Re: Operative experience in essential emergency general surgery procedures: is autonomy achievable during surgical training

2021 ◽  
Vol 91 (11) ◽  
pp. 2546-2546
Author(s):  
Charles A. Coventry ◽  
Andrew J. A. Holland
Keyword(s):  
Surgical Training ◽  
General Surgery ◽  
Emergency General Surgery ◽  
Operative Experience

Operative experience in essential emergency general surgery procedures: is autonomy achievable during surgical training?

2021 ◽  
Author(s):  
Shane Belvedere ◽  
Daniel Joh ◽  
Tim Furlong ◽  
Elizabeth Dennett ◽  
Benjamin P. T. Loveday
Keyword(s):  
Surgical Training ◽  
General Surgery ◽  
Emergency General Surgery ◽  
Operative Experience

scholarly journals Universal SHO and SpR shift rotas adversely influence SHO operative experience

2006 ◽  
Vol 88 (7) ◽  
pp. 244-246 ◽  
Author(s):  
C Beaton ◽  
MR Stephens ◽  
AN Hopper ◽  
WG Lewis
Keyword(s):  
General Hospital ◽  
Shift Work ◽  
Clinical Experience ◽  
Surgical Training ◽  
General Surgery ◽  
District General Hospital ◽  
European Working ◽  
Training Post ◽  
Operative Experience ◽  
Working Time Directive

The European Working Time Directive (EWTD) will reduce the clinical experience obtained by surgeons prior to attaining consultant status from 21,000 surgical hours to 7,640 hours, 1 with shift work obligatory for compliance. We have shown previously that the operative experience of SHOs in general surgery is on the wane in our own hospital, varies with subspecialty interest 2 and has witnessed further erosion by the introduction of the EWTD. 3 The aim of this study was to assess the influence of an all tier shift rota on the emergency and elective operative experience of SHOs in a category 1 general surgical training post working in a large district general hospital serving a population of 600,000.

scholarly journals Impact of the acute care surgery model on resident operative experience in emergency general surgery

2021 ◽  
Vol 64 (3) ◽  
pp. E298-E306
Author(s):  
Michael T. Meschino ◽  
Andrew E. Giles ◽  
Paul T. Engels ◽  
Timothy J. Rice ◽  
Rahima Nenshi ◽  
...  
Keyword(s):  
Acute Care ◽  
General Surgery ◽  
Acute Care Surgery ◽  
Biliary Disease ◽  
Emergency General Surgery ◽  
Primary Operator ◽  
After Hours ◽  
Operative Experience ◽  
Care Surgery ◽  
Junior Residents

Background: The acute care surgery (ACS) model has been shown to improve patient, hospital and surgeon-specific outcomes. To date, however, little has been published on its impact on residency training. Our study compared the emergency general surgery (EGS) operative experiences of residents assigned to ACS versus elective surgical rotations. Methods: Resident-reported EGS case logs were prospectively collected over a 9-month period across 3 teaching hospitals. Descriptive statistics were tabulated and group comparisons were made using χ2 statistics for categorical data and t tests for continuous data. Results: Overall, 1061 cases were reported. Resident participation exceeded 90%). Appendiceal and biliary disease accounted for 49.7% of EGS cases. Residents on ACS rotations reported participating in twice as many EGS cases per block as residents on elective rotations (12.64 v. 6.30 cases, p < 0.01). Most cases occurred after hours while residents were on call rather than during daytime ACS hours (78.8% v. 21.1%, p < 0.01). Senior residents were more likely than junior residents to report having a primary operator role (71.3% v. 32.0%, p < 0.01). Although the timing of cases made no difference in the operative role of senior residents, junior residents assumed the primary operator role more often during the daytime than after hours (50.0% v. 33.1%, p = 0.01). Conclusion: Despite implementation of the ACS model, residents in our program obtained most of their EGS operative experience after hours while on call. Although further research is needed, our study suggests that improved daytime access to the operating room may represent an opportunity to improve the quantity and quality of the EGS operative experience at our academic network.

scholarly journals Telemedicine Experience of General Surgery Trainees: Impact on Patient Care and Education

2021 ◽  
pp. 000313482110234
Author(s):  
Brandon J Nakashima ◽  
Navpreet Kaur ◽  
Chelsey Wongjirad ◽  
Kenji Inaba ◽  
Mohd Raashid Sheikh
Keyword(s):  
Patient Care ◽  
Surgical Training ◽  
General Surgery ◽  
Southern California ◽  
University Of Southern California ◽  
General Surgery Residency ◽  
Surgical Training Program ◽  
Current Utilization ◽  
Surgery Resident ◽  
The Impact

