Effects of Limited Work Hours on Surgical Training

Barden, Catherine B.; Specht, Michelle C.; McCarter, Martin D.; Daly, J.M.; Fahey, Thomas J.

doi:10.1097/01.ogx.0000058698.18516.45

Cited by 31 publications

(39 citation statements)

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“…However, reductions in the amount of one-on-one teaching [3], together with the steep learning curve of RMIS [4], advocate for the development of a new teaching paradigm where surgical skill is automatically assessed and timely feedback is automatically provided.…”

Section: Introductionmentioning

confidence: 99%

Surgical Gesture Segmentation and Recognition

Tao

Zappella

Hager

et al. 2013

Lecture Notes in Computer Science

103

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Abstract. Automatic surgical gesture segmentation and recognition can provide useful feedback for surgical training in robotic surgery. Most prior work in this field relies on the robot's kinematic data. Although recent work [1,2] shows that the robot's video data can be equally effective for surgical gesture recognition, the segmentation of the video into gestures is assumed to be known. In this paper, we propose a framework for joint segmentation and recognition of surgical gestures from kinematic and video data. Unlike prior work that relies on either frame-level kinematic cues, or segment-level kinematic or video cues, our approach exploits both cues by using a combined Markov/semi-Markov conditional random field (MsM-CRF) model. Our experiments show that the proposed model improves over a Markov or semi-Markov CRF when using video data alone, gives results that are comparable to state-of-the-art methods on kinematic data alone, and improves over state-of-the-art methods when combining kinematic and video data.

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Section: Introductionmentioning

confidence: 99%

Surgical Gesture Segmentation and Recognition

Tao

Zappella

Hager

et al. 2013

Lecture Notes in Computer Science

103

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“…2,3 In both the United States and Canada, resident work-hours restrictions have significantly decreased the amount of time that trainees spend in relatively autonomous on-call work. [4][5][6] Internationally, the increasing awareness of medical error, [7][8][9] along with a small body of literature associating increased clinical supervision with better patient outcomes, [10][11][12] has led to calls for increased intensity of clinical supervision in the name of quality of care and patient safety from such varied sources as government committees, 13,14 medicolegal review boards, 15,16 and the popular press. 17 These influences on clinical supervision practices have led to widespread increases in the supervision of clinical trainees.…”

Section: Introductionmentioning

confidence: 99%

Clinical Oversight: Conceptualizing the Relationship Between Supervision and Safety

et al. 2007

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“…11 Search of the references of these studies identified another 14 citations. With further analysis, articles were selected wherein interventions relevant to one or more of the three themes were studied, resulting in a final selection of 56 citations Twenty-one studies analyzed transitions in, during, and after residency education; 19 studies addressed the educational effects of duty hour limits, [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] and 16 articles presented research on use of the competencies in teaching and assessing anesthesiology residents. [19][20][21][22][23][24][25][26][27][52][53][54][55][56][57][58] For the theme ''duty hours and the acquisition of competence'', the only articles included were those that assessed the effect of duty hour limits on measures of physician competence and those that studied changes in patient care experience in anesthesiology that could be attributed to the reduction in resident hours.…”

Section: Methodsmentioning

confidence: 99%

“…35 A small number of studies, all in surgical specialties, have assessed the educational impact of the limits in the United States. One national study 36 and two single institution studies 37,38 found improved scores in the in-training exam in surgical specialties. In a national study of orthopedic surgery residents, 39 three single institution studies in surgery and otolaryngology, [40][41][42] and an older study of the impact of New York state's duty hour regulation on obstetricsgynecology residents 40 showed no changes in in-training exam performance.…”

Section: Duty Hour Limits and The Acquisition Of Competencementioning

confidence: 99%

Review article: Closing the research gap at the interface of learning and clinical practice

Philibert

2011

Can J Anesth/J Can Anesth

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Purpose The dialogue at the interface of education and clinical practice highlights areas of critical importance to the development of new approaches for educating anesthesiologists. The purpose of this article is to examine the literature on education and acquisition of competence in three areas relevant to the interface of learning and clinical practice, with the aim to suggest a research agenda that adds to the evidence on preparing physicians for independent practice. The three areas are: 1) transitions across the continuum of education; 2) the effect of reductions in hours of clinical training on competence; and 3) efforts to incorporate the competencies and CanMEDS roles into teaching and evaluation. Principal findings Fifty-six articles relevant to one or more of the themes were identified in the review, including 21 studies of transitions (in, during, and after residency education), 19 studies on the effects of duty hour limits on residents' acquisition of competence, and 16 articles that assessed competency-based teaching and assessment in anesthesiology. Overall, the findings suggested a relative paucity of scientific evidence and a need for research and the development of new scientific theory. Studies generally treated one of the themes in isolation, while in actuality they interact to produce optimal as well as suboptimal learning situations, while medical education research often is limited by small samples, brief follow-up, and threats to validity. This suggests a ''research gap'' where editorials and commentaries have moved ahead of an evidence base for education. Promising areas for research include preparation for care deemed important by society, work to apply knowledge about the development of expertise in other disciplines to medicine, and ways to embed the competencies in teaching and evaluation more effectively. Conclusion Closing the research gap in medical education will require clear direction for future work. The starting point, at an institution or nationally, is dialogue within the specialty to achieve consensus on some of the most pressing questions.

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Effects of Limited Work Hours on Surgical Training

Cited by 31 publications

References 0 publications

Surgical Gesture Segmentation and Recognition

Surgical Gesture Segmentation and Recognition

Clinical Oversight: Conceptualizing the Relationship Between Supervision and Safety

Review article: Closing the research gap at the interface of learning and clinical practice

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