Journal of Surgical Education最新文献

{"title":"Honing the Cutting Edge of Physician Assistant Surgical Education in the US Military: A Curriculum Update Using Kern’s Approach and a Modified Delphi Method","authors":"Robyn L. Chalupa DSc, PA-C,&nbsp;Ryan A. McMahon DSc, PA-C,&nbsp;Lenard W. Tol DSc, PA-C,&nbsp;Julie A. Rizzo MD,&nbsp;Matthew S. Douglas DSc, PA-C","doi":"10.1016/j.jsurg.2025.103767","DOIUrl":"10.1016/j.jsurg.2025.103767","url":null,"abstract":"<div><div>The US Army–Baylor University Doctor of Science in Physician Assistant Studies—General Surgery program was developed to address a shortage of trauma- and critical care–trained providers for combat operations. While the original program closed, a restructured version launched in 2013 to provide postgraduate specialty training for military physician assistants focused on battlefield and critical care needs.</div></div><div><h3>Problem</h3><div>Despite growth in postgraduate physician assistant fellowships, surgical curricula remain inconsistent, making it difficult to validate training and align outcomes with surgeon expectations.</div></div><div><h3>Approach</h3><div>We applied Kern’s six-step model for curriculum development and used a modified Delphi method to reach consensus among military surgeons on the clinical skills and competencies expected of graduates. Two survey rounds prioritized procedural skills and mapped performance expectations to Accreditation Council for Graduate Medical Education surgery milestones.</div></div><div><h3>Outcomes</h3><div>The resulting 18-month curriculum integrates extensive clinical experience, structured didactic and lab time, and a mentored research project. Surgeons identified central line placement, chest tube insertion, laceration repair, surgical airways, ventilator management, triage, resuscitation, and fracture management as essential skills. They expected trained physician assistants to function at Accreditation Council for Graduate Medical Education surgery milestone level 3 in the areas of “patient evaluation and decision making,” “intraoperative patient care technical skills,” and “postoperative patient care.”</div></div><div><h3>Significance</h3><div>This is the first reported use of Kern’s framework and Delphi consensus to develop a postgraduate surgical physician assistant curriculum. The process produced consensus-driven, measurable objectives tailored to military surgical needs and offers a replicable model for curriculum development in other health professions.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103767"},"PeriodicalIF":2.1,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508603","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":"Too Loud to Learn? Communication Barriers, Psychological Safety, and Learning in the Operating Room","authors":"Sarah E. Hughes BA ,&nbsp;Eunice Y. Lee ,&nbsp;Andrew S. Bolze MD ,&nbsp;Michael J. Brenner MD ,&nbsp;Rishindra M. Reddy MD, MBA ,&nbsp;Kyle H. Sheetz MD, MSc","doi":"10.1016/j.jsurg.2025.103766","DOIUrl":"10.1016/j.jsurg.2025.103766","url":null,"abstract":"<div><h3>Objective</h3><div>To assess how medical students experience communication challenges in the operating room (OR), and how these barriers affect psychological safety.</div></div><div><h3>Design</h3><div>Cross-sectional, anonymous survey study.</div></div><div><h3>Setting</h3><div>A single academic medical center in the United States.</div></div><div><h3>Participants</h3><div>Eighty-three medical students who had completed a surgical clerkship and reported OR experience.</div></div><div><h3>Results</h3><div>The majority (73/83, 88.0%) reported difficulty hearing in the OR. Greater hearing difficulty was associated with lower psychological safety (ρ = –0.46, p &lt; 0.001), especially with hierarchy (ρ = –0.44) and comfort seeking clarification (ρ = –0.42). Over two-thirds (68.7%) said hearing difficulty impaired their learning. Nearly 74% reported reduced confidence or sense of belonging. Thematic analysis of free-text responses revealed 7 themes, including fear of judgment, missed opportunities, and concern about career fit.</div></div><div><h3>Conclusions</h3><div>Hearing-related communication barriers in the OR are common among medical students and are linked to reduced psychological safety, confidence, and learning. These findings suggest a need for structural and interpersonal changes to promote accessible, inclusive surgical education.