div>Medical students, residents, and surgeons included across eligible randomized trials.</div></div><div><h3>RESULTS</h3><div>Warm-up significantly reduced operative time. Trial sequential analysis confirmed the robustness of the findings, indicating that sufficient information is already available in the literature to consider this outcome reliable without the immediate need for further trials.. Secondary outcomes showed improvements in tissue handling, psychomotor skills, and task flow.</div></div><div><h3>CONCLUSIONS</h3><div>Surgical warm-up appears to be an effective, low-cost strategy to optimize technical performance, particularly in training contexts. Future multicenter trials should define optimal warm-up duration, method, and implementation in surgical curricula.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 2","pages":"Article 103818"},"PeriodicalIF":2.1,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866986","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":"Depression Among Incoming Ophthalmology Trainees","authors":"Karthik Reddy BS ,&nbsp;Jaqueline Stoutin MD ,&nbsp;Zhuo Zhao MS ,&nbsp;Anjali R. Shah MD ,&nbsp;Srijan Sen MD, PhD ,&nbsp;Amy D. Zhang MD","doi":"10.1016/j.jsurg.2025.103834","DOIUrl":"10.1016/j.jsurg.2025.103834","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Early medical training affects the mental health of residents. New-onset depression during internship persists beyond training and affects attrition, career satisfaction, and physician suicide. This study investigated depression rates among interns entering ophthalmology training and the relationship to work-related factors.</div></div><div><h3>DESIGN</h3><div>Prospective, multicenter cohort study. Interns were recruited since 2015 and participated in longitudinal assessments before and during their internship. Exposures included time in residency (measured at 3, 6, 9, and 12 months of intern year), work hours, and sleep hours.</div></div><div><h3>SETTING</h3><div>This study was conducted at several institutional academic tertiary care centers located within the United States.</div></div><div><h3>PARTICIPANTS</h3><div>A population-based sample of 98 ophthalmology residents from the Intern Health Study (IHS) from July 2015 to June 2023 who reported their status in ophthalmology residency were included in this study.</div></div><div><h3>MAIN OUTCOME MEASURES</h3><div>Validated measures of depression [Patient Health Questionnaire-9 (PHQ-9)] at preinternship and 3, 6, 9, and 12 months of residency before the start of dedicated ophthalmology training. Outcomes included the proportion of ophthalmology-entering interns with major depression (PHQ-9 score ≥ 10), changes in mean PHQ-9 scores, and the relationship between PHQ-9 scores and mean work and sleep hours.</div></div><div><h3>RESULTS</h3><div>Of the 98 ophthalmology-bound interns (41 [41.8%] with self-reported depression at any timepoint prior to enrollment) included in the study, 3 (3.1%) had major depression on baseline assessment (PHQ-9 ≥ 10). 32 (32.7%) experienced major depression during the internship period. Approximately one-quarter of interns experienced depression in the month prior to starting dedicated ophthalmology training (postgraduate year 2, PGY-2).</div><div>Preinternship mean PHQ-9 score (2.7 [95% CI, 1.6-3.8]) was significantly less than scores at 3 months (5.9 [95% CI, 4.6-7.2]), 6 months (6.1 [95% CI, 4.6-7.6]), 9 months (5.6 [95% CI, 4.3-6.9]), and 12 months (6.0 [95% CI, 4.4-7.5]). History of depression was not significantly predictive of PHQ-9 scores (<em>p</em> = 0.66). Every additional hour of sleep was predictive of a 1.6-point decrease on the PHQ-9 (p &lt; 0.001).</div></div><div><h3>CONCLUSIONS</h3><div>In this prospective multicenter study, there is a rise in depressive symptoms during internship, and these symptoms persist throughout the year. Nearly one-quarter of residents were depressed in the month prior to entering dedicated ophthalmology training (PGY-2). These findings highlight the need to address the mental health of early ophthalmology trainees.