Post Residency Subspecialty Training in Neurosurgery — The Impact of Subspecialty Training on Organized Neurosurgery and Resident Training — Benefits, Responsibilities and Liabilities

1997 ◽  
pp. 140-144 ◽  
Author(s):  
D. G. Piepgras
Keyword(s):  
Resident Training ◽  
Subspecialty Training ◽  
The Impact

Patient Safety/Quality Improvement Primer, Part III: The Role of Simulation

2021 ◽  
pp. 019459982110133
Author(s):  
Ellen S. Deutsch ◽  
Sonya Malekzadeh ◽  
Cecelia E. Schmalbach
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Control Charts ◽  
Neck Surgery ◽  
Resident Training ◽  
Statistical Process ◽  
Ensure Patient Safety ◽  
Statistical Process Control Charts ◽  
The Individual ◽  
The Impact

Simulation training has taken a prominent role in otolaryngology–head and neck surgery (OTO-HNS) as a means to ensure patient safety and quality improvement (PS/QI). While it is often equated to resident training, this tool has value in lifelong learning and extends beyond the individual otolaryngologists to include simulation-based learning for teams and health systems processes. Part III of this PS/QI primer provides an overview of simulation in medicine and specific applications within the field of OTO-HNS. The impact of simulation on PS/QI will be presented in an evidence-based fashion to include the use of run and statistical process control charts to assess the impact of simulation-guided initiatives. Last, steps in developing a simulation program focused on PS/QI will be outlined with future opportunities for OTO-HNS simulation.

scholarly journals Clinical Decision Support for Ovarian Carcinoma Subtype Classification: A Pilot Observer Study With Pathology Trainees

2019 ◽  
Vol 144 (7) ◽  
pp. 869-877 ◽  
Author(s):  
Marios A. Gavrielides ◽  
Meghan Miller ◽  
Ian S. Hagemann ◽  
Heba Abdelal ◽  
Zahra Alipour ◽  
...  
Keyword(s):  
Decision Support ◽  
Ovarian Carcinoma ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Subspecialty Training ◽  
Reference Standard ◽  
Observer Study ◽  
Subtype Classification ◽  
The Impact ◽  
Whole Slide Images

Context.— Clinical decision support (CDS) systems could assist less experienced pathologists with certain diagnostic tasks for which subspecialty training or extensive experience is typically needed. The effect of decision support on pathologist performance for such diagnostic tasks has not been examined. Objective.— To examine the impact of a CDS tool for the classification of ovarian carcinoma subtypes by pathology trainees in a pilot observer study using digital pathology. Design.— Histologic review on 90 whole slide images from 75 ovarian cancer patients was conducted by 6 pathology residents using: (1) unaided review of whole slide images, and (2) aided review, where in addition to whole slide images observers used a CDS tool that provided information about the presence of 8 histologic features important for subtype classification that were identified previously by an expert in gynecologic pathology. The reference standard of ovarian subtype consisted of majority consensus from a panel of 3 gynecologic pathology experts. Results.— Aided review improved pairwise concordance with the reference standard for 5 of 6 observers by 3.3% to 17.8% (for 2 observers, increase was statistically significant) and mean interobserver agreement by 9.2% (not statistically significant). Observers benefited the most when the CDS tool prompted them to look for missed histologic features that were definitive for a certain subtype. Observer performance varied widely across cases with unanimous and nonunanimous reference classification, supporting the need for balancing data sets in terms of case difficulty. Conclusions.— Findings showed the potential of CDS systems to close the knowledge gap between pathologists for complex diagnostic tasks.

The impact of subspecialty training on the management of advanced ovarian cancer

1992 ◽  
Vol 47 (2) ◽  
pp. 203-209 ◽  
Author(s):  
Scott M. Eisenkop ◽  
Nick M. Spirtos ◽  
Thomas W. Montag ◽  
Richard H. Nalick ◽  
He-Jing Wang
Keyword(s):  
Ovarian Cancer ◽  
Advanced Ovarian Cancer ◽  
Subspecialty Training ◽  
The Impact

Attending Surgeon Variation in Operative Case Length: An Opportunity for Quality Improvement

2018 ◽  
Vol 84 (10) ◽  
pp. 1595-1599
Author(s):  
Kirollos S. Malek ◽  
Jukes P. Namm ◽  
Carlos A. Garberoglio ◽  
Maheswari Senthil ◽  
Naveen Solomon ◽  
...  
Keyword(s):  
Operative Time ◽  
Resident Training ◽  
Careful Consideration ◽  
Analysis Of Covariance ◽  
Surgical Resident ◽  
Or Efficiency ◽  
American Society ◽  
Case Logs ◽  
American Society Of Anesthesiologists ◽  
The Impact

