Prompt engineering to increase GPT3.5's performance on the Plastic Surgery In-Service Exams.

This study assesses ChatGPT's (GPT-3.5) performance on the 2021 ASPS Plastic Surgery In-Service Examination using prompt modifications and Retrieval Augmented Generation (RAG). ChatGPT was instructed to act as a "resident," "attending," or "medical student," and RAG utilized a curated vector database for context.

Breast Reduction Surgery in Adolescents.

Macromastia-overgrowth of the female breast-is distressing and disabling, often starting in middle school and continuing into adulthood. Breast reduction is an effective treatment of symptoms of macromastia in adults, and its application in adolescents has been increasing. Special considerations within the adolescent population include interruption of age-appropriate activities, development of healthy body image/esteem, the connection to obesity, potential for postoperative recurrence/continued growth, the effect of surgery on future lactation and breast-feeding, and the adolescent's ability to participate in surgical decision-making (assent).

Top Surgery and Chest Dysphoria Among Transmasculine and Nonbinary Adolescents and Young Adults.

Importance: Transgender and nonbinary (TGNB) adolescents and young adults (AYA) designated female at birth (DFAB) experience chest dysphoria, which is associated with depression and anxiety. Top surgery may be performed to treat chest dysphoria.

Objective: To determine whether top surgery improves chest dysphoria, gender congruence, and body image in TGNB DFAB AYA.

Effectiveness of Evidence-Based Telecoaching Delivered Through an Employer-Sponsored Mental Health Benefits Platform.

Coaches delivering telemental health services as part of an employer-sponsored benefit may increase access to affordable and effective care. We examined the effectiveness of evidence-based telecoaching delivered via videoconferencing to people requesting mental health services during the coronavirus disease 2019 (COVID-19) pandemic. We analyzed data from 1,228 employees (mean age = 35 ± 8 years; 67.

Does Pandemic Crisis Mean Education Crisis? The Chicago Academic Plastic Surgery Collaborative Response to COVID-19.

The health care crisis related to the spread of novel coronavirus (severe acute respiratory syndrome coronavirus 2) has created new challenges to plastic surgery education, mostly because of the decreased volume of procedures. The plastic surgery program directors in Chicago decided to act and identify ways to promote surgical education through citywide, multi-institutional, systematic clinical case discussions. Although the initiative has no impact on the surgical skill of the trainees, it was welcomed by residents and faculty and promoted clinical core knowledge in plastic surgery and collaboration among the institutions.

Association of Chest Dysphoria With Anxiety and Depression in Transmasculine and Nonbinary Adolescents Seeking Gender-Affirming Care.

Purpose: The purpose of this study was to determine the existence and strength of association between chest dysphoria and mental health in transmasculine and nonbinary adolescents.

Methods: This is a cross-sectional cohort study of transmasculine and nonbinary adolescents designated female at birth between 12 and 18 years old. None had undergone prior top surgery.

Mastectomy and Chest Masculinization in Transmasculine Minors: A Case Series and Analysis by Ethical Principles.

Mastectomy for chest masculinization is a commonly performed gender-affirming surgery in minor patients, a vulnerable population with unique developmental and psychosocial needs. We aimed to use principles of medical ethics (eg, autonomy, beneficence, nonmaleficence, and justice) as a framework to analyze preoperative clinical decision making by pediatric plastic surgeons who work with transmasculine and nonbinary adolescents designated female at birth presenting for chest masculinization. Two patients were selected for inclusion in this case series based on the senior author's (J.

Nasal dermoid cysts with intracranial extension: avoiding coronal incision through midline exposure and nasal bone osteotomy.

Objective: Up to 10% of midline nasal dermoid cysts have intracranial extension. Previous techniques of excision include frontal and frontonasal craniotomies via a coronal approach, combined with a direct cutaneous excision of the dermoid cyst. While the coronal incision allows for wide visualization, it carries significant risks of transfusion, blood loss, and scarring.

Orientation to the Operating Room: An Introduction to the Surgery Clerkship for Third-Year Medical Students.

Introduction: The operating room is a complex environment in which individual team members perform specific tasks according to their role. A simulation activity was created to introduce medical students on the surgery clerkship to issues relating to patient safety, infection control, and regulatory requirements.

Methods: This activity takes place prior to general surgery rotation operative experiences, and addresses the need for students to practice roles they will perform while participating in patient care.

Description and Early Outcomes of a Comprehensive Curriculum Redesign at the Northwestern University Feinberg School of Medicine.

In 2012, the Northwestern University Feinberg School of Medicine launched a redesigned curriculum addressing the four primary recommendations in the 2010 Carnegie Foundation for the Advancement of Teaching report on reforming medical education. This new curriculum provides a more standardized evaluation of students' competency achievement through a robust portfolio review process coupled with standard evaluations of medical knowledge and clinical skills. It individualizes learning processes through curriculum flexibility, enabling students to take electives earlier and complete clerkships in their preferred order.

