Pub Date : 2024-08-16DOI: 10.1016/j.jsurg.2024.07.020
OBJECTIVE
This study employed a randomized controlled trial to assess the efficacy of virtual-reality (VR) simulators and physical model simulators on colonoscopy training to explore the optimal and evidence-based simulation training.
DESIGN
Forty participants were divided into 2 groups and randomized as dyads: the VR simulator group and the physical model simulator group. All the participants performed a baseline test through porcine colonoscopy. After a 6 h simulation training, each participant underwent a post-test on a pig after bowel preparation, and the procedures were video-recorded. Both the baseline test and the post-test were blindly assessed by 2 experienced assistant director physicians based on the GAGES-C scoring system.
SETTING
Simulation center, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai.
PARTICIPANTS
Forty surgical residents without colonoscopy experience.
RESULTS
Both the VR simulator group and the physical model simulator group improved significantly over the baseline test. The VR simulator group performed significantly better than the physical model simulator group, p=0.042. The participants in both groups expressed a high level of simulator satisfaction.
CONCLUSIONS
Novice residents can benefit from both VR simulators and physical model simulators. The VR simulator was shown to be more effective for colonoscopy training. VR simulators were more recommended for novices conducting basic colonoscopy training.
{"title":"Colonoscopy Training on Virtual-Reality Simulators or Physical Model Simulators: A Randomized Controlled Trial","authors":"","doi":"10.1016/j.jsurg.2024.07.020","DOIUrl":"10.1016/j.jsurg.2024.07.020","url":null,"abstract":"<div><h3>OBJECTIVE</h3><p>This study employed a randomized controlled trial to assess the efficacy of virtual-reality (VR) simulators and physical model simulators on colonoscopy training to explore the optimal and evidence-based simulation training.</p></div><div><h3>DESIGN</h3><p>Forty participants were divided into 2 groups and randomized as dyads: the VR simulator group and the physical model simulator group. All the participants performed a baseline test through porcine colonoscopy. After a 6 h simulation training, each participant underwent a post-test on a pig after bowel preparation, and the procedures were video-recorded. Both the baseline test and the post-test were blindly assessed by 2 experienced assistant director physicians based on the GAGES-C scoring system.</p></div><div><h3>SETTING</h3><p>Simulation center, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai.</p></div><div><h3>PARTICIPANTS</h3><p>Forty surgical residents without colonoscopy experience.</p></div><div><h3>RESULTS</h3><p>Both the VR simulator group and the physical model simulator group improved significantly over the baseline test. The VR simulator group performed significantly better than the physical model simulator group, p=0.042. The participants in both groups expressed a high level of simulator satisfaction.</p></div><div><h3>CONCLUSIONS</h3><p>Novice residents can benefit from both VR simulators and physical model simulators. The VR simulator was shown to be more effective for colonoscopy training. VR simulators were more recommended for novices conducting basic colonoscopy training.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1931720424003404/pdfft?md5=a30e3e2fefbd5dbb13fcd625b19ff174&pid=1-s2.0-S1931720424003404-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141993514","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}
Pub Date : 2024-08-16DOI: 10.1016/j.jsurg.2024.07.019
OBJECTIVES
Evaluate the utility of a low cost, portable surgical simulator (GlobalSurgBox) for surgical teaching and its ability to dismantle barriers faced by trainers when attempting to use surgical simulation.
DESIGN
An anonymous survey was administered to surgical trainers who were involved in leading simulation events using the GlobalSurgBox in the past 2 years. The survey was designed to understand current barriers to using simulation as a trainer, and the utility of the GlobalSurgBox in overcoming these barriers.
SETTING
Academic medical training centers or conferences in the United States, Rwanda and Kenya.
PARTICIPANTS
10 practicing surgeons, 3 practicing physicians, 11 surgical residents, 15 medical students and 1 anesthesia resident.
RESULTS
The top 3 barriers for effective teaching were lack of convenient access to the simulator (50%), lack of trainer time (43%) and cost (28%). After using the GlobalSurgBox, 100% and 98% of respondents felt that it encourages more practice and offers significant advantages over current simulators in their program. About 90%, 88% and 70% of respondents believed that the GlobalSurgBox makes surgical simulation more convenient, affordable, and compatible with trainer time limitations, respectively. 83% of trainers agreed that it is a good replica of the operating room experience, and 85% practicing physicians were more likely to give autonomy to trainees after demonstrating competence on the GlobalSurgBox.
