Notes

Specialist Improvement Observe to Prepare Long term Educational Physicians.
Entrustable professional activities (EPAs) have been developed to refine competency-based education. The American Board of Surgery has initiated a 2-year pilot study to evaluate the impact of EPAs on the evaluation and feedback of surgical residents. The ACGME Milestones in Surgery is a semiannual competency-based evaluation program to measure resident progression through 16 professional attributes across 8 practice domains. The correlation between these 2 evaluation tools remains unclear. Metabolism inhibitor The purpose of this study is to evaluate this correlation through comparison of an EPA with the corresponding elements of the ACGME Milestones.

From July, 2018 to October, 2019, all residents submitting EPA evaluations for gall bladder disease were evaluated for preoperative, intraoperative, and/or postoperative entrustability. The ratings were converted to a numerical rank from 0 to 4. Milestones scores from May 2019 and November 2019 were obtained for each resident, with scores ranging from 0 to 4. The gall bladder EPpecific feedback than existing tools and, on aggregate, may improve upon existing formative feedback practices provided through the biannual evaluation of surgical residents.
We observed significant correlations between EPAs for cholecystectomy and associated milestones evaluation scores. These findings indicate that EPAs may provide more timely and specific feedback than existing tools and, on aggregate, may improve upon existing formative feedback practices provided through the biannual evaluation of surgical residents.
Laparoscopic box simulators provide surgical residents a cost-effective and accessible learning tool to practice basic laparoscopic skills. Despite effective, high-fidelity simulators used in robotic surgery training, a similar low-fidelity alternative simulation method is not available. The objective of this report and accompanying video is to introduce a low-fidelity method to help those new to robotic-assisted surgery learn fundamental skills even before sitting at the console.

Using 2 fine-point metal tweezers with Velco loops for finger slots, I developed a user-friendly way to practice basic needle handling and intracorporeal knot tying activities similar to those encountered on a high-fidelity robotic simulator. These simple tools mimic the controllers at the actual robot console.

This teaching tool is meant to help surgical trainees and those new to robotic surgery develop the initial dexterity and economy of motion for performing basic tasks. I have greatly improved my own surgical confidence and experience anecdotally using these tools before I sat for actual cases. I hope a motivated trainee may discover the same benefit.

A low-fidelity simulation method may enhance a learner's initial proficiency in robotic-assisted surgery, but future performance studies using this method will be needed.
A low-fidelity simulation method may enhance a learner's initial proficiency in robotic-assisted surgery, but future performance studies using this method will be needed.
To determine if surgeons and non-surgeons agree on the importance of surgical topics covered in the surgical clerkship to the daily practice of non-surgeons.

An IRB-approved anonymous survey ranking the relative importance of 35 topics drawn from surgical clerkship curricula asking physicians to rank the relative importance of each topic, using a five-point Likert scale, to the daily practice of non-surgeons.

Online anonymous survey.

Convenience sample of practicing physicians and trainees. The survey was offered to physicians in all specialties via social media and professional connections, responders identified their practice specialty.

295 physicians completed the survey. Two hundred thirty-one (85%) were from non-surgical specialties emergency medicine (EM, n = 100); primary care (PC, n = 71 - included internal medicine, family medicine, and pediatrics); a variety of others (n = 60). Surgeons and non-surgeons agreed on the relative importance of the acute abdomen, breast disease, inguinal herniaics could be focused differently depending on acute or non-acute non-surgical care career plans.
The COVID-19 pandemic significantly altered medical student education. The ability for students to be a part of the operating room team was highly restricted. Technology can be used to ensure ongoing surgical education during this time of limited in-person educational opportunities.

We have developed an innovative solution of securely live-streaming surgery with real-time communication between the surgeon and students to allow for ongoing education during the pandemic.

We successfully live-streamed multiple different types of neurosurgical operations utilizing multiple video sources. This method uses inexpensive, universal equipment that can be implemented at any institution to enable virtual education of medical students and other learners.

This technology has facilitated education during this challenging time. This technological set-up for live-streaming surgery has the potential of improving medical and graduate medical education in the future.
This technology has facilitated education during this challenging time. This technological set-up for live-streaming surgery has the potential of improving medical and graduate medical education in the future.
To compare differences in operating room (OR) times between teaching and nonteaching cases across calendar years. We hypothesize that time devoted to intraoperative resident education is decreasing, therefore, OR times for teaching and nonteaching cases will be converging.

Teaching cases take longer than similar nonteaching cases, in part due to intraoperative resident education. Pressures to improve OR efficiency and patient safety may threaten resident education and leave less time for intraoperative learning; however, the magnitude of impact is unknown.

National Surgical Quality Improvement Program (NSQIP) deidentified national databases from 2006 to 2012, queried for 30 most common General surgery procedures and case teaching status (i.e., teaching vs. nonteaching cases).

The NSQIP database was retrospectively reviewed to identify the 30 most common General Surgery procedures. Teaching cases included all operations in which a resident participated. Multivariable regression analyses were constructed to determine the impact of resident involvement on OR times, controlling for year, resident participation, procedure, and patient demographics and comorbidities.
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