The APGO Academic Scholars and Leaders Program: Supporting obstetrics and gynecology faculty development for 20 years.

Purpose: We evaluate the impacts of the Academic Scholars and Leaders (ASL) Program in achieving 3 key objectives: treatment of education as a scholarly pursuit, improved education leadership, and career advancement.

Materials And Methods: We report on the twenty-year experience of the ASL Program-a national, longitudinal faculty development program of the Association of Professors of Obstetrics and Gynecology (APGO) covering instruction, curriculum development/program evaluation, assessment/feedback, leadership/professional development, and educational scholarship. We conducted a cross-sectional, online survey of ASL participants who graduated in 1999-2017.

Relationship of procedural numbers with meaningful procedural autonomy in general surgery residents.

Background: Concerns exist regarding the competency of general surgery graduates with performing core general surgery procedures. Current competence assessment incorporates minimal procedural numbers requirements.

Methods: Based on the Zwisch scale we evaluated the level of autonomy achieved by categorical PGY1-5 general surgery residents at 14 U.

What factors influence attending surgeon decisions about resident autonomy in the operating room?

Background: Educating residents in the operating room requires balancing patient safety, operating room efficiency demands, and resident learning needs. This study explores 4 factors that influence the amount of autonomy supervising surgeons afford to residents.

Methods: We evaluated 7,297 operations performed by 487 general surgery residents and evaluated by 424 supervising surgeons from 14 training programs.

Readiness of US General Surgery Residents for Independent Practice.

Objective: This study evaluates the current state of the General Surgery (GS) residency training model by investigating resident operative performance and autonomy.

Background: The American Board of Surgery has designated 132 procedures as being "Core" to the practice of GS. GS residents are expected to be able to safely and independently perform those procedures by the time they graduate.

Effect of Ongoing Assessment of Resident Operative Autonomy on the Operating Room Environment.

Objective: We have previously demonstrated the feasibility and validity of a smartphone-based system called Procedural Autonomy and Supervision System (PASS), which uses the Zwisch autonomy scale to facilitate assessment of the operative performances of surgical residents and promote progressive autonomy. To determine whether the use of PASS in a general surgery residency program is associated with any negative consequences, we tested the null hypothesis that PASS implementation at our institution would not negatively affect resident or faculty satisfaction in the operating room (OR) nor increase mean OR times for cases performed together by residents and faculty.

Methods: Mean OR times were obtained from the electronic medical record at Northwestern Memorial Hospital for the 20 procedures most commonly performed by faculty members with residents before and after PASS implementation.

The Feasibility of Real-Time Intraoperative Performance Assessment With SIMPL (System for Improving and Measuring Procedural Learning): Early Experience From a Multi-institutional Trial.

Purpose: Intraoperative performance assessment of residents is of growing interest to trainees, faculty, and accreditors. Current approaches to collect such assessments are limited by low participation rates and long delays between procedure and evaluation. We deployed an innovative, smartphone-based tool, SIMPL (System for Improving and Measuring Procedural Learning), to make real-time intraoperative performance assessment feasible for every case in which surgical trainees participate, and hypothesized that SIMPL could be feasibly integrated into surgical training programs.

Beta Test of Web-Based Virtual Patient Decision-Making Exercises for Residents Demonstrates Discriminant Validity and Learning.

Introduction: Correct clinical decision-making is a key competency of surgical trainees. The purpose of this study was to assess validity and effect on resident decision-making accuracy of web-based virtual patient case scenarios in general surgery training.

Material And Methods: During the 2013-2014 academic year, the use of web-based virtual patient scenarios for teaching and assessment of resident critical thinking and decision-making was assessed in 2 urban university-based residency programs.

Using just-in-time teaching and peer instruction in a residency program's core curriculum: enhancing satisfaction, engagement, and retention.

Purpose: To assess use of the combined just-in-time teaching (JiTT) and peer instruction (PI) instructional strategy in a residency program's core curriculum.

Method: In 2010-2011, JiTT/PI was piloted in 31 core curriculum sessions taught by 22 faculty in the Northwestern University Feinberg School of Medicine's general surgery residency program. JiTT/PI required preliminary and categorical residents (n=31) to complete Web-based study questions before weekly specialty topic sessions.

Reliability, validity, and feasibility of the Zwisch scale for the assessment of intraoperative performance.

Purpose: The existing methods for evaluating resident operative performance interrupt the workflow of the attending physician, are resource intensive, and are often completed well after the end of the procedure in question. These limitations lead to low faculty compliance and potential significant recall bias. In this study, we deployed a smartphone-based system, the Procedural Autonomy and Supervisions System, to facilitate assessment of resident performance according to the Zwisch scale with minimal workflow disruption.

Defining the autonomy gap: when expectations do not meet reality in the operating room.

Objective: To develop operative independence with essential procedures by the end of their training, residents need graded autonomy as they progress through training. This study compares autonomy expectations, as defined by faculty and residents, with autonomy measured in the operating room.

Methods: Operative procedures performed by general surgery residents between November 2012 and June 2013 were each assigned an autonomy score by the operating attending physician using a previously described rating scale (Zwisch).

Evaluation of a blended learning surgical skills course for rural surgeons.

Background: Rural surgeons have unique learning needs not easily met by traditional continuing medical education courses.

