Cadaveric simulation for improving surgical training in dermatology.

Simulation models are rapidly changing medical education, especially the training of dermatology residents. Various models are available, including cadaveric simulations. Our study evaluates the impact of a cadaveric simulation on the training of dermatology residents. Over a period of three years, cadaveric simulation was shown to increase the surgical knowledge of residents. Residents were more confident in their knowledge of surgical anatomy and also surgical skills. Cadaveric simulation may offer a positive impact on resident training in dermatology

Development of learning objectives for neurology in a veterinary curriculum: Part II: Postgraduates

Background: Specialization in veterinary medicine in Europe is organized through the Colleges of the European Board of Veterinary Specialization. To inform updating of the curriculum for residents of the European College of Veterinary Neurology (ECVN) job analysis was used. Defining job competencies of diploma holders in veterinary neurology can be used as references for curriculum design of resident training. With the support of the diplomates of the ECVN and the members of the European Society of Veterinary Neurology (ESVN) a mixed-method research, including a qualitative search of objectives and quantitative ranking with 149 Likert scale questions and 48 free text questions in 9 categories in a survey was conducted. In addition, opinions of different groups were subjected to statistical analysis and the result compared. Results: A return rate of 62% (n = 213/341) was achieved. Of the competencies identified by the Delphi process, 75% objectives were expected to attain expert level; 24% attain advanced level; 1% entry level. In addition, the exercise described the 11 highly ranked competencies, the 3 most frequently seen diseases of the central and peripheral nervous systems and the most frequently used immunosuppressive, antiepileptic and chemotherapeutic drugs. Conclusion: The outcomes of this “Delphi job analysis” provide a powerful tool to align the curriculum for ECVN resident training and can be adapted to the required job competencies, based on expectations. The expectation is that for majority of these competencies diplomates should attain an expert level. Besides knowledge and clinical skills, residents and diplomates are expected to demonstrate high standards in teaching and communication. The results of this study will help to create a European curriculum for postgraduate education in veterinary neurology

Orthopaedic residency in the time of COVID-19: navigating a new normal

The pandemic had affected outpatient clinics, emergency and elective surgery, rehabilitation, resident training, personnel management, use of personal protective equipment, telemedicine and all sub-specialties of orthopaedics

Resident Training Curriculum in Adolescent Depression and Suicide Screening

Introduction: Routine screening of adolescents for depression and suicide risk is now considered best clinical practice. However, due to a lack of training, many physicians do not engage in screening. The goal of this curriculum is to improve learner knowledge of and comfort in adolescent depression and suicide risk assessment and management. Methods: The didactic session typically takes 60-90 minutes to complete. In addition to a teaching PowerPoint that provides instruction in both the assessment and management of adolescent depression and suicide risk, the curriculum also includes a suicide assessment and management protocol. This protocol outlines an algorithm that assists in distinguishing between individuals at high and low risk of suicide. The algorithm enables clinicians to determine the most appropriate management plan based on the assessed level of suicide risk. Results: Outcome measures indicate that the majority of residents improved their self-perceived knowledge and comfort in assessing and managing depression and suicide risk, with an average of 61.7% of residents moving from the novice to the proficient group at the conclusion of the rotation. These results reflect learners obtaining 4 weeks of supervised clinical experience after the didactic session. Discussion: This curriculum was designed for use with pediatric and internal medicine–pediatric residents during their adolescent medicine rotation but could easily be adapted for use with other learners in different settings

The Effect of Resident Training in the Operating Room

Medical students wanting to be surgeons have a long road of training that only grows with advancing technology and an expanding range of diseases. Faced with duty hour restrictions, today’s residents are experiencing a shift from the traditional training paradigm—instead of learning all basic skills in the operating room (OR), some are being developed with simulation training outside the OR. In order to create a curriculum with an effective blend between operating duties and simulation, it’s important that there’s an understanding of the effect of resident involvement in the OR. Then, a more accurate simulation/education curriculum can be created that will maximize quality and efficiency of training and begin to reduce adverse effects of intraoperative resident involvement (complications, time, and cost). In an effort to determine these effects at the Mayo Clinic, 324 laparoscopic cholecystectomy (gallbladder removal) cases from 2010-2013 were retrospectively reviewed. All cases were performed by one general surgeon with or without a post-graduate year three surgery resident. There were 174 cases with resident involvement and 150 without. Overall, OR time was significantly greater with a resident (88 ± 30 min versus 57 ± 22 min by surgeon only (t(311)=10.33, p2=0.026; p=0.436). Excluding high-risk patients, there were 117 cases with resident involvement and 89 without. Again, operative duration was longer with a resident (88 ± 23 min versus 54 ± 22 min surgeon only (t(192)=8.97, p2=0.102, p=0.370). While a longer operative duration with resident involvement translates into larger costs, no statistically significant difference in complications is quite encouraging. Educators can now modify their simulation/education curriculum to include more laparoscopic fundamentals—potentially reducing the amount of time spent in the OR learning the basics of laparoscopy—as well as adding sessions that include common GS procedures (like LC and laparoscopic appendectomy). The addition of laparoscopic stations in assessments would also be beneficial to ensure residents are meeting competency standards before they can operate. The ultimate goal of these modifications is to create surgeons who are both efficient and effective in the OR: reducing operative duration without risking patient safety

Laparoscopic Ventriculoperitoneal Shunts: Benefits to Resident Training and Patient Safety

This analysis suggests that laparoscopic ventriculoperitoneal shunting may serve as a model to accomplish the goals of improved patient outcomes and quality surgical education

Mastering the Central Line Placement Techniques Through Effective Resident Training Environment

Catheterization of the central vein is one of the fundamental procedures in anesthesiology. Mastering different methods of central venous access is an important part of resident training. At the initial stage residents should master the way of high medial access to the right internal jugular vein that is one of the simplest techniques with the lowest risk of complications for a patient. The operating room can be an optimal training environment where first independent puncture attempts are performed in a stable patient undergoing surgical intervention under general anesthesia. The next stage of training should involve access to other central veins as well performing the procedure in a conscious patient

An Assessment Rubric for a Resident Training Program in Surgery: A Single-Institution Experience

Using a Collaborative Action Research model, our research team established a one-month clinical resident training program for first- and second-year clinical residents. We created and implemented an assessment rubric to assess the residents’ progress toward independent practice in surgery, and thereby, to evaluate the program itself. The program included training in three areas: basic techniques and procedures in the operating room, surgical ward management, and academic activities. The rubric measured the residents’ performance according to three achievement levels: Level 1 (demonstration), Level 2 (active help) and Level 3 (passive help). The program and rubric implementation began in June 2019 and continued until March 2020, when the program outcomes and shortcomings were analyzed. Among nineteen clinical residents, a total of nine clinical residents participated in the study. Most participants reached achievement Level 3 for their performance of basic techniques in the operating room. Finally, we discussed ideas for improvement and drafted plans for an improved rubric to complete the action research cycle. Our research team found the rubric to be a useful tool in evaluating the status of the new clinical resident training program