Attendings' Perceptions of Authentic Evaluation Criteria for Effective Surgical Consults.

Objective: The authors aimed to investigate faculty evaluation criteria for an effective oral surgical presentation in actual patient care contexts.

Design: We conducted a 2-step observation-based qualitative study. Residents audiotaped oral presentations of a surgical consult to an attending.

Medical students' reflections on surgical educators' professionalism: Contextual nuances in the hidden curriculum.

Introduction: Surgical educators' professional behavior constitutes a hidden curriculum and impacts trainee's professional identity formation. This study explores the nuances of professional behaviors as observed in varying surgical settings.

Methods: 411 Transcripts originated from essays written by MS3 students during their surgical clerkship from 2010 to 2016 were collated.

Mock Pages Are a Valid Construct for Assessment of Clinical Decision Making and Interprofessional Communication.

Importance: Answering pages from nurses about patients in need of immediate attention is one of the most difficult challenges a resident faces during their first days as a physician. A Mock Page program has been developed and adopted into a national surgical resident preparatory curriculum to prepare senior medical students for this important skill.

Objective: The purpose of this study is to assess standardized mock page cases as a valid construct to assess clinical decision making and interprofessional communication skills.

Do Surgeons and Gastroenterologists Describe Endoscopic Retrograde Cholangiopancreatography Differently? A Qualitative Study.

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is a technically challenging procedure performed by both surgeons and gastroenterologists. There is controversy in the field regarding the training necessary to perform ERCP. Widely disparate requisite volumes of experience to achieve proficiency have been published by representatives of each specialty.

Interdisciplinary cognitive task analysis: a strategy to develop a comprehensive endoscopic retrograde cholangiopancreatography protocol for use in fellowship training.

Background: Endoscopic retrograde cholangiopancreatography is a challenging procedure performed by surgeons and gastroenterologists. We employed cognitive task analysis to identify steps and decision points for this procedure.

Methods: Standardized interviews were conducted with expert gastroenterologists (7) and surgeons (4) from 4 institutions.

How prepared are your interns to take calls? Results of a multi-institutional study of simulated pages to prepare medical students for surgery internship.

Background: This study evaluated a simulated pages curriculum that was developed to assess communication and clinical decision making in medical students and interns.

Methods: A curriculum consisting of 14 simulated pages was administered across 5 institutions to 150 senior medical students. A 3-case subset was administered to interns who did not participate in the curriculum.

Foundations for teaching surgeons to address the contributions of systems to operating room team conflict.

Background: Prior research has shown that surgeons who effectively manage operating room conflict engage in a problem-solving stage devoted to modifying systems that contribute to team conflict. The purpose of this study was to clarify how systems contributed to operating room team conflict and clarify what surgeons do to modify them.

Methods: Focus groups of circulating nurses and surgeons were conducted at 5 academic medical centers.

The effect of model fidelity on colonoscopic skills acquisition. A randomized controlled study.

Introduction: Colonoscopic simulators offer the opportunity for skill acquisition in the preclinical setting. Currently available simulators vary widely with respect to level of fidelity and technological sophistication. Despite the belief that more realistic is better, there is a paucity of evidence regarding the relative effectiveness of simulator fidelity (high vs low) on the acquisition of basic colonoscopic skills.

Surgeons managing conflict in the operating room: defining the educational need and identifying effective behaviors.

Background: Developing an operating room conflict management educational program for surgeons requires a formal needs assessment and information about behaviors that represent effective conflict management.

Methods: Focus groups of circulating room nurses and surgeons were conducted at 5 participating centers. Participants responded to queries about conflict management training, conflict consequences, and effective conflict management behaviors.

The case of the entitled resident: a composite case study of a resident performance problem syndrome with interdisciplinary commentary.

Background: Residents with performance problems create substantial burden on programs and institutions. Understanding the nature and quality of performance problems can help in learning to address performance problems.

Aim: We sought to illuminate the effects of resident performance problems and the potential solutions for those problems from the perspectives of people with various roles in health care.

Pursuing professional accountability: an evidence-based approach to addressing residents with behavioral problems.

Objective: To develop an evidence-based approach to the identification, prevention, and management of surgical residents with behavioral problems.

Design: The American College of Surgeons and Southern Illinois University Department of Surgery hosted a 1-day think tank to develop strategies for early identification of problem residents and appropriate interventions. Participants read a selection of relevant literature before the meeting and reviewed case reports.

Career development resource: educational leadership in a department of surgery: vice chairs for education.

The growing appreciation of the need to adopt an evidence-based approach to teaching and assessment has led to a demand for faculty who are well versed in best practices in education. Surgeons with interest and expertise in instruction, curriculum development, educational research, and evaluation can have an important impact on the educational mission of a department of surgery. The increased fervor for accountability in education together with the challenges imposed by accreditation agencies and hospitals has made educational leadership responsibilities more time consuming and complex.

