Teaching in the Operating Room: Results of a National Survey

Snyder, Rebecca A.; Tarpley, Margaret J.; Tarpley, John L.; Davidson, Mario; Brophy, Colleen M.; Dattilo, Jeffery B.

doi:10.1016/j.jsurg.2012.06.007

Cited by 75 publications

(37 citation statements)

References 20 publications

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“…The USP definition from S/N is useful in the gradient systems, in which a drift in the baseline is present. Otherwise, in the case of using signal to noise ratio, noise will be overestimated when drift is present (17). …”

Section: Methodsmentioning

confidence: 99%

Development of a Validated HPLC/Photodiode Array Method for the Determination of Isomenthone in the Aerial Parts of Ziziphora tenuior L.

Ghassemi

Ghanadian

Ghaemmaghami

et al. 2013

Jundishapur J Nat Pharm Prod

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Background: Ziziphora tenuior L. known as Kakuti in Persian, is used in traditional medicine for fever, dysentery, uterus infection and as an analgesic. It is used also in the treatment of gastrointestinal disorders as carminative, or remedy of diarrhea or nausea. Major components of plant essential oil including pulegone, isomenthone, thymol, menthone, and piperitone are suggested to be responsible for the mentioned medicinal properties. Objectives: In the present study, a normal high performance liquid chromatography (HPLC)/photodiode array validated method for quantification of isomenthone, one of the major constituents of Ziziphora, was established for the first time with a simple, rapid and accurate method. Materials and Methods: HPLC analysis was done on a Waters system, equipped with 515 HPLC pump and waters 2996 photodiode array detector. The column was a Nova-Pak Silica (3.9 × 150 mm), and Empower software was used for the determination of the compounds and processing the data. The method was validated according to USP 32 requirements. Results: A selective method for the resolution of isomenthone from two nearest peaks, thymol, and carvacrol was obtained with gradient system of hexane (A), and hexane: ethyl acetate (9:1) (B), starting with A: B (100:0) for 2 minutes, then 0-20% B in 5 minutes, A:B (80:20) for 5 minutes, then 20-30% B in 3 minutes, 30-100% B for 5 minutes, A:B (0:100) for 4 minutes following with equilibrating for 10 minutes. The flow rate was 1 mL/min at 22˚C and the injection volume for the standards and the samples was 20 μL. The retention time for isomenthone was found to be 7.45 minutes. The regression equation was y = 143235x -2433 with the correlation co-factor R 2 = 0.9992 and the percent recovery of 65.4 ± 3.85%. The sample obtained from 5 g of Z. teniour dried powder in 6 mL extract was standardized to contain 1.14 ± 0.030 μL/mL isomenthone which is equivalent to % 1.37 μL/g of the dried powdered plant. Limit of detection (LOD) and Limit of Quantification (LOQ) were 0.037, and 0.122 µL/mL determined by using the formula based on the signal to noise ratio. Conclusions: Due to this fact that plant extracts may cause irreversible damages to the capillary GC columns, using validated HPLC method for the analysis of these compounds in cruse plant extracts is recommended.

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Section: Methodsmentioning

confidence: 99%

Development of a Validated HPLC/Photodiode Array Method for the Determination of Isomenthone in the Aerial Parts of Ziziphora tenuior L.

Ghassemi

Ghanadian

Ghaemmaghami

et al. 2013

Jundishapur J Nat Pharm Prod

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“…Recent innovations using crowdsourcing may be an efficient alternative to observation by experts, but their role in surgical training curricula is still uncertain (26–30). Other, less resource intensive approaches, such as in-training evaluations and examinations, or surrogates, such as surgical volume (31–33), do not correlate with objective assessments of surgical technical skill (34). …”

Section: Surgical Technical Skill and Competencymentioning

confidence: 99%

Objective Assessment of Surgical Technical Skill and Competency in the Operating Room

Vedula

Ishii

Hager

2017

Annu. Rev. Biomed. Eng.

106

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Training skillful and competent surgeons is critical to ensure high quality of care and to minimize disparities in access to effective care. Traditional models to train surgeons are being challenged by rapid advances in technology, an intensified patient-safety culture, and a need for value-driven health systems. Simultaneously, technological developments are enabling capture and analysis of large amounts of complex surgical data. These developments are motivating a “surgical data science” approach to objective computer-aided technical skill evaluation (OCASE-T) for scalable, accurate assessment; individualized feedback; and automated coaching. We define the problem space for OCASE-T and summarize 45 publications representing recent research in this domain. We find that most studies on OCASE-T are simulation based; very few are in the operating room. The algorithms and validation methodologies used for OCASE-T are highly varied; there is no uniform consensus. Future research should emphasize competency assessment in the operating room, validation against patient outcomes, and effectiveness for surgical training.

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“…2 In a national survey of the quality of teaching taking place in the OR, the majority of residents reported that attendings offer advice in technical skills, include residents in intraoperative decisions, and verbalize their operative approach, all of which are beneficial for developing skills in the OR. 3 In regards to attending surgeons improving their skills, interaction with more experienced peers and feedback during and after a procedure can be beneficial. An approach that is gaining momentum is surgical peer coaching, similar to athletes, in that surgical techniques are always evolving and few people can achieve and maintain optimal performance on their own.…”

Section: What Is This Box?mentioning

confidence: 99%

“…7 In fact, results from the national survey discussed above indicated that less than 20% of the residents who responded indicated that they preoperatively discussed personal educational operative goals with the attending, and less than 40% reported discussing areas improvement. 3 This is problematic given that previous work shows that, no matter the resident level or the way in which they chose to prepare for the OR, residents felt that they were least prepared for instrument use/ selection and suture selection, 8 but faculty felt that these were the areas in which residents were most prepared. 9 These findings speak to the importance of preoperative interactions between attendings and residents to establish learning needs and goals.…”

Section: What Is This Box?mentioning

confidence: 99%

Development of Technical Skills

Sullivan

Anderson

Pugh³

2015

Journal of Craniofacial Surgery

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The goal of this article is to provide a focused overview of technical skills education inside the operating room (OR), opportunities for learning outside of the OR (with a focus on simulation), and methods for measuring technical skills. In addition, the authors review the role of maintenance of certification in continuing education and quality improvement and consider the role that simulation plays in this process. The perspectives on teaching in the OR of both residents and faculty going into the case affect the learning environment, and preoperative interactions between attendings and residents to establish learning needs and goals are important. Furthermore, in regards to attending surgeons improving their skills, interaction with more experienced peers and feedback during and after a procedure can be beneficial. Simulation is increasingly being utilized as an education tool outside of the OR. Training in plastic surgery is poised to exploit simulation in multiple technical areas. There is potential to utilize these simulation environments to collect real-time data, such as motion, visual focus, and pressure. How to incorporate technical skill evaluation results in ways that are most beneficial for learning should be the focus of future research and curriculum development. Finally, simulation could be better utilized as a mechanism for both self and peer evaluation and assessment for continuing education and quality improvement. Professional development for faculty and surgery trainees on how to engage with simulation for teaching and learning and how to translate these experiences into improving patient care will be required.

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Teaching in the Operating Room: Results of a National Survey

Cited by 75 publications

References 20 publications

Development of a Validated HPLC/Photodiode Array Method for the Determination of Isomenthone in the Aerial Parts of Ziziphora tenuior L.

Development of a Validated HPLC/Photodiode Array Method for the Determination of Isomenthone in the Aerial Parts of Ziziphora tenuior L.

Objective Assessment of Surgical Technical Skill and Competency in the Operating Room

Development of Technical Skills

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