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Dhote A, Puygrenier P, Tranchart H, Penna C, Fuks D, Gaillard M. Publication Fate of Research Works Achieved During Master's Degree in Surgical Science in a French Survey. MEDICAL SCIENCE EDUCATOR 2024; 34:363-370. [PMID: 38686154 PMCID: PMC11055823 DOI: 10.1007/s40670-023-01973-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 05/02/2024]
Abstract
The aim of this study was to assess the publication fate of research projects performed during the research year by students enrolled in a Master's degree (MSc) of surgical science and to identify factors associated with subsequent publication. An anonymous online survey of 35 questions was sent to students enrolled in MSc of surgical science between 2013 and 2020. The questionnaire included student's characteristics, topic, and supervision of the research projects developed during the research year and dissemination of the research work. Data regarding publication was collected using PubMed database. Factors associated with publication were identified by univariate analysis. Among 361 students, 26% completed the survey. Among respondents, the publication rate of research projects was 53.7%. The median time interval between the end of the research year and the date of publication was 2 (1-3) years. The student was listed as a first author in 70.6% of publications. Factors associated with publication of the research work completed during the research year were student's previous publications (P = 0.041) and presentation of the research work in academic conferences (P = 0.005). The most mentioned cause for non-publication was the absence of completion of the research work. Among respondents, the publication rate of research works performed during the MSc was high, which emphasizes the quality of the work carried out by the students and their involvement. Significant efforts must be undertaken to encourage the enrollment of residents in scientific research. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-023-01973-y.
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Affiliation(s)
- Alix Dhote
- Department of Digestive, Hepatobiliary and Endocrine Surgery, Hôpital Cochin, APHP.Centre, 27 rue du Faubourg Saint Jacques, 75014 Paris, France
- Faculté de Médecine, Université Paris Cité, 75006 Paris, France
| | - Pierre Puygrenier
- Department of Digestive, Hepatobiliary and Endocrine Surgery, Hôpital Cochin, APHP.Centre, 27 rue du Faubourg Saint Jacques, 75014 Paris, France
- Faculté de Médecine, Université Paris Cité, 75006 Paris, France
| | - Hadrien Tranchart
- Department of Minimally Invasive Digestive Surgery, Hôpital Antoine Béclère, APHP, Université Paris Saclay, 92140 Clamart, France
- Université Paris Saclay, Faculté de Médecine Paris Sud, 94275 Le Kremlin-Bicêtre, France
| | - Christophe Penna
- Université Paris Saclay, Faculté de Médecine Paris Sud, 94275 Le Kremlin-Bicêtre, France
- Department of Oncologic and Digestive Surgery, Hôpital Bicêtre, APHP, Université Paris Saclay, 94725 Le Kremlin-Bicêtre, France
| | - David Fuks
- Department of Digestive, Hepatobiliary and Endocrine Surgery, Hôpital Cochin, APHP.Centre, 27 rue du Faubourg Saint Jacques, 75014 Paris, France
- Faculté de Médecine, Université Paris Cité, 75006 Paris, France
| | - Martin Gaillard
- Department of Digestive, Hepatobiliary and Endocrine Surgery, Hôpital Cochin, APHP.Centre, 27 rue du Faubourg Saint Jacques, 75014 Paris, France
- Faculté de Médecine, Université Paris Cité, 75006 Paris, France
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Acevedo D, Destiné H, Murdock CJ, LaPorte D, Aiyer AA. Correlation between research productivity during and after orthopaedic surgery training. Surg Open Sci 2024; 18:98-102. [PMID: 38440317 PMCID: PMC10910153 DOI: 10.1016/j.sopen.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/20/2024] [Indexed: 03/06/2024] Open
Abstract
Background Research experience is mandatory for all Orthopaedic Surgery residency programs. Although the allocation of required protected time and resources varies from program to program, the underlying importance of research remains consistent with mutual benefit to both residents and the program and faculty. Authorship and publications have become the standard metric used to evaluate academic success. This study aimed to determine if there is a correlation between the research productivity of Orthopaedic Surgery trainees and their subsequent research productivity as attending Orthopaedic Surgeons. Methods Using the University of Mississippi Orthopaedic Residency Program Research Productivity Rank List, 30 different Orthopaedic Surgery Residency Programs were analyzed for the names of every graduating surgeon in their 2013 class. PubMed Central was used to screen all 156 physicians and collect all publications produced by them between 2008 and August 2022. Results were separated into two categories: Publications during training and Publications post-training. Results As defined above, 156 Surgeons were analyzed for publications during training and post-training. The mean number of publications was 7.02 ± 17.819 post-training vs. 2.47 ± 4.313 during training, P < 0.001. The range of publication post-training was 0-124 vs. 0-30 during training. Pearson correlation between the two groups resulted in a value of 0.654, P < 0.001. Conclusion Higher research productivity while training correlates to higher productivity post-training, but overall Orthopaedic surgeons produce more research after training than during. With the growing importance of research, more mentorship, time, and resources must be dedicated to research to instill and foster greater participation while in training.