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103766"},"PeriodicalIF":2.1,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467129","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":"Novel Use of the ACGME Milestones and Resident Morbidity and Mortality Conference Presentation Feedback","authors":"Michael J. Furey DO, MSMED,&nbsp;Rebecca Michelle Jordan DO, FACS,&nbsp;Alexandra Falvo MD, FACS, FASMBS,&nbsp;Richard A. Lopez DO, MBA, MHA, FACS, FACOS,&nbsp;Joseph P. Bannon MD, FACS, FASCRS,&nbsp;Megan L. Burger DO","doi":"10.1016/j.jsurg.2025.103751","DOIUrl":"10.1016/j.jsurg.2025.103751","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Morbidity and Mortality (M&amp;M) conference presentations are a microcosm of patient care providing a snapshot of a resident’s understanding of clinical care and quality improvement opportunities. The effectiveness of feedback provided during M&amp;M and its utility for identifying residents who may be struggling clinically has been less explored. The Accreditation Council for Graduate Medical Education (ACGME) milestones serve as the gold standard for evaluation of surgery residents. The aims of this study were to investigate the impact of resident feedback on M&amp;M conference presentations and correlate resident presentation skills with ACGME milestones.</div></div><div><h3>METHODS</h3><div>At the conclusion of each weekly M&amp;M conference, attendees are asked to provide feedback via a secure online survey platform. Survey questions solicit both quantitative and qualitative feedback including an overall score (1-10) and an opportunity to provide comments. A second survey of presenters and attendees was used to evaluate the utility of our feedback surveys. Two authors independently selected 7 ACGME milestone competencies most consistent with the goals of the M&amp;M conference. After further deliberation, the top three milestone sub-competencies selected were: Systems-Based Practice (SBP1), Patient Care 1 (PC1), and Patient Care 4 (PC4). Milestone scores, obtained from the most recent clinical competency committee (CCC) meeting, were compared to presenters’ average overall M&amp;M presentation score. Residents with &lt;5 M&amp;M survey evaluations were excluded.</div></div><div><h3>RESULTS</h3><div>A total of 368 evaluations were completed for 20 resident presenters from 36 M&amp;M conferences, with each resident receiving an average of 18 evaluations. Presenters (78.6%) and evaluators (81.8%) found feedback surveys useful. There was no significant difference between resident and attending overall presentation scoring. A positive and significant correlation was noted between the overall presentation score and the three milestone sub-competencies selected.</div></div><div><h3>CONCLUSION</h3><div>This study emphasizes the importance of structured feedback within M&amp;M conferences. Similar to Entrustable Professional Activity assessments, M&amp;M feedback surveys can be considered a micro-assessment, and when used in conjunction with other methods of evaluation, can aid in identifying residents who may be struggling clinically.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 12","pages":"Article 103751"},"PeriodicalIF":2.1,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477279","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":"Fellowship Training After General Surgery Residency: Does it Pay?","authors":"Jack F. Donaghue BA ,&nbsp;Daniel J. Denson MD, MBA ,&nbsp;Matthew C. Carroll MD ,&nbsp;James E. Smith PhD ,&nbsp;Kari M. Rosenkranz MD","doi":"10.1016/j.jsurg.2025.103734","DOIUrl":"10.1016/j.jsurg.2025.103734","url":null,"abstract":"<div><h3>Objective</h3><div>Surgical residents are increasingly pursuing fellowship after general surgery (GS) residency. Fellowship comes at significant opportunity cost and can alter career earnings. This study aims to quantify the return on investment of surgical fellowships when compared to direct entry into GS practice.</div></div><div><h3>Design</h3><div>Using traditional financial analysis tools including net present value (NPV) and breakeven analysis we compared annual salaries for general surgeons to that of surgeons completing one of ten fellowships. Using AAMC academic and MGMA private practice salary data we estimated income over a 35-year surgical career. Modeling for those pursuing fellowship included both a 5-year and a 7-year GS residency training path accounting for possible research time. GS residency was modeled at 5 years of training. We modeled based on both academic and private practice careers.</div></div><div><h3>Setting</h3><div>This study includes survey responses from surgeons across all common practice and hospital types in the United States.</div></div><div><h3>Participants</h3><div>Participants in the MGMA survey used in our analysis are private practice surgeons in the United States. Participants in the AAMC survey used in our analysis are academic surgeons.