Journal of surgical education
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Bile duct injury remains a serious complication of laparoscopic cholecystectomy despite established criteria for the critical view of safety (CVS). Using surgical videos, we compared surgeons' willingness to divide critical structures based on their assessment of the CVS dissection. ⋯ There was minimal agreement on what constituted a safe CVS dissection and there was no difference in the rate of unsafe practices between trainees and faculty. Education may play a more important role than experience when building a culture of safety for laparoscopic cholecystectomy.
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Timely debriefing following a simulated event supports learners in critically reflecting on their performance and areas for improvement. Content of debriefing has been shown to affect learner skill acquisition and retention. The use of good judgment statements from debriefing facilitators is considered superior to judgmental or nonjudgmental statements. Ideally, the majority of the conversation will consist of learner self-reflection and focused facilitation rather than directive performance feedback. We hypothesized that the introduction of a written tool to help facilitate high-quality debriefing techniques could improve the ratio of judgmental, nonjudgmental, and good judgment statements from facilitators, as well as shift the percentage of talk in the debrief away from directive performance feedback and toward self-assessment and focused facilitation. ⋯ The discourse in our interprofessional trauma simulation debriefings unaided by a written debriefing tool skewed heavily toward direct performance feedback, with a preponderance of nonjudgmental statements. After introduction of the tool, dialogue shifted significantly toward learner self-assessment, and there was a large increase in utilization of debriefing with good judgment. This shift toward higher quality debriefing styles demonstrates the utility of such a tool in the debriefing of interprofessional simulations.
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This study aimed to evaluate the proportion and characteristics of women who serve in general surgery program director (PD) and associate program director (APD) positions in the United States. ⋯ Among general surgery program directorship, men continue to hold more positions of educational leadership, although the trend appears to be shifting toward a more equal balance, particularly in those programs with proportionately more women faculty. This discrepancy may be due to academic rank or length of tenure. As more women hold academic positions in the field of general surgery, an increase in the representation of this group in leadership is anticipated. Although senior leadership (PD) positions remain disproportionately held by men, APD positions are filled by a greater percentage of women than academic surgical faculty, although the absolute percentage remains less than 50%. Educational leadership may be a viable path to academic leadership for both women and men.
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Comparative Study
Examining the Impact of Using the SIMPL Application on Feedback in Surgical Education.
The System for Improving and Measuring Procedural Learning (SIMPL) smartphone application allows physicians to provide dictated feedback to surgical residents. The impact of this novel feedback medium on the quality of feedback is unknown. Our objective was to compare the delivery and quality of best-case operative performance feedback given via SIMPL to feedback given in-person. ⋯ Although feedback given via SIMPL was more direct and based on the attendings' perspectives, the quality of the feedback did not differ significantly. Use of the dictation feature of SIMPL to deliver resident operative performance feedback is a reasonable alternative to in-person feedback.
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Trauma patients are triaged by the severity of their injury or need for intervention while en route to the trauma center according to trauma activation protocols that are institution specific. Significant research has been aimed at improving these protocols in order to optimize patient outcomes while striving for efficiency in care. However, it is known that patients are often undertriaged or overtriaged because protocol adherence remains imperfect. The goal of this quality improvement (QI) project was to improve this adherence, and thereby reduce the triage error. It was conducted as part of the formal undergraduate medical education curriculum at this institution. ⋯ The combination of web tool implementation and protocol refinement decreased the combined triage error rate by over 50% (from 16.7%-7.9%). We developed and tested a web tool that improved triage accuracy, and provided a sustainable method to enact future quality improvement. This web tool and QI framework would be easily expandable to other hospitals.