Pub Date : 2025-11-28DOI: 10.1016/j.jsurg.2025.103796
Renata P. Skov MD , Alec Sikarin MD , Jessie Nickolas BS , Erika M. Robertson MD , George G.A. Pujalte MD
Objective
To review the existing literature examining whether playing musical instruments influences surgical aptitude, considering shared motor and cognitive demands in both activities.
Design
Narrative review of published studies evaluating the association between musical experience and surgical performance.
Setting
PubMed was searched for English-language studies from its inception to February 2025. Abstracts and reviews were excluded; eligible studies included assessments of surgical skills across specialties.
Participants
We analyzed 23 studies published from January 2005 to November 2024 involving 1641 individuals. Of these, 1203 were medical students and interns and 438 were residents, fellows, and attending physicians.
Results
Eleven studies (47.8%) found a statistically significant positive association between playing musical instruments and surgical aptitude. One study showed a positive but nonsignificant association and 11 (47.8%) reported no association. Fifteen studies (65.2%) used laparoscopic simulators, while others assessed robotic systems or suturing tasks. Advantages linked to musical training included improved dexterity, precision, and task efficiency. However, results were inconsistent across studies, partly due to heterogeneous definitions of musical experience, variable assessment tools, reliance on self-reported histories, and predominance of simulation-based evaluations.
Conclusions
Evidence on the impact of musical experience on surgical performance remains inconclusive. While nearly half of reviewed studies suggest potential benefits, methodologic limitations restrict generalizability to real surgical settings. Musical training may contribute to the development of fine motor and visuospatial skills relevant to surgery, but it should not be considered a stand-alone predictor of aptitude. Future research using standardized definitions, objective assessments, and randomized controlled designs is needed to clarify whether musical experience meaningfully enhances surgical proficiency.
{"title":"Musical Talent and Surgical Skills: Does Playing an Instrument Help With Surgical Ability?","authors":"Renata P. Skov MD , Alec Sikarin MD , Jessie Nickolas BS , Erika M. Robertson MD , George G.A. Pujalte MD","doi":"10.1016/j.jsurg.2025.103796","DOIUrl":"10.1016/j.jsurg.2025.103796","url":null,"abstract":"<div><h3>Objective</h3><div>To review the existing literature examining whether playing musical instruments influences surgical aptitude, considering shared motor and cognitive demands in both activities.</div></div><div><h3>Design</h3><div>Narrative review of published studies evaluating the association between musical experience and surgical performance.</div></div><div><h3>Setting</h3><div>PubMed was searched for English-language studies from its inception to February 2025. Abstracts and reviews were excluded; eligible studies included assessments of surgical skills across specialties.</div></div><div><h3>Participants</h3><div>We analyzed 23 studies published from January 2005 to November 2024 involving 1641 individuals. Of these, 1203 were medical students and interns and 438 were residents, fellows, and attending physicians.</div></div><div><h3>Results</h3><div>Eleven studies (47.8%) found a statistically significant positive association between playing musical instruments and surgical aptitude. One study showed a positive but nonsignificant association and 11 (47.8%) reported no association. Fifteen studies (65.2%) used laparoscopic simulators, while others assessed robotic systems or suturing tasks. Advantages linked to musical training included improved dexterity, precision, and task efficiency. However, results were inconsistent across studies, partly due to heterogeneous definitions of musical experience, variable assessment tools, reliance on self-reported histories, and predominance of simulation-based evaluations.</div></div><div><h3>Conclusions</h3><div>Evidence on the impact of musical experience on surgical performance remains inconclusive. While nearly half of reviewed studies suggest potential benefits, methodologic limitations restrict generalizability to real surgical settings. Musical training may contribute to the development of fine motor and visuospatial skills relevant to surgery, but it should not be considered a stand-alone predictor of aptitude. Future research using standardized definitions, objective assessments, and randomized controlled designs is needed to clarify whether musical experience meaningfully enhances surgical proficiency.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103796"},"PeriodicalIF":2.1,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618274","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}
Virtual reality (VR) simulation is increasingly used in trauma training as it offers an immersive, cost-effective alternative to traditional simulation; however, its impact may differ between low- and high-resource settings due to resource and training disparities. This study aims to assess the technology acceptance, effectiveness, usability, acceptability and confidence gains of a VR-based pediatric trauma training module in India and Canada, correlating demographics and prior experience to learning outcomes and cybersickness.
Design
A prospective quasi-experimental study was done. Participants completed assessments using the Technology Acceptance Model (assessing perceived usefulness, ease of use, and intention to adopt VR), System Usability Scale, VR Sickness Questionnaire, and a confidence survey.
Setting
Participants attended a virtual reality trauma training course. These courses were held at McGill University’s Steinberg Center for Simulation and Interactive Learning, Canada in May and August 2024 and at the Christian Medical College Ludhiana, India in December 2024.