</div></div><div><h3>Results</h3><div>Academic Cardiothoracic, Plastic, and Pediatric surgery had a positive NPV even when accounting for 7 years of trainee salary. This reflects a positive return on investment. Those pursuing Vascular surgery fellowship had a positive NPV if they completed GS training without research time.</div><div>Private practice Cardiac, Thoracic, Plastic, Vascular and Pediatric surgeons had a positive NPV without added research time. If residency training includes research time only Cardiac and Pediatric surgery are NPV positive.</div><div>Breast, Surgical Oncology, Trauma, Colorectal and Transplant fellowships confer negative NPVs for both academic and private practice even when modeled in a 5-year training paradigm. Trauma surgery had a positive NPV when adjusting for hours worked.</div></div><div><h3>Conclusions</h3><div>This analysis highlights the significant impact that fellowship training has on career earnings and underscores the opportunity cost of research years. These data offer a transparent financial analysis to help guide surgical residents in career decisions as they weigh personal values, interests, financial stress and fiscal expectations.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 12","pages":"Article 103734"},"PeriodicalIF":2.1,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477318","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":"Guidelines and Checklists for Artificial Intelligence (AI) in Surgical Education Research: A Comprehensive Narrative Review","authors":"Caitlin Silvestri MD ,&nbsp;Darian L Hoagland MD ,&nbsp;John M Woodward MD, MS-HPEd ,&nbsp;Ariana Naaseh MD, MPHS ,&nbsp;Colleen E McDermott MD, MPH ,&nbsp;Brian M Carter MD, MSBME ,&nbsp;Sarah Lund MD ,&nbsp;Larry J Prokop MLIS ,&nbsp;Alec Bernard MD, MSCR ,&nbsp;Sergio M Navarro MD, MBA","doi":"10.1016/j.jsurg.2025.103758","DOIUrl":"10.1016/j.jsurg.2025.103758","url":null,"abstract":"<div><h3>Objective</h3><div>Artificial intelligence (AI) has increasingly been used in clinical and healthcare research, prompting the development of new research guidelines to ensure its appropriate use. Similarly, AI has been applied to surgical education research, creating a need to assess the relevance and applicability of existing guidelines in this context. This narrative review synthesized guidelines and checklists related to AI in surgical education, providing researchers with an introductory roadmap for conducting rigorous, reproducible studies and identifying gaps for future framework development.</div></div><div><h3>Design</h3><div>In April 2024, the authors conducted a search using Ovid (Embase and MEDLINE(R)) from 1946 to 2024 to identify guidelines and checklists related to AI research in healthcare and surgical education. Search teams included “artifical intelligence” and related terms, as well as “checklist”, “recommendations”, and terms related to evaluation, reporting, and guidelines. Titles and abstracts were screened and the authors reviewed eligible full-text articles for inclusion through consensus discussions.</div></div><div><h3>Results</h3><div>From 200 studies identified, 47 full-text articles were reviewed, and 16 guidelines and checklists were included. These were grouped into six thematic categories: AI research with health education applications, Generative AI and Large Language Model studies, machine learning/prediction models, AI in imaging, and forthcoming guidelines. Key findings highlighted the diversity in purpose, methodology, and scope. Although gaps were identified in existing guidelines and checklists for surgical education, with only one tailored to AI research in healthcare education, the authors demonstrated how these other resources could be applied.</div></div><div><h3>Conclusions</h3><div>This review highlighted that while existing guidelines and checklists could be applied in certain contexts, significant gaps remained in education-specific research guidance. Future efforts should focus on developing tailored guidelines to address the unique challenges and opportunities of AI integration in surgical education, ensuring rigorous and reproducible research.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103758"},"PeriodicalIF":2.1,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467140","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":"Applying a Shame Lens to Understand Surgical Resident Well-Being: A Call for a Mixed Methods Research Agenda to Build Shame Competence","authors":"Steven Thornton MD ,&nbsp;Sophie Korenek BS ,&nbsp;Jacob A. Greenberg MD, EdM ,&nbsp;William Bynum MD, PhD","doi":"10.1016/j.jsurg.2025.103770","DOIUrl":"10.1016/j.jsurg.2025.103770","url":null,"abstract":"<div><div>There is a well-known but incompletely described well-being crisis in surgery. Rates of poor mental health, substance misuse, and self-harm ideation are concerningly