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Affiliation(s)
- Daniel Acevedo
- Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine (NSU MD), United States of America
| | - Henson Destiné
- University of Miami Leonard M. Miller School of Medicine, United States of America
| | | | - Dawn LaPorte
- Johns Hopkins Medicine Department of Orthopaedic Surgery, United States of America
| | - Amiethab A. Aiyer
- Johns Hopkins Medicine Department of Orthopaedic Surgery, United States of America
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Berk H. Editorial. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2023; 57:294-295. [PMID: 38454208 PMCID: PMC10837588 DOI: 10.5152/j.aott.2023.151223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Affiliation(s)
- Haluk Berk
- Editor-in-Chief, Acta Orthopaedica et Traumatologica Turcica, Turkey
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Athiel Y, Girault A, Gaillard M, Le Ray C, Goffinet F. Publication rate and factors associated with publication of research projects by obstetrics residents in an academic department over 10 years. Eur J Obstet Gynecol Reprod Biol 2023; 287:161-165. [PMID: 37348382 DOI: 10.1016/j.ejogrb.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVES To determine the publication rate of mandatory research projects conducted by obstetrics residents and to evaluate the publication-associated factors and reported obstacles. STUDY DESIGN This retrospective cohort study included all consecutive residents in an academic obstetrics-gynecology department in Paris, France, between 2010 and 2020. All residents were required to conduct a research project. Information about publication was collected by searching PubMed. A closed-ended questions questionnaire was sent to former residents about their characteristics, subsequent professional development, and research project characteristics. Factors associated with publication were identified by univariable and multivariable analysis with logistic regression. RESULTS During the study period, 156 residents trained in our obstetrics-gynecology department. The overall publication rate was 30.8% (48/156) and the median time to publication 27 months (IQR, 18-37). The resident was first author in 36 (75.0%) publications. Among the 130 (83.3%) residents who completed the questionnaire, 43 (33%) had published their research project. Overall, 74/130 (60.8%) residents used their project for their mandatory medical thesis. Factors associated with publication in univariable analysis were younger age (median), completion of a PhD, planned career in academic medicine, prospective study design, presentation at a conference or congress and use their project for their medical thesis. The only factors associated with publication in the multivariable analysis were planned career in academic medicine (aOR 5.62 95 %CI[1.84-17.19]) and the prospective study design of the research project (aOR 6.1 95 %CI[1.24-29.56]). The main reasons for nonpublication reported by resident were lack of time and failure to complete the project. CONCLUSION Among the mandatory clinical research projects conducted by obstetrics residents over a decade in our department, 30.8% were published. The main factors associated with publication were planned career in academic medicine and a prospective design of the research project.
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Affiliation(s)
- Yoann Athiel
- Department of Obstetrics and Gynecology of Port-Royal, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France.
| | - Aude Girault
- Department of Obstetrics and Gynecology of Port-Royal, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France; Obstetrical Perinatal and Pediatric Epidemiology (Epopé) Research Team, Center for Epidemiology and Statistics (CRESS), INSERM U1153, Paris, France
| | - Martin Gaillard
- Department of Digestive, Hepatobiliary and Endocrine Surgery, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France
| | - Camille Le Ray
- Department of Obstetrics and Gynecology of Port-Royal, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France; Obstetrical Perinatal and Pediatric Epidemiology (Epopé) Research Team, Center for Epidemiology and Statistics (CRESS), INSERM U1153, Paris, France
| | - François Goffinet
- Department of Obstetrics and Gynecology of Port-Royal, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France; Obstetrical Perinatal and Pediatric Epidemiology (Epopé) Research Team, Center for Epidemiology and Statistics (CRESS), INSERM U1153, Paris, France
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Tomei KL, Selby LV, Kirk LM, Bello JA, Nolan NS, Varma SK, Turner PL, Elliott VS, Brotherton SE. Beyond Training the Next Generation of Physicians: The Unmeasured Value Added by Residents to Teaching Hospitals and Communities. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1592-1596. [PMID: 35731593 PMCID: PMC9592142 DOI: 10.1097/acm.0000000000004792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Following medical school, most newly graduated physicians enter residency training. This period of graduate medical education (GME) is critical to creating a physician workforce with the specialized skills needed to care for the population. Completing GME training is also a requirement for obtaining medical licensure in all 50 states. Yet, crucial federal and state funding for GME is capped, creating a bottleneck in training an adequate physician workforce to meet future patient care needs. Thus, additional GME funding is needed to train more physicians. When considering this additional GME funding, it is imperative to take into account not only the future physician workforce but also the value added by residents to teaching hospitals and communities during their training. Residents positively affect patient care and health care delivery, providing intrinsic and often unmeasured value to patients, the hospital, the local community, the research enterprise, and undergraduate medical education. This added value is often overlooked in decisions regarding GME funding allocation. In this article, the authors underscore the value provided by residents to their training institutions and communities, with a focus on current and recent events, including the global COVID-19 pandemic and teaching hospital closures.
