Using Interdisciplinary Workgroups to Educate Surgery Residents in Systems-Based Practice

Gillen, Jacob R.; Ramirez, Adriana G.; Farineau, Diane W.; Hoke, Tracey R.; Schirmer, Bruce D.; Williams, Michael D.; Lau, Christine L.

doi:10.1016/j.jsurg.2016.05.017

Cited by 10 publications

(16 citation statements)

References 24 publications

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“…On the risk of bias assessment, >65% of studies scored high on all 5 categories meaning that they had a non-clearly reported study design, lacked randomization, were prone to participants’ selection bias, had incomplete reporting, or lacked evidence supporting their claimed effectiveness. All but 2 studies 9,40 scored high on risk of being uncontrolled studies or without a comparative cohort, whereas all studies scored high on selective reporting except 5 studies 11,28,29,34,38 which were of unclear risk. Finally, 70% of studies scored high on bias on the statistical evidence supporting the effectiveness of the intervention, with only 2 studies scoring low 40,41 and 3 of unclear risk, 9,34,36 as shown in Figure 3B.…”

Section: Resultsmentioning

confidence: 99%

Implementation and Evaluation of Quality Improvement Training in Surgery

et al. 2021

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Objective: The of this study was to review and appraise how quality improvement (QI) skills are taught to surgeons and surgical residents. Background: There is a global drive to deliver capacity in undertaking QI within surgical services. However, there are currently no specifications regarding optimal QI content or delivery. Methods: We reviewed QI educational intervention studies targeting surgeons or surgical trainees/residents published until 2017. Primary outcomes included teaching methods and training materials. Secondary outcomes were implementation frameworks and strategies used to deliver QI training successfully.Results: There were 20,590 hits across 10 databases, of which 11,563 were screened following de-duplication. Seventeen studies were included in the final synthesis. Variable QI techniques (eg, combined QI models, process mapping, and ''lean'' principles) and assessment methods were found. Delivery was more consistent, typically combining didactic teaching blended with QI project delivery. Implementation of QI training was poorly reported and appears supported by collaborative approaches (including building learning collaboratives, and coalitions). Study designs were typically pre-/ post-training without controls. Studies generally lacked clarity on the underpinning framework (59%), setting description (59%), content (47%), and conclusions (47%), whereas 88% scored low on psychometrics reporting. Conclusions: The evidence suggests that surgical QI training can focus on any well-established QI technique, provided it is done through a combination of didactic teaching and practical application. True effectiveness and extent of impact of QI training remain unclear, due to methodological weaknesses and inconsistent reporting. Conduct of larger-scale educational QI studies across multiple institutions can advance the field.

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Section: Resultsmentioning

confidence: 99%

Implementation and Evaluation of Quality Improvement Training in Surgery

et al. 2021

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“…Because of local resource limitations, many of the Moi residents rely on local literature to guide their care and to present during education conferences; as such, IU residents are then exposed to different types of scientific literature. With the focus of the Moi residents on adapting to resource limitations, the IU residents are exposed to systems-based practice in a manner separate from the interprofessional education models [ 6 , 23 ] and are part of discussions reviewing ethical decisions in providing care.…”

Section: Discussionmentioning

confidence: 99%

Bilateral trauma case conferences: an approach to global surgery equity through a virtual education exchange

Bhatia

Munda

Okoth³

et al. 2023

Global Surg Educ

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Purpose With increased interest in international surgical experiences, many residency programs have integrated global surgery into their training curricula. For surgical trainees in low- and middle-income countries (LMICs), physical exchange can be costly, and laws in high-income countries (HICs) prevent LMIC trainees from practicing surgery while on visiting rotations. To enrich the educational experience of trainees in both settings, we established a monthly virtual trauma conference between surgery training programs. Methods General surgery teams from two public institutions, a public university with two surgical training programs in Kenya and a public university with two level I trauma centers in the United States, meet monthly to discuss complex and interesting trauma patients. A trainee from each institution presents a clinical case vignette and supplements the case with pertinent peer-reviewed literature. The attendees then answer a series of multiple-choice questions like those found on surgery board exams. Results Monthly case conferences began in September 2017 with an average of 24 trainees and consultant surgeons. Case discussions serve to stimulate dialogue on patient presentation and management, highlighting cost-conscious, high-quality care and the need to adapt practice patterns to meet resource constraints and provide culturally appropriate care. Conclusion Our 5-year experience with this virtual case conference has created a unique and robust surgical education experience for trainees and surgeons who have withstood the effects of the pandemic. These case conferences have not only strengthened the camaraderie between our departments, but also promoted equity in global surgery education and prioritized the learning of trainees from both settings.

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“…65 Exercises involving trainees tackling true "systems issues" can be especially helpful in preparing them for practice, particularly when coupled with interprofessional collaboration. 66 These efforts to help trainees understand the infrastructure necessary to deliver high-quality neurosurgical care foster their development as clinically competent and safe surgeons. From the perspective of global health, a foundation in health systems science, health policy, and legislative advocacy provides physicians with a skillset necessary to take an active role in systems strengthening and capacity building.…”

Section: Interpersonal and Communication Skillsmentioning

confidence: 99%

Targeted Public Health Training for Neurosurgeons: An Essential Task for the Prioritization of Neurosurgery in the Evolving Global Health Landscape

et al. 2022

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The gap between the tremendous burden of neurological disease requiring surgical management and the limited capacity for neurosurgical care has fueled the growth of the global neurosurgical movement. It is estimated that an additional 23 300 neurosurgeons are needed to meet the burden posed by essential cases across the globe. Initiatives to increase neurosurgical capacity through systems strengthening and workforce development are key elements in correcting this deficit. Building on the growing interest in global health among neurosurgical trainees, we propose the integration of targeted public health education into neurosurgical training, in both high-income countries and low- and middle-income countries. This effort will ensure that graduates possess the fundamental skillsets and experience necessary to participate in and lead capacity-building efforts in the developing countries. This additional public health training can also help neurosurgical residents to achieve the core competencies outlined by accreditation boards, such as the Accreditation Committee on Graduate Medical Education in the United States. In this narrative review, we describe the global burden of neurosurgical disease, establish the need and role for the global neurosurgeon, and discuss pathways for implementing targeted global public health education in the field of neurosurgery.

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Using Interdisciplinary Workgroups to Educate Surgery Residents in Systems-Based Practice

Cited by 10 publications

References 24 publications

Implementation and Evaluation of Quality Improvement Training in Surgery

Implementation and Evaluation of Quality Improvement Training in Surgery

Bilateral trauma case conferences: an approach to global surgery equity through a virtual education exchange

Targeted Public Health Training for Neurosurgeons: An Essential Task for the Prioritization of Neurosurgery in the Evolving Global Health Landscape

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