scholarly journals A Liver Surgery Assessment Tool Identified Predictors of Meaningful Autonomy During Hepatectomy in a Complex General Surgery Oncology Fellowship

2021 ◽  
Vol 233 (5) ◽  
pp. S219
Author(s):  
Megan A. Satyadi ◽  
Benjamin D. Powers ◽  
Samer A. Naffouje ◽  
Jason B. Fleming ◽  
Sean Dineen ◽  
...  
2017 ◽  
Vol 74 (2) ◽  
pp. 243-250 ◽  
Author(s):  
Flemming Bjerrum ◽  
Jeanett Strandbygaard ◽  
Susanne Rosthøj ◽  
Teodor Grantcharov ◽  
Bent Ottesen ◽  
...  

2015 ◽  
Vol 42 (6) ◽  
pp. 407-412 ◽  
Author(s):  
Elizabeth Gomes dos Santos ◽  
Gil Fernando da Costa Mendes de Salles

Objective: To develop and validate an instrument for measuring the acquisition of technical skills in conducting operations of increasing difficulty for use in General Surgery Residency (GSR) programs. Methods: we built a surgical skills assessment tool containing 11 operations in increasing levels of difficulty. For instrument validation we used the face validaity method. Through an electronic survey tool (Survey MonKey(r)) we sent a questionnaire to Full and Emeritus members of the Brazilian College of Surgeons - CBC - all bearers of the CBC Specialist Title. Results: Of the 307 questionnaires sent we received 100 responses. For the analysis of the data collected we used the Cronbach's alpha test. We observed that, in general, the overall alpha presented with values near or greater than 0.70, meaning good consistency to assess their points of interest. Conclusion: The evaluation instrument built was validated and can be used as a method of assessment of technical skill acquisition in the General Surgery Residency programs in Brazil.


Author(s):  
Kailash Charokar ◽  
Anil Kapoor

Introduction: The common practice prevalent in most of the Postgraduate (PG) teaching institutes is that while the PGs are clinically evaluating the patients for the traditional long case, they are mostly not directly observed by the faculty. The presentation of the case by PGs is the main focus of assessment. Workplace Based Assessment (WPBA) tools assess the clinical competence of students at the ‘does’ level of Miller’s pyramid, while they perform in a real setting. Aim: To assess the feasibility, acceptability and effectiveness of Mini-Clinical Evaluation Exercises (Mini-CEX) for the PGs in Surgery. Materials and Methods: This educational intervention study was conducted in the General Surgery Department, over a period of one year. Sixteen PGs of 1st, 2nd, and 3rd-year residency participated in the study, and 13 faculty as assessors. The Mini-CEX was conducted and the abim.org proforma was used to record the observations by the faculty. The perceptions of the PGs and faculty were obtained at the end of the study using a predesigned validated feedback questionnaire. The change in the level of acquisition of clinical skills of the PGs was evaluated using the group mean, median and rank. The Friedman test was applied to calculate the statistical significance at p<0.05 using Statistical Package for the Social Sciences (SPSS) version 20. Results: A total of 124 Mini-CEX encounters were conducted over a period of one year. The mean satisfaction score for the Mini-CEX encounters was 7.3±0.88 and 6±0.89 on the global rating (0-9) among the PGs and faculty respectively. While 14 PGs (87.5%) accepted that Mini-CEX was easy to conduct as compared to the traditional long case. Ten faculty (76.5%) accepted that it was feasible to conduct with the prevailing professional workload. Twelve PGs perceived that Mini-CEX was an effective tool for improving clinical skills. Statistically significant (p-value <0.05) improvement was found in the competencies of medical interviewing, physical examination, counseling skills, and professionalism. Conclusion: Mini-CEX was acceptable to the PGs and faculty. It was found to be an effective and formative assessment tool for learning clinical skills in a supportive workplace-based environment for clinical skills improvements


2020 ◽  
Vol 63 (4) ◽  
pp. 1071-1082
Author(s):  
Theresa Schölderle ◽  
Elisabet Haas ◽  
Wolfram Ziegler

