Objective: The first year of surgical training sometimes includes marginally educational or service-related tasks with limited direct interactions with faculty. We instituted a prototype rotation to address the changing needs and expectations of our intern class. This study was designed to evaluate the new rotation 17 months after it was implemented.
Design: Interns spend 4 weeks in our outpatient surgery center. Elements of the rotation include performance of operative cases and perioperative management of outpatients under direct faculty supervision, daily one-on-one structured teaching sessions with faculty, and call coverage twice monthly. At the conclusion of the rotation, interns make a presentation on a topic of their choosing to a teaching conference. Rotation evaluations and case and work-hour logs for the outpatient surgery rotation (OSR) were compared with those for the remaining intern rotations combined. A faculty survey of the OSR also was conducted.
Results: The OSR consistently received maximum overall ratings (4 of 4), significantly higher than the average overall score for the remaining rotations (3.17, p < 0.01). Similarly, teaching by faculty, time spent in the operating room, and quality of operating room time were rated significantly higher than for the other intern rotations (p = 0.05). Interns performed an average of 44 cases in 4 weeks of OSR, compared with an average of 94 in the remaining rotations (p < 0.001), and they worked an average of 62 hours per week (range, 49-76 hours). Of the participating faculty, 93% reported that the interaction gave them the opportunity to know the interns better at a personal level, that the sessions were beneficial and improved working relationships with interns, and that the program should continue.
Conclusions: Changing program requirements, time restrictions, public scrutiny, and increasing awareness for quality of life all obligate a paradigm shift in surgical education. Our outpatient rotation is logistically simple and rewarding both for residents and faculty.
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http://dx.doi.org/10.1016/j.jsurg.2008.07.012 | DOI Listing |
Sci Rep
January 2025
Department of General Surgery, Shaoxing Central Hospital (The Central Affiliated Hospital, Shaoxing University), Shaoxing, 312030, Zhejiang Province, China.
Ventral hernias pose a prevalent challenge in abdominal wall surgery, with ongoing advancements in repair techniques designed to enhance patient outcomes. This study evaluates the efficacy, safety, and socio-economic impact of Totally Extraperitoneal Sublay Repair (TES) versus Laparoscopic Intraperitoneal Onlay Mesh Repair (IPOM) for small to medium-sized ventral hernias, with a particular focus on postoperative quality of life and patient satisfaction. A retrospective cohort study was conducted, encompassing 125 patients who underwent ventral hernia repair between May 2018 and November 2023.
View Article and Find Full Text PDFZhonghua Fu Chan Ke Za Zhi
January 2025
Gynecological Minimally Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100006, China.
To investigate the correlation between uterine volume and intrauterine adhesion (IUA). From June 2018 to November 2019, totally 7 007 patients who underwent hysteroscopy in outpatient operating rooms of Gynecological Minimally Invasive Center, Beijing Obstetrics and Gynecology Hospital were retrospectively analyzed Patients of reproductive age with IUA without uterine fibroids and adenomyosis were selected as IUA group, and patients of reproductive age without uterine fibroids and adenomyosis without IUA during the same period were selected as the control group. The propensity score matching (PSM) method was used to perform 1∶1 matching for the two groups of patients, matching variables included age, height, weight, body mass index (BMI), gravidity, parity, and number of abortion curettage.
View Article and Find Full Text PDFNefrologia (Engl Ed)
January 2025
Servicios de Nefrología, Unidad Funcional de Acceso Vascular, Hospital Clínico de Barcelona, Barcelona, Spain.
Background And Objectives: The key points of a monographic vascular access (VA) consultation are an adequate preoperative assessment, as well as a correct management and optimization of waiting lists. Our main objective of present study was to evaluate the degree of exploratory-dependent concordance in outpatient clinics regarding implanted VA, between nephrology and vascular surgery.
Materials And Methods: We analyzed VA created or surgically repaired between 2021 and 2022.
BMJ Case Rep
January 2025
Orthopaedic Surgery and Sports Medicine, Amsterdam UMC Location AMC, Amsterdam, The Netherlands.
A patient in his 40s presented at the outpatient clinic with sudden pain and swelling over his medial malleolus, 16 weeks after he had undergone osteoperiosteal autografting with a medial malleolar osteotomy for his tertiary osteochondral lesion of the talus. Postoperatively, the patient was treated using the regular evidence-based rehabilitation protocol of 5 weeks of non-weight-bearing and 5 weeks of partial weight-bearing. However, after the confirmed radiological union the patient experienced an acute on chronic stress fracture through the osteotomy line.
View Article and Find Full Text PDFAm J Kidney Dis
January 2025
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, CANADA; O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, CANADA.
Rationale & Objective: People with advanced kidney disease undergo more non-cardiac operations compared to the general population, with a higher risk of perioperative cardiac events and death. However, little is known about the associations between severity of preoperative kidney dysfunction with postoperative length of hospitalization and discharge disposition; these were the focus of this study.
Study Design: Population-based retrospective cohort.
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