Non-invasive Transcutaneous Spinal Cord Stimulation Programming Recommendations for the Treatment of Upper Extremity Impairment in Tetraplegia.

Objectives: This study analyzes the stimulation parameters implemented during two successful trials that used non-invasive transcutaneous spinal cord stimulation (tSCS) to effectively improve upper extremity function after chronic spinal cord injury (SCI). It proposes a framework to guide stimulation programming decisions for the successful translation of these techniques into the clinic.

Materials And Methods: Programming data from 60 participants who completed the Up-LIFT trial and from 17 participants who subsequently completed the LIFT Home trial were analyzed.

Non-invasive spinal cord electrical stimulation for arm and hand function in chronic tetraplegia: a safety and efficacy trial.

Cervical spinal cord injury (SCI) leads to permanent impairment of arm and hand functions. Here we conducted a prospective, single-arm, multicenter, open-label, non-significant risk trial that evaluated the safety and efficacy of ARC Therapy to improve arm and hand functions in people with chronic SCI. ARC Therapy involves the delivery of externally applied electrical stimulation over the cervical spinal cord during structured rehabilitation.

Activity-dependent plasticity and spinal cord stimulation for motor recovery following spinal cord injury.

Spinal cord injuries lead to permanent physical impairment despite most often being anatomically incomplete disruptions of the spinal cord. Remaining connections between the brain and spinal cord create the potential for inducing neural plasticity to improve sensorimotor function, even many years after injury. This narrative review provides an overview of the current evidence for spontaneous motor recovery, activity-dependent plasticity, and interventions for restoring motor control to residual brain and spinal cord networks via spinal cord stimulation.

Multisite Transcutaneous Spinal Stimulation for Walking and Autonomic Recovery in Motor-Incomplete Tetraplegia: A Single-Subject Design.

Objective: This study investigated the effect of cervical and lumbar transcutaneous spinal cord stimulation (tSCS) combined with intensive training to improve walking and autonomic function after chronic spinal cord injury (SCI).

Methods: Two 64-year-old men with chronic motor incomplete cervical SCI participated in this single-subject design study. They each underwent 2 months of intensive locomotor training and 2 months of multisite cervical and lumbosacral tSCS paired with intensive locomotor training.

Non-technical skill assessments across levels of US surgical training.

Background: To ensure safe patient care, regulatory bodies worldwide have incorporated non-technical skills proficiency in core competencies for graduation from surgical residency. We describe normative data on non-technical skill ratings of surgical residents across training levels using the US-adapted Non-Technical Skills for Surgeons (NOTSS-US) assessment tool.

Methods: We undertook an exploratory, prospective cohort study of 32 residents-interns (postgraduate year 1), junior residents (postgraduate years 2-3), and senior residents (postgraduate years 4-5)-across 3 US academic surgery residency programs.

Optimizing the Implementation of Surgical Coaching Through Feedback From Practicing Surgeons.

Importance: Surgical coaching is maturing as a tangible strategy for surgeons' continuing professional development. Resources to spread this innovation are not yet widely available.

Objective: To identify surgeon-derived implementation recommendations for surgical coaching programs from participants' exit interviews and ratings of their coaching interactions.

Training Novice Raters to Assess Nontechnical Skills of Operating Room Teams.

Objective: To our knowledge, no curricula have been described for training novice, nonclinician raters of nontechnical skills in the operating room (OR). We aimed to report the reliability of Oxford Non-Technical Skills (NOTECHS) ratings provided by novice raters who underwent a scalable curriculum for learning to assess nontechnical skills of OR teams.

Design: In-person training course to apply the NOTECHS framework to assessing OR teams' nontechnical skill performance, led by 2 facilitators and involving 5 partial-day sessions of didactic presentations, video simulation, and live OR observation with postassessment debriefing.

Surgeons' Coaching Techniques in the Surgical Coaching for Operative Performance Enhancement (SCOPE) Program.

Objective: To evaluate coaching techniques used by practicing surgeons who underwent dedicated coach training in a peer surgical coaching program.

Background: Surgical coaching is a developing strategy for improving surgeons' intraoperative performance. How to cultivate effective coaching skills among practicing surgeons is uncertain.

Surgical Coaching for Operative Performance Enhancement (SCOPE): skill ratings and impact on surgeons' practice.

Background: Evidence for surgical coaching has yet to demonstrate an impact on surgeons' practice. We evaluated a surgical coaching program by analyzing quantitative and qualitative data on surgeons' intraoperative performance.

