Journal of surgical education
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Randomized Controlled Trial
Hemostasis in a noncompressible hemorrhage model: an end-user evaluation of hemostatic agents in a proximal arterial injury.
1. Evaluate hemostatic bandages by the end user using subjective and objective criteria. 2. Determine if user training and education level impact overall hemostatic outcomes. 3. Our hypothesis was that prior medical training would be directly linked to improved hemostatic outcomes in noncompressible hemorrhage indepen- dent of dressing used. ⋯ There is no significant difference in hemostasis between hemostatic bandages for proximal arterial hemorrhage. Hemostasis significantly improves between 2 and 4 minutes using direct pressure and hemostatic agents. Prior medical training leads to 20% greater efficacy when using hemostatic dressings.
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Self-assessment is important to learning but few studies have utilized video self-assessment of basic surgical skills. We compared a video self-assessment of suturing and knot tying skills by novice trainees to the assessment by a senior attending surgeon. ⋯ Novice trainees over-estimate their basic technical skills performance compared to the assessment by a senior surgeon. Video self-assessment may be a valuable addition to a pre-residency and surgical internship preparatory curriculum in basic suturing and knot tying.
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To determine the perceived effectiveness of surgical subspecialty training programs in teaching and assessing the 6 ACGME core competencies including research. ⋯ Not all 6 core competencies and research are effectively being taught in surgery subspecialty training programs and mentorship in areas outside of patient care and research is lacking. Emphasis should be placed on faculty supervision and feedback when designing methods to better incorporate all 6 core competencies, research, and mentorship.
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Reliance upon fluoroscopy within urology is increasing, with urologists key in determining radiation exposure to patients, themselves, and other healthcare personnel. However, education in occupational radiation safety is nonstandardized, often lacking. Consequently, residents and practicing urologists risk overexposure. We assessed occupational radiation safety attitudes and practices of training urologists. ⋯ Our findings show that protective equipment usage and occupational radiation monitoring for the training urologist are insufficient. Despite frequent exposure, resident education in radiation safety was found lacking. Efforts should be made to address these deficiencies on a local and national level.
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Congenital agenesis of the gallbladder and cystic duct represents a rare anomaly of the biliary system. It likely results from an embryologic mishap in the development of the hepatobiliary bud and can occur with other associated malformations. We report the case of congenital absence of the gallbladder and cystic duct incidentally found during laparoscopy in a 44-year-old Caucasian female. ⋯ After introducing the laparoscope, the gallbladder and cystic duct were absent and the procedure aborted. Gallbladder and cystic duct agenesis was confirmed by magnetic resonance cholangiopancreatography. We describe here the difficulties with diagnosis and pain management, and review the literature of this rare pathology.