National perception of service and education during surgical training

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Scientific Poster Presentations: 2015 Clinical Congress

RESULTS: Operation time was significantly longer in resident group (267 min, 150-419) than in fellow group (239 min, 120390), and the number of harvested lymph-nodes was significantly greater in resident group (22, 4-65) than in fellow group (27, 694). There were no statistical differences in patients’ characteristics, such as age, gender, body mass index, American Society of Anesthesiologists physical status, past history of previous upper abdominal surgery and endoscopic sub-mucosal dissection (ESD), and other operative findings, such as complications, blood loss, conversion to laparotomy, diameter of the tumor and the number of lymphnode metastases between two groups. All patients are alive and disease free as of today. CONCLUSIONS: Surgical residents can perform LADG feasibly and safely with experts’ assistance and instruction. National perception of service and education during surgical training Kimberly M Hendershot, MD, FACS, Randy J Woods, MD, FACS, Priti Parikh, PhD, Melissa L Whitmill, MD, FACS, Melissa Keller Wright State University Boonshoft School of Medicine, Dayton, OH INTRODUCTION: The ACGME questions residents yearly regarding “service” obligations that negatively impact “education” during residency. Single institution studies demonstrate differing perceptions amongst healthcare personnel regarding these terms. Therefore, a nationwide study was performed to identify perceptions and if they are dependent on program type, size, or location. METHODS: An IRB-approved questionnaire was given nationally to surgery participants. Participants were asked general questions about the terms “service” and “education” and to rate common resident tasks (5 point Likert scale, service opposite education). RESULTS: 372 surveys were analyzed. Participants (surgery students, residents, attendings) had different perceptions of the educational value of resident tasks, including H&P’s, talking with families, answering nursing calls, and surgical procedures. No difference was seen when compared by program type or location. Overall, 77% think service and education are NOT at opposite ends of a spectrum and 90% think service is sometimes educational. 40% of residents and 56% of attendings don’t know what the terms “service” and “education” mean in regards to the ACGME survey. CONCLUSIONS: Surgical providers have different perceptions of the educational value of many common resident tasks. Participants do not believe that service is the opposite of education and do see value in “service” tasks. We believe that national surveys attempting to determine if residents are involved in excessive amounts of loweducational tasks need to ask specific task-related questions and avoid the general terms “service” and “education.” Further, before penalizing a residency program, the differences in perception shown in this national study should be considered.

J Am Coll Surg

Overlearning enhances skill retention in a simulated model of laparoscopic cholecystectomy Vincent Marcucci, Lawrence Greenawald, MD, Jorge L Uribe, MD, Faiz U Shariff, MD, D Scott Lind, MD, Patricia A Shewokis, PhD, Sharon Griswold, MD, MPH, Andres E Castellanos, MD, FACS Drexel University College of Medicine, Philadelphia, PA INTRODUCTION: There is an urgent need to determine the optimal method for the acquisition and retention of surgical skills. In this pilot study, we examined the effect of overlearning on laparoscopic skill retention in a simulated cholecystectomy model. METHODS: Following informed consent, 20 general surgery and emergency medicine (PGY1-3) residents were randomized to control (n¼10) and overlearning (n¼10) groups and then asked to complete a laparoscopic cholecystectomy on a LapSimÒ virtual reality (VR) simulator (Surgical Science, Gothenburg, Sweden). The control group practiced on the simulator in a continuous, uninterrupted session until they achieved proficiency, defined as a total simulator score  80. The overlearning group, after achieving proficiency, performed additional uninterrupted practice equivalent to the number of task repetitions it took to reach a total score of 80 (i.e. 100% overlearning). Performance metrics included global score, total-time, tip trajectory, right/left tissue penetration, and electrocautery injuries. Skill retention in both groups was assessed at 1, 4, and 12 weeks after baseline. We used a two-level linear mixed model to assess individual change in performance across time. RESULTS: The overlearning group had significantly better retention for global score ([), total time (Y), tip trajectory (Y) and left instrument tissue penetrations (Y) than the control group. The main effects represent aggregate scores. The retention models fit both linear and quadratic components to explain the variancecovariance. CONCLUSIONS: Overlearning enhances skill retention on a virtual reality laparoscopic cholecystectomy simulator. These findings have implications for laparoscopic skills curricula. Peer resident assessment in surgical education: is it equivalent to expert attending assessment? Melissa K Stewart, MD, Carmelle V Romain, MD, Arna Banerjee, MD, FCCM, Wang Li, Andrew J Murphy, MD, Kevin W Sexton, MD, Lynn E Webb, PhD, Kyla P Terhune, MD, FACS Vanderbilt University Medical Center, Nashville, TN INTRODUCTION: Attending participation in education is limited by competing demands, making resident involvement in surgical education necessary and valuable. Despite this, a paucity of literature exists regarding the validity of resident assessment of peers. We sought to determine if resident and attending evaluations were equitable in assessment of an intern simulation exercise. METHODS: Fifty-one surgery/anesthesia interns underwent a simulation exercise in which they were asked to attain informed consent (IC), insert a central venous catheter in a partial task