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 2","pages":"Article 103834"},"PeriodicalIF":2.1,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840437","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":"Enhancing Technical Skill Acquisition And Reducing Evaluation Bias Through Simulation-Based Vascular Anastomosis Training Using Blinded Video Analysis","authors":"Jorge Sulca Flores BS ,&nbsp;Kenneth Lynch PhD, APRN ,&nbsp;Carla C. Moreira MD ,&nbsp;Adena J. Osband MD ,&nbsp;Peter Soden MD ,&nbsp;Katherine MacCallum MD ,&nbsp;Thomas Carruthers MD ,&nbsp;Christina Raker ScD ,&nbsp;Ashlie Haas-Rodriguez BS ,&nbsp;Thomas Miner MD","doi":"10.1016/j.jsurg.2025.103827","DOIUrl":"10.1016/j.jsurg.2025.103827","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To evaluate the effectiveness of video replay in simulation-based vascular anastomosis training on technical skill acquisition, alignment between resident self-assessments and faculty evaluations, and reduction of potential evaluator bias.</div></div><div><h3>METHODS</h3><div>Over the course of 3 years, 31 PGY-2 general surgery residents completed a 7-week structured vascular anastomosis training program at a single academic institution. Training included simulation-based practice and video-recorded pre- and post-test performances of end-to-side anastomoses. Two independent surgical attendings reviewed blinded videos; residents conducted unblinded self-assessments. Performance was evaluated using a modified Mini-Objective Structured Assessment of Technical Skills (MOSAT) and a Global Rating Scale (GRS), with a total score of 62. Paired and unpaired t-tests were used for statistical analysis.</div></div><div><h3>RESULTS</h3><div>Significant improvements were observed in both self-assessed and faculty assessed technical scores (p &lt; 0.0001). Residents’ self-assessments increased from a mean of 29.1 to 46.6 (p &lt; 0.0001), while attending scores rose from 29.6 to 49.9 (p &lt; 0.0001). Mean leak volume decreased by 15.3 mL (p &lt; 0.0001), while completion time showed no significant change. At baseline, no differences were found between resident and attending scores. Post-test, attendings rated resident performance significantly higher than residents did in GRS and overall scores (p = 0.024 and p = 0.033, respectively), particularly in domains such as flow of operation and instrument handling. At pre-test, attending scores rated female residents significantly higher than male residents in anastomosis (p = 0.024) and overall score (p = 0.040). Post-test, no significant gender differences were observed in any category or in overall scores (p = 0.541).</div></div><div><h3>CONCLUSIONS</h3><div>Simulation-based vascular training using blinded video replay has been shown to improve technical skills significantly and may reduce gender-based evaluation bias. Despite access to performance footage, residents tend to underestimate their abilities compared to faculty assessments.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 2","pages":"Article 103827"},"PeriodicalIF":2.1,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840439","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 Application Value of Three-Dimensional Reconstruction Technology in Liver Surgery Teaching","authors":"Haixiong Zhang,&nbsp;Xianbo Wu,&nbsp;Fa Luo,&nbsp;Jianfeng Huang","doi":"10.1016/j.jsurg.2025.103847","DOIUrl":"10.1016/j.jsurg.2025.103847","url":null,"abstract":"<div><h3>Introduction</h3><div>To explore the application value of three-dimensional (3D) reconstruction technology in liver surgery teaching.</div></div><div><h3>Methods</h3><div>A randomized controlled trial was conducted involving 50 physicians rotating through the Department of Hepatobiliary Surgery at Foshan Fosun Chancheng Hospital between January 2023 and June 2024. Participants were randomly assigned to a traditional teaching group (<em>n</em> = 25) or a 3D teaching group (<em>n</em> = 25). The 3D teaching group utilized 3D reconstruction technology to create dynamic liver models, combined with virtual surgical planning and surgical videos for teaching, while the traditional teaching group used conventional anatomical atlases, physical models, and surgical videos. Both groups received instruction from senior attending physicians, with consistent faculty, syllabi, clinical cases, and total teaching hours. Teaching effectiveness was evaluated through standardized assessments and questionnaires.