Balancing resident education with operating room (OR) efficiency, while accommodating different styles of surgical educators and learners, is a challenging task. We sought to evaluate variability in operative time for breast surgery cases. Accreditation Council for Graduate Medical Education case logs of breast operations from 2011 to 2017 for current surgical residents at Loma Linda University were correlated with patient records. The main outcome measure was operative time. Breast cases were assessed as these operations are performed during all postgraduate years (PGY). Breast procedures were grouped according to similarity. Variables analyzed included attending surgeon, PGY level, procedure type, month of operation, and American Society of Anesthesiologists class. Of 606 breast cases reviewed, median overall operative time was 150 minutes (interquartile range 187–927). One-way analysis of covariance demonstrated statistically significant variation in operative time by attending surgeon controlling for covariates (PGY level, procedure, American Society of Anesthesiologists class, and month) ( P = 0.04). With institutional OR costs of $30 per minute, the average difference between slowest and fastest surgeon was $2400 per case [(218–138) minutes 3 $30/min]. Minimizing variability for common procedures performed by surgical educators may enhance OR efficiency. However, the impact of case length on surgical resident training requires careful consideration.

scholarly journals Impact of Video Describing Cataract Surgical Simulator Training on Patients' Perceptions of Resident Involvement in Cataract Surgery

2021 ◽  
Vol 13 (02) ◽  
pp. e96-e101
Author(s):  
Zachary C. Landis ◽  
John B. Fileta ◽  
Allen R. Kunselman ◽  
Joseph Sassani ◽  
Ingrid U. Scott
Keyword(s):  
Cataract Surgery ◽  
Medical Training ◽  
Resident Training ◽  
Simulator Training ◽  
Surgical Simulator ◽  
Resident Involvement ◽  
Group 2 ◽  
The Impact ◽  
Group 1 ◽  
Patient Willingness

Abstract Purpose The aim of this article is to investigate the impact of a 1-minute video describing resident training with a cataract surgical simulator on patients' perceptions regarding resident involvement in cataract surgery and to identify factors associated with patient willingness to have cataract surgery performed by a resident. Design Cross-sectional survey. Methods An anonymous Likert-style survey was conducted among 430 consecutive adult patients who presented for eye examination at the Penn State Health Eye Center. The survey included questions regarding demographics, understanding of the medical training hierarchy, and patient willingness to have a resident perform their cataract surgery. There were six questions regarding patient willingness to have residents perform their cataract surgery and the second question in this set informs the patient that residents are supervised by an experienced cataract surgeon. Patients were randomly assigned to one of two groups: patients in Group 1 completed the survey only, while patients in Group 2 watched a 1-minute video describing resident training with a cataract surgical simulator prior to completing the survey. Results Four hundred fourteen of the 430 patients (96.3%) completed the survey. Overall, 24.7% (n = 102) of respondents expressed willingness to allow an ophthalmology resident to perform their cataract surgery, and that proportion increased to 54.0% (n = 223) if the patient was informed that the resident would be supervised by an experienced cataract surgeon. Patients in Group 2 were twice as likely compared with patients in Group 1 to express willingness to allow an ophthalmology resident to perform their cataract surgery (odds ratio 1.92 [1.18–3.11], p = 0.009). Conclusions A thorough informed consent process including information regarding attending supervision and a brief video detailing resident training with a cataract surgery simulator may increase patient willingness to allow resident participation in cataract surgery.

scholarly journals Lessons Learned From the Effects of COVID-19 on the Training and Education Workflow of Radiology Residents—A Time for Reflection: Perspectives of Residency Program Directors and Residents in Canada

2020 ◽  
pp. 084653712096364
Author(s):  
William Warnica ◽  
Alan Moody ◽  
Linda Probyn ◽  
Eric Bartlett ◽  
Navneet Singh ◽  
...  
Keyword(s):  
Residency Program ◽  
Program Directors ◽  
Resident Training ◽  
Lessons Learned ◽  
Radiology Resident ◽  
Training And Education ◽  
Radiology Training ◽  
Radiology Residency ◽  
Residency Program Directors ◽  
The Impact

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has led to widespread changes in all health care settings including academic radiology departments. The purpose of this survey-based study was to investigate the impact of COVID-19 on radiology resident training and education workflow in Canada in terms of the nature, scale, and heterogeneity of the changes, preparedness and adaptation, and perceptions of the present and future of radiology training. Methods: A 30-question web-based survey was sent to 17 radiology residency program directors across Canada. A separate 32-question survey was sent to 460 residents currently enrolled in a radiology residency in Canada. These surveys were open for 3 weeks. Results: We received responses from 16 program directors and 80 residents (response rates 94.1% and 17.4%, respectively). Most respondents agreed that objectives were being met for knowledge and interpretation but less so for case volumes and technical skills. Less time was allotted for on-site activities (eg, readouts) with more time for off-site activities (eg, videoconferencing). Daytime rotations were at least partly cancelled. Most respondents felt these changes were met with enthusiasm by both faculty and residents. However, there were perceived challenges including lack of training on virtual platforms for delivery of teaching and decreased staff–resident interaction, with short- and long-term anxiety reported. Conclusions: The coronavirus disease 2019 has dramatically changed radiology resident training in Canada, with increased virtual learning at the expense of cancelled rotations and the resultant reduction in case volumes and staff–resident interaction. Although adopted with enthusiasm, these changes present substantial challenges and anxiety regarding the future of radiology resident education.