Methods: In the 2018-2019 Surgical Coaching for Operative Performance Enhancement (SCOPE) program, 46 practicing surgeons in multiple specialties at four academic medical centers were recruited to complete three peer coaching sessions, each comprising preoperative goal-setting, intraoperative observation, and postoperative debriefing.

Surgical coaching to achieve the ABMS vision for the future of continuing board certification.

In February 2019, the American Board of Medical Specialties (ABMS) released the final report of the Continuing Board Certification: Vision for the Future initiative, issuing strong recommendations to replace ineffective, traditional mechanisms for physicians' maintenance of certification with meaningful strategies that strengthen professional self-regulation and simultaneously engender public trust. The Vision report charges ABMS Member Boards, including the American Board of Surgery (ABS), to develop and implement a more formative, less summative approach to continuing certification. To realize the ABMS's Vision in surgery, new programs must support the assessment of surgeons' performance in practice, identification of individualized performance gaps, tailored goals to address those gaps, and execution of personalized action plans with accountability and longitudinal support.

Assessment of the Non-Technical Skills for Surgeons (NOTSS) framework in the USA.

Background: Surgeons' non-technical skills are important for patient safety. The Non-Technical Skills for Surgeons assessment tool was developed in the UK and recently adapted to the US surgical context (NOTSS-US). The aim of this study was to evaluate the reliability and distribution of non-technical skill ratings given by attending (consultant) surgeons who underwent brief online training.

Performance Coaching for Practicing Surgeons Enhancing Clinical Performance, Well-Being, and Trainee Experience.

Performance coaching can help surgeons, hospitals, and healthcare systems to continually improve patient care delivery by enhancing surgeons' professional development. Equally important, coaching also has great potential to combat burnout, promote physician well-being, and subsequently improve trainee education and experience. In this article, we discuss the rationale for, early evidence for, and ways to address implementation barriers for performance coaching among practicing surgeons and surgical trainees.

Variation in global uptake of the Surgical Safety Checklist.

Background: The Surgical Safety Checklist (SSC) is a patient safety tool shown to reduce mortality and to improve teamwork and adherence with perioperative safety practices. The results of the original pilot work were published 10 years ago. This study aimed to determine the contemporary prevalence and predictors of SSC use globally.

Using Smartphones to Capture Novel Recovery Metrics After Cancer Surgery.

Importance: Patient-generated health data captured from smartphone sensors have the potential to better quantify the physical outcomes of surgery. The ability of these data to discriminate between postoperative trends in physical activity remains unknown.

Objective: To assess whether physical activity captured from smartphone accelerometer data can be used to describe postoperative recovery among patients undergoing cancer operations.

Identifying Naturalistic Coaching Behavior Among Practicing Surgeons in the Operating Room.

Objective: The aim of this study was to identify examples of naturalistic coaching behavior among practicing surgeons operating together by analyzing their intraoperative discussion.

Background: Opportunities to improve surgical performance are limited for practicing surgeons; surgical coaching is one strategy to address this need. To develop peer coaching programs that integrate with surgical culture, a better understanding is needed of how surgeons routinely discuss operative performance.

Comparing the Learning Effectiveness of Healthcare Simulation in the Observer Versus Active Role: Systematic Review and Meta-Analysis.

The benefits of observation in simulation-based education in healthcare are increasingly recognized. However, how it compares with active participation remains unclear. We aimed to compare effectiveness of observation versus active participation through a systematic review and meta-analysis.

Visual-Spatial Memory Deficits Are Related to Increased Knee Valgus Angle During a Sport-Specific Sidestep Cut.

Background: Identifying athletes at an increased risk of injury is a promising approach to improve the effect of injury prevention interventions; however, it requires first identifying the potential athlete-specific risk factors. Cognitive ability was recently shown to correlate with noncontact anterior cruciate ligament injury rates and lower extremity mechanics, marking an underexplored area. A better understanding of how individuals' cognitive ability is associated with neuromuscular control during sport-specific tasks may improve injury prevention.

"Development of an Academic Surgical Student Program for Enhancing Student-Faculty Engagement".

Objective: We describe an innovative medical student surgery interest group and its influence on mentorship and career exploration.

Design: SCRUBS, created to promote interest in academic surgery, is student-led, with continual surgical faculty and resident involvement. Its 3-component programming focuses on clinical skills, research, and mentorship opportunities for medical students to get involved in academic surgery early in medical education.

Safety considerations in learning new procedures: a survey of surgeons.

Background: There exists a tension between surgical innovation and safety. The learning curve associated with the introduction of new procedures/technologies has been associated with preventable patient harm. Surgeon's perceptions regarding the safety of methods for learning new procedures/technologies are largely uncharacterized.