</div></div><div><h3>Results</h3><div>Standardized assessments revealed significantly higher written test scores, practical operation scores, and total scores in the 3D group compared to the traditional group (p &lt; 0.001). Questionnaire results indicated that the 3D teaching group scored significantly higher in 5 core dimensions, including teaching method satisfaction, learning interest stimulation, knowledge acquisition efficiency, learning motivation, and content mastery (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>3D reconstruction technology significantly enhances student learning motivation and facilitates a shift in teaching methodology from traditional passive knowledge acquisition towards a novel model of active exploratory learning. This interactive approach holds promise as a core teaching methodology for standardized liver surgery education.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 2","pages":"Article 103847"},"PeriodicalIF":2.1,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851959","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 Cardiothoracic Surgery Training Pathways: Three Decades of Evolution","authors":"Nayeem Nasher ,&nbsp;Faizaan Siddique ,&nbsp;Daler Rahimov ,&nbsp;Olugbenga Okusanya ,&nbsp;Nathaniel Evans ,&nbsp;Joseph E Bavaria ,&nbsp;Vakhtang Tchantchaleishvili","doi":"10.1016/j.jsurg.2025.103830","DOIUrl":"10.1016/j.jsurg.2025.103830","url":null,"abstract":"<div><h3>Objective</h3><div>Cardiothoracic (CT) surgery training pathways in the United States have undergone considerable changes to keep up with changing demands and interest in the field. We sought to characterize the temporal factors and trends in CT surgery training over the past 3 decades to inform prospective trainees interested in CT surgery.</div></div><div><h3>Design</h3><div>The National Resident Matching Program (NRMP) database was leveraged for the thoracic surgery match data in the US between 1995 and 2025. Match years were categorized into Era 1 (1995-2003), Era 2 (2004-2014), and Era 3 (2015-2025), as visually informed by using a stacked area chart. Statistical analyses were performed according to distributions between eras and training pathways.</div></div><div><h3>Results</h3><div>During Era 1, fellowship applicants declined, but consistently exceeded the number of positions available, yielding 92.8% of programs filled with an applicant match rate of 80.8%. Era 2 saw a marked decline in the number of applicants, with a steady decline in available positions, resulting in 78.2% of positions filled. There was no significant difference in USMD and non-USMD applicant match rates during this period (92.6% vs 89.9%, p = 0.052). Era 3 was characterized by a rising number of applicants for CT surgery fellowship and a stable number of positions offered, with 98.2% of positions filled and a match rate of 66.0%.</div></div><div><h3>Conclusion</h3><div>Current trends in CT surgery training may signal the beginning of an era where CT surgery training may be equally selective regardless of the training pathway.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 2","pages":"Article 103830"},"PeriodicalIF":2.1,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840440","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":"Obstetrics and Gynecology Residency: A Time Motion Analysis Evaluating Time Allocation and Duty Hours","authors":"Alejandra Cacheiro MD ,&nbsp;Lauren A. Cadish MD, MAS ,&nbsp;Amira Zayed MS ,&nbsp;Jenny Chang MPH ,&nbsp;Felicia Lane MD","doi":"10.1016/j.jsurg.2025.103828","DOIUrl":"10.1016/j.jsurg.2025.103828","url":null,"abstract":"<div><h3>Objective</h3><div>Our study seeks to examine the distribution of residents’ time spent across a work week and identify strategies for safely reducing nonessential tasks while maintaining necessary training experience.</div></div><div><h3>Design</h3><div>observational time-motion study.</div></div><div><h3>Setting</h3><div>single academic tertiary medical center.</div></div><div><h3>Participants</h3><div>Among 27 Obstetrics and Gynecology residents, 14 (51.9%) were rotating at home institution between April and June 2024 and were eligible to participate in the study. Eligible participants were shadowed by trained observers who recorded their clinical and nonclinical activities. To achieve this, training sessions were structured to include a review of the data collection tool. For all shifts, observed duty hours were compared to logged hospital hours using the MedHub system.