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Importance: The suspension of elective operations in March 2020 to prepare for the COVID-19 surge posed significant challenges to resident education. To mitigate the potential negative effects of COVID-19 on surgical education, it is important to quantify how the pandemic influenced resident operative volume.
Objective: To examine the association of the pandemic with general surgical residents' operative experience by postgraduate year (PGY) and case type and to evaluate if certain institutional characteristics were associated with a greater decline in surgical volume.
Design, Setting, And Participants: This retrospective review included residents' operative logs from 3 consecutive academic years (2017-2018, 2018-2019, and 2019-2020) from 16 general surgery programs. Data collected included total major cases, case type, and PGY. Faculty completed a survey about program demographics and COVID-19 response. Data on race were not collected. Operative volumes from March to June 2020 were compared with the same period during 2018 and 2019. Data were analyzed using Kruskal-Wallis test adjusted for within-program correlations.
Main Outcome And Measures: Total major cases performed by each resident during the first 4 months of the pandemic.
Results: A total of 1368 case logs were analyzed. There was a 33.5% reduction in total major cases performed in March to June 2020 compared with 2018 and 2019 (45.0 [95% CI, 36.1-53.9] vs 67.7 [95% CI, 62.0-72.2]; P < .001), which significantly affected every PGY. All case types were significantly reduced in 2020 except liver, pancreas, small intestine, and trauma cases. There was a 10.2% reduction in operative volume during the 2019-2020 academic year compared with the 2 previous years (192.3 [95% CI, 178.5-206.1] vs 213.8 [95% CI, 203.6-223.9]; P < .001). Level 1 trauma centers (49.5 vs 68.5; 27.7%) had a significantly lower reduction in case volume than non-level 1 trauma centers (33.9 vs 63.0; 46%) (P = .03).
Conclusions And Relevance: In this study of operative logs of general surgery residents in 16 US programs from 2017 to 2020, the first 4 months of the COVID-19 pandemic was associated with a significant reduction in operative experience, which affected every PGY and most case types. Level 1 trauma centers were less affected than non-level 1 centers. If this trend continues, the effect on surgical training may be even more detrimental.
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http://dx.doi.org/10.1001/jamasurg.2021.1978 | DOI Listing |
J Endourol
December 2024
Department of Urology, University of California San Francisco, San Francisco, California, USA.
To develop and validate a high-fidelity, nonbiohazardous simulator model for the ultrasound-guided percutaneous nephrolithotomy procedure. We employed a systematic framework based on Delphi consensus and modern education theory to design a simulation model. Twelve expert surgeons provided input through a hierarchal task analysis and identified procedural tasks, anatomical landmarks, and potential errors.
View Article and Find Full Text PDFClin J Sport Med
December 2024
SW Washington Sports Medicine Fellowship and Family Medicine Residency, Vancouver, Washington.
Objective: Learning environments affect the well-being of surgical faculty and trainees. Psychological safety (PS) has been linked with learning behaviors and aspects of well-being within medicine; however, given the unique challenges inherent to the surgical learning environment, there is a need to more closely examine these concepts for surgical faculty and trainees. The objective of this study is to examine the relationships between learning environment and PS, as well as PS and well-being with surgery.
View Article and Find Full Text PDFN Am Spine Soc J
December 2024
Department of Neurosurgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Background: Spine surgical training faces increasing challenges due to restricted working hours and greater sub specialization. Modern simulators offer a promising approach to teaching both simple and complex spinal procedures. This study evaluated the acceptance and efficacy of spine simulator training using a lumbar herniated disc model tested by 16 neurosurgical residents (PGY-1-6), and compared 3D and 2D teaching methods.
View Article and Find Full Text PDFCureus
November 2024
Department of Obstetrics and Gynecology and Urology, New York Medical College, Valhalla, USA.
Background The United States continues to rank as one of the most expensive healthcare systems in the world, and cataract surgery, the most commonly performed surgery, is one of the primary drivers of healthcare expenditure. Increasing efforts have been made to try to minimize U.S.
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