Participants
Sixty participants aged 25-35 years old (paramedics, medical officers, nurses, emergency technicians, and medical students) participated in a VR-based pediatric trauma training simulation module in India (n = 27) and Canada (n = 33).
Results
67% of participants had no VR experience and 48% had no previous trauma training. No significant interactions were seen by gender, age, or prior VR use. Novices without trauma training reported higher TAM scores in all categories. The SUS and VRSQ scores did not differ by prior trauma training. Confidence gains before and after simulation were significantly lower in the group with prior trauma training (p < 0.001). While previous VR experience was similar in both Canada and India (33%), formal simulation training was reported by 85% of Canadians, but only by 11.1% of Indians (p ≤ 0.0001). The mean perceived usefulness of the module was also much higher for Indians than for Canadians (82% vs. 65.6%, respectively; p ≤ 0.0011), while the mean ease of use scores were 57.8% and 70.4% (p ≤ 0.0201), respectively. Confidence in trauma management increased by 14.4% in Canada and by 30.6% in India (p ≤ 0.0001). The higher rate of usefulness, ease-of-use, and confidence increase in India suggest VR had a greater impact in that setting.
Conclusion
VR is a feasible and accepted tool for pediatric trauma training, with the greatest benefit seen in resource-limited settings and among novices. Minimal cybersickness supports its use as an adjunct to standard methods. VR may help address gaps in trauma education, especially where prior simulation experience is limited.
{"title":"Comparing Virtual Reality Trauma Training Across Diverse Clinical Backgrounds: A Mixed-Methods Study in Canada And India","authors":"Boaz Laor BS , Samia Benabess BS , Shreenik Kundu MBBS, MSc , Ayla Gerk MD , Fabio Botelho MD, PhD , Jean-Robert Kwizera BS , Arjunaditya Kundu , Tom Dolby , Elena Guadagno MLIS , Dhruva Ghosh MD , Vishal Micheal MD , Rohit Theodore MD , Thejus Varghese MD , Dan Poenaru MD, PhD","doi":"10.1016/j.jsurg.2025.103794","DOIUrl":"10.1016/j.jsurg.2025.103794","url":null,"abstract":"<div><h3>Objective</h3><div>Virtual reality (VR) simulation is increasingly used in trauma training as it offers an immersive, cost-effective alternative to traditional simulation; however, its impact may differ between low- and high-resource settings due to resource and training disparities. This study aims to assess the technology acceptance, effectiveness, usability, acceptability and confidence gains of a VR-based pediatric trauma training module in India and Canada, correlating demographics and prior experience to learning outcomes and cybersickness.</div></div><div><h3>Design</h3><div>A prospective quasi-experimental study was done. Participants completed assessments using the Technology Acceptance Model (assessing perceived usefulness, ease of use, and intention to adopt VR), System Usability Scale, VR Sickness Questionnaire, and a confidence survey.</div></div><div><h3>Setting</h3><div>Participants attended a virtual reality trauma training course. These courses were held at McGill University’s Steinberg Center for Simulation and Interactive Learning, Canada in May and August 2024 and at the Christian Medical College Ludhiana, India in December 2024.</div></div><div><h3>Participants</h3><div>Sixty participants aged 25-35 years old (paramedics, medical officers, nurses, emergency technicians, and medical students) participated in a VR-based pediatric trauma training simulation module in India (n = 27) and Canada (n = 33).</div></div><div><h3>Results</h3><div>67% of participants had no VR experience and 48% had no previous trauma training. No significant interactions were seen by gender, age, or prior VR use. Novices without trauma training reported higher TAM scores in all categories. The SUS and VRSQ scores did not differ by prior trauma training. Confidence gains before and after simulation were significantly lower in the group with prior trauma training (p < 0.001). While previous VR experience was similar in both Canada and India (33%), formal simulation training was reported by 85% of Canadians, but only by 11.1% of Indians (p ≤ 0.0001). The mean perceived usefulness of the module was also much higher for Indians than for Canadians (82% vs. 65.6%, respectively; p ≤ 0.0011), while the mean ease of use scores were 57.8% and 70.4% (p ≤ 0.0201), respectively. Confidence in trauma management increased by 14.4% in Canada and by 30.6% in India (p ≤ 0.0001). The higher rate of usefulness, ease-of-use, and confidence increase in India suggest VR had a greater impact in that setting.</div></div><div><h3>Conclusion</h3><div>VR is a feasible and accepted tool for pediatric trauma training, with the greatest benefit seen in resource-limited settings and among novices. Minimal cybersickness supports its use as an adjunct to standard methods. VR may help address gaps in trauma education, especially where prior simulation experience is limited.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103794"},"PeriodicalIF":2.1,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598502","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 : 2025-11-20DOI: 10.1016/j.jsurg.2025.103793
Alyssa Zhou BS , Kelsey Ogomori MD , Alexis Colley MD, MS , Julie Ann Sosa MD, MA , Madhulika G. Varma MD , Lucy Z. Kornblith MD , Ava Yap MD , Karen Trang MD , Lan Vu MD, MAS
Objective
We sought to explore key obstacles faced by surgical trainees navigating pregnancy and early parenthood, identify opportunities for improved programmatic support, and assess the effectiveness of our institution’s Parenting in Surgery initiative in addressing these challenges.
