Journal of the American College of Surgeons
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We designed a model for pre- and postoperative discussions between faculty and trainees to maximize educational yield of cases and accelerate residents' technical development. We sought to study its effect on surgical education via participant perceptions and longitudinal validated performance evaluations. ⋯ Our structured model for perioperative educational discussions, consisting of the preoperative "Education Time Out" and postoperative "Education Debrief," significantly improved faculty and resident satisfaction and was associated with measurable improvements in resident technical skills without requiring significantly more time.
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Despite patients being important stakeholders in surgical training, little is known about the public's perception of trainee participation in surgical care. This study evaluates the public's perception of surgical resident autonomy and supervision. ⋯ Among survey participants broadly representing the US population, resident participation in operations is not universally accepted. Public perception of surgical resident autonomy and supervision is important, as GME continues to evolve to address readiness for independent practice.
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Thirty years after the Mangled Extremity Severity Score was developed, advances in vascular, trauma, and orthopaedic surgery have rendered the sensitivity of this score obsolete. A significant number of patients receive amputation during subsequent admissions, which are often missed in the analysis of amputation at the index admission. We aimed to identify risk factors for and predict amputation on initial admission or within 30 days of discharge (peritraumatic amputation [PTA]). ⋯ Machine learning-based prediction models combined with sampling algorithms (such as the NearMiss algorithm in this study), can help identify patients with traumatic arterial injuries at high risk for amputation and guide targeted intervention in the modern age of vascular surgery.