Learning to teach: A novel method for assessing surgical trainees' teaching and operative knowledge.

Background: The purpose of this study was to investigate the feasibility of a simulated teaching activity as an assessment of surgical knowledge and teaching competencies.

Methods: In this prospective observational study, 15 residents and 1 fellow in the Department of Surgery watched three video clips of laparoscopic cholecystectomies and provided feedback to a participant learner. Qualitative and statistical analysis identified differences in surgical knowledge and teaching strategies.

Impact of a Surgical Subspecialty Roundtable on Career Perception for Preclerkship Medical Students.

Background: Limited exposure to surgical subspecialties during medical school may be responsible for decreasing medical student interest in surgery. Although most medical schools have surgery interest groups to increase exposure, our aim was to evaluate the impact of a focused surgical subspecialty roundtable on preclerkship students' perceptions of surgical careers.

Methods: Faculty members from each surgical subspecialty shared their experiences and led roundtable discussions with five to seven first- and second-year medical students at a time (total n = 59).

Perceptions Regarding Mentorship Among General Surgery Trainees With Academic Career Intentions.

Objective: Effective mentorship may be an opportunity to mitigate career de-prioritization, improve stress management, and bolster professional growth. Relatively few studies address specific challenges that occur for general surgery trainees. We conducted a focus group-based investigation to determine facilitators/barriers to effective mentorship among general surgery residents, who are intending to pursue an academic career.

A qualitative study of gender differences in the experiences of general surgery trainees.

Background: Women surgeons continue to face unique challenges to professional advancement. Higher attrition rates and lower confidence among female surgical residents suggest that experiences during residency differ by gender. Few studies have investigated gender-specific experiences during training.

Changes in inflammatory endometrial cancer risk biomarkers in individuals undergoing surgical weight loss.

Objective: Obesity has been strongly linked to endometrial cancer (EC) risk. A number of potential EC risk biomarkers have been proposed, including heightened pro-inflammatory cytokines and adipokines. To evaluate if bariatric surgery can serve as a means for altering levels of such EC risk biomarkers, we investigated changes in these biomarkers after weight loss.

How can surgeons facilitate resident intraoperative decision-making?

Background: Cognitive skills such as decision-making are critical to developing operative autonomy. We explored resident decision-making using a recollection of specific examples, from the attending surgeon and resident, after laparoscopic cholecystectomy.

Methods: In a separate semi-structured interview, the attending and resident both answered five questions, regarding the resident's operative roles and decisions, ways the attending helped, times when the attending operated, and the effect of the relationship between attending and resident.

Endometrial cancer associated biomarkers in bariatric surgery candidates: exploration of racial differences.

Background: Obesity is the main risk factor for endometrial cancer (EC), the most common gynecologic malignancy in the United States. A number of potential risk biomarkers have been associated with EC development, including altered proinflammatory cytokines, chemokines, and adipokines.

Objectives: The overarching aim of this research is to investigate racial differences in the expression of EC-associated biomarkers among bariatric surgery candidates.

Prophylactic mesh placement for prevention of incisional hernia after open bariatric surgery: a systematic review and meta-analysis.

Background: Prophylactic mesh during laparotomy has been shown to be effective in preventing postoperative incisional hernia (IH) in high-risk patients. Since obesity is a risk factor for IH, we wished to determine whether mesh prevents IH in open and laparoscopic bariatric surgery patients.

Methods: We conducted a systematic review of the literature with meta-analysis.

The effect of video review of resident laparoscopic surgical skills measured by self- and external assessment.

Background: Video review of surgical skills is an educational modality that allows trainees to reflect on self-performance. The purpose of this study was to determine whether resident and attending assessments of a resident's laparoscopic performance differ and whether video review changes assessments.

Methods: Third-year surgery residents were invited to participate.

Endometrial histology in severely obese bariatric surgery candidates: an exploratory analysis.

Background: Endometrial pathology risk has been linked to obesity; however, little is known of its prevalence in severely obese women not seeking care for endometrial pathology associated symptoms. This pilot study was designed to explore the frequency and risk factors associated with endometrial pathology in cancer-free, severely obese, bariatric surgery candidates using the Pipelle endometrial sampling technique (SureFlex Preferred Curette, Bioteque America, Inc, New Taipei City, Taiwan).