CONCLUSION
The GlobalSurgBox mitigates several barriers surgical educators experience when practicing surgical skills with trainees. The convenience of the GlobalSurgBox can help facilitate the development of foundational surgical skills outside of the operating room.
{"title":"Teaching With the GlobalSurgBox: Trainer Perceptions of a Portable Surgical Simulator","authors":"","doi":"10.1016/j.jsurg.2024.07.019","DOIUrl":"10.1016/j.jsurg.2024.07.019","url":null,"abstract":"<div><h3>OBJECTIVES</h3><p>Evaluate the utility of a low cost, portable surgical simulator (GlobalSurgBox) for surgical teaching and its ability to dismantle barriers faced by trainers when attempting to use surgical simulation.</p></div><div><h3>DESIGN</h3><p>An anonymous survey was administered to surgical trainers who were involved in leading simulation events using the GlobalSurgBox in the past 2 years. The survey was designed to understand current barriers to using simulation as a trainer, and the utility of the GlobalSurgBox in overcoming these barriers.</p></div><div><h3>SETTING</h3><p>Academic medical training centers or conferences in the United States, Rwanda and Kenya.</p></div><div><h3>PARTICIPANTS</h3><p>10 practicing surgeons, 3 practicing physicians, 11 surgical residents, 15 medical students and 1 anesthesia resident.</p></div><div><h3>RESULTS</h3><p>The top 3 barriers for effective teaching were lack of convenient access to the simulator (50%), lack of trainer time (43%) and cost (28%). After using the GlobalSurgBox, 100% and 98% of respondents felt that it encourages more practice and offers significant advantages over current simulators in their program. About 90%, 88% and 70% of respondents believed that the GlobalSurgBox makes surgical simulation more convenient, affordable, and compatible with trainer time limitations, respectively. 83% of trainers agreed that it is a good replica of the operating room experience, and 85% practicing physicians were more likely to give autonomy to trainees after demonstrating competence on the GlobalSurgBox.</p></div><div><h3>CONCLUSION</h3><p>The GlobalSurgBox mitigates several barriers surgical educators experience when practicing surgical skills with trainees. The convenience of the GlobalSurgBox can help facilitate the development of foundational surgical skills outside of the operating room.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141993513","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}
Pub Date : 2024-08-12DOI: 10.1016/j.jsurg.2024.07.007
OBJECTIVE
Increasingly, medical schools integrate clinical skills into early didactic coursework. The Stop the Bleed® Campaign emphasizes prehospital hemorrhage control to reduce preventable deaths; however, this course overlooks team interactions. We assessed the impact of high-fidelity simulation during medical student orientation on identification and treatment of life-threatening hemorrhage in a team setting.
DESIGN
In this mixed method, prospective pre-, post-, and follow-up survey analysis assessing student knowledge and attitudes, student teams encountered a standardized patient in a prehospital environment with pulsatile bleeding from an extremity wound. Individual students completed surveys assessing previous experience, willingness and ability to assist bleeding person(s), and knowledge and attitudes about tourniquets. Postscenario, faculty preceptors made qualitative observations on teamwork.
SETTING
Medical student orientation at a tertiary care academic medical center with long-term follow-up.
PARTICIPANTS
Medical students (N = 150).
RESULTS
Ninety students (60%) completed both pre- and postsimulation questionnaires. Sixteen (17%) students had previous tourniquet training experience although none had applied a tourniquet outside of training. Postsimulation, students reported increased likelihood of providing treatment until additional help arrived (p = 0.035), improved ability to identify life-threatening hemorrhage (p < 0.001), and more favorable opinions about tourniquet use (p < 0.001) and potential for limb-salvage (p = 0.018). Long-term follow-up respondents (n = 34, 23%) reported increased ability to identify life-threatening hemorrhage (p = 0.010) and universal willingness to intervene until additional help arrived. Follow-up survey responses elicited themes in hemorrhage control including recognition of the importance of continuous pressure, appropriate use of tourniquets, a desire for repeated team training, and the recognition of clerkship rotations as an optimal setting for skill reinforcement. Preceptors noted variable team responses but uniformly endorsed the exercise.
CONCLUSIONS
High-fidelity bleeding simulation during medical student orientation improved students’ knowledge and attitudes about treating life-threatening hemorrhage and served as an introduction to team-based emergency care. Future studies should further explore team training and hemorrhage control education.