Design
In this sequential exploratory mixed methods study, we conducted semi-structured interviews with surgical trainees and junior faculty who were parents or expectant parents. The “Parenting in Surgery” initiative was developed to address concerns identified by interviewees. A postimplementation survey assessing perceptions of parenting during training was sent to all surgical residents 17 months after initiative launch.
Setting
This study was conducted at a large, urban academic medical center.
Participants
Thirteen trainees and junior faculty participated in semi-structured interviews. Seventeen trainees completed the postimplementation survey.
Results
Interviewees identified 5 themes: (1) Fear of appearing weak results in reticence to ask for help; (2) Physical demands of pregnancy vary for individuals; (3) Challenges during the postpartum period are often overlooked; (4) Emotional challenges are unspoken and isolating; and (5) Financial and logistical obstacles create an additional layer of stress. In the postimplementation survey, participants were most concerned about having a healthy pregnancy and child, managing the workload of residency, and the financial strain of family planning and parenting. While 71% felt comfortable confiding in co-residents or faculty, only 35% thought the program’s infrastructure provides support. Knowledge of existing resources was mixed, with 60% and 24% of respondents reporting knowing where to access family leave and family planning information, respectively. 40% of respondents were aware of childcare resources.
Conclusions
This study highlights persistent gaps in institutional support for surgical trainees becoming parents. The Parenting in Surgery initiative provides structured protocols and resources, however additional efforts are needed to effectively increase awareness. Ongoing evaluation is critical for ensuring these initiatives adequately support trainees and foster long-term satisfaction.
{"title":"Parenting in Surgery: A Structured Initiative to Support Surgeons Navigating Pregnancy and Early Parenthood During Training","authors":"Alyssa Zhou BS , Kelsey Ogomori MD , Alexis Colley MD, MS , Julie Ann Sosa MD, MA , Madhulika G. Varma MD , Lucy Z. Kornblith MD , Ava Yap MD , Karen Trang MD , Lan Vu MD, MAS","doi":"10.1016/j.jsurg.2025.103793","DOIUrl":"10.1016/j.jsurg.2025.103793","url":null,"abstract":"<div><h3>Objective</h3><div>We sought to explore key obstacles faced by surgical trainees navigating pregnancy and early parenthood, identify opportunities for improved programmatic support, and assess the effectiveness of our institution’s Parenting in Surgery initiative in addressing these challenges.</div></div><div><h3>Design</h3><div>In this sequential exploratory mixed methods study, we conducted semi-structured interviews with surgical trainees and junior faculty who were parents or expectant parents. The “Parenting in Surgery” initiative was developed to address concerns identified by interviewees. A postimplementation survey assessing perceptions of parenting during training was sent to all surgical residents 17 months after initiative launch.</div></div><div><h3>Setting</h3><div>This study was conducted at a large, urban academic medical center.</div></div><div><h3>Participants</h3><div>Thirteen trainees and junior faculty participated in semi-structured interviews. Seventeen trainees completed the postimplementation survey.</div></div><div><h3>Results</h3><div>Interviewees identified 5 themes: (1) Fear of appearing weak results in reticence to ask for help; (2) Physical demands of pregnancy vary for individuals; (3) Challenges during the postpartum period are often overlooked; (4) Emotional challenges are unspoken and isolating; and (5) Financial and logistical obstacles create an additional layer of stress. In the postimplementation survey, participants were most concerned about having a healthy pregnancy and child, managing the workload of residency, and the financial strain of family planning and parenting. While 71% felt comfortable confiding in co-residents or faculty, only 35% thought the program’s infrastructure provides support. Knowledge of existing resources was mixed, with 60% and 24% of respondents reporting knowing where to access family leave and family planning information, respectively. 40% of respondents were aware of childcare resources.</div></div><div><h3>Conclusions</h3><div>This study highlights persistent gaps in institutional support for surgical trainees becoming parents. The Parenting in Surgery initiative provides structured protocols and resources, however additional efforts are needed to effectively increase awareness. Ongoing evaluation is critical for ensuring these initiatives adequately support trainees and foster long-term satisfaction.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103793"},"PeriodicalIF":2.1,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571768","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 : 2025-11-20DOI: 10.1016/j.jsurg.2025.103792
Ethan Angle BS , Linda Peng BA , Jasmine Peterson MD , Brian Longbottom MD , Adrienne Davis MD , Hassan Aziz MD, FACS
Objective
There remains a lack of multi-center nationwide data that examine residents’ self-reported level of comfort with obtaining informed consent. Our study sought to acquire these data and discover relationships affecting the subjective experiences of general surgery residents during consent acquisition so that general surgery residency programs can better understand their trainees’ needs.
