20 research outputs found
EQIP\u27s First Year: A Step Closer to Higher Quality in Surgical Education.
OBJECTIVE: To describe the first year of the Educational Quality Improvement Program (EQIP) DESIGN: The Educational Quality Improvement Program (EQIP) was formed by the Association of Program Directors in Surgery (APDS) in 2018 as a continuous educational quality improvement program. Over 18 months, thirteen discrete goals for the establishment of EQIP were refined and executed through a collaborative effort involving leaders in surgical education. Alpha and beta pilots were conducted to refine the data queries and collection processes. A highly-secure, doubly-deidentified database was created for the ingestion of resident and program data.
SETTING & PARTICIPANTS: 36 surgical training programs with 1264 trainees and 1500 faculty members were included in the dataset. 51,516 ERAS applications to programs were also included. Uni- and multi-variable analysis was then conducted.
RESULTS: EQIP was successfully deployed within the timeline described in 2020. Data from the ACGME, ABS, and ERAS were merged with manually entered data by programs and successfully ingested into the EQIP database. Interactive dashboards have been constructed for use by programs to compare to the national cohort. Risk-adjusted multivariable analysis suggests that increased time in a technical skills lab was associated with increased success on the ABS\u27s Qualifying Examination, alone. Increased time in a technical skills lab and the presence of a formal teaching curriculum were associated with increased success on both the ABS\u27s Qualifying and Certifying Examination. Program type may be of some consequence in predicting success on the Qualifying Examination.
CONCLUSIONS: The APDS has proved the concept that a highly secure database for the purpose of continuous risk-adjusted quality improvement in surgical education can be successfully deployed. EQIP will continue to improve and hopes to include an increasing number of programs as the barriers to participation are overcome
Ad astra per aspera (Through Hardships to the Stars): Lessons Learned from the First National Virtual APDS Meeting, 2020
This article is made available for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.Objective
After COVID-19 rendered in-person meetings for national societies impossible in the spring of 2020, the leadership of the Association of Program Directors in Surgery (APDS) innovated via a virtual format in order to hold its national meeting.
Design
APDS leadership pre-emptively considered factors that would be important to attendees including cost, value, time, professional commitments, education, sharing of relevant and current information, and networking.
Setting
The meeting was conducted using a variety of virtual formats including a web portal for entry, pre-ecorded poster and oral presentations on the APDS website, interactive panels via a web conferencing platform, and livestreaming.
Participants
There were 298 registrants for the national meeting of the APDS, and 59 participants in the New Program Directors Workshop. The registrants and participants comprised medical students, residents, associate program directors, program directors, and others involved in surgical education nationally.
Results
There was no significant difference detected for high levels of participant satisfaction between 2019 and 2020 for the following items: overall program rating, topics and content meeting stated objectives, relevant content to educational needs, educational format conducive to learning, and agreement that the program will improve competence, performance, communication skills, patient outcomes, or processes of care/healthcare system performance.
