Increasing medical student confidence in gender and sexual health through a student-initiated lecture series.

Introduction: Medical students self-report insufficient training in topics of gender and sexuality in medicine, which may ultimately lead to negative health outcomes in patients for whom they will provide care. This study aims to identify whether a student-initiated lecture series on topics related to gender and sexual health leads to greater student comfort with discussing topics related to diverse sexual content.

Methods: Medical students matriculated during two consecutive academic years were invited to participate in the lecture series.

Epidemiology of Sports Related Concussion in Brazilian Jiu-Jitsu: A Cross-Sectional Study.

Brazilian Jiu-Jitsu (BJJ) is a rapidly growing grappling sport with a wide spectrum of participants. This cross-sectional study examined the lifetime prevalence of concussion in adult BJJ practitioners in the United States using a 17-item survey. A total of 778 (11.

Validation of the Omni: A Novel, Multimodality, and Longitudinal Surgical Skills Assessment.

Objective: The breadth of technical skills included in general surgery training continues to expand. The current competency-based training model requires assessment tools to measure acquisition, learning, and mastery of technical skill longitudinally in a reliable and valid manner. This study describes a novel skills assessment tool, the Omni, which evaluates performance in a broad range of skills over time.

Systemic blood pressure trends and antihypertensive utilization following continuous-flow left ventricular assist device implantation: an analysis of the interagency registry for mechanically assisted circulatory support.

Background: Elevated systemic blood pressure (SBP) has been linked to complications in Continuous-flow left ventricular assist devices (CF-LVADs), including stroke and pump thrombosis. We queried Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) to describe the response of SBP to CF-LVAD implantation and to delineate contemporary trends in antihypertensive (AH) utilization for patients with these pumps.

Methods: We identified all CF-LVAD implantations in patients older than 18 years from 2006-2014, excluding those whose durations were less than 30 days.

American College of Surgeons Resident Objective Structured Clinical Examination: a national program to assess clinical readiness of entering postgraduate year 1 surgery residents.

Objective: This report describes the development, initial implementation, and reliability of American College of Surgeons Resident Objective Structured Clinical Examination (ACS OSCE).

Background: Variability in clinical knowledge and skills of entering surgery residents has been demonstrated. The ACS OSCE was developed to evaluate and help remediate residents' knowledge and skills in managing patients with life-threatening conditions.

Advanced surgical skills for exposure in trauma: a new surgical skills cadaver course for surgery residents and fellows.

Background: Surgical education is changing owing to workforce and economic demands. Simulation and other technical teaching methods are used to acquire skills transferable to the operating room. Operative management of traumatic injuries has declined, making it difficult to acquire and maintain competence.

Mechanism of injury predicts case fatality and functional outcomes in pediatric trauma patients: the case for its use in trauma outcomes studies.

Background/purpose: The mechanism of injury (MOI) may serve as a useful adjunct to injury scoring systems in pediatric trauma outcomes research. The objective is to determine the independent effect of MOI on case fatality and functional outcomes in pediatric trauma patients.

Methods: Retrospective review of pediatric patients ages 2 to 18 years in the National Trauma Data Bank from 2002 through 2006 was done.

Geriatric motor vehicle collision survival: the role of institutional trauma volume.

Background: Links between trauma center volumes and outcomes have been inconsistent in previous studies. This study examines the role of institutional trauma volume parameters in geriatric motor vehicle collision (MVC) survival.

Methods: The New York Statewide Planning and Research Cooperative Systems database was analyzed for all trauma admissions to state-designated Level I and II trauma centers from 1996 to 2003.

Women in surgery residency programs: evolving trends from a national perspective.

Background: Similar numbers of men and women are currently graduating from United States (US) medical schools; therefore, surgery residency programs need to attract graduates of both genders. This study compared gender distributions of allopathic US medical graduates (USMG) from academic years 1999-2000 through 2004-2005. In addition, the gender distributions of USMG and international medical graduates (IMG; analyzed separately) entering accredited general surgery (GS) programs and USMG entering other surgical specialty programs were compared across academic years 2000-2001 through 2005-2006.

Preimplementation predictors of website use: preliminary findings from the SCORE portal pilot study.

Background: in 2008, the Surgical Council on Resident Education selected 33 residency programs to pilot its General Surgery Resident Curriculum Website Portal. The portal aims to reduce program variability in curricula, align teaching and learning with essential content, and improve resident study and performance.

Methods: two online surveys were sent to all program directors and their residents before releasing the portal.

Promoting self-efficacy in minimally invasive surgery training.

Many surgeons continue to actively pursue surgical approaches that are less invasive for their patients. This pursuit requires the surgeon to adapt to new instruments, techniques, technologies, knowledge bases, visual perspectives, and motor skills, among other changes. The premise of this paper is that surgeons adopting minimally invasive approaches are particularly obligated to maintain an accurate perception of their own competencies and learning needs in these areas (ie, self-efficacy).

Reactions of surgical program directors to a web-based interactive educational program focusing on cognitive skills.

Objective: To assess reactions by program directors (PDs) to a preview of a scenario from the Fundamentals of Surgery Curriculum (FSC), which is a case-based interactive curriculum developed by the American College of Surgeons's (ACS) Division of Education and designed to be delivered online to first-year (PGY-1) surgical residents.

