Does variability among surgical skills diminish throughout surgical internship? Analysis of a 5-task surgical simulation assessment program starting Day 1

Limberg, Jessica; Karnick, Aleksandr T.; Bagautdinov, Iskander; Aveson, Victoria G.; Stefanova, Dessislava; Fehling, David; Fahey, Thomas J.

doi:10.1016/j.surg.2019.09.026

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…Models for skills measurement include inexpensive elements commonly available to surgical training programs (eg, an Ethicon knot-tying model, a TruSuture skin pad from Apex Accucate, a SynAtomy carotid artery segment from SynDaver, and FLS supplies). These tasks assess a wide range of resident technical skills spanning multiple levels of difficulty and competence and full details for implementation of this assessment process is described in Limberg et al 18 The relatively straightforward and inexpensive implementation provides an opportunity for programs to develop objective measures of resident performance to improve resident evaluation and indicate specific areas for improvement using a selfdirected learning paradigm or through formal remediation processes.…”

Section: Discussionmentioning

confidence: 99%

“…The specific design of each task has been previously described. 18 All skill assessments were video recorded anonymously and evaluated by a team of reviewers using the Objectively Structured Assessment of Technical Skills format. 19e21 Research residents were trained to review videos anonymously using a structured Objectively Structured Assessment of Technical Skills system with specific metrics for procedural steps and guidelines for assessing competence (Appendix 1).…”

Section: Study Design and Participantsmentioning

confidence: 99%

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Can general surgery interns accurately measure their own technical skills? Analysis of cognitive bias in surgical residents’ self-assessments

Karnick

Limberg

Bagautdinov

et al. 2021

Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Study Design and Participantsmentioning

confidence: 99%

Can general surgery interns accurately measure their own technical skills? Analysis of cognitive bias in surgical residents’ self-assessments

Karnick

Limberg

Bagautdinov

et al. 2021

Surgery

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“…A recent study has demonstrated the ability of simulation programs to supplement surgical skills, assess longitudinal progress, and to offer an objective feedback. 15 A Cochrane review found that virtual reality training decreases the operating time and improve operative performance of surgical trainees with limited laparoscopic experience when compared with no training or with box training. 16 We are aware that this practice might be challenging in developing countries where economic and technologic resources are scarce.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Appendectomy Performed by Surgical Interns: Is it Too Early?

Valinoti

Dreifuss²,

Angeramo³

et al. 2020

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Laparoscopic appendectomy (LA) is a common procedure among surgical trainees. However, first-year residents' involvement in this procedure is scarcely studied. We aimed to determine the safety and outcomes of LA performed by surgical interns early in their first year of surgical training. Materials and Methods:A retrospective review of all patients who underwent LA for acute appendicitis from 2006 to 2019 was performed. All patients operated by surgical interns were included. The sample was divided into 2 groups: LA performed during the first (G1) and last 3 months (G2) of their first year of residency. Demographics, operative variables, and postoperative outcomes were compared between groups.Results: A total of 2009 LA were performed during the study period; 1647 (82%) were done by surgical interns. A total of 934 LA were performed at both ends of the year; 505 belonged to G1 and 429 to G2. Each surgical intern performed a mean of 40 LA. Demographics, complicated appendicitis rates, and presence of peritonitis were comparable between groups. Operative time was longer in G1

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“…To be effective, the simulation must be directed by dedicated faculty and methods for measuring skills are used to ensure adequate skills are acquired before the trainees operate on patients. Limberg and colleagues 13 demonstrated significant improvement in surgical skills using simulation.…”

Section: Introductionmentioning

confidence: 99%

For the People and the Profession

Richards

2021

The American Surgeon

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In 1982 Dean Warren delivered the presidential address “Not for the Profession… For the People” in which he identified substandard surgical residency programs graduating residents who were unable to pass American Board of Surgery exams. Drs. Warren and Shires as members of the independent ACGME began to close the substandard programs in order to improve surgical care for average Americans i.e. “for the people”. By 2003 these changes dramatically reduced the failure rate for the ABS exams and trained good surgeons who could operate independently however the residents were on duty for every other or every third night. In 2003 the ACGME mandated duty hour restrictions in order improve resident wellness and improve the training environment for the profession. However, work hour restrictions reduced the time surgical residents spent in the hospital environment primarily when residents had more autonomy and had exposure to emergency cases which degraded readiness for independent practice. Surgical educators in the 2 decades after the work hour restrictions have improved techniques of training so graduates could not only pass the board exams but also be prepared for independent practice. Surgical residency training has improved by both the changes implemented by the independent ACGME in 1981 and by the work hour restrictions mandated in 2003. Five recommendations are made to ensure that Dr Warren's culture of excellence in surgical training continues in an environment that enhances wellbeing of the trainee i.e. “For the People and the Profession”.

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Does variability among surgical skills diminish throughout surgical internship? Analysis of a 5-task surgical simulation assessment program starting Day 1

Cited by 6 publications

References 19 publications

Can general surgery interns accurately measure their own technical skills? Analysis of cognitive bias in surgical residents’ self-assessments

Can general surgery interns accurately measure their own technical skills? Analysis of cognitive bias in surgical residents’ self-assessments

Laparoscopic Appendectomy Performed by Surgical Interns: Is it Too Early?

For the People and the Profession

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