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Affiliation(s)
- Krystal L. Tomei
- K.L. Tomei is associate professor of pediatric neurosurgery, Rainbow Babies & Children’s Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Luke V. Selby
- L.V. Selby is assistant professor of surgery, Department of Surgery, Division of Colorectal and Oncologic Surgery, University of Kansas Medical Center, Kansas City, Kansas; ORCID: https://orcid.org/0000-0002-0202-9646
| | - Lynne M. Kirk
- L.M. Kirk is chief of accreditation and recognition, Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Jacqueline A. Bello
- J.A. Bello is director of neuroradiology and professor of radiology and neurosurgery, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, New York
| | - Nathan S. Nolan
- N.S. Nolan is medical education fellow and infectious disease physician, Washington University Hospital, St. Louis, Missouri
| | - Surendra K. Varma
- S.K. Varma is executive associate dean for graduate medical education and resident affairs, university distinguished professor, and vice chair, Department of Pediatrics, Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas
| | - Patricia L. Turner
- P.L. Turner is executive director, American College of Surgeons, and clinical associate professor of surgery, University of Chicago Medicine, Chicago, Illinois
| | - Victoria Stagg Elliott
- V.S. Elliott is a technical writer, Medical Education Outcomes, American Medical Association, Chicago, Illinois; ORCID: https://orcid.org/0000-0003-1223-0084
| | - Sarah E. Brotherton
- S.E. Brotherton is director, Data Acquisition Services, American Medical Association, Chicago, Illinois
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Training Surgery Residents to be Leaders: Construction of a Resident Leadership Curriculum. Plast Reconstr Surg 2022; 149:765-771. [PMID: 35196699 DOI: 10.1097/prs.0000000000008853] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
SUMMARY Historically, the traditional pathways into plastic surgery required board eligibility in a surgical specialty such as general surgery, orthopedics, urology, neurosurgery, otolaryngology, or ophthalmology. This requirement resulted in plastic surgery residents who had served as chief residents before plastic surgery training. Their maturity emotionally and surgically allowed them to immediately concentrate on the new language and principles of plastic surgery. They had led others and were capable of leading themselves in a new surgical discipline. Today, medical students typically match into surgical specialties directly out of medical school and need to spend their time learning basic surgical skills and patient care because of the contracted time afforded to them. Formal leadership training has historically been limited in surgical training. The authors set out to delineate the creation, implementation, and perceptions of a leadership program within a surgical residency and provide guideposts for the development of engaged, conscious, and dedicated leaders within the residencies they lead.
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Baumann Q, Bulaid Y, Van Vliet A, Gabrion A, Klein C, Mertl P. Sleep Deprivation Adversely Impacts Resident Performance for Simulated Arthroscopy. Arthrosc Sports Med Rehabil 2021; 3:e1125-e1132. [PMID: 34430893 PMCID: PMC8365208 DOI: 10.1016/j.asmr.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 04/18/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of the study was to assess the performance of residents in orthopaedics before and after a 24-hour shift on a shoulder arthroscopy simulator. The primary study endpoint was an overall performance score (OPS) generated by the simulator. Methods A prospective, comparative study of 120 simulator trials by 10 resident junior surgeons was performed in our university hospital’s simulation center between May and November 2018. To avoid memorization bias, all participants performed the same exercise 10 times on a VirtaMed ArthroS simulator prior to the study. Each resident’s performance (the OPS, the operating time, the proportion of procedures with iatrogenic lesions, the camera path length and the hook path length) in two different simulated arthroscopy exercise tasks was assessed once before and once after a 24-hour shift. This sequence was performed three times during the semester, and the change over time in performance was also evaluated. Results The OPS was significantly lower after the night shift (P = 0.035 for the first exercise, and P = 0.025 for the second). Conclusion In a group of previously trained resident junior surgeons, overall performance with an arthroscopy simulator was significantly worse after a 24-hour shift. The study of secondary parameters of the OPS and the subgroup analysis based on the sleep time and Epworth score vary depending on the type of exercise performed arthroscopically. However, the use of a simulator after a night shift did not prevent the trainee from improving his/her level of performance over time. Level of Evidence II, a prospective, comparative study
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Affiliation(s)
- Quentin Baumann
- Department of Orthopedic and Trauma Surgery, SOS Mains, Amiens University Medical Center and Jules Verne University of Picardie, Amiens cedex 1, France
- Address correspondence to Quentin Baumann, M.D., Department of Orthopedic and Trauma Surgery, Amiens University Medical Center and Jules Verne University of Picardie, F-80054 Amiens cedex 1, France.
