Publications by authors named "Andrea Winthrop"
Background: During the COVID-19 pandemic, opportunities for hands-on surgical and procedural skills training and practice were significantly reduced, as many curricular activities were deferred or converted to a virtual format. This study focused on whether these changes contributed to increased anxiety and decreased confidence for medical students performing these skills.
Methods: The Surgical Skills Technology Elective Program (SSTEP) is an annual five-day intensive procedural skills program after second-year medical school.
Effective pain control after major surgery in neonates presents many challenges. Parenteral opioids (and co-analgesics) are often used but inadequate analgesia and oversedation are not uncommon. Although continuous thoracic epidural analgesia is highly effective and opioid-sparing, its associated risks and the need for staff with specialised skills and/or neonatal intensive care unit staff buy-in may preclude this option even in many academic centres.
View Article and Find Full Text PDFIntroduction: The Surgical Skills and Technology Elective Program (SSTEP) is a bootcamp for preclinical medical students that uses simulation learning methodology to provide exposure to procedural specialties and enhance surgical skills. Despite the widespread adoption of similar bootcamps, evidence is lacking regarding their impact on students' decision to pursue surgical/procedural careers.
Methods: This exploratory analysis consisted of a retrospective, cross-sectional assessment of SSTEP involving a survey examining engagement during clerkship rotations and career decision-making was sent to all SSTEP participants since the program's inception (n = 184).
Objective: The Surgical Skills and Technology Elective Program (SSTEP) is a one-week, simulation-based procedural skills bootcamp for preclinical medical students. Using cognitive load (CL) as a useful framework for understanding simulation in medical education, our aims were to (1) examine the ability of SSTEP to decrease medical students' CL during procedural skills training and (2) determine the impact of SSTEP on secondary learning.
Methods: In this prospective cohort study, twenty SSTEP participants and twenty controls were recruited.
Article Synopsis
- CBME faces a challenge due to the heavy assessment load on faculty, prompting a need to evaluate the effectiveness of peer assessment for surgical skills.
- A study involved 42 second-year medical students, whose surgical task performances were assessed by trained novice and expert raters using OSATS checklists, with agreement levels measured by the intraclass correlation coefficient (ICC).
- The results revealed strong agreement between novice and expert raters, indicating that novice raters can effectively learn to assess peer surgical skills like suturing and tying tasks.
Objectives: Describe changes in the diagnostic approach and treatment for pediatric intussusception over two decades.
Study Design: Administrative universal healthcare data were used to conduct a population-based cohort study of intussusception between January 1997 and December 2016 in Ontario, Canada. A validated case definition was used to identify all patients (<18 years) treated for intussusception in the province at community or tertiary care centers.
This interactive session was held at the 51st Annual Meeting of the Canadian Association of Pediatric Surgeons (CAPS) in preparation for the transition of Pediatric Surgery training in Canada to Competency by Design (a CBME-based model of residency training developed by the Royal College of Physicians and Surgeons of Canada).
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- A retrospective study in Ontario analyzed healthcare costs for children under 18 treated for intussusception between 2003-2016, examining the impact of non-surgical vs. surgical management on expenses.
- Non-surgical treatment costs were the lowest ($2467), while surgical treatment costs were the highest ($8863), with increased costs for failed non-surgical attempts rising significantly over the years.
- The study suggests that standardizing care to enhance non-surgical success and promote early discharge could lead to financial savings for the healthcare system.
Article Synopsis
- A study examined how a simulation-based technical skills course affected anxiety levels in second-year medical students regarding various technical skills.
- Before the course, anxiety levels for these skills ranged from 19% to 86%, but after the course, this dropped to 0-48%.
- The course participants showed a significant reduction in anxiety compared to a peer group, with notable decreases in 15 out of 21 skills.
Background: Suturing is a fundamental skill in undergraduate medical education. It can be taught by faculty-led, peer tutor-led, and holography-augmented methods; however, the most educationally effective and cost-efficient method for proficiency-based teaching of suturing is yet to be determined.
Methods: We conducted a randomized controlled trial comparing faculty-led, peer tutor-led, and holography-augmented proficiency-based suturing training in pre-clerkship medical students.
The following is a summary of the fourth Ein Panel Debate Session from the 50th Annual Meeting of the Canadian Association of Pediatric Surgeons (CAPS) held in Toronto, ON, from September 26-29, 2018. The session focused on surgeon well-being at different stages of career: role of mentorship at the start of career, second victim syndrome, litigation stress syndrome, and retirement. Using Maslach Burnout Inventory Survey, CAPS members were presented their wellness scores as a group compared to other health care providers.
