Using Concurrent Complication Reporting to Evaluate Resident Critical Thinking and Enhance Adult Learning.

Objective: Critical thinking and accurate case analysis is difficult to quantify even within the context of routine morbidity and mortality reporting. We designed and implemented a HIPAA-compliant adverse outcome reporting system that collects weekly resident assessments of clinical care across multiple domains (case summary, complications, error analysis, Clavien-Dindo Harm, cognitive bias, standard of care, and ACGME core competencies). We hypothesized that incorporation of this system into the residency program's core curriculum would allow for identification of areas of cognitive weakness or strength and provide a longitudinal evaluation of critical thinking development.

The Surgical Learning Curve: Does Robotic Technical Skill Explain Differences in Operative Performance?

Prior studies on technical skills use small collections of videos for assessment. However, there is likely heterogeneity of performance among surgeons and likely improvement after training. If technical skill explains these differences, then it should vary among practicing surgeons and improve over time.

Does Surgeon Experience Correlate with Crowd-Sourced Skill Assessment in Robotic Bariatric Surgery?

Background: The Global Evaluative Assessment of Robotic Skills (GEARS) rubric provides a measure of skill in robotic surgery. We hypothesize surgery performed by more experienced operators will be associated with higher GEARS scores.

Method: Patients undergoing sleeve gastrectomy from 2016 to 2020 were analyzed.

Outcome prediction in bariatric surgery through video-based assessment.

Introduction: The relationship between intraoperative surgical performance scores and patient outcomes has not been demonstrated at a single-case level. The GEARS score is a Likert-based scale that quantifies robotic surgical proficiency in 5 domains. Given that even highly skilled surgeons can have variability in their skill among their cases, we hypothesized that at a patient level, higher surgical skill as determined by the GEARS score will predict individual patient outcomes.

Reducing surgical site infections after colectomy: bundle item compliance, process, and outlier identification.

Background: The purpose of this study was to implement a checklist monitoring system and identify critical surgical checklist items associated with post-colectomy surgical site infections (SSI). The relationship between checklist compliance, infection rates, and identification of non-compliant surgeons was explored.

Materials And Methods: National Health Safety Network (NHSN) data were imported annually to establish baseline incidence of post-colectomy SSI from 2016 to 2019.

Blinded intraoperative skill evaluations avoid gender-based bias.

Introduction: Gender bias has been identified consistently in written performance evaluations. Qualitative tools may provide a standardized way to evaluate surgical skill and minimize gender bias. We hypothesized that there is no difference in operative time or GEARS scores in robotic hysterectomy for men vs women surgeons.

Impact of Timing of Tocilizumab Use in Hospitalized Patients With SARS-CoV-2 Infection.

Background: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) continues to be a global challenge due to the lack of definitive treatment strategies. We sought to determine the efficacy of early administration of anti-interleukin 6 therapy in reducing hospital mortality and progression to mechanical ventilation.

Methods: This was a retrospective chart review of 11,512 patients infected with SARS-CoV-2 who were admitted to a New York health system from March to May 2020.

Cognitive bias and severity of harm following surgery: Plan for workflow debiasing strategy.

Introduction: This study analyzes the relationship between cognitive bias (CB) and harm severity as measured by Clavien-Dindo Scores (CD).

Methods: A prospectively collected series of 655 severity matched general surgical cases with complications were analyzed. Cases were evaluated for CB and assigned harm scores as defined by CD grade.

Cognitive Bias Impact on Management of Postoperative Complications, Medical Error, and Standard of Care.

Background: Cognitive bias (CB) is increasingly recognized as an important source of medical error and up to 75% of errors in internal medicine are thought to be cognitive in origin (O'Sullivan ED, Schofield SJ. Cognitive bias in clinical medicine. J R Coll Physicans Edinb.

Correlation between operative time and crowd-sourced skills assessment for robotic bariatric surgery.

Introduction: Operative time has been traditionally used as a proxy for surgical skill and is commonly utilized to measure the learning curve, assuming that faster operations indicate a more skilled surgeon. The Global Evaluative Assessment of Robotic Skills (GEARS) rubric is a validated Likert scale for evaluating technical skill. We hypothesize that operative time will not correlate with the GEARS score.

Core Competency Self-Assessment Enhances Critical Review of Complications and Entrustable Activities.

Background: The Accreditation Council for Graduate Medical Education has defined six core competencies (CCs) that every successful physician should possess. However, the assessment of CC achievement among trainees is difficult. This project was designed to prospectively evaluate the impact of resident identification of CC as a component of morbidity review on error identification and standard of care (SOC) assessments.