{"title":"High-Fidelity Bleeding Control Simulation Scenario During Medical Student Orientation Improves Students’ Self-Reported Ability to Identify and Treat Life-Threatening Bleeding with 3-year Follow-up","authors":"","doi":"10.1016/j.jsurg.2024.07.007","DOIUrl":"10.1016/j.jsurg.2024.07.007","url":null,"abstract":"<div><h3>OBJECTIVE</h3><p>Increasingly, medical schools integrate clinical skills into early didactic coursework. The Stop the Bleed® Campaign emphasizes prehospital hemorrhage control to reduce preventable deaths; however, this course overlooks team interactions. We assessed the impact of high-fidelity simulation during medical student orientation on identification and treatment of life-threatening hemorrhage in a team setting.</p></div><div><h3>DESIGN</h3><p>In this mixed method, prospective pre-, post-, and follow-up survey analysis assessing student knowledge and attitudes, student teams encountered a standardized patient in a prehospital environment with pulsatile bleeding from an extremity wound. Individual students completed surveys assessing previous experience, willingness and ability to assist bleeding person(s), and knowledge and attitudes about tourniquets. Postscenario, faculty preceptors made qualitative observations on teamwork.</p></div><div><h3>SETTING</h3><p>Medical student orientation at a tertiary care academic medical center with long-term follow-up.</p></div><div><h3>PARTICIPANTS</h3><p>Medical students (N = 150).</p></div><div><h3>RESULTS</h3><p>Ninety students (60%) completed both pre- and postsimulation questionnaires. Sixteen (17%) students had previous tourniquet training experience although none had applied a tourniquet outside of training. Postsimulation, students reported increased likelihood of providing treatment until additional help arrived (p = 0.035), improved ability to identify life-threatening hemorrhage (p < 0.001), and more favorable opinions about tourniquet use (p < 0.001) and potential for limb-salvage (p = 0.018). Long-term follow-up respondents (n = 34, 23%) reported increased ability to identify life-threatening hemorrhage (p = 0.010) and universal willingness to intervene until additional help arrived. Follow-up survey responses elicited themes in hemorrhage control including recognition of the importance of continuous pressure, appropriate use of tourniquets, a desire for repeated team training, and the recognition of clerkship rotations as an optimal setting for skill reinforcement. Preceptors noted variable team responses but uniformly endorsed the exercise.</p></div><div><h3>CONCLUSIONS</h3><p>High-fidelity bleeding simulation during medical student orientation improved students’ knowledge and attitudes about treating life-threatening hemorrhage and served as an introduction to team-based emergency care. Future studies should further explore team training and hemorrhage control education.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977583","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}
Pub Date : 2024-08-10DOI: 10.1016/j.jsurg.2024.06.020
Introduction
The healthcare sector accounts for 8.5% of United States (U.S.) greenhouse gas emissions, of which one-third comes from operating rooms (ORs). As a result, there is great interest in decarbonizing the OR and surgical care. However, surgical residents are not routinely educated on the negative environmental impact of surgery or how to reduce it. In this paper, we present a formal needs assessment for a sustainability curriculum geared towards surgical residents.
Methods
Using Kern's Six-Step Framework for curriculum development, we conducted focus groups with surgical residents to perform a targeted needs assessment on 3 main topics: 1) the current state of surgical sustainability curricula; 2) resident knowledge regarding the environmental impact of surgery and barriers to sustainable practice; and 3) preferred educational methods and topics within sustainability education. We audio-recorded all focus groups and performed thematic analysis using anonymized transcripts.
Results
Fourteen residents participated in 3 focus groups, from which a qualitative analysis revealed 4 themes. First, surgery residents receive limited formal teaching on the negative environmental impact of surgical care or how to reduce this impact. Second, surgery residents have variable levels of prior education about and interest in sustainability in surgery. Third, several barriers prevent the implementation of sustainable changes in surgical practice, including a lack of institutional initiative, cultural inertia, concerns about workflow efficiency, and limited formal education. Finally, residents prefer to learn about practical ways to reduce waste, specifically through interactive approaches such as quality improvement initiatives.
Conclusions
Given the increasing importance of sustainability in surgery, there is an urgent need for formal resident education on this topic. This needs assessment provides a valuable foundation for future sustainability curriculum development.
