Current surgery
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Assessing the risk and predicting the outcome of surgery, trauma, and surgical intensive care is an important aspect of perioperative practice. There have been attempts to devise and validate many scoring systems to predict the prognosis of patients having a similar severity of illness. This article reviews some of the commonly used systems with respect to their development, strengths, and limitations. ⋯ Risk assessment scores may assist in the perioperative risk evaluation with respect to organ systems. Prognostication of critically ill patients belonging to a category of illness may be done using physiological scoring systems taking into account the difference in the case-mix of the particular unit.
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The purpose of this study is to review the patterns of cervical spine evaluation in blunt trauma patients to identify redundant, inefficient, or risky practices at our community hospital.
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Comparative Study
Do general surgery applicants really want to be general surgeons?
The authors sought to compare categorical general surgery applicants with applicants in other specialties regarding their final specialty-choice ranking for residency positions. ⋯ In 2004, the categorical general surgery applicant pool was relatively uncommitted to the specialty of general surgery. The number of applicants ranking categorical general surgery as a non-preferred specialty was likely even higher than these data indicate, as unmatched applicants in non-NRMP matches who then ranked categorical general surgery programs in the NRMP were tabulated by the NRMP as having ranked categorical general surgery as their preferred specialty.
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Prior data have shown that resident duty-hour reform has not affected faculty work hours; yet the preservation of faculty hours may have been at the expense of productivity. We sought to examine change in clinical productivity. ⋯ Faculty have preserved work hours and clinical productivity, despite a tendency to take on work previously done by residents. This suggests that academic activities may have suffered.
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We continue to increase the amount of evaluations to improve the outcomes of our residency programs. Although ongoing faculty evaluations clearly are an important part of faculty development, their value in terms of improving the program needs to be evaluated. The questions asked were as follows: (1) Do faculty evaluations continue to improve the faculty over the course of successive evaluation periods? (2) Are there groups of faculty who would benefit the most from faculty evaluation feedback? (3) Are there any specific objective categories within the evaluation that carry more value and may help to shorten this form? ⋯ (1) Ongoing faculty evaluations indeed are a powerful tool to improve the faculty as a whole. (2) The faculty members with the lowest evaluations showed the largest amount of improvement. (3) Providing feedback to the residents seems to be the most valued factor by the residents for faculty evaluations and perhaps could become the basis of the evaluation for the most accomplished faculty.