</div></div><div><h3>Results</h3><div>Data was collected from 14 (51.9%) residents across eight rotations. In total, 28 observation shifts were completed in their entirety, 10,948 minutes were observed, resulting in 1,002 recorded tasks. Direct care activities comprised the largest share of residents’ time (6,499 minutes, 59.4%). Documentation and administration activities were the least observed at 171 (1.6%) and 453 (4.1%) minutes, respectively. No significant differences were found between weekly hours observed and logged hours (p = 0.51).</div></div><div><h3>Conclusions</h3><div>Understanding residents’ workflow and time management is essential for evaluating potential changes in the Accreditation Council for Graduate Medical Education (ACGME) common program requirements. Initiatives aimed at optimizing nonclinical activities, including documentation and administrative responsibilities, may present an opportunity to alleviate residents’ workload and support feasible duty-hour adjustments without compromising education or patient care.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 2","pages":"Article 103828"},"PeriodicalIF":2.1,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840438","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":"A Scoping Review to Assess Current Interventions and Gaps in Recruiting for an Inclusive Surgical Workforce","authors":"Jamila K. Picart MD MSc ,&nbsp;Rachna Sridhar BS ,&nbsp;Steven Xie MD ,&nbsp;Roopa Gorur BS ,&nbsp;Jacie E. Lemos MS ,&nbsp;Mahdi Mazeh BS ,&nbsp;Mark MacEachern MLIS ,&nbsp;Staci T. Aubry MD ,&nbsp;Hope T. Jackson MD ,&nbsp;Gurjit Sandhu PhD","doi":"10.1016/j.jsurg.2025.103819","DOIUrl":"10.1016/j.jsurg.2025.103819","url":null,"abstract":"<div><h3>PURPOSE</h3><div>While the diversity of the surgical workforce has well-studied benefits for patient care, surgical subspecialties have historically been unsuccessful in recruiting diverse trainees. Although surgical programs have made substantial efforts to address this problem, to progress, we need to (1) synthesize the evidence for successful strategies for recruiting diverse surgical trainees and (2) identify the dimensions of diversity that have not been studied. This scoping review assesses strategies for the effective recruitment of diverse surgical trainees, identifies the level of evidence supporting these strategies, and examines the current gaps in the literature.</div></div><div><h3>METHODS</h3><div>NLM PubMed, Elsevier Embase, and Clarivate Web of Science were searched on September 4, 2024. We included studies reporting original data assessing interventions to recruit diverse trainees, defined broadly, e.g., gender and sexual minorities, ethnic and racial minorities, persons with disabilities, and veterans, into graduate surgical training programs (general surgery, otolaryngology, orthopedic surgery, plastic surgery, urology, neurosurgery, vascular surgery, oral and maxillofacial surgery, and cardiothoracic surgery).</div></div><div><h3>RESULTS</h3><div>In this scoping review of 25 articles, we found the most common interventions included early exposure programs (11 of 25 included studies; 44%), efforts to reduce bias in the interview process (8 of 25; 32%), and improving programmatic structure to promote inclusion (6 out of 25; 24%). We found that the highest level of evidence achieved in the literature was level 3 (20 out of 25 included studies; 80%). Studies most commonly intervened to increase racial and ethnic minority representation (19/25; 76%) and women's representation (11/25; 44%).</div></div><div><h3>CONCLUSION</h3><div>This scoping review summarizes and assesses the literature on evidence-based practices for recruiting a diverse surgical workforce. This work outlines interventions institutions can develop to promote diversity within the surgical workforce. Furthermore, it provides areas for advancing the recruitment of an inclusive surgical workforce.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 2","pages":"Article 103819"},"PeriodicalIF":2.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822595","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}