A qualitative analysis describing attrition from bariatric surgery to identify strategies for improving retention in patients who desire treatment.

Background: Among patients who express interest in bariatric surgery, dropout rates from bariatric surgery programs are reported as high as 60%. There is a lack of understanding how we can better support patients to obtain treatment of this serious chronic disease.

Methods: Semi-structured interviews with individuals who dropped out of bariatric surgery programs from three clinical sites were conducted.

"The captain of the ship." A qualitative investigation of surgeon identity formation.

Background: Professional identity formation is essential to medical trainee education. Surgeons are expected to guide trainees through this process but may be unprepared as they may not understand their own professional identity.

Methods: We purposively selected 46 surgeons across Michigan to participate in semi-structured qualitative interviews intended to explore surgical decision-making in 2019.

"You Remember Those Days"-A Qualitative Study of Resident Surgeon Responses to Complications and Deaths.

Objective: Postoperative complications and deaths are unavoidable aspects of a surgical career, but little is known about the impacts of these unwanted outcomes on resident surgeons. The goal of this study was to characterize the impact of complications and deaths on surgery residents in order to facilitate development of improved support systems.

Design: This qualitative study was designed to explore resident surgeons' experiences with unwanted outcomes, including postoperative complications and death.

Palliative care education in surgery.

Though incorporating palliative care principles with standard medical and surgical care has been associated with multiple benefits, surgical training devotes far less time to developing skills within the palliative care domains. In this review, we sought to explore the existing literature concerning palliative care education within the context of surgical training. Current studies may be categorized under two major areas: (I) measurement of trainee exposure through needs assessments and (II) implementation of novel palliative care-based training curricula.

High-risk surgery among older adults: Not-quite shared decision-making.

Background: Shared decision-making is critical to optimal patient-centered care. For elective operations, when there is sufficient time for deliberate discussion, little is known about how surgeons navigate decision-making and how surgeons align care with patient preferences. In this context, we sought to explore surgeons' approaches to decision-making for adults ≥65 years at high-risk of postoperative complications or death.

The Impact of Nonpharmacological Interventions on Patient Experience, Opioid Use, and Health Care Utilization in Adult Cardiac Surgery Patients: Protocol for a Mixed Methods Study.

Background: Despite pharmacological treatments, patients undergoing cardiac surgery experience severe anxiety and pain, which adversely affect outcomes. Previous work examining pediatric and nonsurgical adult patients has documented the effectiveness of inexpensive, nonpharmacological techniques to reduce anxiety and pain as well as health care costs and length of hospitalization. However, the impact of nonpharmacological interventions administered by a dedicated comfort coach has not been evaluated in an adult surgical setting.

Exploring Emotional Responses After Postoperative Complications: A Qualitative Study of Practicing Surgeons.

Objective: This qualitative study explored the impact of postoperative complications on surgeons and their well-being.

Background: Complications are an inherent component of surgical practice. Although there have been extensive efforts to reduce postoperative complications, the impact of complications on surgeons have not been well-studied.

Optimizing Surgeon Well-Being: A Review and Synthesis of Best Practices.

Unlabelled: Through a systematic review and mixed-methods meta-synthesis of the existing literature on surgeon well-being, we sought to identify the specific elements of surgeon well-being, examine factors associated with suboptimal well-being, and highlight opportunities to promote well-being.

Background: Suboptimal surgeon well-being has lasting and substantial impacts to the individual surgeon, patients, and to society as a whole. However, most of the existing literature focuses on only 1 aspect of well-being-burnout.

Exploration of Surgeon Motivations in Management of Abdominal Wall Hernias: A Qualitative Study.

Importance: Although evidence-based guidelines designed to minimize health care variation and promote effective care are widely accepted, creating guidelines alone does not often lead to the desired practice change. Such knowledge-to-practice gaps are well-recognized in the management of patients with abdominal wall hernia, where wide variation in patient selection and operative approach likely contributes to suboptimal patient outcomes. To create sustainable, scalable, and widespread adherence to evidence-based guidelines, it is imperative to better understand individual surgeon motivations and behaviors associated with surgical decision-making.

Surgeon Attitudes and Beliefs Toward Abdominal Wall Hernia Repair in Female Patients of Childbearing Age.

This qualitative study examines surgeon’s thoughts on decision-making in repairing an abdominal wall hernia in a woman or girl of childbearing age.