Educational Policy Development as a Leadership Experience: Inclusive Institutional Change.

Medical students have a unique opportunity to advocate for educational policies that promote best practices in undergraduate medical education. At the Geisel School of Medicine at Dartmouth, students play a crucial role in the development of medical education policies. This article describes two innovative, inclusive, and effective approaches to increase student engagement: (1) restructuring Medical Education Subcommittees to diversify student perspectives and (2) including students in a values-based design thinking approach to the development of new academic advancement and promotion and conduct policies.

Surgical Providers' Perceptions of the Patient Portal: Before and After the 21st Century Cures Act.

Introduction: In April 2021, the Information Blocking Rule (IBR) of the 21st Century Cures Act went into effect giving patients immediate access to notes, radiology reports, lab results, and surgical pathology. We aimed to examine changes in surgical providers' perceptions of patient portal usage before and after its implementation.

Methods: We administered a 37-question survey prior to the implementation of the IBR and a 39-question follow-up survey 3 mo later.

Genetic Testing for Adrenal Tumors-What the Contemporary Surgeon Should Know.

Surgical diseases of the adrenal gland include pheochromocytoma/paraganglioma, primary hyperaldosteronism, Cushing syndrome, and adrenocortical carcinoma. These conditions may be associated with familial syndromes, and genetic testing is available and recommended in most. For adrenal surgeons to be familiar with these syndromes and know when to consider referral for genetic counseling and genetic testing is important.

Extreme Elevation of Baseline Intraoperative Parathyroid Hormone Measurements: Should Usual Protocols Apply?

Introduction: Intraoperative parathyroid hormone (IOPTH) monitoring is routinely used to facilitate minimally invasive parathyroidectomy. Many IOPTH protocols exist for predicting biochemical cure. Some patients are found to have extremely high baseline IOPTH levels (defined in this study as >500 pg/mL), which may affect the likelihood of satisfying certain final IOPTH criteria.

Qualities of excellent resident and attending teachers recognized by medical students: A qualitative analysis of nominations for surgical clerkship teaching awards.

Background: Effective teaching positively impacts student experience during the surgical clerkship. We sought to better understand how medical students characterize excellent surgical educators and how these characteristics may differ between residents and attendings.

Methods: 289 nominations by third-year medical students for a surgical resident and attending teaching award were examined for thematic content using conventional content analysis.

A Diagnosis of Normocalcemic Primary Hyperparathyroidism Prompted by "Salt and Pepper" Lesions of the Calvarium.

Background: We report a case of normocalcemic primary hyperparathyroidism, a diagnosis prompted by radiographic "salt and pepper" calvarial lesions, typically described in hypercalcemic primary hyperparathyroidism or secondary hyperparathyroidism.

Case Report: A 60-year-old woman noticed indentations of her scalp and presented to her primary care provider. Radiography of the calvarium demonstrated granular "salt and pepper" lesions, prompting investigation.

Using molecular testing to improve the management of thyroid nodules with indeterminate cytology: an institutional experience with review of molecular alterations.

Introduction: Molecular testing has helped clinicians and cytopathologists to further categorize indeterminate thyroid fine needle aspiration (FNA) specimens. The purpose of the present study was to evaluate the accuracy of commercially available molecular tests, review their effects on patient treatment, and correlate the molecular alterations with the histologic findings.

Materials And Methods: A pathology laboratory information system search identified thyroid FNAs performed at our institution between January 1, 2015 and June 30, 2020.

Hopes, fears, and rumors: Medical students and the general surgery clerkship.

Background: Surgical educators have worked to manage the hopes and fears as well as the recurring rumors that plague the surgical clerkship. It is not known if this has effected change over time.

Methods: We gathered information on hopes, fears, and rumors during our clerkship orientations from 2017 to 2019 using anonymous polling software with real-time feedback.

How Much is Enough? Public Perception of Minimum Surgeon Volumes.

Background: A large body of literature supports an association between surgical volumes and outcomes. Research on this subject has resulted in attempts to quantify minimum volume standards for specific surgeries. However, the extent to which the public takes interest in or is able to interpret surgical volume information is not known.

Telemedicine for Surgical Consultations - Pandemic Response or Here to Stay?: A Report of Public Perceptions.

Objective: This study aims to determine the public's perception of telemedicine surgical consultations, during the COVID-19 pandemic and beyond.

Summary Background Data: With rapid expansion and uptake of telemedicine during the pandemic, many have posited that virtual visits will endure even as in-person visits are reinstated. The public's perception of telemedicine for an initial surgical consultation has not been previously studied.

The Evolving Practice Patterns of Academic Endocrine Surgeons: A Cross-sectional Analysis of the Faculty Practice Solutions Center Database 2014 to 2017.

Objective: To examine the evolution of an academic endocrine surgeon's practice over time.

Summary Background: Amid growing recognition that surgical volume and specialization are linked to better outcomes, endocrine surgery is one of the youngest fields to develop its own formal fellowship training program. However, 3 decades after the emergence of endocrine surgery as a distinct specialty, the medical community and public still have a limited understanding of endocrine surgeons and what they do.

The biochemical severity of primary hyperparathyroidism correlates with the localization accuracy of sestamibi and surgeon-performed ultrasound.

Background: Minimally invasive parathyroidectomy for primary hyperparathyroidism is dependent on preoperative localization, commonly with ultrasound and sestamibi imaging. This study sought to determine if preoperative serum calcium and parathyroid hormone (PTH) levels correlate with localization sensitivity and positive predictive value (PPV).

Study Design: This is a retrospective analysis of a prospective database of 1,910 patients with primary hyperparathyroidism from 2002 to 2013, who had surgeon-performed ultrasound and/or sestamibi for preoperative localization.

Secondary overtriage: the burden of unnecessary interfacility transfers in a rural trauma system.

Importance: Unnecessary interfacility transfer of minimally injured patients to a level I trauma center (secondary overtriage) can cause inefficient use of resources and personnel within a regional trauma system.

Objective: To describe the burden of secondary overtriage in a rural trauma system with a single level I trauma center.

Design: Retrospective analysis of institutional trauma registry data.

Effect of prior cardiac operations on survival after coronary artery bypass grafting.

Background: We examined a recent regional experience to determine the effect of a prior cardiac operation on short-term and midterm outcomes after coronary artery bypass grafting (CABG).

Methods: We identified 20,703 patients who underwent nonemergent CABG at 8 centers in northern New England from 2000 to 2008, of whom 818 (3.8%) had undergone prior cardiac operations.

Long-term survival of the very elderly undergoing aortic valve surgery.

Background: Increasing numbers of the very elderly are undergoing aortic valve procedures. We describe the short- and long-term survivorship for this cohort.

Methods And Results: We conducted a cohort study of 7584 consecutive patients undergoing open aortic valve surgery without (51.