Methods: Twenty-nine severely obese bariatric surgery candidates with intact uteruses and no history of endometrial cancer or endometrial ablation were included in this subanalysis from a larger cohort of 47.

S/he who can, does and teaches. S/he who cannot, doesn't.

Background: The saying, "[h]e who can, does. He who cannot, teaches." suggests that those who have the skills to perform do so, whereas those who do not have those skills become teachers.

Validity and interrater reliability of a regional mock oral board examination.

Background: There have been decreasing pass rates recently on the American Board of Surgery Certifying Examination (ABSCE). General surgery residents from the University of Pittsburgh Medical Center, the West Penn Allegheny Health System, the Conemaugh Health System, and Mercy Hospital participate in a mock oral board examination, which is similar to the ABSCE. The aims of the study are to compare examinee performance on the mock oral boards with the ABSCE and to evaluate the interrater reliability of examiner pairs.

The traveling salesman problem in surgery: economy of motion for the FLS Peg Transfer task.

Background: In the Peg Transfer task in the Fundamentals of Laparoscopic Surgery (FLS) curriculum, six peg objects are sequentially transferred in a bimanual fashion using laparoscopic instruments across a pegboard and back. There are over 268 trillion ways of completing this task. In the setting of many possibilities, the traveling salesman problem is one where the objective is to solve for the shortest distance traveled through a fixed number of points.

Practice-based learning and improvement: a two-year experience with the reporting of morbidity and mortality cases by general surgery residents.

Background: The Accreditation Council for Graduate Medical Education (ACGME) core competency of practice-based learning and improvement can be assessed with surgical Morbidity and Mortality Conference (MMC). We aim to describe the MMC reporting patterns of general surgery residents, describe the adverse event rate for patients and compare that with existing published rates, and describe the nature of our institutional adverse events. We hypothesize that reporting patterns and incidence rates will remain constant over time.

The effect of gastric bypass on the pharmacokinetics of serotonin reuptake inhibitors.

Objective: Morbidly obese patients frequently present with mood and anxiety disorders, which are often treated with serotonin reuptake inhibitors (SRIs). Having observed that patients treated with SRIs frequently relapse after Roux-en-Y gastric bypass surgery, the authors sought to assess whether SRI bioavailability is reduced postoperatively.

Method: Twelve gastric bypass candidates treated with an SRI for primary mood or anxiety disorders were studied prospectively.

The American Board of Surgery Certifying Examination: a retrospective study of the decreasing pass rates and performance for first-time examinees.

Background: There has been a noticeable decrease in the pass rate for the American Board of Surgery Certifying Examination during the last 5 years. We hypothesize that this decline is statistically significant, and we wish to determine whether the pass rates had any geographic patterns of distribution.

Methods: In this retrospective cohort trial, publically available electronic data sets of pass rates on the American Board of Surgery Certifying Examination were evaluated from the American Board of Surgery website.

Research priorities in surgical simulation for the 21st century.

Background: Despite tremendous growth, research in surgical simulation remains uncoordinated and unfocused. The objective of this study was to develop research priorities for surgical simulation.

Methods: By using a systematic methodology (Delphi), members of the Association for Surgical Education submitted 5 research questions on surgical simulation.

Minimally invasive surgery.

Minimally invasive surgery (MIS), or laparoscopic surgery, plays a vital role in residency training in a number of surgical disciplines including general surgery, surgical oncology, colorectal surgery, pediatric surgery, and thoracic surgery. The tremendous patient demand for MIS over the past 2 decades has resulted in surgeons rapidly embracing this technique. Many general surgery residencies cover basic laparoscopy within their residency program; however, the experience with more advanced cases is more variable.

Is there a benefit to delaying cholecystectomy for symptomatic gallbladder disease during pregnancy?

Background: The indications for nonemergent operations during pregnancy remain undefined. Many surgeons defer nonemergent operations until after delivery to minimize fetal risk. We wished to determine the outcome of delaying cholecystectomy in pregnant patients hospitalized for nonacute gallbladder disease.

Laparoscopic management of vaginal evisceration: case report and review of the literature.

Vaginal evisceration is a rare condition that presents with protruding mass, vaginal bleeding, and pelvic pain. Vaginal evisceration is most commonly associated with previous vaginal surgery but may occur spontaneously, and represents a surgical emergency. We report a case of vaginal evisceration in a 42-year-old premenopausal woman 6 months after hysterectomy.