Design
We internally developed a 22-item survey assessing the demographics of general surgery residents who commonly obtain consent, the amount of formal informed consent training provided in residency, and residents’ comfort level with the consent process.
Setting
The study originated from the University of Iowa Health Care Department of Surgery. Our survey was distributed nationally via mass electronic-mailing to recruit participants.
Participants
The survey was iteratively sent to 323 ACGME-accredited general surgery residency programs across the United States via program leadership. Eight weeks were allowed for response accumulation from May to June 2025. There were 140 total survey responses (1.4% response rate) with a likely unrepresentative national sample.
Results
Across all respondent training levels, first-year residents (interns) were identified as the most frequent consenters. Only 14.3% of interns felt “very comfortable” obtaining surgical consent. Although most senior residents reported receiving consent training during their PGY1 year, 73.3% of interns reported not receiving any formal instruction during residency. Interns made up 60% of respondents who reported being “very dissatisfied” with their formal consent training. Furthermore, 64.3% of interns were either very dissatisfied (21.4%) or slightly dissatisfied (42.9%) with consent training. Nearly half of interns reported “usually” obtaining consent for procedures they felt would be more appropriate for senior residents, and 57.1% reported acquiring consent for unfamiliar procedures “about half the time.”
Conclusions
These findings suggest a possible disconnect between expectations and preparation among surgical trainees who are expected to obtain informed consent. This self-reported lack of preparation may represent a lapse in patient safety standards and supports our continued research into the necessity of developing a standardized informed consent curriculum for all general surgery residents with a revamped participant recruitment strategy.
{"title":"Piloting a Nationwide Survey of General Surgery Residents Investigating Their Experience with Obtaining Procedural Consent","authors":"Ethan Angle BS , Linda Peng BA , Jasmine Peterson MD , Brian Longbottom MD , Adrienne Davis MD , Hassan Aziz MD, FACS","doi":"10.1016/j.jsurg.2025.103792","DOIUrl":"10.1016/j.jsurg.2025.103792","url":null,"abstract":"<div><h3>Objective</h3><div>There remains a lack of multi-center nationwide data that examine residents’ self-reported level of comfort with obtaining informed consent. Our study sought to acquire these data and discover relationships affecting the subjective experiences of general surgery residents during consent acquisition so that general surgery residency programs can better understand their trainees’ needs.</div></div><div><h3>Design</h3><div>We internally developed a 22-item survey assessing the demographics of general surgery residents who commonly obtain consent, the amount of formal informed consent training provided in residency, and residents’ comfort level with the consent process.</div></div><div><h3>Setting</h3><div>The study originated from the University of Iowa Health Care Department of Surgery. Our survey was distributed nationally via mass electronic-mailing to recruit participants.</div></div><div><h3>Participants</h3><div>The survey was iteratively sent to 323 ACGME-accredited general surgery residency programs across the United States via program leadership. Eight weeks were allowed for response accumulation from May to June 2025. There were 140 total survey responses (1.4% response rate) with a likely unrepresentative national sample.</div></div><div><h3>Results</h3><div>Across all respondent training levels, first-year residents (interns) were identified as the most frequent consenters. Only 14.3% of interns felt “very comfortable” obtaining surgical consent. Although most senior residents reported receiving consent training during their PGY1 year, 73.3% of interns reported not receiving any formal instruction during residency. Interns made up 60% of respondents who reported being “very dissatisfied” with their formal consent training. Furthermore, 64.3% of interns were either very dissatisfied (21.4%) or slightly dissatisfied (42.9%) with consent training. Nearly half of interns reported “usually” obtaining consent for procedures they felt would be more appropriate for senior residents, and 57.1% reported acquiring consent for unfamiliar procedures “about half the time.”</div></div><div><h3>Conclusions</h3><div>These findings suggest a possible disconnect between expectations and preparation among surgical trainees who are expected to obtain informed consent. This self-reported lack of preparation may represent a lapse in patient safety standards and supports our continued research into the necessity of developing a standardized informed consent curriculum for all general surgery residents with a revamped participant recruitment strategy.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103792"},"PeriodicalIF":2.1,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571826","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 : 2025-11-19DOI: 10.1016/j.jsurg.2025.103727
Rebecca Tang MD , Michael Kochis MD, EdM , Dandan Chen PhD , Rachael Acker MD , Julia Kasmirski MD , Jonathan Greer MD , Brenessa Lindeman MD, MEHP , Abbey Fingeret MD, MHPTT , Roy Phitayakorn MD, MHPE
Objectives
Surgeons with smaller hand size experience ergonomic mismatch related to instrument design. We aim to describe the impact of these ergonomic disadvantages on the educational experiences of surgical trainees and identify strategies for mitigating such challenges.
