Incorporation of Simulation in Graduate Medical Education: Historical Perspectives, Current Status, and Future Directions.

Technological advancement and improved training strategies have transformed the healthcare practice environment in the last few decades. Simulation has evolved as one of the leading training models for the next generation of healthcare professionals. Simulation-based training enables healthcare professionals to acquire knowledge and skills in a safe and educationally oriented environment and can be a valuable tool for improving clinical practice and patient outcomes.

Gender Representation of Editors at Journals Affiliated with Major U.S. Medical Societies.

To assess the gender composition of upper-level specialty-specific editor positions among United States (U.S.) medical society-affiliated journals and to evaluate the equitable inclusion of women and women physicians.

Creation of a High-Fidelity, Low-Cost, Intraosseous Line Placement Task Trainer via 3D Printing.

The description of procedural task trainers includes their use as a training tool to hone technical skills through repetition and rehearsal of procedures in a safe environment before ultimately performing the procedure on a patient. Many procedural task trainers available to date suffer from several drawbacks, including unrealistic anatomy and the tendency to develop user-created 'landmarks' after the trainer tissue undergoes repeated manipulations, potentially leading to inappropriate psychomotor skill development. To ameliorate these drawbacks, a process was created to produce a high-fidelity procedural task trainer, created from anatomy obtained from computed tomography (CT) scans, that utilize ubiquitous three-dimensional (3D) printing technology and off-the-shelf commodity supplies.

Gender equity in ergonomics: does muscle effort in laparoscopic surgery differ between men and women?

Background: Women surgeons may experience more ergonomic challenges while performing surgery. We aimed to assess ergonomics between men and women surgeons.

Methods: Laparoscopic surgeons from a single institution were enrolled.

Fertility and Reproductive Health in Women Physicians.

Our aim was to evaluate trends of childbearing during medical training, evaluate issues of infertility, and measure institutionalized barriers to childbearing among women physicians. Attendees of a national women physician's leadership conference (Brave Enough Women Physicians Continuing Medical Education Conference) were surveyed during the conference using Qualtrics (2019 Qualtrics, Provo, UT), in September 2019. Survey data included demographics, training level, and medical specialty.

Citizenship Tasks and Women Physicians: Additional Woman Tax in Academic Medicine?

Our aim was to evaluate differences in reported citizenship tasks among women physicians due to personal or demographic factors and time spent performing those tasks for work. Attendees of a national women physician's leadership conference (Brave Enough Women Physicians Continuing Medical Education Conference) replied to a survey using Qualtrics (2019 Qualtrics, Provo, UT), in September 2019. Data collected included age, race, ethnicity, training level, medical practice, specialty, current annual total compensation, educational debt, and number of children.

Surgical and clinical outcomes comparison of mesh usage in laparoscopic hiatal hernia repair.

Purpose: Use of absorbable mesh in hiatal hernia (HH) repair has been shown to decrease recurrence rates. Our aim was to compare the efficiency of three meshes in relation to the surgical outcomes of patients undergoing HH repair.

Methods: A single-institution retrospective review was done for adult patients who underwent HH repair with mesh between 2004 and 2016.

How high is too high? Extensive mediastinal dissection in patients with hiatal hernia repair.

Background: Approximately 10% of patients receiving anti-reflux procedures present with shortened esophagus. Collis gastroplasty (CG) is the current gold standard for esophageal lengthening, but mediastinal esophageal mobilization without gastroplasty may be an alternative approach. This study assesses preoperative and intraoperative hernia characteristics and mediastinal dissection impact in patients with large hiatal hernia repair (HHR).

Current state of robotic use in inguinal hernia repair: a survey of minimally invasive hernia surgeons.

Little is known about how robot technology is employed by surgeons in minimally invasive surgery (MIS). We evaluated the needs of established robotic surgeons and of those who are new to this technology. A survey was designed and sent electronically to MIS surgeons.

Minimally invasive approach to hiatal hernia repair is superior to open, even in the emergent setting: a large national database analysis.