| | - Yassine Bulaid
- Department of Pediatric Orthopedic Surgery. Amiens University Medical Center and Jules Verne University of Picardie, Amiens cedex 1, France
| | - Axel Van Vliet
- Department of Orthopedic and Trauma Surgery, SOS Mains, Amiens University Medical Center and Jules Verne University of Picardie, Amiens cedex 1, France
| | - Antoine Gabrion
- Department of Orthopedic and Trauma Surgery, SOS Mains, Amiens University Medical Center and Jules Verne University of Picardie, Amiens cedex 1, France
| | - Céline Klein
- Orthopedic and Sports Surgery Center, Cap Ortho, Clinique Anne d’Artois, Bethune, France
| | - Patrice Mertl
- Department of Orthopedic and Trauma Surgery, SOS Mains, Amiens University Medical Center and Jules Verne University of Picardie, Amiens cedex 1, France
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Ferhatoğlu MF, Kıvılcım T, Kartal A, Filiz Aİ, Kebudi A. An analysis of general surgery theses set up between years 1998-2018 in Turkey: Evidence levels and publication rates of 1996 theses. Turk J Surg 2020; 36:9-14. [PMID: 32637870 DOI: 10.5578/turkjsurg.4405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/27/2019] [Indexed: 11/15/2022]
Abstract
Objectives Setting up and advocating a thesis is mandatory at the end of the residency training program to become a specialist in general surgery according to the regulations on medical specialization in Turkey. Writing a thesis helps the resident to learn to ask structured questions, assembling the most accurate study design, managing the study process, collecting the results and building a conclusion with medical implications. In this descriptive study, we aimed to investigate the publication rates of the theses written in the field of general surgery and to assess the properties of the published theses. Material and Methods We performed an online search on September 1, 2018, about the theses of general surgery residents on the website of National Thesis data center of Academic Educational Board in Turkey including theses of medical residents in university-affiliated hospitals and analyzed theses accomplished between 1998-2018. The publication status of the theses was assessed by the entry of author name, the title of the theses and keywords of the theses by using the search engines of PubMed, Google Scholar and Turkish Academic Network and Information Center Turkish Database (ULAKBIM). Data were presented in a descriptive form as absolute numbers and percentages. Results Between 1998-2018, 1996 theses were completed. 393 (20.5%) of these were published in a journal, and 288 (14.4%) were published in a journal indexed in SCI/SCIE. According to research methodologies, 79.2% of the experimental studies were published in SCI/SCIE indexed journals. Conclusion Publication rates of the theses in the field of general surgery are low as they are in other specialties of medicine. This descriptive study might give an idea about the low scientific publication rates of general surgery theses. Further studies are needed to understand the underlying factors, which are responsible for this scant scientific performance.
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Affiliation(s)
| | - Taner Kıvılcım
- Department of General Surgery, Okan University School of Medicine, Istanbul, Turkey
| | - Abdulcabbar Kartal
- Department of General Surgery, Okan University School of Medicine, Istanbul, Turkey
| | - Ali İlker Filiz
- Department of General Surgery, Okan University School of Medicine, Istanbul, Turkey
| | - Abut Kebudi
- Department of General Surgery, Okan University School of Medicine, Istanbul, Turkey
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Demirtaş A, Karadeniz H, Akman YE, Duymuş TM, Çarkcı E, Azboy İ. Academic productivity and obstacles encountered during residency training: A survey among residents in orthopedics and traumatology programs in Turkey. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2020; 54:311-319. [PMID: 32442120 DOI: 10.5152/j.aott.2020.03.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study aimed to investigate the academic productivity of and the obstacles encountered by orthopedic residents in Turkey. METHODS Overall, 220 orthopedic specialists who were registered in the Ministry of Health and had started orthopedic residency between 2009 and 2010 were invited to participate in a survey through e-mail. The survey comprised a total of 19 questions to evaluate the academic works conducted and obstacles encountered during residency. Academic work was defined as an article published in the peer-reviewed journals as well as an oral or poster presentation at a national or international congress. Case reports, letters to the editor, and technical notes were excluded. RESULTS Data were obtained from 116 respondents who completed the survey. In peer-reviewed journals in Science Citation Index (SCI) or SCI-Expanded, the mean number of articles published with and without the first name per resident was 0.09 and 0.73, respectively. In peer-reviewed journals other than those in SCI and SCI-Expanded, the mean number of articles published with and without the first name per resident was 0.37 and 1, respectively. The mean number of oral and poster presentations per resident at national and international congresses was 2.63 and 4.67, respectively. No significant difference in the number of academic works was noted between the regions and institutions (p>0.05). A significant positive correlation was observed between the number of associate professors and assistant professors in the clinic and the total number of academic works (article plus presentation) (p<0.01 and p=0.017, respectively). Regarding encouragement and support to academic works, 6.9% of the respondents found the clinic to be excellent, 20.7% good, 24.1% moderate, and 48.3% bad. No significant difference in encouragement and support to academic works was noted among the institutions (p=0.115). The most common obstacle encountered in conducting academic works was long working hours (74.5%). CONCLUSION Regardless of the region and institution, the participation of orthopedic residents in academic works is low in Turkey. Several obstacles were encountered in conducting academic works, with the most common being long working hours. LEVEL OF EVIDENCE Level IV, Diagnostic study.