Design
A survey queried demographics, hand size, and perceived impact of hand size on completing operative tasks. Results were summarized with descriptive statistics, and perceived impact of hand size compared between residents with and without small hand size (SHS, defined as glove ≤6.5) via t-test. A subset of respondents including trainees with SHS and their educators completed semi-structured interviews further investigating their perspectives. Interview transcripts were analyzed using an inductive thematic approach.
Setting
Three large academic medical centers.
Participants
One hundred residents (51.0% response rate) and 123 attendings (49.6%) completed the survey. Eleven residents and 8 attendings were interviewed.
Results
Residents with SHS noticed an impact of hand size on completing operative tasks 50.0% of the time, compared to 15.5% in residents without SHS (p < 0.001). Main themes surrounding the challenges facing surgical trainees with SHS included: (1) Technical challenges related to instrument handling, (2) Slower skill acquisition particularly in early years of training, (3) Negative psychological consequences for trainees including self-doubt and fear of judgment, (4) Negative impact on resident evaluations and operative autonomy, (5) Inadequate support from educators, and (6) Overcoming challenges through technical workarounds, deliberate practice, self-advocacy, and role-modeling.
Conclusions
Surgical trainees with SHS face challenges that significantly impact their learning environment. Developing and practicing technical workarounds, self-advocating, and identifying role models allows trainees with SHS to overcome these challenges and become excellent surgeons. This study highlights the ongoing need for faculty development to increase awareness of this issue and improved instrument design for this growing sector of the surgical workforce.
{"title":"Challenges Experienced by Surgical Trainees With Small Hand Size: A Multi-Institutional Mixed Methods Study","authors":"Rebecca Tang MD , Michael Kochis MD, EdM , Dandan Chen PhD , Rachael Acker MD , Julia Kasmirski MD , Jonathan Greer MD , Brenessa Lindeman MD, MEHP , Abbey Fingeret MD, MHPTT , Roy Phitayakorn MD, MHPE","doi":"10.1016/j.jsurg.2025.103727","DOIUrl":"10.1016/j.jsurg.2025.103727","url":null,"abstract":"<div><h3>Objectives</h3><div>Surgeons with smaller hand size experience ergonomic mismatch related to instrument design. We aim to describe the impact of these ergonomic disadvantages on the educational experiences of surgical trainees and identify strategies for mitigating such challenges.</div></div><div><h3>Design</h3><div>A survey queried demographics, hand size, and perceived impact of hand size on completing operative tasks. Results were summarized with descriptive statistics, and perceived impact of hand size compared between residents with and without small hand size (SHS, defined as glove ≤6.5) via t-test. A subset of respondents including trainees with SHS and their educators completed semi-structured interviews further investigating their perspectives. Interview transcripts were analyzed using an inductive thematic approach.</div></div><div><h3>Setting</h3><div>Three large academic medical centers.</div></div><div><h3>Participants</h3><div>One hundred residents (51.0% response rate) and 123 attendings (49.6%) completed the survey. Eleven residents and 8 attendings were interviewed.</div></div><div><h3>Results</h3><div>Residents with SHS noticed an impact of hand size on completing operative tasks 50.0% of the time, compared to 15.5% in residents without SHS (p < 0.001). Main themes surrounding the challenges facing surgical trainees with SHS included: (1) Technical challenges related to instrument handling, (2) Slower skill acquisition particularly in early years of training, (3) Negative psychological consequences for trainees including self-doubt and fear of judgment, (4) Negative impact on resident evaluations and operative autonomy, (5) Inadequate support from educators, and (6) Overcoming challenges through technical workarounds, deliberate practice, self-advocacy, and role-modeling.</div></div><div><h3>Conclusions</h3><div>Surgical trainees with SHS face challenges that significantly impact their learning environment. Developing and practicing technical workarounds, self-advocating, and identifying role models allows trainees with SHS to overcome these challenges and become excellent surgeons. This study highlights the ongoing need for faculty development to increase awareness of this issue and improved instrument design for this growing sector of the surgical workforce.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103727"},"PeriodicalIF":2.1,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558675","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 : 2025-11-19DOI: 10.1016/j.jsurg.2025.103774
Sophie Dream MD, MPH, FACS , Patrica Martinez Quinones MD, PhD , Helen M. Johnson MD , Chantal Reyna MD FACS , Lisa K. Cannada MD, FAAOS, FAOA, FACS , Maria S. Altieri MD, MS, FACS , Mecker G. Möller MD, FACS, MAMSE , Association of Women Surgeons Publication Committee
Since its foundation in 1937, the American Board of Surgery (ABS) has provided board certification for surgeons who have met rigorous standards of education, training, and professional requirements in general surgery. The ABS regulates the administration of standardized testing for general surgeons, which includes the two board certification exams - the General Surgery Qualifying Examination (QE) and the General Surgery Certifying Examination (CE) - the ABS In-Training Examination (ABSITE), and the Continuous Certification Assessment (CCA). These exams are offered annually on very select dates, and no formal policy exists for exceptions. As trainees and early-career surgeons may experience various life events during these fixed times, we call on the ABS to consider additional flexibility in written exam scheduling, including the ABSITE and QE, to mitigate the potential negative effects of major life events on an individual’s surgical career.
