Preoperative Briefings and Postoperative Debriefings to Increase Resident Operative Autonomy and Performance

Zhou, Nancy J.; Kamil, Rebecca J.; Zhu, Jiafeng; Hillel, Alexander T.; Tan, Marietta; Walsh, Jonathan; Russell, Jonathon O.; Eisele, David W.; Akst, Lee M.

doi:10.1016/j.jsurg.2021.03.002

Cited by 3 publications

(9 citation statements)

References 21 publications

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“…For example, modern duty hour restrictions lead to less operative time for residents. [3][4][5][6] Any degree of compromise to surgical education, and particularly operative volume, may leave some residents feeling unprepared for performing certain procedures upon graduation. 5 Finally, there is an ever-increasing volume, variety, and complexity of cases as new surgeons enter independent practice.…”

Section: Background Of Modern Surgical Educationmentioning

confidence: 99%

“…[3][4][5][6] Any degree of compromise to surgical education, and particularly operative volume, may leave some residents feeling unprepared for performing certain procedures upon graduation. 5 Finally, there is an ever-increasing volume, variety, and complexity of cases as new surgeons enter independent practice. 5 Most assuredly, structured, guided, deliberate learning is crucial for resident success.…”

Section: Background Of Modern Surgical Educationmentioning

confidence: 99%

“…5 Finally, there is an ever-increasing volume, variety, and complexity of cases as new surgeons enter independent practice. 5 Most assuredly, structured, guided, deliberate learning is crucial for resident success.…”

Section: Background Of Modern Surgical Educationmentioning

confidence: 99%

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Preoperative Planning for Your Career

Schallmo¹,

Turk²,

Scannell³

et al. 2022

Journal of the Pediatric Orthopaedic Society of North America

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Surgical residents face significant demands to obtain the requisite skills and knowledge for their specialty by the time they graduate. Structured, guided, deliberate learning in a manner that is reproducible is crucial for surgical resident success and for ensuring residents will be able to meet the increasing demands of clinical practice. Use of an organized surgical planning tool, such as the PERFECT (Position, Exposure, Reduction, Fixation, Evaluation, Closure, and Therapy) model described in this article, is fundamental and indispensable to not only resident education, but to ones’ future career and to orthopaedic practice more broadly. This tool helps to emphasize important elements of a case, allows for mental rehearsal, serves as a custom educational resource for the resident, provides a framework for focused and intentional communication between the resident and attending surgeon, helps to encourage a critical appraisal of a procedure by all participants, and provides the resident guidance for future practice. Broadly instituting teaching frameworks such as the PERFECT model has demonstrated the potential to improve the standardization and overall learning experience for orthopaedic surgical residents, who continue to be tasked with learning more efficiently in a changing healthcare and education landscape.

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Section: Background Of Modern Surgical Educationmentioning

confidence: 99%

Section: Background Of Modern Surgical Educationmentioning

confidence: 99%

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Preoperative Planning for Your Career

Schallmo¹,

Turk²,

Scannell³

et al. 2022

Journal of the Pediatric Orthopaedic Society of North America

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“…A limited number of studies have introduced the use of several instruments to evaluate resident operative experiences and operative skills. [7][8][9][10] However, little is known about potential factors that may cause variability across otolaryngology training experiences. Herein, we conducted a multicenter study to characterize the factors that affect operative skill training in otolaryngology.…”

Section: Introductionmentioning

confidence: 99%

“…Efforts to quantify, characterize and improve surgical education in otolaryngology have been scarce. A limited number of studies have introduced the use of several instruments to evaluate resident operative experiences and operative skills 7–10 . However, little is known about potential factors that may cause variability across otolaryngology training experiences.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting operative autonomy and performance during otolaryngology training: A multicenter trial

Chen

Miller

Filimonov

et al. 2022

Laryngoscope Investig Oto

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Objective Surgical education is changing in an era of new regulations and evolving training cultures. We sought to understand the factors that affect operative experiences during otolaryngology residency. Methods From December 2019 to December 2020, five otolaryngology training programs used the SIMPL OR smartphone application to evaluate residents after each operation. Residents and attendings rated the trainee's autonomy on a 4‐level Zwisch scale, performance on a 5‐level scale, and case complexity on a 3‐level scale. We examined associations between ratings of autonomy and performance with variables including postgraduate year (PGY), case complexity, gender, week of the academic year (AY), and whether multiple procedures were logged. Results 78 attendings and 92 residents logged 2984 evaluations. PGY level and week of the AY were positively associated with attending ratings of autonomy and performance (PGY3 vs. PGY2: B = 0.63, p < .001 for autonomy and B = 1.05, p < .001 for performance; week of the AY: B = 0.013, p = .002 for autonomy; B = 0.025, p < .001 for performance). Multiple procedures logged and increasing case complexity were negatively associated with attending ratings (multiple procedures: B = −0.19, p = .04 for autonomy and B = −0.48, p < .001 for performance; hardest vs. easiest 1/3 of cases: B = −1.01, p < .001 for autonomy and B = −0.59, p < .001 for performance). Attending and trainee genders were not associated with attending ratings of autonomy or performance. Conclusion Resident autonomy and performance were positively associated with PGY level and week of the academic year, and negatively associated with case complexity and multiple procedures. These findings highlight the need to align training level with case complexity to promote quality operative experiences. Level of Evidence 2.

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Optimizing Surgical Efficiency in Complex Spine Surgery Using Virtual Reality as a Communication Technology to Promote a Shared Mental Model: A Case Series and Review

Laskay,

Parr,

Mooney

et al. 2023

Operative Neurosurgery

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BACKGROUND AND OBJECTIVES: Virtual reality (VR) is an emerging technology that can be used to promote a shared mental model among a surgical team. We present a case series demonstrating the use of 3-dimensional (3D) VR models to visually communicate procedural steps to a surgical team to promote a common operating objective. We also review the literature on existing uses of VR for preoperative communication and planning in spine surgery. METHODS: Narrations of 3 to 4-minute walkthroughs were created in a VR visualization platform, converted, and distributed to team members through text and email the night before surgical intervention. A VR huddle was held immediately before the intervention to refine surgical goals. After the intervention, the participating team members’ perceptions on the value of the tool were assessed using a survey that used a 5-point Likert scale. MEDLINE, Google Scholar, and Dimensions AI databases were queried from July 2010 to October 2022 to examine existing literature on preoperative VR use to plan spine surgery. RESULTS: Three illustrative cases are presented with accompanying video. Postoperative survey results demonstrate a positive experience among surgical team members after reviewing preoperative plans created with patient-specific 3D VR models. Respondents felt that preoperative VR video review was “moderately useful” or more useful in improving their understanding of the operational sequence (71%, 5/7), in enhancing their ability to understand their role (86%, 6/7), and in improving the safety or efficiency of the case (86%, 6/7). CONCLUSION: We present a proof of concept of a novel preoperative communication tool used to create a shared mental model of a common operating objective for surgical team members using narrated 3D VR models. Initial survey results demonstrate positive feedback among respondents. There is a paucity of literature investigating VR technology as a means for preoperative surgical communication in spine surgery. ETHICS: Institutional review board approval (IRB-300009785) was obtained before this study.

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Preoperative Briefings and Postoperative Debriefings to Increase Resident Operative Autonomy and Performance

Cited by 3 publications

References 21 publications

Preoperative Planning for Your Career

Preoperative Planning for Your Career

Factors affecting operative autonomy and performance during otolaryngology training: A multicenter trial

Optimizing Surgical Efficiency in Complex Spine Surgery Using Virtual Reality as a Communication Technology to Promote a Shared Mental Model: A Case Series and Review

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