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- - Bronchogenic cysts are rare, congenital cysts that arise from respiratory epithelium and are mostly found in the chest, with very few cases appearing on the skin.
- - There have only been 19 reported cases of cutaneous bronchogenic cysts in the scapular area, almost all of which occurred in male patients; however, this case features a female patient who experienced recurrent cellulitis due to one.
- - The case presented is significant as it is the first recorded instance of a cutaneous scapular bronchogenic cyst in Canada, and the article also reviews existing literature on the topic.
Purpose: Favorable surgical outcomes depend on timely access to care. This study quantifies these delays and explores caregiver barriers to access in a Ugandan facility.
Methods: An interviewer-facilitated survey was administered over 8months to consecutive pediatric surgical families at Mbarara Regional Referral Hospital (MRRH).
Article Synopsis
- Two new rubrics with behavioral anchors were created to enhance feedback for medical students during their surgery clerkship at Queen's UGME.
- * These rubrics were part of a broader overhaul of assessment methods in response to the transition to competency-based medical education (CBME) in postgraduate training.
- * The assessment process was developed through three phases, leading to improved, clear, and actionable feedback for students, fostering better understanding of their performance.
Background: The Surgical Skills and Technology Elective Program (SSTEP) is a voluntary preclerkship surgical bootcamp that uses simulation learning to build procedural knowledge and technical skills before clerkship.
Methods: Eighteen second year students (n = 18) participated in simulation workshops over the course of 7 days to learn clerkship-level procedural skills. A manual was supplied with the program outline.
We report a case of severe respiratory distress in a neonate who was not endotracheally intubated soon after esophageal atresia/tracheoesophageal fistula (EA/TEF) repair. In this serious situation, any form of emergency respiratory support or definitive airway management may compromise the esophageal anastomosis and fistula repair. The cause of respiratory distress in the early postoperative period after EA/TEF is multifactorial, and in this case, included symptomatic tracheomalacia, which is commonly associated with EA/TEF.
View Article and Find Full Text PDFBackground: The Surgical Procedure Feedback Rubric (SPR) is a tool to document resident intraoperative performance and provide targeted feedback to support learning in a competency-based model of surgical education. It differs from other assessment tools because it defines performance criteria by increasing complexity through the use of behavioral anchors, thus embedding standards of performance within the tool. This study explores aspects of validity of the SPR as an assessment tool.
View Article and Find Full Text PDFPurpose: Medical student education has begun to embrace integration across specialties in order to improve understanding of diseases. The Medical College of Wisconsin's Trauma and Injury Control course was developed to expose students to the science, principles, and practice of injury prevention and control, with emphasis on collaboration among disciplines. This paper describes the development, implementation, and evaluation of that course.
View Article and Find Full Text PDFPurpose: The aim of this study was to evaluate whether discharge from the emergency department (ED) after successful hydrostatic reduction (HR) of intussusception is safe.
Methods: We conducted a single institution review of patient records with a diagnosis code of intussusception from 1995 to 2006. Data collected included age, clinical presentation, imaging, surgical interventions, pathology, recurrence, and disposition.
Purpose Of Review: Pediatric injury results in significant preventable morbidity and functional limitations, with long-term impact on the quality of life of children and their families. The purpose of this review is to outline recent research in health-related quality of life (HRQOL) in pediatric trauma, with an emphasis on identification of predictors of outcome that will impact interventions and allocation of resources to optimize recovery.
Recent Findings: Studies of HRQOL in pediatric trauma use a variety of generic measurement tools that have now been validated in this patient population.
Background: Students' satisfaction with the educational quality of a surgical clerkship is influenced by their experiences at assigned clinical sites. We sought to identify key variables perceived by students to be associated with educationally valued clerkship sites.
Methods: Between 1998 and 2002, third-year medical students completed a surgery site survey for each of the 2 sites on which they rotated during their required 2-month surgery rotation, representing a total of 16 sites.
The vacuum-assisted closure (VAC) system has become an accepted treatment modality for acute and chronic wounds in adults. The use of negative-pressure dressing has been documented in adults and, to some extent, in children. However, its use in premature infants has not been reported in the literature.
View Article and Find Full Text PDFBackground/purpose: Data on functional outcomes after pediatric pelvic fractures are limited to those obtained at hospital discharge. This study assesses functional status at both hospital discharge and at 6 months after injury.
Methods: A national multicenter prospective study began in February 2002 and is ongoing.