Conclusions
A virtual format for a national society meeting can provide education, engagement, and community, and the lessons learned by the APDS in the process can be used by other societies for utilization and further improvement
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General Surgery Residency After Graduation From US Medical Schools Visa-Related Challenges for the International Citizen
International-United States medical graduates (I-USMGs) are non-US citizen graduates of US medical schools. Although academically equivalent to US-citizen peers, they are subject to the same visa requirements as non-US citizen international medical graduates. We hypothesized that visa sponsorship policies of general surgery programs (GSPs) may be discordant with the enrollment patterns of I-USMGs. A total of 196 GSPs participated in a telephone survey regarding visa sponsorship policies. Whereas GSPs preferred J-1 to H-1B sponsorship (64.2% vs 32.6%), I-USMG enrollment favored programs supporting H-1B sponsorship (72.1% vs 7.5%) (P=.01). University-affiliated programs were more likely to sponsor H1-Bs than independent programs (39.6% vs 24.4%) (P=.03) and trained a greater proportion of I-USMGs than independent programs (40.6% vs 14.0%) (P<.01). Restrictive policies against H-1B sponsorship may limit GSPs' I-USMG applicant pool and restrict I-USMGs' surgical training options. JAMA Surg. 2013;148(3):292-29
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Complications of Pancreaticoduodenectomy
Although pancreaticoduodenectomy (PD) was initially performed by Kausch in 1909 and popularized by Allen Whipple in 1935, the operation was traditionally regarded with significant skepticism due to high mortality and morbidity rates. During the past two decades, however, PD has slowly gained acceptance as a safe and effective treatment modality for both malignant and benign diseases of the periampullary region. Due to advances in operative technique and perioperative care, perioperative mortality rates have generally declined from 25–30% to <5% at high-volume centers (1–3). Nevertheless, morbidity rates are still significant—between 30% and 50% in many series (1, 3–5). Given the poor overall survival even in successfully resected patients and the continued need for aggressive and often toxic adjuvant therapy regimens, the impact for postoperative morbidity on the patient’s quality of life as well their ability to receive these adjuvant therapies is even more significant. This chapter reviews the most common complications following PD including the diagnosis, risk factors, prevention, and treatment
Does intentional support of degree programs in general surgery residency affect research productivity or pursuit of academic surgery?
Many residents supplement general surgery training with years of dedicated research, and an increasing number at our institution pursue additional degrees. We sought to determine whether it was worth the financial cost for residency programs to support degrees.
We reviewed graduating chief residents (n = 69) in general surgery at Vanderbilt University from 2001 to 2010 and collected the data including research time and additional degrees obtained. We then compared this information with the following parameters: (1) total papers, (2) first-author papers, (3) Journal Citation Reports impact factors of journals in which papers were published, and (4) first job after residency or fellowship training.
The general surgery resident training program at Vanderbilt University is an academic program, approved to finish training 7 chief residents yearly during the time period studied.
Chief residents in general surgery at Vanderbilt who finished their training 2001 through 2010.
We found that completion of a degree during residency was significantly associated with more total and first-author publications as compared with those by residents with only dedicated research time (p = 0.001 and p = 0.017). Residents completing a degree also produced publications of a higher caliber and level of authorship as determined by an adjusted resident impact factor score as compared with those by residents with laboratory research time only (p = 0.005). Degree completion also was significantly correlated with a first job in academia if compared to those with dedicated research time only (p = 0.046).
Our data support the utility of degree completion when economically feasible and use of dedicated research time as an effective way to significantly increase research productivity and retain graduates in academic surgery. Aggregating data from other academic surgery programs would allow us to further determine association of funding of additional degrees as a means to encourage academic productivity and retention
Influence of Resident Education in Correctly Diagnosing Extremity Soft Tissue Sarcoma
Background. One-third of all extremity soft tissue sarcomas are misdiagnosed and inappropriately excised without proper preoperative diagnosis and planning. This study aimed at examining the clinical judgment of residents in both general and orthopaedic surgery and at determining whether resident education plays a role in appropriately managing unknown soft tissue masses. Methods. A case-based survey was used to assess clinical decisions, practice patterns, and demographics. Aggregate response for all of the clinical cases by each respondent was correlated with the selections made for practice patterns and demographic data. Results. A total of 381 responses were returned. A higher percentage of respondents from the orthopaedic group (84.2%) noted having a dedicated STS rotation as compared to the general surgery group (35.8%) P<0.001. Depth, size, and location of the mass, rate of growth, and imaging characteristics were considered to be important factors. Each additional year of training resulted in 10% increased odds of selecting the correct clinical decision for both groups. Conclusion. Our study showed that current residents in both orthopaedic surgery and general surgery are able to appropriately identify patients with suspicious masses. Continuing education in sarcoma care should be implemented beyond the years of residency training