Journal of surgical education
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Comparative Study
The utility of endovascular simulation to improve technical performance and stimulate continued interest of preclinical medical students in vascular surgery.
New training paradigms in vascular surgery allow for early specialization out of medical school. Surgical simulation has emerged as an educational tool for trainees to practice procedures in a controlled environment allowing interested medical students to perform procedures without compromising patient safety. The purpose of this study is to assess the ability of a simulation-based curriculum to improve the technical performance and interest level of medical students in vascular surgery. ⋯ The use of high fidelity endovascular simulation within an introductory vascular surgery course improves medical student performance with respect to technical skill, patient safety parameters, and global performance assessment. Mentored exposure to endovascular procedures on the simulator positively impacts long term medical student attitudes towards vascular surgery. Simulator-based courses may have the potential to be an important component in the assessment and recruitment of medical students for future surgical training programs.
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Comparative Study
Factors correlated with surgery resident choice to practice general surgery in a rural area.
General surgery workforce shortages in the rural United States are likely to worsen over the next decade. We sought to identify reasons that general surgery residency graduates choose rural versus urban practice. ⋯ General surgery residency graduates and their spouses who choose rural practices are more likely than those selecting urban practices to have rural backgrounds and interests. Completing a rural clerkship during medical school and choosing a residency program committed to rural general surgery preparation are strongly correlated with rural practice. These findings may help formulate strategies to increase recruitment and retention of rural general surgeons.
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Comparative Study
Four-year experience with a regional program providing simulation-based endovascular training for vascular surgery fellows.
High-fidelity procedure simulation has been found useful for training vascular surgery residents in endovascular procedures, but the costs of acquiring, maintaining, and operating simulators represent a barrier to routine use of endovascular simulation in vascular surgery programs. Providing simulation training opportunities through regional centers may make simulation more cost effective, but the costs and benefits of this approach have not been reported previously. We reviewed participation costs in a regional simulation program to provide a benchmark for comparison with other training options. ⋯ Vascular surgery fellows' participation in simulation training at regional centers offers program directors a lower cost alternative for providing high-fidelity simulation training, compared with acquiring and operating an endovascular procedure simulator at their individual institutions.
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In response to the Accreditation Council for Graduate Medical Education (ACGME) mandated 80-hour workweek, the night float coverage model was one system created to comply with the work-hour restriction. However, concern has risen as to the operative case volume achieved with this model. The purpose of this study is to determine which system of call (night float vs traditional rotating call) provided the senior surgical resident with the greatest surgical case volume while in compliance with the 80-hour workweek. ⋯ Because of the work-hour restrictions, maximizing surgical education has become a necessity. With the various call systems used throughout general surgery programs, this study specifically compares a traditional 1-in-6 call schedule versus an NFS. Senior residents lost significant operative experience while operating under an NFS as compared with a TCS. Evidence suggests that the more hours spent by a chief resident during normal operative time elicits more operative experience.