{"title":"Needs Assessment for the Development of a Sustainability Curriculum for Surgical Residents","authors":"","doi":"10.1016/j.jsurg.2024.06.020","DOIUrl":"10.1016/j.jsurg.2024.06.020","url":null,"abstract":"<div><h3>Introduction</h3><p>The healthcare sector accounts for 8.5% of United States (U.S.) greenhouse gas emissions, of which one-third comes from operating rooms (ORs). As a result, there is great interest in decarbonizing the OR and surgical care. However, surgical residents are not routinely educated on the negative environmental impact of surgery or how to reduce it. In this paper, we present a formal needs assessment for a sustainability curriculum geared towards surgical residents.</p></div><div><h3>Methods</h3><p>Using Kern's Six-Step Framework for curriculum development, we conducted focus groups with surgical residents to perform a targeted needs assessment on 3 main topics: 1) the current state of surgical sustainability curricula; 2) resident knowledge regarding the environmental impact of surgery and barriers to sustainable practice; and 3) preferred educational methods and topics within sustainability education. We audio-recorded all focus groups and performed thematic analysis using anonymized transcripts.</p></div><div><h3>Results</h3><p>Fourteen residents participated in 3 focus groups, from which a qualitative analysis revealed 4 themes. First, surgery residents receive limited formal teaching on the negative environmental impact of surgical care or how to reduce this impact. Second, surgery residents have variable levels of prior education about and interest in sustainability in surgery. Third, several barriers prevent the implementation of sustainable changes in surgical practice, including a lack of institutional initiative, cultural inertia, concerns about workflow efficiency, and limited formal education. Finally, residents prefer to learn about practical ways to reduce waste, specifically through interactive approaches such as quality improvement initiatives.</p></div><div><h3>Conclusions</h3><p>Given the increasing importance of sustainability in surgery, there is an urgent need for formal resident education on this topic. This needs assessment provides a valuable foundation for future sustainability curriculum development.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918417","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}
Pub Date : 2024-08-10DOI: 10.1016/j.jsurg.2024.07.003
OBJECTIVE
Many surgical residencies have passed along attendings preferences and procedural knowledge as a highly utilized but informal resource. The objective was to assess the effect of providing operative steps and attending preferences on surgical resident performance.
DESIGN
This was a prospective observational study with a survey-based design.
SETTING
We created and shared vascular surgery operative steps including institutional and attending preferences with junior residents at the Massachusetts General Hospital.
PARTICIPANTS
There were a total of 31 residents who completed a survey to assess self-perception of performance in operative knowledge and Accreditation Council for Graduate Medical Education (ACGME) Milestone criteria.
RESULTS
Advice from colleagues was the most utilized resource, followed by web-based materials. Of the web-based materials, almost all residents utilized Google searches over other web-based resources designed to specifically help surgical trainees. The vascular surgery resource was used by 90% of residents more than 3 times per week to prepare for operative cases. There was significant improvement in patient positioning, instrument selection, operative field exposure, anatomy, sequence of procedure, procedure choices, and peri-operative care knowledge.
CONCLUSIONS
Development of institutional resources that specifically capture attending surgeon procedural variations can improve resident performance, encourage resident autonomy, and provide a catalog of approaches to challenging operative situations.
{"title":"Pilot Study to Improve Resident Experience on Vascular Surgery by Standardizing Dissemination of Operative Steps","authors":"","doi":"10.1016/j.jsurg.2024.07.003","DOIUrl":"10.1016/j.jsurg.2024.07.003","url":null,"abstract":"<div><h3>OBJECTIVE</h3><p>Many surgical residencies have passed along attendings preferences and procedural knowledge as a highly utilized but informal resource. The objective was to assess the effect of providing operative steps and attending preferences on surgical resident performance.</p></div><div><h3>DESIGN</h3><p>This was a prospective observational study with a survey-based design.</p></div><div><h3>SETTING</h3><p>We created and shared vascular surgery operative steps including institutional and attending preferences with junior residents at the Massachusetts General Hospital.</p></div><div><h3>PARTICIPANTS</h3><p>There were a total of 31 residents who completed a survey to assess self-perception of performance in operative knowledge and Accreditation Council for Graduate Medical Education (ACGME) Milestone criteria.</p></div><div><h3>RESULTS</h3><p>Advice from colleagues was the most utilized resource, followed by web-based materials. Of the web-based materials, almost all residents utilized Google searches over other web-based resources designed to specifically help surgical trainees. The vascular surgery resource was used by 90% of residents more than 3 times per week to prepare for operative cases. There was significant improvement in patient positioning, instrument selection, operative field exposure, anatomy, sequence of procedure, procedure choices, and peri-operative care knowledge.</p></div><div><h3>CONCLUSIONS</h3><p>Development of institutional resources that specifically capture attending surgeon procedural variations can improve resident performance, encourage resident autonomy, and provide a catalog of approaches to challenging operative situations.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914960","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}
Pub Date : 2024-08-07DOI: 10.1016/S1931-7204(24)00355-6
{"title":"Table of Contents & Bacode","authors":"","doi":"10.1016/S1931-7204(24)00355-6","DOIUrl":"10.1016/S1931-7204(24)00355-6","url":null,"abstract":"","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1931720424003556/pdfft?md5=63f9e62e45c579303e6e9c1d805b9826&pid=1-s2.0-S1931720424003556-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952017","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}
Pub Date : 2024-08-03DOI: 10.1016/j.jsurg.2024.07.001
Objective
To explore the financial interactions between urology residents and the healthcare industry over a 5-year training period, assessing the implications of these interactions on medical education and practice considering the Physician Payments Sunshine Act.