Using the hidden curriculum to teach professionalism during the surgery clerkship.

Background: It has been shown that medical student professionalism is influenced by the hidden curriculum, although the extent to which this occurs during the surgery clerkship is unknown. Furthermore, the processes within the hidden curriculum have been used to teach professionalism to medical students, but this strategy has not been used during the surgery clerkship. The purpose of this study was to review a 2-year experience with a surgery clerkship instructional session where the hidden curriculum was used to teach professionalism to medical students.

Career development needs of vice chairs for education in departments of surgery.

Aim: To identify the career development needs Vice Chair for Education in Surgery Departments (VCESDs).

Methods: In all, 33 VCESDs were invited to complete an online survey to identify the scope of duties, scholarly activity, job satisfaction, and career development needs.

Results: A total of 29/33 (88%) VCESDs responded.

Engaging medical students in the feedback process.

Background: There are potential advantages to engaging medical students in the feedback process, but efforts to do so have yielded mixed results. The purpose of this study was to evaluate a student-focused feedback instructional session in an experimental setting.

Methods: Medical students were assigned randomly to either the intervention or control groups and then assigned randomly to receive either feedback or compliments.

Teaching operating room conflict management to surgeons: clarifying the optimal approach.

Context: Conflict management has been identified as an essential competence for surgeons as they work in operating room (OR) teams; however, the optimal approach is unclear. Social science research offers two alternatives, the first of which recommends that task-related conflict be managed using problem-solving techniques while avoiding relationship conflict. The other approach advocates for the active management of relationship conflict as it almost always accompanies task-related conflict.

Use of simulated pages to prepare medical students for internship and improve patient safety.

Purpose: During the transition from medical school to internship, trainees experience high levels of stress related to pages on the inpatient wards. The steep learning curve during this period may also affect patient safety. The authors piloted the use of simulated pages to improve medical student preparedness, decrease stress related to pages, and familiarize medical students with common patient problems.

Knowledge and attitudes regarding colorectal cancer screening among medical students: a tale of two schools.

Colorectal cancer (CRC) screening has been shown to decrease the incidence of CRC cancers and decrease mortality. Studies show that the most important predictor of patient compliance with CRC screening is physician recommendation. We assessed the knowledge and attitudes of medical students regarding cancer screening.

Refining the evaluation of operating room performance.

Purpose: An accurate and consistent evaluation of resident operative performance is necessary but difficult to achieve. This study continues the examination of the Southern Illinois University (SIU) operative performance rating system (OPRS) by studying additional factors that may influence reliability, accuracy, and interpretability of results.

Methods: OPRS evaluations of surgical residents by faculty at SIU, from 2001 to 2008, were analyzed for the most frequently rated procedures to determine (1) the elapsed time from the procedure until completion of rating, (2) the patterns in responses of procedure-specific and global surgical skills items, and (3) whether particular evaluating surgeons differed in their stringency of ratings of resident operative performance.

Skills coaches as part of the educational team: a randomized controlled trial of teaching of a basic surgical skill in the laboratory setting.

Background: The aim of this study was to compare the laboratory teaching of a basic technical skill by a nonphysician skills coach and a faculty surgeon.

Methods: Medical students were randomized to instruction of skin suturing in the skills laboratory by a faculty surgeon or by a nonphysician skills coach. Testing of performance occurred at 3 time points.

Robot-assisted laparoscopic skills development: formal versus informal training.

Introduction: The learning curve for robotic surgery is not completely defined, and ideal training components have not yet been identified. We attempted to determine whether skill development would be accelerated with formal, organized instruction in robotic surgical techniques versus informal practice alone.

Materials And Methods: Forty-three medical students naive to robotic surgery were randomized into two groups and tested on three tasks using the robotic platform.

A theory-based curriculum for enhancing surgical skillfulness.

Background: Curricula for surgical technical skills laboratories have traditionally been designed to accommodate the clinical activities of residents, so they typically consist of individual, episodic training sessions. We believe that the skills laboratory offers an opportunity to design a surgical skills curriculum based on the fundamental elements known to be important for motor skill instruction. We hypothesized that training novices with such a curriculum for a 1-month period would yield skills performance levels equivalent to those of second year surgery residents who had trained in a traditional program.

Surgeon information transfer and communication: factors affecting quality and efficiency of inpatient care.

Objective: To determine the nature of surgeon information transfer and communication (ITC) errors that lead to adverse events and near misses. To recommend strategies for minimizing or preventing these errors.

Summary Background Data: Surgical hospital practice is changing from a single provider to a team-based approach.

An investigation of medical student reactions to feedback: a randomised controlled trial.

Background: Medical educators have indicated that feedback is one of the main catalysts required for performance improvement. However, medical students appear to be persistently dissatisfied with the feedback that they receive. The purpose of this study was to evaluate learning outcomes and perceptions in students who received feedback compared to those who received general compliments.