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Affiliation(s)
- Abdullah Demirtaş
- Department of Orthopaedics and Traumatology, Medeniyet University, School of Medicine, İstanbul, Turkey
| | - Hilmi Karadeniz
- Department of Orthopaedics and Traumatology, Bahçelievler Medical Park Hospital, İstanbul, Turkey
| | - Yunus Emre Akman
- Department of Orthopaedics and Traumatology, Metin Sabancı Baltalimanı Bone and Joint Diseases Training and Research Hospital, İstanbul, Turkey
| | - Tahir Mutlu Duymuş
- Clinic of Orthopedics and Traumatology, Özel Saygı Hospital, İstanbul, Turkey
| | - Engin Çarkcı
- Department of Orthopaedics and Traumatology, Bahçelievler Medical Park Hospital, İstanbul, Turkey
| | - İbrahim Azboy
- Department of Orthopaedics and Traumatology, Medipol University, School of Medicine, İstanbul, Turkey
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Bui R, Doan N, Chaaban MR. Epidemiologic and Outcome Analysis of Epistaxis in a Tertiary Care Center Emergency Department. Am J Rhinol Allergy 2019; 34:100-107. [DOI: 10.1177/1945892419876740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background The association between hypertension and recurrent epistaxis is controversial. The objective of this study is to examine the factors associated with recurrent epistaxis visits to the emergency department (ED) and establish an otolaryngology (ENT [ear, nose, and throat]) consult algorithm to optimize treatment and minimize unnecessary consultation. Methods A retrospective review of 100 patients presenting to the ED for epistaxis requiring ENT consult from 2013 to 2018 was conducted. Patient demographics, comorbidities, epistaxis etiology, blood pressure measurements during admission, and treatment methods were analyzed. Patient charts were reviewed for ED admissions, complications, and procedures. A consult algorithm was subsequently devised and retrospectively applied to our cohort. Results Patients who required more than one ED visit for epistaxis were more often males (77.8% vs 49.3%, P = .01), required posterior packing (51.9% vs 17 .8%, P < .001), and had more comorbid hypertension (66.7% vs 38.4%, P = .01) compared to patients who had 1 visit. Compared to patients presenting during summer and fall (May–October), patients presenting during winter and spring (November–April) were more often treated for anterior epistaxis with Surgicel®/Surgifoam® rather than posterior nasal packing (57.4% vs 37.0%, P = .04). Application of our consult algorithm decreased consultation by 78% and liberated 58.5 hours of ENT resident time. Conclusion Patients with recurrent epistaxis tended to be male and had more comorbid hypertension. Further prospective studies are warranted to ascertain the factors associated with recurrent epistaxis. Our consult algorithm for epistaxis helped reduce unnecessary ENT consultation and facilitated reallocation of valuable resident work hours.
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Affiliation(s)
- Roger Bui
- School of Medicine, University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Nicolette Doan
- School of Medicine, University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Mohamad R. Chaaban
- Department of Otolaryngology, University of Texas Medical Branch at Galveston, Galveston, Texas
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Yu HW, Choi JY, Park YS, Park HS, Choi Y, Ahn SH, Kang E, Oh HK, Kim EK, Cho JY, Kim DW, Park DJ, Yoon YS, Kang SB, Kim HH, Han HS, Lee T. Implementation of a resident night float system in a surgery department in Korea for 6 months: electronic medical record-based big data analysis and medical staff survey. Ann Surg Treat Res 2019; 96:209-215. [PMID: 31073510 PMCID: PMC6483933 DOI: 10.4174/astr.2019.96.5.209] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 12/13/2018] [Accepted: 12/21/2018] [Indexed: 11/30/2022] Open
Abstract
Purpose To evaluate superiority of a night float (NF) system in comparison to a traditional night on-call (NO) system for surgical residents at a single institution in terms of efficacy, safety, and satisfaction. Methods A NF system was implemented from March to September 2017 and big data analysis from electronic medical records was performed for all patients admitted for surgery or contacted from the emergency room (ER). Parameters including vital signs, mortality, and morbidity rates, as well as promptness of response to ER calls, were compared against a comparable period (March to September 2016) during which a NO system was in effect. A survey was also performed for physicians and nurses who had experienced both systems. Results A total of 150,000 clinical data were analyzed. Under the NO and NF systems, a total of 3,900 and 3,726 patients were admitted for surgery. Mortality rates were similar but postoperative bleeding was significantly higher in the NO system (0.5% vs. 0.2%, P = 0.031). From the 1,462 and 1,354 patients under the NO and NF systems respectively, that required surgical consultation from the ER, the time to response was significantly shorter in the NF system (54.5 ± 70.7 minutes vs. 66.8 ± 83.8 minutes, P < 0.001). Both physicians (90.4%) and nurses (91.4%) agreed that the NF system was more beneficial. Conclusion This is the first report of a NF system using big data analysis in Korea, and potential benefits of this new system were observed in both ward and ER patient management.