{"title":"Adapting to Change: Proposed Next Steps for an Evolving and More Inclusive American Board of Surgery Examination Paradigm","authors":"Sophie Dream MD, MPH, FACS , Patrica Martinez Quinones MD, PhD , Helen M. Johnson MD , Chantal Reyna MD FACS , Lisa K. Cannada MD, FAAOS, FAOA, FACS , Maria S. Altieri MD, MS, FACS , Mecker G. Möller MD, FACS, MAMSE , Association of Women Surgeons Publication Committee","doi":"10.1016/j.jsurg.2025.103774","DOIUrl":"10.1016/j.jsurg.2025.103774","url":null,"abstract":"<div><div>Since its foundation in 1937, the American Board of Surgery (ABS) has provided board certification for surgeons who have met rigorous standards of education, training, and professional requirements in general surgery. The ABS regulates the administration of standardized testing for general surgeons, which includes the two board certification exams - the General Surgery Qualifying Examination (QE) and the General Surgery Certifying Examination (CE) - the ABS In-Training Examination (ABSITE), and the Continuous Certification Assessment (CCA). These exams are offered annually on very select dates, and no formal policy exists for exceptions. As trainees and early-career surgeons may experience various life events during these fixed times, we call on the ABS to consider additional flexibility in written exam scheduling, including the ABSITE and QE, to mitigate the potential negative effects of major life events on an individual’s surgical career.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103774"},"PeriodicalIF":2.1,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566851","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 : 2025-11-18DOI: 10.1016/j.jsurg.2025.103775
Jenny A Foster BS , Elaine Lin BS , Joey Liang BS , Brett T Phillips MD, MBA
Objective
Integrated plastic surgery residency programs are among the most competitive to match into, characterized by a low match rate and substantial financial burdens on applicants. This study aims to analyze the costs associated with the application process for plastic surgery residency from 2021 to 2024.
Design
Data were collected from the Texas Seeking Transparency in Application to Residency (STAR) database. Costs for application fees, interview expenses, and away rotations were assessed. Kruskal-Wallis test and Welch’s t-test, were employed to compare costs across years, with a focus on matched versus unmatched applicants.
Setting
Texas STAR database, a national, multi-institutional database.
Participants
Graduating medical students from 2021 to 2024.
Results
Median interview costs increased from $250 in 2021 to 2023 to $2000 in 2024 (p < 0.001). Median away rotation costs increased over time (p < 0.001), from $750 in 2021 to $5,250 in 2024. Median application fee costs decreased from $1,750 (2021-2023) to $750 in 2024 (p < 0.001). Median total cost increased across years (p < 0.001), increasing from $2250 in 2021 to $10,000 in 2024. The number of applications submitted did not differ by match status. Among students who reported at least one away rotation, there were no significant differences in the number of away rotations between matched and unmatched applicants across all years. Matched applicants spent more on average than unmatched applicants in 2022 (p = 0.018) and 2024 (p = 0.023), with matched applicants spending $10,561.34 compared to $6,790.34 for unmatched applicants in 2024.
Conclusions
Although the Plastic Surgery Common Application reduced application fees in 2024, overall financial burdens remain high due to away rotations and interviews. Potential cost reduction strategies for applicants may include only completing the median number of away rotations. Plastic surgery programs should continue to consider subsidization for interviewed applicants to promote an equitable application process.
