Patient Handoff Among General Surgery Residents in Saudi Arabia: A Cross-Sectional Study

Background Communication failure is a common cause of adverse events. An essential element of communication among healthcare providers is patient handoffs. To explore this practice, we assessed patient handoffs among general surgery residents in Saudi Arabia. Methods A cross-sectional survey was conducted with individuals in accredited general surgery residency programs in Saudi Arabia between 2020 to 2021. Results Participants comprised 118 general surgery residents—66 (57.3%) were females; 67 (72.8%) did not receive any formal training on patient handoff; 35 (38.8%) reported that they were sometimes interrupted during the patient handoff process. The most common reason for such interruptions was medical personnel paging. Further, 60 (68.1%) general surgery residents stated that such interruptions led to a decreased quality of effective communication, 39 (44.3%) believed it led to decreased quality of patient care, 63(71.5%) believed it led to the loss of some information related to patient handoff, and 16 (18.1%) believed it led to patient harm. Finally, 31 (34.4%) general surgery residents believed that the existing handoff system at their institutions neither adequately protected the patient’s safety nor allowed for continuity of care; and 51 (68%) reported that they did not have a standardized protocol for patients’ verbal handoff process at their institution. There were higher proportion of patients with minor harm in residents who did not, rare or some time received verbal or written hand off (67% vs 33%). Conclusion The patient handoff process among general surgery residents in Saudi Arabia is subjective, not standardized, and can contribute to patient harm. Standardizing it is paramount to improve patient safety.

General Surgery Twitter during COVID-19: Tweets, Trends, and Implications for Recruitment Strategies

Background The COVID-19 pandemic has disrupted traditional resident recruitment practices, requiring virtual interviews and new forms of outreach. Social media, such as Twitter, is one tool programs can use to connect with applicants. This study sought to assess changes in Twitter use during the COVID-19 pandemic among general surgery programs. Methods Twitter and residency program websites were queried for public Twitter accounts related to general surgery residency programs. Publicly available tweets for available accounts were reviewed for all posts for the period March 15, 2019-November 25, 2020. Thematic analysis of each tweet was performed, and engagement was determined by likes and retweets on each tweet. Results The number of programs with active Twitter accounts increased after the onset of COVID-19 pandemic, as did the number of tweets, likes-, and retweets-per-tweet. There was a significant increase in the number of tweets regarding resident promotion, program promotion, and virtual event promotion. Tweets received more likes-per-tweet if the subject was program promotion and resident promotion than tweets regarding virtual events. All results were statistically significant ( P < .05). Discussion Twitter use and engagement with residency programs have increased significantly since pandemic onset. Engagement is highest for tweets regarding program and resident promotion as measured by likes-per-tweet and highest for program promotion and virtual events as measured by retweets-per-tweet. Given the nearly nationwide increase in Twitter engagement after pandemic onset, programs should consider the impact of Twitter as a means of communication with applicants and program branding.

The Importance of the Institution of a Robotic Curriculum on Resident Training and Performance

In 2018, general surgery topped the number of robotic cases. Over 90% of residents participate, but only 65% of programs have a formal curriculum, and less than half track progress. Many are insufficient at training due to an observational role. This paper reviews Marshall University General Surgery Residency program’s robotic curriculum, which started in 2018. The curriculum consists of a weekend course and simulations, enabling residents obtain certification. Residents participated in Intuitive’s Resident Robotic Olympics with first place in 2019 and second and third place in 2020. For the 2021 year, the robotic curriculum was revised into phases based on year. Deadlines and forms help improve and track progress. It is important to develop a curriculum with a protocol for training, monitoring, and credentialing to ensure proficiency. Marshall University General Surgery robotic curriculum has been successful at improving robotic skill, enabling residents to obtain a robotic surgery certification upon graduation.

Diversity, Equity, and Inclusion: A Current Analysis of General Surgery Residency Programs

Background Local, regional, and national diversity, equity, and inclusion (DEI) initiatives have been established to combat barriers to entry and promote retention in surgery residency programs. Our study evaluates changes in diversity in general surgery residency programs. We hypothesize that diversity trends have remained stable nationally and regionally. Materials and Methods General surgery residents in all postgraduate years were queried regarding their self-reported sex, race, and ethnicity following the 2020 ABSITE. Residents were then grouped into geographic regions. Data were analyzed utilizing descriptive statistics, Kruskal-Wallis test, and chi-square analyses. Results A total of 9276 residents responded. Nationally, increases in female residents were noted from 38.0 to 46.0% ( P < .001) and in Hispanic or Latinx residents from 7.3 to 8.3% ( P = .031). Across geographic regions, a significant increase in female residents was noted in the Northwest (51.9 to 58.3%, P = .039), Midwest (36.9 to 43.3%, P = .006), and Southwest (35.8 to 47.5%, P = .027). A significant increase in black residents was only noted in the Northwest (0 to 15.8%, P = .031). The proportion of white residents decreased nationally by 8.9% and in the Mid-Atlantic, Southeast, and Southwest between 5.5 and 15.9% ( P < .05). Discussion In an increasingly diverse society, expanding the numbers of underrepresented surgeons in training, and ultimately in practice, is a necessity. This study shows that there are region-specific increases in diversity, despite minimal change on a national level. This finding may suggest the need for region-specific DEI strategies and initiatives. Future studies will seek to evaluate individual programs with DEI plans and determine if there is a correlation to changing demographics.