high. There is a growing interest in, and a related body of literature seeking to understand, surgical residents’ experiences of shame and how this emotionally complex phenomenon is related to established constructs such as burnout, grit, and depression. These early studies lay an important quantitative foundation for research into the shame experienced during surgical training and connect it to existing intellectual frameworks for understanding the phenomenon. Still, important opportunities exist to advance the rigor with which we conduct quantitative shame research, namely through the newly developed Shame Frequency Questionnaire, yet to be deployed, for studying shame in surgical trainees. Likewise, qualitative studies remain an underutilized area for deep exploration into the nature and meaning of shame experiences in surgical training. Leveraging a mixed methods approach will inform nuanced and relevant ways to apply tools such as shame competence – a framework to guide healthy engagement with shame – within surgical training environments.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103770"},"PeriodicalIF":2.1,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461056","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":"Corrigendum to Standardizing Pediatric Facial Laceration Management to Advance Equity and Education, J Surg Educ, 82, 9, 2025, 103613","authors":"Ogonna N. Nnamani Silva ,&nbsp;David M. Mills ,&nbsp;Eric W. Fleegler ,&nbsp;Jason A. Levy ,&nbsp;John G. Meara ,&nbsp;Andrew F. Miller ,&nbsp;Ingrid M. Ganske","doi":"10.1016/j.jsurg.2025.103772","DOIUrl":"10.1016/j.jsurg.2025.103772","url":null,"abstract":"","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103772"},"PeriodicalIF":2.1,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Outcomes Through High-Fidelity Advanced Life Support Education: An Interdisciplinary Approach to Implementation and Quality Improvement","authors":"Jennifer Peterson DNP, ARNP, ACNP-BC ,&nbsp;Jenelle Badulak MD ,&nbsp;Jordan Surrusco PA-C ,&nbsp;Janet Regan-Baggs DNP, RN, ACNS-BC, CCNS, CCRN ,&nbsp;Megan Robinson RN ,&nbsp;Ruth Rogers MN, RN, CNOR, CHSE ,&nbsp;Joel Green MSN, RN, CCRN-CSC-CMC ,&nbsp;Jenny Garnett MFA, CST ,&nbsp;Kailey Sparks RN ,&nbsp;Melissa Cullen RT ,&nbsp;Allison Chen ,&nbsp;Emeline Wong ,&nbsp;Angela D. Pal PhD, APRN, ACNP-BC, CHSE ,&nbsp;Aaron M. Cheng MD, FACS ,&nbsp;Jay D. Pal MD, PhD","doi":"10.1016/j.jsurg.2025.103764","DOIUrl":"10.1016/j.jsurg.2025.103764","url":null,"abstract":"<div><h3>Objective</h3><div>Cardiac arrest in postcardiac surgery patients presents distinct challenges that standard Advanced Cardiac Life Support (ACLS) protocols may not fully address. Cardiac advanced life support (CALS) provides specialized training to improve recognition and management of these emergencies. We developed and implemented a CALS code process to enhance postarrest outcomes in this patient population.</div></div><div><h3>Methods</h3><div>This study assessed the impact of an interdisciplinary CALS education program on healthcare providers’ knowledge and response capabilities. The program included didactic sessions, high-fidelity simulation exercises, and pre- and post-training assessments. Participants included registered nurses (RNs), advanced practice providers, critical care physicians, pharmacists, respiratory therapists (RTs), and cardiac surgeons. Training included key CALS principles, highlighting differences from standard ACLS protocols. Simulated scenarios reinforced team-based responses, including management of emergent sternotomy. Patient outcomes following cardiac arrest were evaluated before and after implementation of the CALS code process.</div></div><div><h3>Results</h3><div>A total of 141 participants completed training (57 providers, 75 RNs/RTs, and 9 pharmacists). Confidence in the CALS response improved on a 5-point Likert scale (3.08-4.19, <em><u>P</u></em> &lt; .05), when measured as a cohort. Knowledge scores improved from 85% to 95% for providers and from 80% to 90% for RNs/RTs. Postcardiac arrest patient survival showed an improvement after implementation of the CALS-focused educational program but was not statistically significant.</div></div><div><h3>Conclusions</h3><div>A CALS-focused educational program enhanced interdisciplinary team preparedness for postcardiac surgery arrests and led to better patient survival. Additional ongoing multidisciplinary team training may be needed to further demonstrate a sustainable improvement in patient survival.