Journal of surgical education
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Comparative Study
Comparison of surgical residency applicants from U.S. medical schools with U.S.-born and foreign-born international medical school graduates.
Compare characteristics of U.S. medical school graduates with U.S.-born and foreign-born international medical school (IMG) graduates. ⋯ IMGs are older, frequently male, hold more advanced degrees, and produce more scholarly works but require multiple attempts to pass the USMLE. IMGs also hold more jobs after graduation with most positions being in research or surgery.
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The objectives for this study are as follows: (1) to determine whether a weekly educational program for surgical residents resulted in an improvement in 5-year first-time pass rates on the ABS qualifying (QE), certifying (CE), and combined (QE/CE) examinations at our institution and (2) to determine a minimum ABSITE threshold for predicting ABS pass rates. ⋯ An educational program of weekly assigned reading, followed by weekly examinations prepared and administered by the PD, resulted in an increase in the 5-year first-time pass rates on the QE, CE, and combined QE/CE. An ABSITE score less than the 30th percentile, or scoring less than the 35th percentile more than once during residency, identified a group at significantly increased risk of failing the QE. Programs that seek to increase the ABS examinations passage rates should consider instituting this type of program.
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To identify the learning needs of faculty members who are not perceived by residents as outstanding teachers in the operating room. ⋯ Resident perceptions of operating room teaching by faculty surgeons are strongly associated with overall perceptions of the surgeon and with perceptions of specific teaching behaviors exhibited in the operating room. Regression analysis suggests that approximately 76% of the variability in resident evaluations of operating room teaching may be associated with the extent to which a surgeon demonstrates a positive attitude toward teaching, remains calm and courteous, and provides a "hands on" learning experience. Faculty development efforts aimed at operating room teaching that focus on reinforcing or modifying these behaviors may contribute to improved overall perceptions of faculty by residents.
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To determine whether LapSim training (version 3.0; Surgical Science Ltd, Göteborg, Sweden) to criteria for novice PGY1 surgical residents had predictive validity for improvement in the performance of laparoscopic cholecystectomy. ⋯ Using current criteria, we doubt that the time and effort spent training novice PGY1 Surgical Residents on the basic LapSim training programs is justified, as such training to competence lacks predictive validity in most domains of the GOALS program. We are investigating 2 other approaches: more difficult training exercises using the LapSim system and an entirely different approach using haptic technology (ProMis; Haptica Ltd., Ireland), which uses real instruments, with training on realistic 3-dimensional models with real rather than simulated cutting, sewing, and dissection. Although experienced video gamers achieve competency faster than nongamers on LapSim programs, that skill set does not translate into improved clinical performance.
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The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) defines a "handoff" as a contemporaneous, interactive process of passing patient-specific information from one caregiver to another for the purpose of ensuring the continuity and safety of patient care. The purpose of this study was to conduct a comprehensive investigation on the determinants of an effective handoff management system. Specifically, we sought to address the following null hypotheses: There is no difference before and after implementation of a new, low-cost, low-tech process for surgery patient handoffs in accuracy of information, completeness, clarity of exact time of patient transfer, and number of tasks appropriately handed off. ⋯ By simplifying and standardizing the handoff instrument, we demonstrated improvements in resident perceptions of accuracy, completeness, and number of tasks transferred. This low-cost, low-tech paradigm may be useful to others.