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Affiliation(s)
- Hyeong Won Yu
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - June Young Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Suk Park
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyung Sub Park
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - YoungRok Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang-Hoon Ahn
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eunyoung Kang
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Heung-Kwon Oh
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eun-Kyu Kim
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jai Young Cho
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Duck-Woo Kim
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Do Joong Park
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yoo-Seok Yoon
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung Bum Kang
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyung-Ho Kim
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Ho-Seong Han
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Taeseung Lee
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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Rushing CJ, Roland DA, Pham A, Bodden VM, Soldano SA, Epstein S, Rushing DC, Ramil MC, Chussid F, Spinner SM, Hardigan P. A Formal Work Hour Analysis of the Resident Foot and Ankle Surgeon. J Foot Ankle Surg 2019; 58:80-85. [PMID: 30583784 DOI: 10.1053/j.jfas.2018.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Indexed: 02/03/2023]
Abstract
As new documentation requirements by governments and third-party payees increasingly occupy physicians' time, duty hour restrictions have continued to restrict the work hours of residents, leaving programs tasked to produce proficient foot and ankle surgeons (FASs) in less time. The purpose of the present study was to quantify the workday of resident FASs at our institution to identify areas suited for revision to improve efficiency and training. A resident from each postgraduate year (PGY) was recruited and consented for minute-to-minute observation by 4 independent observers over 5 consecutive workdays. The time recorded was placed into a predefined work model consisting of 9 categories (education, research, operating room, patient care, documentation/administration, communications, transit, basic needs, and standby) within 1 of 3 value groups (positive, neutral, or negative). A fifth independent observer reviewed and recorded all collected data. Over 5 consecutive days, ancillary staff frequently disrupted the PGY-1 resident's workflow. The interruptions fragmented the resident's thoughts, increased inefficiency, and resulted in the largest proportion of the resident's time (16.7%) being occupied by documentation/administration duties. For the PGY-2 and PGY-3 residents, unexpected trends in standby were identified during the preoperative period. Secondary analysis revealed that during unexpected preoperative delays, resident efficiency was poor. To maximize efficiency and improve training, residents must increase their awareness of self-inefficiency while minimizing unnecessary interruptions and the time occupied by duties of lesser value. It is our hope that the present study will aid other institutions in facilitating similar improvements to the education and training of our fellow resident FASs.
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Affiliation(s)
- Calvin J Rushing
- Resident, Westside Regional Medical Center, Plantation, FL; Board Member, Foot and Ankle Research Foundation of South Florida Inc., Plantation, FL.
| | | | - Alyssa Pham
- Resident, Westside Regional Medical Center, Plantation, FL
| | | | - Spenser A Soldano
- Resident, University of Florida Health Jacksonville, Jacksonville, FL
| | - Sarina Epstein
- Resident, Adventura Hospital & Medical Center, Adventura, FL
| | - Denae C Rushing
- Dental Student, Nova Southeastern College of Dental Medicine, Plantation, FL
| | - Madelin C Ramil
- Research Director, Westside Regional Medical Center, Plantation, FL; Board Member, Foot and Ankle Research Foundation of South Florida Inc., Plantation, FL
| | - Fredric Chussid
- Associate Director, Westside Regional Medical Center, Plantation, FL; Board Member, Foot and Ankle Research Foundation of South Florida Inc., Plantation, FL
| | - Steven M Spinner
- Residency Director, Westside Regional Medical Center, Plantation, FL; Board Member, Foot and Ankle Research Foundation of South Florida Inc., Plantation, FL
| | - Patrick Hardigan
- Director of the Statistical Consulting Center, Nova Southeastern University, Ft. Lauderdale, FL
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Truong HT, Chan JJ, Leong WL, Sultana R, Koh DL, Sng BL. Interest and experience of anaesthesiology residents in doing research during residency training. Indian J Anaesth 2019; 63:42-48. [PMID: 30745612 PMCID: PMC6341890 DOI: 10.4103/ija.ija_543_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background and Aims: The SingHealth Anaesthesiology Residency Program is a 5-year postgraduate training programme whose curriculum covers clinical and academic training, through research and educational activities. This study aimed to describe the needs of the residents in promoting research participation during residency. Methods: After obtaining ethics committee approval, we conducted an online anonymous survey among all residents in the Residency Program. The questionnaire comprised questions of demographic data, levels of research interest, areas of interest, the obstacles to research and the potential areas where help can be improved. SAS (version 9.4, 2017; SAS Institute Inc.) was used for descriptive analysis and logistic regression. Results: Sixty-seven of the 79 residents (84.8%) in the Program responded with 58 (73.4%) completing the survey. Fifty-six of the 62 (90%) expressed some level of interest in research. The top two areas of research interest were clinical research and medical education research. The top obstacles to research were lack of time (due to competing clinical time and work–life balance) and lack of mentorship. The top three areas of research support needed by residents were supervised research protected time, departmental research manpower support and mentorship with topic expertise. Senior Residents were more likely to have higher research interest, self-initiated research participation and consideration for research as part of career progression, compared with junior residents. Conclusion: Residents faced many obstacles in doing research during residency training. Our findings also highlighted some of the needs for research support reported by the residents during their specialty training.