Design: After previewing a scenario, each PD completed a questionnaire requesting age and ratings of comfort using computers, the scenario's utility in addressing 9 educational goals (eg, provides a solid foundation for future learning), and 6 separate features of the scenario (eg, ease of use and feasibility). All ratings were based on a 1-9 scale.

Efforts to enhance operating room teaching.

Objective: To identify the learning needs of faculty members who are not perceived by residents as outstanding teachers in the operating room.

Design: General surgery residents electronically evaluated each faculty surgeon with whom they had significant contact upon completion of each clinical rotation between July 2005 and October 2006. Evaluation forms requested global ratings (1-5 scale ranging from poor to excellent) in 10 separate teaching-related areas, 1 of which was operating room teaching.

Comparison of resident self-assessments with trained faculty and standardized patient assessments of clinical and technical skills in a structured educational module.

Background: This study assessed the reliability of surgical resident self-assessment in comparison with faculty and standardized patient (SP) assessments during a structured educational module focused on perioperative management of a simulated adverse event.

Methods: Seven general surgery residents participated in this module. Residents were assessed during videotaped preoperative and postoperative SP encounters and when dissecting a tumor off of a standardized inanimate vena cava model in a simulated operating room.

Multi-institutional validation of a web-based core competency assessment system.

Objective: The Association of Program Directors in Surgery and the Division of Education of the American College of Surgeons developed and implemented a web-based system for end-of-rotation faculty assessment of ACGME core competencies of residents. This study assesses its reliability and validity across multiple programs.

Methods: Each assessment included ratings (1-5 scale) on 23 items reflecting the 6 core competencies.

Validation of a relative head injury severity scale for pediatric trauma.

Background: Brain injury is the most important independent predictor of mortality and morbidity in pediatric trauma. The Glasgow Coma Score (GCS) is the commonly used clinical instrument to assess brain injury. However, the GCS or one of its components is often not applicable in children under a certain age or cannot be computed reliably because of the patient's condition or the circumstances surrounding resuscitation efforts.

Management of adverse surgical events: a structured education module for residents.

Background: This pilot project involved the development of a structured, experiential, educational module using a bench model technical skills simulation and standardized patients. It integrated teaching and assessment of clinical, technical, and interpersonal skills, as well as professionalism within the context of an adverse surgical event.

Methods: General surgery residents (postgraduate year [PGY] 2, 3) were asked to participate in the pre-, intra-, and postoperative management of a patient with a retroperitoneal sarcoma.

Intubation of pediatric trauma patients in the field: predictor of negative outcome despite risk stratification.

Background: Recently, evidence has shown that intubation in the field may not improve or may even adversely affect outcomes. Our objective was to analyze outcomes in pediatric intubated trauma patients using a large national pediatric trauma registry.

Methods: The patient population was derived from the last phase of the National Pediatric Trauma Registry, comprising admissions from 1994 through 2002.

Injury prevention priority score: a new method for trauma centers to prioritize injury prevention initiatives.

Background: Trauma centers are expected to develop injury prevention programs that address needs of the local population. A relatively simple, objective, and quantitative method is needed for prioritizing local injury prevention initiatives based on both injury frequency and severity.

Study Design: Pediatric trauma patients (16 years or younger; n= 7,958) admitted to two Level I regional trauma centers (Johns Hopkins Children Center and Westchester Medical Center) from 1993 to 1999 were grouped by injury causal mechanism according to ICD-9 external cause codes.

Determination of national pediatric injury prevention priorities using the Injury Prevention Priority Score.

Purpose: Previous studies have found that the Injury Prevention Priority Score (IPPS) provides a reliable and valid method to gauge the relative importance of different injury causal mechanisms at individual trauma centers. This study examines its applicability to prioritizing injury mechanisms on a national level and within defined pediatric age groups.

Methods: A total of 47,158 patients (age <17) in the National Pediatric Trauma Registry were grouped into common injury mechanisms based on ICD-9 E-Codes.

Assessing educational validity of the Morbidity and Mortality conference: a pilot study.

Purpose: To assess inter-rater agreement in perceptions of cases presented during Morbidity & Mortality conference (M&M) and changes associated with initiation of a modified M&M.

Methods: Faculty, residents, fellows, and students at weekly M&M between June 2001 and March 2002 voluntarily completed an anonymous questionnaire after each M&M case presentation, which asked: if the complication was avoidable (yes/no/not sure), if consensus was reached among participants (yes/no/not sure), the primary cause of the complication (diagnostic error, technical error, judgment error, nature of disease, other), when the primary cause occurred (preoperatively, intraoperatively, postoperatively), and which, if any, of 16 listed actions could prevent similar future problems. On September 24, 2001, the conference was lengthened and modified.

Visual spatial perception and surgical competence.

Background: Proficiency in visual spatial perception (VSP) is a hypothetical component of surgical competence.

Methods: Four tests of VSP, taken from the Cognitive Laterality Battery (CLB), were administered to 301 surgeons and surgical residents. Mean scores on each test were compared by Student t tests to those of the normative sample (n = 251) on which the test was originally standardized.