Journal of Surgical Education最新文献

{"title":"Concerning Trends in Acute Care Surgeries Among General Surgery Trainees","authors":"Sameh Yousef MD ,&nbsp;Jin Park MD ,&nbsp;Franklin Burg MD ,&nbsp;Tul Maya Gurung MD ,&nbsp;Pooja Shah MD ,&nbsp;Awinita Barpujari ,&nbsp;Raj Lingnurkar MD ,&nbsp;Jeremy Jen MD ,&nbsp;Kanika Trehan MD ,&nbsp;Mark Seamon MD ,&nbsp;Aley Tohamy MD ,&nbsp;Karen Kish MD ,&nbsp;Prashanth Ramachandra MD","doi":"10.1016/j.jsurg.2025.103776","DOIUrl":"10.1016/j.jsurg.2025.103776","url":null,"abstract":"<div><h3>Background</h3><div>Surveys of residents, program directors, and fellowship leaders have raised concerns about general surgery graduates’ readiness for independent practice. Evolving practice patterns, particularly the rise of laparoscopic surgery, advanced endoscopy, and interventional radiology, have altered residents’ exposure to traditional open procedures. However, the impact of these changes on operative experience in acute care surgery (ACS) has not been well quantified.</div></div><div><h3>Objective</h3><div>This study assessed temporal trends in the operative experience of general surgery trainees in the acute care surgery component.</div></div><div><h3>Design</h3><div>We analyzed publicly available ACGME operative case logs for graduating general surgery trainees from 2000 to 2023. Procedures categorized under acute care surgery were identified. Temporal trends were assessed using the Mann-Kendall trend test and visualized with line plots.</div></div><div><h3>Results</h3><div>The average total case volume increased from 903 cases per trainee in 2006 to 1,062 in 2023. Despite the overall increase in case volume, exposure to multiple key ACS operations has declined to critically low levels. Notably, average case numbers per trainee for procedures such as splenectomy, duodenal perforation repair, open common bile duct exploration, choledochoenteric anastomosis, pancreatic abscess drainage, and esophageal perforation repair have fallen to fewer than 1 per trainee. The laparoscopic approach has largely supplanted the open approach across various procedures.</div></div><div><h3>Conclusion</h3><div>Although the total operative volume for general surgery trainees has increased over time, exposure to essential open ACS procedures has markedly declined. This trend raises concerns about the adequacy of operative experience in foundational emergency surgeries and may contribute to ongoing perceptions of insufficient preparedness among graduates.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103776"},"PeriodicalIF":2.1,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residents as Leaders: Creating a Trauma Team Leader Nontechnical Skills Simulation Workshop","authors":"Baila Maqbool MD","doi":"10.1016/j.jsurg.2025.103759","DOIUrl":"10.1016/j.jsurg.2025.103759","url":null,"abstract":"<div><h3>Introduction</h3><div>Effective trauma resuscitation requires strong leadership and mastery of nontechnical skills (NTS), including communication, situational awareness, decision-making, and teamwork. With trauma team leadership increasingly shared between surgical and emergency medicine physicians, there is a need for structured, interdisciplinary training focused on NTS. This study evaluates the effectiveness of a simulation-based trauma team leader (TTL) curriculum in enhancing NTS among senior residents.</div></div><div><h3>Methods</h3><div>A prospective, mixed-methods educational intervention was conducted from 2020 to 2024 at a single academic institution. Participants included general surgery and emergency medicine residents with prior ATLS certification and trauma rotation experience. The half-day TTL workshop included didactic instruction, eight high-fidelity simulation scenarios with rotating leadership roles, and structured debriefings using the Trauma Non-TECHnical Skills (T-NOTECHS) rubric. Assessments included pre- and postworkshop knowledge tests, confidence surveys, faculty evaluations, and a 1-year follow-up survey. Descriptive statistics and paired comparisons were used for analysis.</div></div><div><h3>Results</h3><div>Fifty-three residents (29 surgery, 24 emergency medicine) participated. Statistically significant improvements (p &lt; 0.001) were observed across all NTS domains: leadership (2.9-4.4), communication (3.2-4.6), situational awareness (3.1-4.5), decision-making (3.0-4.3), and cooperation/resource management (3.0-4.4). No significant differences were found between specialties. Participant satisfaction was high, with 96% rating the workshop as effective or extremely effective. At 1-year follow-up (<em>n</em> = 34), 88% reported improved readiness for trauma leadership, and 85% applied skills regularly in clinical settings.