Design
Longitudinal analysis of Open Payments data for a single class of urology residents from 2018 to 2023.
Setting
Data were extracted from the CMS Open Payments Database and cross-referenced with residency program information from the American Urological Association (AUA) and the Accreditation Council for Graduate Medical Education (ACGME).
Participants
A cohort of 314 urology residents were identified to have matched in 2018, with 173 residents having reported financial interactions through the Open Payments Program (OPP), representing 55% of the cohort.
Results
Analysis revealed that $129,632 was disbursed to the 173 residents throughout their surgical training, with a significant majority (approximately three-quarters or around $100,000) allocated for food and beverage. A statistically significant difference in payment amounts was observed between genders, with male residents receiving an average of $869 compared to $454 for female residents. Payments increased progressively with each postgraduate year (PGY) level, peaking in the fifth year. Despite notable disparities in compensation across AUA sections, no statistically significant variation was found (p = 0.21). The study also highlighted the underestimation of industry influence due to discretionary and heterogeneous reporting practices.
Conclusions
The study underscores a significant, yet potentially underreported, financial interaction between urology residents and the healthcare industry, suggesting a deepening relationship as residents progress through their training. The findings call for a more uniform reporting system to enhance transparency and provide a clearer understanding of the industry's role in medical education and practice. Additionally, many residents may not be aware that their financial interactions are being documented and made public, a factor that could influence their professional behavior and expectations.
{"title":"Exploring Industry Payments to Urology Residents: A Longitudinal Analysis Under the Sunshine Act","authors":"","doi":"10.1016/j.jsurg.2024.07.001","DOIUrl":"10.1016/j.jsurg.2024.07.001","url":null,"abstract":"<div><h3>Objective</h3><p>To explore the financial interactions between urology residents and the healthcare industry over a 5-year training period, assessing the implications of these interactions on medical education and practice considering the Physician Payments Sunshine Act.</p></div><div><h3>Design</h3><p>Longitudinal analysis of Open Payments data for a single class of urology residents from 2018 to 2023.</p></div><div><h3>Setting</h3><p>Data were extracted from the CMS Open Payments Database and cross-referenced with residency program information from the American Urological Association (AUA) and the Accreditation Council for Graduate Medical Education (ACGME).</p></div><div><h3>Participants</h3><p>A cohort of 314 urology residents were identified to have matched in 2018, with 173 residents having reported financial interactions through the Open Payments Program (OPP), representing 55% of the cohort.</p></div><div><h3>Results</h3><p>Analysis revealed that $129,632 was disbursed to the 173 residents throughout their surgical training, with a significant majority (approximately three-quarters or around $100,000) allocated for food and beverage. A statistically significant difference in payment amounts was observed between genders, with male residents receiving an average of $869 compared to $454 for female residents. Payments increased progressively with each postgraduate year (PGY) level, peaking in the fifth year. Despite notable disparities in compensation across AUA sections, no statistically significant variation was found (p = 0.21). The study also highlighted the underestimation of industry influence due to discretionary and heterogeneous reporting practices.</p></div><div><h3>Conclusions</h3><p>The study underscores a significant, yet potentially underreported, financial interaction between urology residents and the healthcare industry, suggesting a deepening relationship as residents progress through their training. The findings call for a more uniform reporting system to enhance transparency and provide a clearer understanding of the industry's role in medical education and practice. Additionally, many residents may not be aware that their financial interactions are being documented and made public, a factor that could influence their professional behavior and expectations.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1931720424003179/pdfft?md5=5be6a936e3872289c736c5a6cfe58fc5&pid=1-s2.0-S1931720424003179-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891441","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}
Pub Date : 2024-07-25DOI: 10.1016/j.jsurg.2024.07.002
Objective
As surgical residents continue in their training, they are expected to not only take part in more complicated procedures, but to also serve as leaders in their respective care teams. While surgical skills are intensively taught in surgical residency programs, leadership is often learned informally, to the detriment of residents. Our curriculum was developed and implemented to provide foundational knowledge for surgical residents as they take on senior roles so that they may successfully act as leaders. This educational workshop was effective and efficient and can be applied at other residency programs that seek to improve the leadership skills of their residents.