{"title":"Matching Into Integrated Plastic Surgery Residency: What’s The Price?","authors":"Jenny A Foster BS , Elaine Lin BS , Joey Liang BS , Brett T Phillips MD, MBA","doi":"10.1016/j.jsurg.2025.103775","DOIUrl":"10.1016/j.jsurg.2025.103775","url":null,"abstract":"<div><h3>Objective</h3><div>Integrated plastic surgery residency programs are among the most competitive to match into, characterized by a low match rate and substantial financial burdens on applicants. This study aims to analyze the costs associated with the application process for plastic surgery residency from 2021 to 2024.</div></div><div><h3>Design</h3><div>Data were collected from the Texas Seeking Transparency in Application to Residency (STAR) database. Costs for application fees, interview expenses, and away rotations were assessed. Kruskal-Wallis test and Welch’s t-test, were employed to compare costs across years, with a focus on matched versus unmatched applicants.</div></div><div><h3>Setting</h3><div>Texas STAR database, a national, multi-institutional database.</div></div><div><h3>Participants</h3><div>Graduating medical students from 2021 to 2024.</div></div><div><h3>Results</h3><div>Median interview costs increased from $250 in 2021 to 2023 to $2000 in 2024 (<em>p</em> < 0.001). Median away rotation costs increased over time (<em>p</em> < 0.001), from $750 in 2021 to $5,250 in 2024. Median application fee costs decreased from $1,750 (2021-2023) to $750 in 2024 (<em>p</em> < 0.001). Median total cost increased across years (<em>p</em> < 0.001), increasing from $2250 in 2021 to $10,000 in 2024. The number of applications submitted did not differ by match status. Among students who reported at least one away rotation, there were no significant differences in the number of away rotations between matched and unmatched applicants across all years. Matched applicants spent more on average than unmatched applicants in 2022 (<em>p</em> = 0.018) and 2024 (<em>p</em> = 0.023), with matched applicants spending $10,561.34 compared to $6,790.34 for unmatched applicants in 2024.</div></div><div><h3>Conclusions</h3><div>Although the Plastic Surgery Common Application reduced application fees in 2024, overall financial burdens remain high due to away rotations and interviews. Potential cost reduction strategies for applicants may include only completing the median number of away rotations. Plastic surgery programs should continue to consider subsidization for interviewed applicants to promote an equitable application process.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103775"},"PeriodicalIF":2.1,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558728","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 : 2025-11-18DOI: 10.1016/j.jsurg.2025.103779
Nuno Silva Gonçalves MD , Carlos Collares MD, PhD , José Miguel Pêgo MD, PhD
Background
Even though suture skills are recognized as important for medical graduates, they are often underdeveloped due to reduced surgical exposure, limited feedback opportunities, and constraints on teaching resources. While various feedback strategies exist to support skill acquisition, comparative evidence on their effectiveness from the learner's perspective is limited.
Objective
To assess the impact of 3 feedback modalities: video review alone, video review with structured self-assessment, and video review with expert feedback, on the acquisition of basic suture skills among medical students, using both quantitative and qualitative methods.
Methods
Sixty-eight students were randomly assigned to 3 feedback groups (A: video only, B: video + structured self-assessment, and C: video + expert feedback). Each performed a basic suture task (Part A), received group-specific feedback, and repeated the task (Part B). Performances were video-recorded and rated by blinded assessors using a 15-item checklist and a global score. Additionally, thirteen participants from group C completed semi-structured interviews on their feedback experience.
Results
The mean global score rose from 3.24 to 3.52 in Group A, 3.46 to 3.63 in Group B, and 3.51 to 3.76 in Group C. ANOVA showed no significant differences between groups (F(2,65) = 0.669, p = 0.516, ηp² = 0.020). Qualitative findings indicated that expert feedback, particularly when combined with video review, significantly enhanced motivation, confidence, and clarity. Group C participants described shifting from “fear of performing sutures” to “confidence,” attributing this to the personalized, emotionally supportive feedback.
Conclusion
Although performance outcomes were similar across feedback types, expert feedback offered unique emotional and cognitive benefits. These findings support the integration of structured, learner-centered feedback in surgical training, combining scalability with pedagogical value.