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Affiliation(s)
- Ha Tt Truong
- Anaesthesiology and Perioperative Sciences Academic Clinical Program, Singapore General Hospital, Singapore
| | - Jason Ji Chan
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore
| | - Wan Ling Leong
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore
| | - Rehena Sultana
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore
| | - Darren Lk Koh
- Department of Anaesthesiology, Singapore General Hospital, Singapore
| | - Ban Leong Sng
- Anaesthesiology and Perioperative Sciences Academic Clinical Program, Singapore General Hospital, Singapore.,Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore
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Osborn PM, Ames SE, Turner NS, Caird MS, Karam MD, Mormino MA, Krueger CA. An Analysis of Research Quality and Productivity at Six Academic Orthopaedic Residencies. JOURNAL OF SURGICAL EDUCATION 2018; 75:1635-1642. [PMID: 29884523 DOI: 10.1016/j.jsurg.2018.04.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 02/28/2018] [Accepted: 04/30/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE It remains largely unknown what factors impact the research productivity of residency programs. We hypothesized that dedicated resident research time would not affect the quantity and quality of a program's peer-reviewed publication within orthopedic residencies. These findings may help programs improve structure their residency programs to maximize core competencies. DESIGN Three hundred fifty-nine residents and 240 staff from six different US orthopedic residency programs were analyzed. All publications published by residents and faculty at each program from January 2007 to December 2015 were recorded. SCImago Journal Rankings (SJR) were found for each journal. RESULTS There were no significant differences in publications by residents at each program (p > 0.05). Faculty with 10+ years of on staff, had significantly more publications than those with less than 10 years (p < 0.01). Programs with increased resident research time did not consistently produce publications with higher SJR than those without dedicated research time. CONCLUSIONS Increased dedicated resident research time did not increase resident publication rates or lead to publications with higher SJR.
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Affiliation(s)
- Patrick M Osborn
- Orthopaedic Surgery, San Antonio Military Medical Center, Ft. Sam Houston, Texas
| | - S Elizabeth Ames
- Orthopaedic Surgery, University of Vermont, South Burlington, Vermont
| | | | - Michelle S Caird
- Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
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15
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Brandt AM, Rettig SA, Kale NK, Zuckerman JD, Egol KA. Can a Clinician-Scientist Training Program Develop Academic Orthopaedic Surgeons? One Program's Thirty-Year Experience. JOURNAL OF SURGICAL EDUCATION 2018; 75:1039-1044. [PMID: 29102560 DOI: 10.1016/j.jsurg.2017.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 08/14/2017] [Accepted: 10/09/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Clinician-scientist numbers have been stagnant over the past few decades despite awareness of this trend. Interventions attempting to change this problem have been seemingly ineffective, but research residency positions have shown potential benefit. OBJECTIVE We sought to evaluate the effectiveness of a clinician-scientist training program (CSTP) in an academic orthopedic residency in improving academic productivity and increasing interest in academic careers. METHODS Resident training records were identified and reviewed for all residents who completed training between 1976 and 2014 (n = 329). There were no designated research residents prior to 1984 (pre-CSTP). Between 1984 and 2005, residents self-selected for the program (CSTP-SS). In 2005, residents were selected by program before residency (CSTP-PS). Residents were also grouped by program participation, research vs. clinical residents (RR vs. CR). Data were collected on academic positions and productivity through Internet-based and PubMed search, as well as direct e-mail or phone contact. Variables were then compared based on the time duration and designation. RESULTS Comparing all RR with CR, RR residents were more likely to enter academic practice after training (RR, 34%; CR, 20%; p = 0.0001) and were 4 times more productive based on median publications (RR, 14; CR, 4; p < 0.0001). Furthermore, 42% of RR are still active in research compared to 29% of CR (p = 0.04), but no statistical difference in postgraduate academic productivity identified. CONCLUSIONS The CSTP increased academic productivity during residency for the residents and the program. However, this program did not lead to a clear increase in academic productivity after residency and did not result in more trainees choosing a career as clinician-scientists.
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Affiliation(s)
- Aaron M Brandt
- Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | - Samantha A Rettig
- Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York City, New York
| | - Neel K Kale
- Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York City, New York
| | - Joseph D Zuckerman
- Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York City, New York
| | - Kenneth A Egol
- Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York City, New York.