Design
Implementation of a 3-day program focused on leadership, surgical skills, and career development to provide rising PGY-4 surgical residents with the abilities necessary for successful training.
Setting
This program was implemented at the University of Minnesota General Surgery residency program.
Participants
Rising PGY-4 general surgery residents.
Results
The program consisted of a 3-day workshop which all rising PGY-4 residents participating in before transitioning into their respective roles. The program was led by the general surgery faculty.
Conclusions
Curricula focused on developing leadership skills in residents can be effectively applied in a time-efficient manner that can benefit the residents as they move into official leadership roles on the care team.
{"title":"Developing Leaders in Surgical Residency: A Curriculum for Success","authors":"","doi":"10.1016/j.jsurg.2024.07.002","DOIUrl":"10.1016/j.jsurg.2024.07.002","url":null,"abstract":"<div><h3>Objective</h3><p>As surgical residents continue in their training, they are expected to not only take part in more complicated procedures, but to also serve as leaders in their respective care teams. While surgical skills are intensively taught in surgical residency programs, leadership is often learned informally, to the detriment of residents. Our curriculum was developed and implemented to provide foundational knowledge for surgical residents as they take on senior roles so that they may successfully act as leaders. This educational workshop was effective and efficient and can be applied at other residency programs that seek to improve the leadership skills of their residents.</p></div><div><h3>Design</h3><p>Implementation of a 3-day program focused on leadership, surgical skills, and career development to provide rising PGY-4 surgical residents with the abilities necessary for successful training.</p></div><div><h3>Setting</h3><p>This program was implemented at the University of Minnesota General Surgery residency program.</p></div><div><h3>Participants</h3><p>Rising PGY-4 general surgery residents.</p></div><div><h3>Results</h3><p>The program consisted of a 3-day workshop which all rising PGY-4 residents participating in before transitioning into their respective roles. The program was led by the general surgery faculty.</p></div><div><h3>Conclusions</h3><p>Curricula focused on developing leadership skills in residents can be effectively applied in a time-efficient manner that can benefit the residents as they move into official leadership roles on the care team.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763634","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}
Pub Date : 2024-07-22DOI: 10.1016/j.jsurg.2024.06.019
OBJECTIVE
To investigate interview and match outcomes of medical students who received pass/fail USMLE reporting vs medical students with numeric scoring during the same period.
DESIGN
Retrospective analysis of a cross-sectional survey-based study.
SETTING
United States 2023 residency match.
PARTICIPANTS
Medical student applicants in the 2023 residency match cycle who responded to the Texas Seeking Transparency in Application to Residency (STAR) survey.
RESULTS
Among 6756 applicants for the 2023 match, 496 (7.3%) took USMLE Step 1 with pass/fail reporting. Pass/fail reporting was associated with lower USMLE Step 2-CK scores (245.9 vs 250.7), fewer honored clerkships (2.4 vs 3.1), and lower Alpha Omega Alpha membership (12.5% vs 25.2%) (all p < 0.001). Applicants with numeric USMLE Step 1 scores received more interview offers after adjusting for academic performance (beta coefficient 1.04 (95% CI 0.28-1.79); p = 0.007). Numeric USMLE Step 1 scoring was associated with more interview offers in nonsurgical specialties (beta coefficient 1.64 [95% CI 0.74-2.53]; p < 0.001), but not in general surgery (beta coefficient 3.01 [95% CI −0.82 to 6.84]; p = 0.123) or surgical subspecialties (beta coefficient 1.92 [95% CI −0.78 to 4.62]; p = 0.163). Numeric USMLE Step 1 scoring was not associated with match outcome.