Methods: A multidisciplinary team developed and implemented a skills curriculum focused on leadership and communication, advanced endoscopy, emergency urology, emergency gynecology, facial plastic surgery, ultrasound, and management of fingertip amputations.

Results: Twenty-five of 30 (89%) rural surgeons who completed a follow-up course evaluation reported that the knowledge acquired during the course had improved their practice and/or the quality of patient care, particularly by refining commonly used skills and expanding the care options they could offer to their patients.

Review of influential articles in surgical education: 2002-2012.

Background: Exploring the trends in surgical education research offers insight into concerns, developments, and questions researchers are exploring that are relevant to teaching and learning in surgical specialties.

Objective: We conducted a review of the surgical education literature published between 2002 and 2012. The purpose was 2-fold: to provide an overview of the most frequently cited articles in the field of surgical education during the last decade and to describe the study designs and themes featured in these articles.

Development and verification of a taxonomy of assessment metrics for surgical technical skills.

Purpose: To create and empirically verify a taxonomy of metrics for assessing surgical technical skills, and to determine which types of metrics, skills, settings, learners, models, and instruments were most commonly reported in the technical skills assessment literature.

Method: In 2011-2012, the authors used a rational analysis of existing and emerging metrics to create the taxonomy, and used PubMed to conduct a systematic literature review (2001-2011) to test the taxonomy's comprehensiveness and verifiability. Using 202 articles identified from the review, the authors classified metrics according to the taxonomy and coded data concerning their context and use.

Implementing an excellence in teaching recognition system: needs analysis and recommendations.

Purpose: Teaching awards have been suggested to serve a variety of purposes. The specific characteristics of teaching awards and the associated effectiveness at achieving planned purposes are poorly understood. A needs analysis was performed to inform recommendations for an Excellence in Teaching Recognition System to meet the needs of surgical education leadership.

Duration of faculty training needed to ensure reliable or performance ratings.

Objectives: The American Board of Surgery has mandated intraoperative assessment of general surgery residents, yet the time required to train faculty to accurately and reliably complete operating room performance evaluation forms is unknown. Outside of surgical education, frame-of-reference (FOR) training has been shown to be an effective training modality to teach raters the specific performance indicators associated with each point on a rating scale. Little is known, however, about what form and duration of FOR training is needed to accomplish reliable ratings among surgical faculty.

Use of cognitive task analysis to guide the development of performance-based assessments for intraoperative decision making.

Background: There is a paucity of performance-based assessments that focus on intraoperative decision making. The purpose of this article is to review the performance outcomes and usefulness of two performance-based assessments that were developed using cognitive task analysis (CTA) frameworks.

Methods: Assessment-A used CTA to create a "think aloud" oral examination that was administered while junior residents (PGY 1-2's, N = 69) performed a porcine-based laparoscopic cholecystectomy.

What surgical skills rural surgeons need to master.

Background: As new technology is developed and scientific evidence demonstrates strategies to improve the quality of care, it is essential that surgeons keep current with their skills. Rural surgeons need efficient and targeted continuing medical education that matches their broader scope of practice. Developing such a program begins with an assessment of the learning needs of the rural surgeon.

Development and participant assessment of a practical quality improvement educational initiative for surgical residents.

Background: As patient-safety and quality efforts spread throughout health care, the need for physician involvement is critical, yet structured training programs during surgical residency are still uncommon. Our objective was to develop an extended quality-improvement curriculum for surgical residents that included formal didactics and structured practical experience.

Methods: Surgical trainees completed an 8-hour didactic program in quality-improvement methodology at the start of PGY3.

Using optimization models to demonstrate the need for structural changes in training programs for surgical medical residents.

The primary goal of a residency program is to prepare trainees for unsupervised care. Duty hour restrictions imposed throughout the prior decade require that residents work significantly fewer hours. Moreover, various stakeholders (e.

Teaching for understanding in medical classrooms using multimedia design principles.

Objectives: In line with a recent report entitled Effective Use of Educational Technology in Medical Education from the Association of American Medical Colleges Institute for Improving Medical Education (AAMC-IME), this study examined whether revising a medical lecture based on evidence-based principles of multimedia design would lead to improved long-term transfer and retention in Year 3 medical students. A previous study yielded positive effects on an immediate retention test, but did not investigate long-term effects.

Methods: In a pre-test/post-test control design, a cohort of 37 Year 3 medical students at a private, midwestern medical school received a bullet point-based PowerPoint™ lecture on shock developed by the instructor as part of their core curriculum (the traditional condition group).

A theory-based model for teaching and assessing residents in the operating room.

The operating room (OR) remains primarily a master/apprenticeship-based learning environment for surgical residents. Changes in surgical education and health care systems challenge faculty to efficiently and effectively graduate residents truly competent in operations classified by the Surgical Council on Resident Education as "common essential" and "uncommon essential." Program directors are charged with employing resident evaluation systems that yield useful data, yet feasible enough to fit into a busy surgical faculty member's workflow.

Surgical residents' perception of competence and relevance of the clinical curriculum to future practice.

Introduction: General surgery residents maintain a case log throughout residency in order to achieve a targeted number of designated operations. Program directors must certify that each graduate is competent to enter general surgery practice without direct supervision. Our purpose was twofold, to determine: 1) graduates' perception of competence and relevance of specific operations to their practice; and 2) if case volume is related to competence.