scholarly journals The role of international partnerships in improving urethral reconstruction in low- and middle-income countries

2019 ◽  
Vol 38 (12) ◽  
pp. 3003-3011 ◽  
Author(s):  
Maahum Haider ◽  
Mohamed Jalloh ◽  
Jiaqi Yin ◽  
Amadou Diallo ◽  
Nancy Puttkammer ◽  
...  
Keyword(s):  
Data Collection ◽  
Success Rate ◽  
Urethral Stricture ◽  
Urethral Reconstruction ◽  
Subspecialty Training ◽  
Middle Income ◽  
Middle Income Countries ◽  
Urethral Stricture Disease ◽  
The Impact ◽  
Low And Middle Income

Abstract Purpose To explore the impact of education and training in international surgical partnerships on outcomes of urethral stricture disease in low- and middle-income countries. To encourage data collection and outcomes assessments to promote evidence-based and safe surgical care. Methods Qualitative data were collected through observation of a reconstructive surgical workshop held by IVUmed at a host site in Dakar, Senegal. Quantitative data were collected through a retrospective review of 11 years of hospital data to assess surgical outcomes of urethral stricture disease before and after IVUmed started reconstructive workshops at the site. Results In the 11-year study period, 569 patients underwent 774 surgical procedures for urethral strictures. The numbers and types of urethroplasty techniques increased after IVUmed started its workshops. The average number of urethroplasties increased from 10 to 18.75/year. There was a statistically significant improvement in the mean success rate of urethroplasties from 12.7% before to 29% after the workshops. Anastomotic urethroplasty success rates doubled from 16.7 to 35.1%, but this was not statistically significant (p = 0.07). The improved success rate was sustained in cases performed without an IVUmed provider. Conclusions Urethral stricture disease treatment in low- and middle-income countries is fraught with challenges due to complex presentations and limited subspecialty training. Improper preoperative management, lack of specialty instruments, and suboptimal wound care all contribute to poor outcomes. International surgical groups like IVUmed who employ the “teach-the-teacher” model enhance local practitioner expertise and independence leading to long-term improvements in patient outcomes. Tailoring practice guidelines to the local resource framework and encouraging data collection and outcomes assessment are vital components of providing responsible care and should be encouraged.

scholarly journals Current Educational Issues in the Clinical Neurosciences

2001 ◽  
Vol 28 (4) ◽  
pp. 283-292 ◽  
Author(s):  
R. Desbiens ◽  
M.G. Elleker ◽  
G. Goldsand ◽  
J. Max Findlay ◽  
H. Hugenholtz ◽  
...  
Keyword(s):  
Residency Training ◽  
Royal College ◽  
Clinical Teaching ◽  
Resident Training ◽  
Subspecialty Training ◽  
Optimal Care ◽  
Medical Specialties ◽  
Canadian Health Care System ◽  
Personal Time ◽  
Canadian Association

Objective:Canadian training in the clinical neurosciences, neurology and neurosurgery, faces significant challenges. New balances are being set by residents, their associations and the Royal College of Physicians and Surgeons of Canada between clinical service, education and personal time. The nature of hospital-provided medical service has changed significantly over the past decade, impacting importantly on resident training. Finally, future manpower needs are of concern, especially in the field of neurosurgery, where it appears that soon more specialists will be trained than can be absorbed into the Canadian health care system.Methods:A special symposium on current challenges in clinical neuroscience training was held at the Canadian Congress of Neurological Sciences in June 2000. Representatives from the Canadian Association of Interns and Residents, the Royal College of Physicians and Surgeons of Canada and English and French neurology and neurosurgery training programs made presentations, which are summarized in this report.Results:Residency training has become less service-oriented, and this trend will continue. In order to manage the increasingly sophisticated hospital services of neurology and neurosurgery, resident-alternatives in the form of physician “moonlighters” or more permanent hospital-based clinicians or “hospitalists” will be necessary in order to operate major neuroclinical units. Health authorities and hospitals will need to recognize and assume this responsibility. As clinical experience diminishes during residency training, inevitably so will the concept of the fully competent “generalist” at the end of specialty training. Additional subspecialty training is being increasingly sought by graduates, particularly in neurosurgery.Conclusion:Training in neurology and neurosurgery, as in all medical specialties, has changed significantly in recent years and continues to change. Programs and hospitals need to adapt to these changes in order to ensure the production of fully qualified specialists in neurology and neurosurgery and the provision of optimal care to patients in clinical teaching units.

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