A formative midterm test increases accuracy of identifying students at risk of failing a third year surgery clerkship.

Background: Providing midclerkship feedback to identify students at risk for failing is a Liaison Committee on Medical Education standard. Objective criteria for that feedback are critical. The investigators studied the value of a formative midterm (MT) test in identifying students at risk for failing a surgery clerkship.

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.

Prevention of postpartum traumatic stress in mothers with preterm infants: manual development and evaluation.

Premature birth has been associated with multiple adverse maternal psychological outcomes that include depression, anxiety, and trauma as well as adverse effects on maternal coping ability and parenting style. Infants who are premature are more likely to have poorer cognitive and developmental functioning and, thus, may be harder to parent, both as infants and as they get older. In response to these findings, a number of educational and behavioral interventions have been developed that target maternal psychological functioning, parenting, and aspects of the parent-infant relationship.

Considerations in breast augmentation in the adolescent patient.

Nearly 320,000 breast augmentations were performed in 2011, with adolescents under 18 years of age accounting for 4,830 procedures (1.5%). Breast development typically starts at 11 years (range, 8-13 years) and is complete at 15 years (range, 11-18 years).

Composite score validity in clerkship grading.

Background: Composite score validity depends on its reliability, content, and comparison with other outcomes measures. This study examined all three aspects of a composite score used in a third-year surgery clerkship.

Method: Composite score reliability was calculated using stratified alpha; several other reasonable composite combinations were tested.

Computer-enhanced visual learning method: a paradigm to teach and document surgical skills.

Innovation: Changes in health care are stimulating residency training programs to develop new methods for teaching surgical skills. We developed Computer-Enhanced Visual Learning (CEVL) as an innovative Internet-based learning and assessment tool. The CEVL method uses the educational procedures of deliberate practice and performance to teach and learn surgery in a stylized manner.

Postoperative pain control for primary cleft lip repair in infants: is there an advantage in performing peripheral nerve blocks?

Background: Primary cleft lip repair is performed in infants under 1 year of age. The efficacy of an infraorbital nerve block vs intravenous fentanyl was compared in our prospective, randomized controlled trial.

Methods: Forty-six infants scheduled for primary cleft lip repair were prospectively randomized to one of two groups: group F that received 2 mcg x kg(-1) of fentanyl intravenously and an infraorbital nerve block with 0.

A new computer enhanced visual learning method to train urology residents in pediatric orchiopexy: a prototype for Accreditation Council for Graduate Medical Education documentation.

Purpose: Residency programs must continue to restructure teaching and assessment of surgical skills to improve the documentation of Accreditation Council for Graduate Medical Education competencies. To improve teaching and documenting resident performance we developed a computer enhanced visual learning method that includes a curriculum and administrative reports. The curriculum consists of 1) study of a step-by-step surgical tutorial of computer enhanced visuals that show specific surgical skills, 2) a checklist tool to objectively assess resident performance and 3) a log of postoperative feedback that is used to structure deliberate practice.

Patient assessment and management examination: lack of correlation between faculty assessment and resident self-assessment.

Background: The Patient Assessment and Management Examination (PAME) is a standardized patient examination designed to assess management skills of senior residents. This study explored the relationship between faculty and resident self-evaluation by using PAME.

Methods: Nine postgraduate year (PGY) 4 and PGY5 residents were examined with a 5 case PAME.

Description and impact of using a standard-setting method for determining pass/fail scores in a surgery clerkship.

Background: Research on performance evaluation highlights the importance of using multiple measures to develop an accurate profile of students, yet we found no literature describing the use of a standard-setting method for determining a pass/fail cutoff for a clerkship based on multiple assessment methods.

Method: Steps in setting an absolute standard for a pass/fail grade are described. The new cut-off score was used to compare what decisions would have been made had it been applied in previous clerkships.

Treatment of large and giant nevi.

Excision of large and giant melanocytic nevi presents a distinct challenge to the pediatric plastic surgeon. The exact risk of malignant degeneration remains unknown. These unsightly lesions can be psychologically damaging to both parent and child.

Surgical management of the cutaneous manifestations of linear nevus sebaceus syndrome.

Linear nevus sebaceus syndrome is characterized by the association of nevus sebaceus covering extensive areas on the head and scalp with abnormalities of the central nervous system, ophthalmologic and skeletal changes, and malignancies. The incidence is approximately one per 10,000 live births, and there is no sexual predilection reported. The original description of this syndrome was followed by extensive literature describing the dermatologic, neurologic, and ophthalmologic manifestations of this disease.