Purpose The aim of this study was to collect auditory-perceptual data on established symptom categories of dysarthria from typically developing children between 3 and 9 years of age, for the purpose of creating age norms for dysarthria assessment. Method One hundred forty-four typically developing children (3;0–9;11 [years;months], 72 girls and 72 boys) participated. We used a computer-based game specifically designed for this study to elicit sentence repetitions and spontaneous speech samples. Speech recordings were analyzed using the auditory-perceptual criteria of the Bogenhausen Dysarthria Scales, a standardized German assessment tool for dysarthria in adults. The Bogenhausen Dysarthria Scales (scales and features) cover clinically relevant dimensions of speech and allow for an evaluation of well-established symptom categories of dysarthria. Results The typically developing children exhibited a number of speech characteristics overlapping with established symptom categories of dysarthria (e.g., breathy voice, frequent inspirations, reduced articulatory precision, decreased articulation rate). Substantial progress was observed between 3 and 9 years of age, but with different developmental trajectories across different dimensions. In several areas (e.g., respiration, voice quality), 9-year-olds still presented with salient developmental speech characteristics, while in other dimensions (e.g., prosodic modulation), features typically associated with dysarthria occurred only exceptionally, even in the 3-year-olds. Conclusions The acquisition of speech motor functions is a prolonged process not yet completed with 9 years. Various developmental influences (e.g., anatomic–physiological changes) shape children's speech specifically. Our findings are a first step toward establishing auditory-perceptual norms for dysarthria in children of kindergarten and elementary school age. Supplemental Material https://doi.org/10.23641/asha.12133380


2020 ◽  
Vol 29 (4) ◽  
pp. 1944-1955 ◽  
Author(s):  
Maria Schwarz ◽  
Elizabeth C. Ward ◽  
Petrea Cornwell ◽  
Anne Coccetti ◽  
Pamela D'Netto ◽  
...  

Purpose The purpose of this study was to examine (a) the agreement between allied health assistants (AHAs) and speech-language pathologists (SLPs) when completing dysphagia screening for low-risk referrals and at-risk patients under a delegation model and (b) the operational impact of this delegation model. Method All AHAs worked in the adult acute inpatient settings across three hospitals and completed training and competency evaluation prior to conducting independent screening. Screening (pass/fail) was based on results from pre-screening exclusionary questions in combination with a water swallow test and the Eating Assessment Tool. To examine the agreement of AHAs' decision making with SLPs, AHAs ( n = 7) and SLPs ( n = 8) conducted an independent, simultaneous dysphagia screening on 51 adult inpatients classified as low-risk/at-risk referrals. To examine operational impact, AHAs independently completed screening on 48 low-risk/at-risk patients, with subsequent clinical swallow evaluation conducted by an SLP with patients who failed screening. Results Exact agreement between AHAs and SLPs on overall pass/fail screening criteria for the first 51 patients was 100%. Exact agreement for the two tools was 100% for the Eating Assessment Tool and 96% for the water swallow test. In the operational impact phase ( n = 48), 58% of patients failed AHA screening, with only 10% false positives on subjective SLP assessment and nil identified false negatives. Conclusion AHAs demonstrated the ability to reliably conduct dysphagia screening on a cohort of low-risk patients, with a low rate of false negatives. Data support high level of agreement and positive operational impact of using trained AHAs to perform dysphagia screening in low-risk patients.


Author(s):  
Matthew L. Hall ◽  
Stephanie De Anda

Purpose The purposes of this study were (a) to introduce “language access profiles” as a viable alternative construct to “communication mode” for describing experience with language input during early childhood for deaf and hard-of-hearing (DHH) children; (b) to describe the development of a new tool for measuring DHH children's language access profiles during infancy and toddlerhood; and (c) to evaluate the novelty, reliability, and validity of this tool. Method We adapted an existing retrospective parent report measure of early language experience (the Language Exposure Assessment Tool) to make it suitable for use with DHH populations. We administered the adapted instrument (DHH Language Exposure Assessment Tool [D-LEAT]) to the caregivers of 105 DHH children aged 12 years and younger. To measure convergent validity, we also administered another novel instrument: the Language Access Profile Tool. To measure test–retest reliability, half of the participants were interviewed again after 1 month. We identified groups of children with similar language access profiles by using hierarchical cluster analysis. Results The D-LEAT revealed DHH children's diverse experiences with access to language during infancy and toddlerhood. Cluster analysis groupings were markedly different from those derived from more traditional grouping rules (e.g., communication modes). Test–retest reliability was good, especially for the same-interviewer condition. Content, convergent, and face validity were strong. Conclusions To optimize DHH children's developmental potential, stakeholders who work at the individual and population levels would benefit from replacing communication mode with language access profiles. The D-LEAT is the first tool that aims to measure this novel construct. Despite limitations that future work aims to address, the present results demonstrate that the D-LEAT represents progress over the status quo.


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