Post Night Shift Education for Interns: A Pilot Program.

Background: Night float rotations are associated with decreased feedback, educational conference attendance, and operative time. Interns are also more isolated and spend less time on teams. We therefore developed a novel post night shift initiative to address these shortcomings and examined its impact on the educational experience and sense of belonging among interns.

Minimally invasive colorectal cancer surgery: an observational study of medicare advantage and fee-for-service beneficiaries.

Background: Enrollment of Medicare beneficiaries in medicare advantage (MA) plans has been steadily increasing. Prior research has shown differences in healthcare access and outcomes based on Medicare enrollment status. This study sought to compare utilization of minimally invasive colorectal cancer (CRC) surgery and postoperative outcomes between MA and Fee-for-Service (FFS) beneficiaries.

Medical Student Perceptions of Academic Surgery: Rose-Colored Glasses or Jaded Prism?

Objective: Stereotypes of surgeons are pervasive and play a role in medical students' decisions about pursuing a surgical career. This study aimed to determine: (1) how medical students' perceptions of surgery and surgeons changed following exposure to surgery during clerkship rotations; and (2) if gender and racial/ethnic identification played a role in this process.

Design, Setting, And Participants: In this mixed-method study, clerkship students at one U.

Mapping and modeling human colorectal carcinoma interactions with the tumor microenvironment.

The initiation and progression of cancer are intricately linked to the tumor microenvironment (TME). Understanding the function of specific cancer-TME interactions poses a major challenge due in part to the complexity of the in vivo microenvironment. Here we predict cancer-TME interactions from single cell transcriptomic maps of both human colorectal cancers (CRCs) and mouse CRC models, ask how these interactions are altered in human tumor organoid (tumoroid) cultures, and functionally recapitulate human myeloid-carcinoma interactions in vitro.

The Road to Mastery: An Analysis of Goal Orientation in the Transition from Medical School to Surgical Residency.

Purpose: Goal orientation (GO) is a psychological construct which describes an individual's intrinsic motivation for learning in terms of mastery and performance goals. Mastery goals relate to the intrinsic drive to learn for the sake of learning, while performance goals are oriented toward validating one's own competence by seeking favorable judgments (Performance Approach; PAP) or avoiding negative judgments (Performance Avoid; PAV). Having a mastery GO has been shown to improve overall job satisfaction as well as optimize job performance.

Development of a Machine Learning Model to Identify Colorectal Cancer Stage in Medicare Claims.

Purpose: Staging information is essential for colorectal cancer research. Medicare claims are an important source of population-level data but currently lack oncologic stage. We aimed to develop a claims-based model to identify stage at diagnosis in patients with colorectal cancer.

Outcomes of the 2021-2022 APDS General Surgery Recruitment Process Recommendations.

Background: In recent years, mounting challenges for applicants and programs in resident recruitment have catapulted this topic into a top priority in medical education. These challenges span all aspects of recruitment-from the time an applicant applies until the time of the Match-and have widespread implications on cost, applicant stress, compromise of value alignment, and holistic review, and equity. In 2021-2022, the Association of Program Directors in Surgery (APDS) set forth recommendations to guide processes for General Surgery residency recruitment.

Comparison of Simulated Outcomes of Colorectal Cancer Surgery at the Highest-Performing vs Chosen Local Hospitals.

Importance: Variation in outcomes across hospitals adversely affects surgical patients. The use of high-quality hospitals varies by population, which may contribute to surgical disparities.

Objective: To simulate the implications of data-driven hospital selection for social welfare among patients who underwent colorectal cancer surgery.

Exploring ethnic differences in post-discharge patterns of surgical care for older adults admitted with diverticulitis.

Aim: We aimed to evaluate ethnic differences in patterns of care following an index nonoperative admission for acute diverticulitis amongst a universally insured patient cohort.

Methods: We identified nationwide Medicare beneficiaries aged 65.5 years or older hospitalized between 1 July 2015 and 1 November 2017 for nonoperative management of an index admission for diverticulitis.

Evaluating Changes in Surgical Outcomes for Patients With Inflammatory Bowel Disease Following Medicaid Expansion.

Background: Little is known about the impact of Medicaid expansion on the surgical care of inflammatory bowel disease. We sought to determine whether Medicaid expansion is associated with improved postsurgical outcomes for patients with inflammatory bowel disease undergoing a colorectal resection.

Methods: We performed a risk-adjusted difference-in-difference study examining postsurgical outcomes for patients ages 26 to 64 with Crohn's disease or ulcerative colitis undergoing a colorectal resection across 15 states that did and did not expand Medicaid before (2012-2013) and after (2016-2018) policy reform.