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103764"},"PeriodicalIF":2.1,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460994","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":"Advancing Future Surgeons: Utilization of Surgical Simulation in Medical Student Surgery Clerkships","authors":"Benjamin Thomae BS,&nbsp;Parul Rai BS,&nbsp;Kristof S. Gutowski BS,&nbsp;Jennifer Slota BA,&nbsp;Umer A. Qureshi MEd,&nbsp;Arun K. Gosain MD","doi":"10.1016/j.jsurg.2025.103765","DOIUrl":"10.1016/j.jsurg.2025.103765","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluates the current integration of simulation-based training (SBT) within core surgical clerkships and sub-internships at U.S. medical schools, comparing usage and identifying areas for improvement.</div></div><div><h3>Design</h3><div>A cross-sectional survey was distributed to third-year surgery clerkship directors and fourth-year general surgery sub-internship directors across U.S. allopathic and osteopathic medical schools. The survey inquired about the use of SBT, including the types of simulations, their frequency, and skill emphasis. Data were analyzed using descriptive statistics and Fisher's exact test.</div></div><div><h3>Setting</h3><div>Data collection was completed via an anonymous Qualtrics survey.</div></div><div><h3>Participants</h3><div>A total of 73 responses were received from 53 of the total 191 institutions contacted, representing a 28% response rate. Respondents included core surgical clerkship directors (<em>n</em> = 46, 63%) and sub-internship directors (<em>n</em> = 27, 37%).</div></div><div><h3>Results</h3><div>The survey revealed that 81% of core clerkships incorporate SBT, compared to 32% of sub-internships (p &lt; 0.001). Core clerkships predominantly utilize low-fidelity models (89%), such as suture pads and basic task trainers, with limited use of high-fidelity models (34%) utilizing advanced technology and effort to create more immersive experiences. Sub-internships primarily use low-fidelity models (100%), but with less integration of SBT overall. Programs incorporating SBT emphasize non-technical skills training more in core clerkships (77%) than in sub-internships (33%) (p = 0.05).</div></div><div><h3>Conclusions</h3><div>SBT is relatively well-established in core surgery clerkships but underutilized in sub-internships, presenting an opportunity to enhance surgical preparedness. Expanding both low- and high-fidelity SBT in sub-internships could address competency gaps noted by program directors. Similarly, increasing SBT for non-technical skills in sub-internships may better prepare students for surgical residency. Future research should explore long-term outcomes and barriers to broader SBT use, particularly for development and use of high-fidelity simulations.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103765"},"PeriodicalIF":2.1,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461054","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":"Safely Debriefing Unexpected Simulation Death: How We Did It","authors":"Joseph C. L’Huillier MD, MS-HPEd ,&nbsp;Sasha M. Ulrich MD ,&nbsp;Sarah A. Jung PhD ,&nbsp;Ann P. O’Rourke MD, MPH, FACS ,&nbsp;Amy E. Liepert MD, FACS","doi":"10.1016/j.jsurg.2025.103760","DOIUrl":"10.1016/j.jsurg.2025.103760","url":null,"abstract":"<div><h3>Purpose</h3><div>Medical students feel inadequately prepared to cope with patient death. Simulation training may provide learners with the opportunity to experience death in a safe environment with a structured debriefing.</div></div><div><h3>Methods</h3><div>Nineteen fourth-year medical students who matched into surgical specialties participated in a 2-week surgical intern preparatory course. During an individual surgical decision-making simulation, 6 learners experienced unexpected patient death at the hands of a facilitator who deviated from the simulation script. Subjectively, these learners displayed high anxiety before the debriefing. Objectively, their self-reported anxiety after the structured debriefing was similar to the self-reported anxiety of learners who did not experience simulation death.</div></div><div><h3>Results</h3><div>We formalized a bi-directional debriefing instrument using the Gather Analyze Summarize (GAS) model as a framework. We recognized that learners who experienced simulation death need to debrief on 2 aspects of the simulation: 1) Simulation death and 2) Scientific content.</div></div><div><h3>Conclusion</h3><div>Our unexpected experience with simulation death led to the development of a debriefing tool that can be used by other surgical educators. Learning how to process the ensuing emotional response to patient death in simulation may benefit trainees provided they undergo a structured debriefing.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"83 1","pages":"Article 103760"},"PeriodicalIF":2.1,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454421","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}