CONCLUSIONS
Applicants with numeric USMLE Step 1 scoring had stronger academic profiles than those with pass/fail scoring; however, adjusted analyses found only weak associations with interview or match outcomes. Further research is warranted to assess longitudinal outcomes.
目的调查接受美国医学考试合格/不合格报告的医学生与同期接受数字评分的医学生的面试和匹配结果：设计：基于横断面调查的回顾性分析：参与者：参加2023年美国住院医师考试的医学生申请人：结果：在 6756 名 2023 年住院医师考试的申请人中，有 6756 人对住院医师考试的分数进行了公布，其中有 6756 人对住院医师考试的分数进行了公布，其中有 6756 人对住院医师考试的分数进行了公布：在 6756 名参加 2023 年匹配的申请人中，有 496 人（7.3%）参加了 USMLE 第 1 步考试，并提交了及格/不及格报告。通过/未通过报告与较低的 USMLE 第 2 步-CK 分数（245.9 vs 250.7）、较少的荣誉实习（2.4 vs 3.1）和较低的 Alpha Omega Alpha 会员资格（12.5% vs 25.2%）有关（所有 p <0.001）。在调整学业成绩后，USMLE 第 1 步数字分数申请者获得的面试机会更多（β 系数 1.04 (95% CI 0.28-1.79)；p = 0.007）。数值型 USMLE 第 1 步考试成绩与非外科专业（贝塔系数 1.64 [95% CI 0.74-2.53]；p < 0.001）的更多面试机会有关，但与普通外科（贝塔系数 3.01 [95% CI -0.82 至 6.84]；p = 0.123）或外科亚专业（贝塔系数 1.92 [95% CI -0.78 至 4.62]；p = 0.163）无关。USMLE 第 1 步的数字评分与匹配结果无关：结论：USMLE 第 1 步数字评分的申请者比及格/不及格评分的申请者具有更强的学术背景；然而，调整后的分析发现与面试或匹配结果只有微弱的关联。需要进一步研究以评估纵向结果。
{"title":"Association of USMLE Step 1 Pass/Fail Reporting with Interview and Match Outcomes","authors":"","doi":"10.1016/j.jsurg.2024.06.019","DOIUrl":"10.1016/j.jsurg.2024.06.019","url":null,"abstract":"<div><h3>OBJECTIVE</h3><p>To investigate interview and match outcomes of medical students who received pass/fail USMLE reporting vs medical students with numeric scoring during the same period.</p></div><div><h3>DESIGN</h3><p>Retrospective analysis of a cross-sectional survey-based study.</p></div><div><h3>SETTING</h3><p>United States 2023 residency match.</p></div><div><h3>PARTICIPANTS</h3><p>Medical student applicants in the 2023 residency match cycle who responded to the Texas Seeking Transparency in Application to Residency (STAR) survey.</p></div><div><h3>RESULTS</h3><p>Among 6756 applicants for the 2023 match, 496 (7.3%) took USMLE Step 1 with pass/fail reporting. Pass/fail reporting was associated with lower USMLE Step 2-CK scores (245.9 vs 250.7), fewer honored clerkships (2.4 vs 3.1), and lower Alpha Omega Alpha membership (12.5% vs 25.2%) (all p < 0.001). Applicants with numeric USMLE Step 1 scores received more interview offers after adjusting for academic performance (beta coefficient 1.04 (95% CI 0.28-1.79); p = 0.007). Numeric USMLE Step 1 scoring was associated with more interview offers in nonsurgical specialties (beta coefficient 1.64 [95% CI 0.74-2.53]; p < 0.001), but not in general surgery (beta coefficient 3.01 [95% CI −0.82 to 6.84]; p = 0.123) or surgical subspecialties (beta coefficient 1.92 [95% CI −0.78 to 4.62]; p = 0.163). Numeric USMLE Step 1 scoring was not associated with match outcome.</p></div><div><h3>CONCLUSIONS</h3><p>Applicants with numeric USMLE Step 1 scoring had stronger academic profiles than those with pass/fail scoring; however, adjusted analyses found only weak associations with interview or match outcomes. Further research is warranted to assess longitudinal outcomes.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753708","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}
Pub Date : 2024-07-20DOI: 10.1016/j.jsurg.2024.06.010
OBJECTIVES
Using Texas STAR (seeking transparency in application to residency), we aimed to 1) examine predictors of matching success in integrated plastic surgery residency programs and 2) assess the reliability of the tool.