Quality and readability assessment of online patient information on cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

Background And Objectives: We aim to assess the quality and readability of online information available to patients considering cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).

Methods: The top three search engines (Google, Bing, and Yahoo) were searched in March 2022. Websites were classified as academic, hospital-affiliated, foundation/advocacy, commercial, or unspecified.

Evaluating the Implementation of a Medical Student's Handoff Curriculum During the Surgery Clerkship.

Introduction: Early introduction to essential communication skills is important. We sought to determine if a handoff curriculum (HC) would improve confidence, decrease anxiety, and increase participation in clinical handoffs during the surgical clerkship.

Methods: A multi-center prospective cohort study was performed at two medical schools.

Embracing Allyship in Academic Surgery: How All Surgeons Can Become Effective Champions for Change.

As the surgical community continues to work towards greater diversity, equity, and inclusion, the need for buy-in from all surgeons-including those of the White majority-becomes increasingly apparent. This article invites all surgeons to aid in diversity, equity, and inclusion efforts as "allies," "upstanders," and "champions for change," and provides 2 specific frameworks for enacting allyship within the surgical field. Overt and conscious efforts to embrace allyship are imperative as we seek to fulfill our professional responsibilities to patients and will help create a workplace environment where all persons feel accepted, valued, welcomed, and respected.

Pulling Back from the Brink: A Multi-Pronged Approach to Address General Surgery Resident Clinical Work Hour Adherence.

Purpose: The conflict between prioritizing education for surgical trainees, promoting trainee wellness, and maintaining optimal patient care has remained challenging since the introduction of the Accreditation Council for Graduate Medical Education (ACGME) work hour restrictions in 2003. There is still a dearth of research examining which interventions successfully enable duty hour adherence. This study assessed the impact of a combination of strategic interventions on improving clinical work hour adherence.

Reshaping Residency Recruitment: Achieving Alignment Between Applicants and Programs in Surgery.

Objective: The residency recruitment process has become increasingly challenging for both applicants and program directors, in part, due to the inflation in the number of applications per student. As a result, it has become more daunting for programs to design processes that evaluate applicants holistically. Furthermore, the existing methods used to evaluate and select applicants do not necessarily predict success in residency and may inadvertently lend to gender, racial, and ethnic bias.

Smart-phone Based Geofencing: A Novel Approach to Monitoring Clinical Work Hours in Surgery Residency.

Objective: The Accreditation Council for Graduate Medical Education specifies strict requirements for clinical work hours during residency training, with serious consequences for violations. Self-reporting of work hours by trainees can be inaccurate due to recall bias, giving program directors limited data to influence change. We aimed to assess the impact of a smart-phone based geofencing application on submission rates for work hours and reported violations in a general surgery residency program at a university-based medical center.

Trainee Sex and Accreditation Council for Graduate Medical Education Milestone Assessments During General Surgery Residency.

Importance: In evaluating the effectiveness of general surgery (GS) training, an unbiased assessment of the progression of residents with attention to individual learner factors is imperative.

Objective: To evaluate the role of trainee sex in milestone achievement over the course of GS residency using national data from the Accreditation Council for Graduate Medical Education (ACGME).

Design, Setting, And Participants: This cross-sectional study evaluated female and male GS residents enrolled in ACGME-accredited programs in the US from 2014 to 2018 with reported variation in milestones performance across years in training and representation.

The Flipped Operating Room: Establishing Best Practices in Surgical Education Using Resident-Initiated, Inquiry-Based Preoperative Briefing: Resident-Initiated Preoperative Briefing.

Objective: We performed a pilot study of a resident-initiated, inquiry-based preoperative briefing (R-PROB) to determine the feasibility and potential impact on the educational experience.

Design: A prospective, qualitative pilot study was performed in a general surgery residency program. The R-PROB included pre-operative emails to faculty with case summaries, learning goals, and questions.

In Search of Workforce Diversity? A Program's Successful Approach.

The persistence of health care disparities along racial and ethnic lines highlights the complex and multifactorial nature of this national concern. The paucity of physicians ethnically underrepresented in medicine to treat an ever-growing heterogeneous population inherently contributes to these ongoing disparities. The authors proposed an approach to improve the representation of physicians underrepresented in medicine in their plastic surgery residency program.

The impact of the affordable care act on surgeon selection amongst colorectal surgery patients.

Background: It is unclear how the Affordable Care Act's state-based Medicaid Expansion (ME) has impacted surgeon selection for colorectal resections (CRS).

Methods: We performed a risk-adjusted DID analysis on state discharge data of CRS patients aged 26-64 from NY (Expansion) and FL (non-Expansion) before (2012-2013) and after (2016-2017) ME. Primary outcome was use of a high-volume or colorectal-boarded surgeon.