</div></div><div><h3>Conclusion</h3><div>The TTL simulation workshop significantly improved NTS confidence and preparedness among senior surgical and emergency medicine residents, with sustained benefits at 1 year. This curriculum represents a valuable model for interdisciplinary trauma leadership training. Future directions include expanding the course to include additional trauma team members and integrating real-time assessment of NTS into clinical practice to further enhance team performance and patient outcomes.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103759"},"PeriodicalIF":2.1,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Rapid Cycle Deliberate Practice (RCDP) on Technical and Non-Technical Skills in Chest Tube Insertion and Fixation: A Pilot Study","authors":"Killen H. Briones-Zamora MD ,&nbsp;Melani Chávez Vega MD ,&nbsp;Anahí D. Briones-Zamora MD ,&nbsp;Absalón Quiroz Farfán MD ,&nbsp;Jaime Benítes Solís MD, PhD ,&nbsp;Killen H. Briones-Claudett MD, PhD","doi":"10.1016/j.jsurg.2025.103763","DOIUrl":"10.1016/j.jsurg.2025.103763","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness of Rapid Cycle Deliberate Practice (RCDP) compared to traditional simulation and Peyton’s Four-Step Approach in improving technical and non-technical skills, during chest tube insertion and fixation in medical students.</div></div><div><h3>Design</h3><div>Pilot quasi-experimental study conducted in 3 instructional cohorts. Each cohort received training through a different educational methodology: traditional simulation (control), RCDP, or Peyton’s Four-Step Approach. All participants completed 2 standardized training sessions, followed by an individual simulation-based assessment. Technical performance was evaluated using the Objective Structured Assessment of Technical Skills (OSATS), patient communication skills were assessed with the CoMeD-OSCE scale, and non-technical skills such as leadership and teamwork were measured using the Non-Technical Skills for Surgeons (NOTSS) framework.</div></div><div><h3>Setting</h3><div>The study was conducted between August 2024 and May 2025 at a teaching simulation center in Ecuador.</div></div><div><h3>Results</h3><div>A total of 55 third-year medical students completed the study. The RCDP group achieved significantly higher scores in technical performance (OSATS mean 41.11, SD 8.32, p &lt; 0.001), patient communication (CoMeD-OSCE mean 15.27, SD 3.93, p &lt; 0.001), and non-technical skills (NOTSS mean 39.05, SD 4.97, p &lt; 0.001) compared to the control and Peyton groups. Strong positive correlations were observed between technical and non-technical performance (OSATS and NOTSS r = 0.84; OSATS and CoMeD r = 0.61; both p &lt; 0.001). Female students scored significantly higher in communication (p = 0.008) but not in leadership (p = 0.254).</div></div><div><h3>Conclusions</h3><div>RCDP is an effective educational method for enhancing both technical and non-technical competencies in chest tube insertion and fixation among medical students. The integration of RCDP into simulation-based curricula may foster comprehensive clinical skill development. Future studies with randomized designs and larger sample sizes are recommended to assess long-term retention and generalizability across diverse clinical scenarios.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103763"},"PeriodicalIF":2.1,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and the Impact of Early Mentorship of Medical Students in Neurosurgery: A Qualitative Study","authors":"Franciska Otaner ,&nbsp;Abrar Ahmed MD ,&nbsp;Zeel Patel MD ,&nbsp;Farbod Niazi ,&nbsp;Saman Arfaie MDCM ,&nbsp;Sandalia Genus PhD ,&nbsp;Ashish Kumar MBBS, MCh, MSc","doi":"10.1016/j.jsurg.2025.103778","DOIUrl":"10.1016/j.jsurg.2025.103778","url":null,"abstract":"<div><h3>Objective</h3><div>To explore how early exposure influences Canadian medical students’ perceptions of neurosurgery and identify strategies to promote equitable interest and access to neurosurgical careers.</div></div><div><h3>Design</h3><div>A qualitative, multi-institutional study using focus groups, grounded in thematic analysis.