{"title":"Assessing the Impact of Different Feedback Mechanisms on Suture Skills Acquisition: A Mixed Methods Study Using Phenomenological and Quantitative Analysis","authors":"Nuno Silva Gonçalves MD , Carlos Collares MD, PhD , José Miguel Pêgo MD, PhD","doi":"10.1016/j.jsurg.2025.103779","DOIUrl":"10.1016/j.jsurg.2025.103779","url":null,"abstract":"<div><h3>Background</h3><div>Even though suture skills are recognized as important for medical graduates, they are often underdeveloped due to reduced surgical exposure, limited feedback opportunities, and constraints on teaching resources. While various feedback strategies exist to support skill acquisition, comparative evidence on their effectiveness from the learner's perspective is limited.</div></div><div><h3>Objective</h3><div>To assess the impact of 3 feedback modalities: video review alone, video review with structured self-assessment, and video review with expert feedback, on the acquisition of basic suture skills among medical students, using both quantitative and qualitative methods.</div></div><div><h3>Methods</h3><div>Sixty-eight students were randomly assigned to 3 feedback groups (A: video only, B: video + structured self-assessment, and C: video + expert feedback). Each performed a basic suture task (Part A), received group-specific feedback, and repeated the task (Part B). Performances were video-recorded and rated by blinded assessors using a 15-item checklist and a global score. Additionally, thirteen participants from group C completed semi-structured interviews on their feedback experience.</div></div><div><h3>Results</h3><div>The mean global score rose from 3.24 to 3.52 in Group A, 3.46 to 3.63 in Group B, and 3.51 to 3.76 in Group C. ANOVA showed no significant differences between groups (F(2,65) = 0.669, p = 0.516, ηp² = 0.020). Qualitative findings indicated that expert feedback, particularly when combined with video review, significantly enhanced motivation, confidence, and clarity. Group C participants described shifting from “fear of performing sutures” to “confidence,” attributing this to the personalized, emotionally supportive feedback.</div></div><div><h3>Conclusion</h3><div>Although performance outcomes were similar across feedback types, expert feedback offered unique emotional and cognitive benefits. These findings support the integration of structured, learner-centered feedback in surgical training, combining scalability with pedagogical value.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103779"},"PeriodicalIF":2.1,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558770","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 : 2025-11-18DOI: 10.1016/j.jsurg.2025.103715
Sandra Tomlinson-Hansen MD , Julia Rozenberg MD , Jessica Bilz MD , Yancey E. Warren MD , Rachel S. Handelsman MD , Jennifer S. Gass MD , Ashley R. Stuckey MD , Micaela A. Weaver DO , Stephanie Ng MD, MPH , David A. Edmonson MD
Background
Residents applying for surgical breast fellowships increasingly rely on the internet – a change that sets this generation of applicants apart from previous. Data on surgical breast fellowship websites (SBFW) is limited and content is variable among program websites.
Methods
All 63 American SSO-approved breast surgical oncology fellowship programs available for the 2023 match were included. SBFW were evaluated by 2 residents interested in breast fellowship for 41 categories of content, which were subdivided into 6 broad categories: program description, education, research, recruitment, alumni/current fellows/faculty and fellow lifestyle/DEI initiatives.
Results
Of the 63 approved programs, 54 had breast fellowship-specific program websites (85.7%) and some form of program description. Of the programs, 60.3% had educational information, 68.3% had research initiative information, 22.2% had resident recruitment information, 52.4% had information on alumni, current fellows and/or faculty, and 23.8% described fellow lifestyle/experience. Four websites (6.3%) listed diversity/equity/inclusivity information.
After reviewing SBFW, the residents evaluated that 33 (61.1%) and 53 (84.1%) of the programs met applicant needs. They rated that 12 (22.2%) and 32 (50.8%) of the websites provided complete information for an interested applicant.
Conclusion
SBFW provide limited information across programs and fail to convey important program information to applicants. Improving websites may improve the ability of the Match to align the most ideal programs to applicants.
{"title":"Surgical Oncology Breast Fellowship Websites: A Critical Analysis of Accessibility and Content for Society of Surgical Oncology (SSO)-Approved Program Websites","authors":"Sandra Tomlinson-Hansen MD , Julia Rozenberg MD , Jessica Bilz MD , Yancey E. Warren MD , Rachel S. Handelsman MD , Jennifer S. Gass MD , Ashley R. Stuckey MD , Micaela A. Weaver DO , Stephanie Ng MD, MPH , David A. Edmonson MD","doi":"10.1016/j.jsurg.2025.103715","DOIUrl":"10.1016/j.jsurg.2025.103715","url":null,"abstract":"<div><h3>Background</h3><div>Residents applying for surgical breast fellowships increasingly rely on the internet – a change that sets this generation of applicants apart from previous. Data on surgical breast fellowship websites (SBFW) is limited and content is variable among program websites.</div></div><div><h3>Methods</h3><div>All 63 American SSO-approved breast surgical oncology fellowship programs available for the 2023 match were included. SBFW were evaluated by 2 residents interested in breast fellowship for 41 categories of content, which were subdivided into 6 broad categories: program description, education, research, recruitment, alumni/current fellows/faculty and fellow lifestyle/DEI initiatives.</div></div><div><h3>Results</h3><div>Of the 63 approved programs, 54 had breast fellowship-specific program websites (85.7%) and some form of program description. Of the programs, 60.3% had educational information, 68.3% had research initiative information, 22.2% had resident recruitment information, 52.4% had information on alumni, current fellows and/or faculty, and 23.8% described fellow lifestyle/experience. Four websites (6.3%) listed diversity/equity/inclusivity information.</div><div>After reviewing SBFW, the residents evaluated that 33 (61.1%) and 53 (84.1%) of the programs met applicant needs. They rated that 12 (22.2%) and 32 (50.8%) of the websites provided complete information for an interested applicant.</div></div><div><h3>Conclusion</h3><div>SBFW provide limited information across programs and fail to convey important program information to applicants. Improving websites may improve the ability of the Match to align the most ideal programs to applicants.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103715"},"PeriodicalIF":2.1,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558722","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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