Objective The COVID-19 pandemic has had a significant impact on patient care, including the increased utilization of contact-free clinic visits using telemedicine. We looked to assess current utilization of, experience with, and opinions regarding telemedicine by general surgery residents at an academic university–based surgical training program. Design A response-anonymous 19-question survey was electronically distributed to all general surgery residents at a single academic university–based general surgery residency program. Setting University of Southern California (USC) general surgery residency participants: Voluntarily participating general surgery residents at the University of Southern California. Results The response rate from USC general surgery residents was 100%. A majority of residents (76%) had utilized either video- or telephone-based visits during their careers. No resident had undergone formal training to provide telemedicine, although most residents indicated a desire for training (57.1%) and acknowledged that telemedicine should be a part of surgical training (75.6%). A wide variety of opinions regarding the educational experience of residents participating in telemedicine visits was elicited. Conclusions The COVID-19 pandemic brought telemedicine to the forefront as an integral part of future patient care, including for surgical patients. Additional investigations into nationwide telemedicine exposure and practice among United States general surgery residencies is imperative, and the impact of the implementation of telemedicine curricula on general surgery resident telemedicine utilization, comfort with telemedicine technology, and patient outcomes are further warranted. Competencies Practice-based learning, systems-based practice, interpersonal and communication skills

scholarly journals French survey on a cohort of emergency general surgery modifications induced by lockdown of the SARS-CoV-2 pandemic

2021 ◽  
Author(s):  
Clement Julien ◽  
◽  
Pauline Duconseil ◽  
Diane Mege ◽  
Damien Massalou ◽  
...  
Keyword(s):  
General Surgery ◽  
Emergency General Surgery

Appraising the Quality of Reporting of American College of Surgeons NSQIP Emergency General Surgery Studies

2021 ◽  
Vol 232 (5) ◽  
pp. 671-680 ◽  
Author(s):  
Mohamad El Moheb ◽  
Hadi Sabbagh ◽  
Daniel Badin ◽  
Tala Mahmoud ◽  
Basil Karam ◽  
...  
Keyword(s):  
General Surgery ◽  
Emergency General Surgery ◽  
Quality Of Reporting ◽  
American College Of Surgeons

scholarly journals 892 Emergency General Surgical Practice at a District General Hospital during COVID-19 Pandemic: Implementing Royal College of Surgeons Guidance

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
K Hashmi ◽  
S Khalid ◽  
K Raja ◽  
A Zaka ◽  
J Easterbrook
Keyword(s):  
Informed Consent ◽  
Royal College ◽  
Mortality Risk ◽  
General Surgery ◽  
Surgical Care ◽  
District General Hospital ◽  
Emergency General Surgery ◽  
Surgical Practice ◽  
Full Compliance ◽  
Type Of Surgery

Abstract Introduction COVID-19 pandemic had a significant impact on surgical practice across NHS. RCS released guidance on altering surgical practise during the pandemic to deliver safe surgical care in March, 2020. We present an audit conducted at a DGH comparing practice of emergency general surgery (EGS) with RCS guidance at the peak of COVID-19 pandemic. Method Consecutive patients undergoing EGS from 1st April to 15th May,2020. Data of demographics, ASA grade, comorbidities, type of surgery, hospital stay, informed COVID-19 pneumonia consent, complications and 30-day mortality were collected. Pre- and post-operative COVID-19 status was determined. Results Forty-four (n = 44) patients, mean age 47.5 and IQR (26-69). Male (55.8%) and females (44.2%). Preoperative COVID19 status was confirmed in around 79.1% patients. All (100%) patients who underwent CT imaging preoperatively had CT chest performed. Informed consent for COVID19 pneumonia was taken in 4.7% patients. 30-day mortality risk was 7% and complications risk was 4.7%. RR of 30-day mortality in preoperative COVID19 status positive patients was RR = 0.92 (CI 0.85-1.01) and for complications was RR = 0.95 (CI 0.88-1.02). Conclusions RCS guidance on managing and altering practice in EGS during COVID-19 pandemic is reliable, implementable, and measurable in a DGH setting. Simple improvements in consent process can achieve full compliance with RCS guidelines.

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