</div></div><div><h3>Setting</h3><div>Three Canadian medical schools: Laval University, McGill University, and the University of Toronto.</div></div><div><h3>Participants</h3><div>Six medical students from the participating institutions, representing diverse stages of training and backgrounds, participated in a semi-structured, virtual focus group interview.</div></div><div><h3>Results</h3><div>Three key themes emerged: the role of early exposure to neurosurgery, the impact of gender-related barriers, and the limitations of the current undergraduate medical curricula. Students with early exposure to neurosurgery, through research, mentorship, or clinical shadowing, demonstrated increased interest in the field, greater willingness to pursue neurosurgical electives, and a more nuanced understanding of the specialty. Those without such exposure often held misconceptions about neurosurgery, particularly regarding lifestyle, neurosurgeon personalities, and working conditions. As a result, they tended to miss elective opportunities and felt at a disadvantage when interest in the field developed later. Female participants, in particular, highlighted concerns about work-life balance, family planning, and underrepresentation, which negatively influenced their interest in the field. Across institutions, students described minimal structured exposure to neurosurgery in the preclerkship and clerkship curricula. Suggestions for improvement included earlier and more accessible electives, increased visibility of diverse mentors, funding for research and conference participation, and formal mentorship opportunities to help challenge misconceptions about the field.</div></div><div><h3>Conclusions</h3><div>This is the first multi-institutional qualitative study exploring Canadian medical student perceptions of neurosurgery. Early exposure plays a critical role in shaping interest and reducing misconceptions about the field. Addressing curricular gaps, supporting mentorship, and improving accessibility, especially for underrepresented groups, may help create a more inclusive and informed pathway into neurosurgical careers. These findings support targeted reforms in undergraduate medical education to promote equitable engagement with neurosurgery.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103778"},"PeriodicalIF":2.1,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Resident Gender Concordance Influences Perceived Communication Quality in Orthopedic Care","authors":"Katherine L. Esser BS ,&nbsp;Kaylee Scarnati BS ,&nbsp;Austin Lawrence BS ,&nbsp;Jennida Chan BS ,&nbsp;David Yatsonsky MD ,&nbsp;Emily Cage MD ,&nbsp;Kristin Toy MD ,&nbsp;Christopher Sanford MD ,&nbsp;Martin Skie MD ,&nbsp;David Sohn MD","doi":"10.1016/j.jsurg.2025.103757","DOIUrl":"10.1016/j.jsurg.2025.103757","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess orthopedic residents’ communication effectiveness via patient-reported surveys and examine the impact of age, race, and gender concordance on patient perceptions.</div></div><div><h3>Methods</h3><div>This prospective observational study was conducted at a single urban academic institution with an orthopedic residency program. Surveys, including a modified Communication Assessment Tool and custom items, were administered during outpatient visits involving orthopedic residents. Demographic data were collected, and nonparametric statistics with multivariable regression were used to analyze associations between patient-resident demographic concordance and communication ratings. Residents with ≥10 surveys were included.</div></div><div><h3>Results</h3><div>Ninety-nine surveys evaluating 11 residents were analyzed. Gender-concordant pairs (e.g., male-male, female-female) received significantly higher communication ratings than discordant pairs (p &lt; 0.05, Cohen’s <em>d</em> = 0.62), with scores tightly clustered near the maximum. Female patients rated communication more understandable than male patients (p &lt; 0.05, <em>d</em> = 0.74). Older patients reported higher satisfaction than younger ones (p &lt; 0.05). Multivariable regression confirmed that gender and racial concordance significantly predicted higher satisfaction (p &lt; 0.05), while discordant combinations (e.g., elderly patients with senior residents, male patients with racially discordant residents) were associated with lower satisfaction.