Background: We aimed to examine the outcomes and utilization of different hiatal hernia repair (HHR) approaches in elective and emergent/urgent settings.

Methods: Vizient 2015-2017 database was queried for adult patients who underwent HHR. Patients were grouped into open (OHHR), laparoscopic (LHHR), or robotic-assisted (RHHR), and further stratified by elective or urgent status and severity of illness at admission.

Achalasia Treatment in Patients over 80 Years of Age: A Multicenter Survey.

Laparoscopic Heller's myotomy (LHM), per oral endoscopic myotomy, and pneumatic dilatation are well-established methods to treat achalasia. The ideal treatment algorithm in elderly patients is, however, still elusive. This multicenter study aims to evaluate outcomes and changes in routine therapeutic options in patients >80 years of age.

Patients undergoing intragastric balloon achieve approximately 50% of their target weight loss in the first month postoperatively: an MBSAQIP analysis.

Background: Intragastric balloon (IGB) placement can provide a mean percent total weight loss (%TWL) of 10.2% at 6-month follow-up.

Objectives: We aimed to evaluate 30-day outcomes and safety of patients undergoing IGB placement.

Updates on Monogenic Obesity in a Multifactorial Disease.

Obesity is a worldwide epidemic with rates nearly doubling over the last 30 years. Despite increasing prevalence, the multifactorial pathogenesis of obesity continues to be widely misunderstood. Investigating genetic drivers in the development of obesity is an important area of focus, as genetics move to the forefront of medicine and personalized treatment evolves.

Robot-assisted cholecystectomy is a safe but costly approach: A national database review.

Background: This study sought to evaluate surgical outcomes, cost, and opiate utilization of patients who underwent laparoscopic (LC) or robotic cholecystectomy (RC).

Methods: The Vizient database was queried for patients admitted with mild to moderate severity of illness (SOI) scores who underwent LC or RC from January 2015 through December 2017. Rates of overall complications, postoperative infection, mortality, LOS, cost, and opiate utilization were compared between groups using IBM SPSS v.

Outcomes and impact of laparoscopic inguinal hernia repair versus open inguinal hernia repair on healthcare spending and employee absenteeism.

Background: This study compares the impact of open (OIHR) versus laparoscopic (LIHR) inguinal hernia repair on healthcare spending and postoperative outcomes.

Methods: The TRUVEN database was queried using ICD9 procedure codes for open, laparoscopic, and robotic-assisted IHR, from 2012 to 2013. Patients > 18 years of age and continuously enrolled for 12 months postoperatively were included.

Prolonged non-operative management of clostridium difficile colitis is associated with increased mortality, complications, and cost.

Background: We aim to investigate the effects of delaying surgery on outcomes and cost in patients admitted with severe clostridium difficile infection (CDI).

Methods: The Vizient database was queried for patients with CDI who underwent open total abdominal colectomy (TAC). Patients operated on the day of admission were excluded.

Predictors of Hiatal Hernia Recurrence After Laparoscopic Anti-reflux Surgery with Hiatal Hernia Repair: a Prospective Database Analysis.

Background: The aim of this study is to identify factors that can predict hiatal hernia recurrence (HHR) in patients after anti-reflux surgery with hiatal hernia (HH) repair.

Methods: A single-institution, prospectively collected database was reviewed (January 2002-October 2015) with inclusion criteria of GERD and laparoscopic anti-reflux (AR) surgery with HH repair. Demographics, esophageal symptom scores, and pre- and post-upper gastrointestinal imaging (UGI) were collected.

Ergonomics of minimally invasive surgery: an analysis of muscle effort and fatigue in the operating room between laparoscopic and robotic surgery.

Background: Our aim was to determine how objectively-measured and self-reported muscle effort and fatigue of the upper-limb differ between surgeons performing laparoscopic (LAP) and robotic-assisted (ROBOT) surgeries.

Methods: Surgeons performing LAP or ROBOT procedures at a single-institution were enrolled. Objective muscle activation and self-reported fatigue were evaluated, and comparisons were made between approaches.