DESIGN, SETTING, AND PARTICIPANTS
A retrospective analysis of self-reported nationwide data of plastic surgery residency applicants between 2021 and 2023 across 146 participating medical schools were included. A comparison analysis was performed between matched and unmatched applicants using chi-squared tests, t-tests, and logistic regression models. NRMP data and literature were referenced to determine reliability.
RESULTS
Of the 209 plastic surgery resident applications, 147 matched (70.3%) and 62 went unmatched (29.7%). Average United States Medical Licensing Examination (USMLE) Step 1 and 2 scores were 248 and 257, respectively. Between matched and unmatched cohorts, no significant differences were observed in Alpha Omega Alpha (AOA) status, Gold Humanism Honor Society (GHHS) status, mean number of research experiences/presentations, volunteer experiences, leadership positions, and programs applied. Significant predictors of matching included taking a research year (OR 2.07, CI 0.99-4.34, p= 0.052), 8+ peer-reviewed publications (OR 2.29, CI 1.22-4.30, p = 0.009), geographic connection (p = 0.02), and 13+ interviews attended (OR 2.94, CI 1.56 -5.51, p < 0.001). These findings are consistent with current literature and the NRMP. Upon analysis of the qualitative free text responses on general recommendations for prospective applicants by users, subinternships, connections, interviews, research, letter of recommendation quality, home advantage, and mentorship were prominent themes of advice provided by both matched and unmatched cohorts.
CONCLUSIONS
Texas STAR is a resourceful and reliable tool. We conclude that a research year and geographic connections are strong predictors of matching in plastic surgery. However, more factors (e.g., applicants’ home medical school, number of sub internships, and number of mentors) should be considered to make a well-informed decision on determining their own competitiveness, away rotations and residency programs.
{"title":"Unveiling the Need to Improve Personalized Applicant Tools: A Critical Evaluation of the Reliability of the Texas STAR database in Predicting Match Success for Plastic Surgery Applicants","authors":"","doi":"10.1016/j.jsurg.2024.06.010","DOIUrl":"10.1016/j.jsurg.2024.06.010","url":null,"abstract":"<div><h3>OBJECTIVES</h3><p>Using Texas STAR (seeking transparency in application to residency), we aimed to 1) examine predictors of matching success in integrated plastic surgery residency programs and 2) assess the reliability of the tool.</p></div><div><h3>DESIGN, SETTING, AND PARTICIPANTS</h3><p>A retrospective analysis of self-reported nationwide data of plastic surgery residency applicants between 2021 and 2023 across 146 participating medical schools were included. A comparison analysis was performed between matched and unmatched applicants using chi-squared tests, t-tests, and logistic regression models. NRMP data and literature were referenced to determine reliability.</p></div><div><h3>RESULTS</h3><p>Of the 209 plastic surgery resident applications, 147 matched (70.3%) and 62 went unmatched (29.7%). Average United States Medical Licensing Examination (USMLE) Step 1 and 2 scores were 248 and 257, respectively. Between matched and unmatched cohorts, no significant differences were observed in Alpha Omega Alpha (AOA) status, Gold Humanism Honor Society (GHHS) status, mean number of research experiences/presentations, volunteer experiences, leadership positions, and programs applied. Significant predictors of matching included taking a research year (OR 2.07, CI 0.99-4.34, p= 0.052), 8+ peer-reviewed publications (OR 2.29, CI 1.22-4.30, p = 0.009), geographic connection (p = 0.02), and 13+ interviews attended (OR 2.94, CI 1.56 -5.51, p < 0.001). These findings are consistent with current literature and the NRMP. Upon analysis of the qualitative free text responses on general recommendations for prospective applicants by users, subinternships, connections, interviews, research, letter of recommendation quality, home advantage, and mentorship were prominent themes of advice provided by both matched and unmatched cohorts.</p></div><div><h3>CONCLUSIONS</h3><p>Texas STAR is a resourceful and reliable tool. We conclude that a research year and geographic connections are strong predictors of matching in plastic surgery. However, more factors (e.g., applicants’ home medical school, number of sub internships, and number of mentors) should be considered to make a well-informed decision on determining their own competitiveness, away rotations and residency programs.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736200","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}
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