</div></div><div><h3>Conclusion</h3><div>Patient-resident gender and racial concordance correlated with higher communication scores. These findings highlight the value of integrating patient feedback and tailored communication training into residency curricula to foster equitable, effective interactions across diverse patient populations.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103757"},"PeriodicalIF":2.1,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainability of the “Name, Ask, Thank” Method to Improve Student Mattering in the Operating Room","authors":"Halen Turner MD,&nbsp;Caitlin Patten MD,&nbsp;Rachel Silverman MD,&nbsp;Rana M. Higgins MD","doi":"10.1016/j.jsurg.2025.103739","DOIUrl":"10.1016/j.jsurg.2025.103739","url":null,"abstract":"<div><h3>Introduction</h3><div>Mattering is a psychosocial construct in which a person feels valued with domains including awareness, reliance, and importance. This study aimed to determine the sustainability of the “Name, Ask, Thank” (NAT) method for maintaining medical student mattering on the surgery clerkship in the operating room.</div></div><div><h3>Methods</h3><div>The NAT method was introduced at General Surgery Grand Rounds in 2021. Surveys were sent to residents, fellows, and faculty to assess the implementation of the method between 2021 and 2023. Chi-squared analysis was conducted to compare the years 2021-2022 to 2023 for the sustainability of the intervention. Medical students’ end-of-rotation feedback regarding mattering was analyzed pre- and postintervention.</div></div><div><h3>Results</h3><div>There were 49 survey responses from educators from 2021 to 2022 and 33 in 2023. 71.4% of educators from 2021 to 2022 versus 75.8% in 2023 affirmed they utilized the NAT method (p = 0.9). 55.1% from 2021 to 2022 versus 57.6% in 2023 were always or often utilizing NAT (p = 0.94). The most frequent barrier to implementation was forgetting about the NAT method (43% and 36%). There was no statistical difference in medical student end-of-rotation feedback pre- and postintervention.</div></div><div><h3>Conclusions</h3><div>The NAT method had sustained implementation by educators over 2 years when utilizing low-effort reminders. Further interventions to increase its use and improve mattering could include visual reminders in the operating room as the most frequent barriers cited by educators were forgetting about the method and distractions in the operating room.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103739"},"PeriodicalIF":2.1,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Analysis—Enhancing Faculty Academic Success Through Team-Based Mentorship: 5-Year Insights","authors":"Jenny M. Shao MD ,&nbsp;Delaney C. Ryan MPH ,&nbsp;Chad Jobin MSW ,&nbsp;Lesly A. Dossett MD, MPH ,&nbsp;Erika A. Newman MD ,&nbsp;Justin B. Dimick MD, MPH ,&nbsp;Dana A. Telem MD, MPH ,&nbsp;Lauren A. Szczygiel PhD","doi":"10.1016/j.jsurg.2025.103773","DOIUrl":"10.1016/j.jsurg.2025.103773","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the successes, challenges and areas for improvement in teambased mentorship program aimed at supporting early-career faculty. It is well known that mentorship and sponsorship are critical for success in academic surgery to enhance productivity, accelerate promotion, improve retention, and boost career satisfaction. However, formal mentorship programs, particularly those using teambased formats, still remain underutilized.</div></div><div><h3>Design</h3><div>This qualitative study involved conducting semi-structured interviews with faculty mentees who participated in the launch team program. A purposeful sampling strategy was used to identify representative participants. Thematic analysis was used to assess mentorship effectiveness in supporting professional growth, emotional wellbeing, and career advancement.</div></div><div><h3>Setting</h3><div>University of Michigan, Department of Surgery.</div></div><div><h3>Participants</h3><div>A total of 15 early career mentees were invited to participate, this included 9 (60%) identified as White, 4 (26.7%) as Asian and 2 as Black (13.3%). Additionally, 9 (60%) identified as female and 6 (40%) as male. One invited mentee did not participate in the interview.</div></div><div><h3>Results</h3><div>We identified 3 overarching themes that captured their perspectives on the successes and challenges of the program: (1) Adaptive Mentorship and Support in Evolving Contexts – highlighting the need for combining informational resources with emotional and well-being support, (2) Coordination, Communication, and Program Expectations, - emphasizing the importance of a clear understanding of roles and objectives, effective communication of program details and functional program administration and (3) Team Composition - underscoring the need for a balance in expertise and epistemic diversity, as well as the consideration of power dynamics and psychological safety.</div></div><div><h3>Conclusions</h3><div>These findings further emphasize the need for mentorship for early career faculty. Expanding structured, team-based mentorship models to other institutions could further strengthen professional development efforts within academic surgery.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103773"},"PeriodicalIF":2.1,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Program Differences in ACGME Milestone 2.0 Ratings in General Surgery: Patient Care and Systems-Based Practice","authors":"Jonah D. Thomas MD, MS ,&nbsp;Claire Ferguson MD ,&nbsp;Shaghayegh Sabbaghan Kermani MD ,&nbsp;Sophia McKinley MD ,&nbsp;Jonathan Greer MD ,&nbsp;Kenji Yamazaki PhD ,&nbsp;Sean Hogan PhD ,&nbsp;Roy Phitayakorn MD ,&nbsp;Dandan Chen PhD","doi":"10.1016/j.jsurg.2025.103732","DOIUrl":"10.1016/j.jsurg.2025.103732","url":null,"abstract":"<div><h3>Objective</h3><div>Our aim was to quantify the extent to which program-level differences contribute to variation in Milestone 2.0 ratings for ACGME Milestones 2.0 patient care (PC) and systems-based practice (SBP) competencies among general surgery residents.</div></div><div><h3>Design</h3><div>Retrospective study analyzing ACGME Milestones 2.0 ratings data from general surgery residency programs across the United States for the academic year 2020-2021. Intraclass correlation coefficients (ICCs) were used to measure the extent of program-level variation in ratings across postgraduate year (PGY) levels 1-5.</div></div><div><h3>Setting</h3><div>This study utilized a national dataset of deidentified ACGME Milestone ratings for general surgery residents in the United States, obtained under a data use agreement with the Accreditation Council for Graduate Medical Education (ACGME).</div></div><div><h3>Participants</h3><div>The dataset included 7581 general surgery residents (PGY1 through PGY5) from 328 U.S. general surgery programs. All residents were actively enrolled in accredited residency programs, and complete Milestones data for PC and SBP domains was available for inclusion.</div></div><div><h3>Results</h3><div>Significant program-driven variation was identified across all PC and SBP sub-competencies, most pronounced (i.e., higher ICC value) at the PGY1 and PGY5 levels. ICCs indicated that program-level factors accounted for 38% to 63% of the total variance in residents’ PC ratings and 45% to 75% in SBP ratings. The highest program-level influence was observed in SBP3 (Physician role in health care systems), ranging from 55% to 75%. Uniform resident rating occurred at each PGY level and subcompetency.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that a substantial portion of the variation in PC and SBP Milestone ratings is driven by program-level factors rather than resident performance alone. This variation may result from differences in clinical competency committee rating practices, institutional culture, and clinical training environments. Future research should explore how specific institutional practices residents’ impact Milestones ratings.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 12","pages":"Article 103732"},"PeriodicalIF":2.1,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Quality of General Surgery Entrustable Professional Activities Using the EQual Rubric","authors":"Stephanie Seale MD ,&nbsp;Connie Y. Gan MD ,&nbsp;Cara A. Liebert MD, FACS ,&nbsp;Jason W. Kempenich MD, FACS ,&nbsp;Daniel L. Dent MD, FACS ,&nbsp;David A. Spain MD, FACS ,&nbsp;James R. Korndorffer Jr. MD, MHPE, FACS","doi":"10.1016/j.jsurg.2025.103747","DOIUrl":"10.1016/j.jsurg.2025.103747","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To apply the EQual rubric to the American Board of Surgery General Surgery EPAs in order to evaluate their quality and identify opportunities for refinement.</div></div><div><h3>DESIGN</h3><div>The EPAs were evaluated using the EQual rubric by 4 current or former program directors. All items from the rubric which were shown to have generalizability were included in the assessment on 5-point Likert scales. Raters were trained to ensure consistent application of the rubric. Each participant independently completed the rubric and statistical analysis was performed.</div></div><div><h3>SETTING</h3><div>Current or former program directors at tertiary academic centers.</div></div><div><h3>PARTICIPANTS</h3><div>Raters were identified based on their leadership roles in general surgery programs and scholarship in surgical education research.</div></div><div><h3>RESULTS</h3><div>The composite mean score of all EPAs was 4.63 (0.19), which is greater than the EQual study cutoff of 4.07 used to identify EPAs requiring major revisions. Each EPA also individually scored above this cutoff. However, 3 EPAs: Provide Surgical Consultation, Gastrointestinal Endoscopy, and Peri-operative Care of the Critically Ill Surgical Patient scored below the cutoff score for the <em>Discrete Unit of Work</em> domain. Each of these 3 EPAs additionally scored one or more standard deviations below the composite mean.</div></div><div><h3>CONCLUSIONS</h3><div>While all of the ABS General Surgery EPAs scored above the major revision cutoff, 3 EPAs scored significantly lower than the others, indicating an opportunity for revisions or restructuring. Use of this objective tool could be valuable in the iterative development and revision of future EPAs.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 12","pages":"Article 103747"},"PeriodicalIF":2.1,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming the Challenges of EPA Engagement: A Tool to Increase the Number of Submissions","authors":"Xinyi Luo MD,&nbsp;Hiyori Roberts MS,&nbsp;Vivien Okechukwu MD,&nbsp;Michael Ghio MD,&nbsp;Grace Millsaps BA,&nbsp;Dylan Wolff MD,&nbsp;David Yu MD,&nbsp;Jeanette Zhang MD","doi":"10.1016/j.jsurg.2025.103777","DOIUrl":"10.1016/j.jsurg.2025.103777","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of incorporating Entrustable Professional Activity (EPA) submission and completion statistics into weekly Morbidity and Mortality (M&amp;M) Conferences on resident engagement and faculty participation in a high-volume surgical training environment.</div></div><div><h3>Design</h3><div>This retrospective cohort study compares EPA submissions and completions before and after the intervention. Data were collected from weekly M&amp;M reports, and analyses including descriptive statistics, Pearson’s correlation, and chi-squared tests were completed to evaluate changes in submission and completion rates.</div></div><div><h3>Setting</h3><div>This study was conducted at Tulane University’s general surgery residency program in New Orleans, LA. The main teaching sites are urban, tertiary care centers that function as safety net hospitals for the community.</div></div><div><h3>Participants</h3><div>All general surgery residents and teaching faculty involved in EPA assessments between July 2023 and December 2024 were included. Preintervention data were collected from July to December 2023, and postintervention data were collected from January to December 2024.</div></div><div><h3>Results</h3><div>Following the intervention, mean weekly EPA submissions increased significantly from 8.1 to 21.0 (<em>P</em> &lt; 0.001), and the proportion of EPA-eligible cases for which a micro-assessment was generated rose from 17.1% to 25.9% (<em>P</em> = 0.001). The mean number of completed EPA micro-assessments increased from 6.9 to 16.3 per week (<em>P</em> &lt; 0.001), with completions among eligible cases rising from 14.6% to 20.1% (<em>P</em> = 0.01). EPA submissions correlated moderately with EPA-eligible case volume (<em>r</em> = 0.31). Variability in submission patterns and rates throughout the year suggests fluctuating engagement during the academic year.</div></div><div><h3>Conclusions</h3><div>Integrating EPA statistics into weekly M&amp;M Conferences significantly increased EPA submission and completion rates without adding a substantial burden to the residents or faculty. This simple, scalable intervention effectively engages both residents and faculty with competency-based assessments. Future research should explore barriers to micro-assessment completion and use qualitative methods to understand fluctuating engagement.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 12","pages":"Article 103777"},"PeriodicalIF":2.1,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508597","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}