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Williams BR, Agel JA, Van Heest AE. Protected Time for Research During Orthopaedic Residency Correlates with an Increased Number of Resident Publications. J Bone Joint Surg Am 2017; 99:e73. [PMID: 28678134 DOI: 10.2106/jbjs.16.00983] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The Accreditation Council for Graduate Medical Education (ACGME) requires orthopaedic residency programs to promote scholarship and research, which manifest differently among programs. We assess the impact of protected research time during orthopaedic residency on the number of resident publications. METHODS Rotation schedules and resident names were collected from 125 ACGME-accredited U.S. orthopaedic residency programs. Protected research time was classified as 1 of 3 types: (1) block time, (2) longitudinal time, or (3) no dedicated time. In April 2016, we searched residents in postgraduate year (PGY)-3 to PGY-5 on pubmed.gov to generate all orthopaedic publications with a PubMed identifier published during residency. Each publication's 2015 Thomson Reuters Journal Citation Reports 5-Year Journal Impact Factor and resident first authorship were noted. The number of PubMed identifiers for each program was summed and was divided by the number of residents in PGY-3 to PGY-5, giving a mean number of publications per resident. The relationship between output and program research time was compared using t tests and analysis of variance (ANOVA). RESULTS A total of 1,690 residents were included, with an overall mean number (and standard deviation) of 1.2 ± 2.4 publications per resident. Eighty-seven programs reported block time, 14 programs reported longitudinal time, and 24 programs reported no time. There was a significant difference (p = 0.02) in the mean number of publications per resident when compared between programs with protected time (1.1 ± 1.2 publications) and programs with no protected time (0.6 ± 0.5 publication). One-way ANOVA demonstrated a significant mean difference across the 3 groups (p < 0.001), with longitudinal time correlating with significantly greater output at 1.9 ± 1.8 publications than block time at 1.0 ± 1.0 publication or no time at 0.6 ± 0.5 publication, a difference that persisted when adjusted to include only impact factors of >0 and exclude case reports (p = 0.0015). CONCLUSIONS Both the presence of and the type of dedicated research time correlate with residents' research productivity; further consideration of protected research time during residency is warranted. CLINICAL RELEVANCE This article provides objective data with regard to research strategies in training orthopaedic surgeons.
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Affiliation(s)
- Benjamin R Williams
- 1Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota 2Department of Orthopaedics and Sports Medicine, Harborview Medical Center, Seattle, Washington
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Krueger CA, Hoffman JD, Balazs GC, Johnson AE, Potter BK, Belmont PJ. Protected Resident Research Time Does Not Increase the Quantity or Quality of Residency Program Research Publications: A Comparison of 3 Orthopedic Residencies. JOURNAL OF SURGICAL EDUCATION 2017; 74:264-270. [PMID: 27651048 DOI: 10.1016/j.jsurg.2016.08.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 06/01/2016] [Accepted: 08/06/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The effect of dedicated resident research time in terms of residency program research productivity remains largely unknown. We hypothesize that the quantity and quality of a residency program's peer-reviewed publications (PRPs) increase proportionately with the amount of dedicated research time given to residents. METHODS Three residency programs (P1, P2, and P3) were examined. P1 has a mandatory research year for all residents between postgraduate years 3 and 4. P2 has an elective research year for 1 resident between postgraduate years 2 and 3. P3 has no dedicated research time for residents. All publications produced by residents and staff at each program from January 2007 through December were recorded from PUBMED. SCImago Journal Rankings were used as a proxy to measure research quality. RESULTS There was no significant difference in the number of publications produced between the institutions on a per-staff (p = 0.27) and per-resident (p = 0.80) basis. There were no residents at P3 who graduated without at least 1 PRP, whereas there were 7 residents from P1 and 8 residents from P2 who graduated without a PRP. There were no significant differences between programs in terms of the SCImago Journal Ranking for the journals containing their publications (p = 0.135). DISCUSSION Residency programs with dedicated research time did not produce significantly (p > 0.05) more, or higher quality, PRPs than residencies without dedicated research time. It may be that the quantity and quality of PRPs is related more to faculty engagement, research interest, and mentorship at individual programs rather than the number of residents given dedicated time to complete research. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
- Chad A Krueger
- Department of Orthopaedic Surgery, Womack Army Medical Center, Fort Bragg, North Carolina.
| | - Jeffery D Hoffman
- Department of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, Texas
| | - George C Balazs
- Department of Orthopaedics, USU-Walter Reed Surgery, Bethesda, Maryland
| | - Anthony E Johnson
- Department of Orthopaedic Surgery and Rehabilitation, San Antonio Military Medical Center, Fort Sam Houston, Texas
| | - Benjamin K Potter
- Department of Orthopaedics, USU-Walter Reed Surgery, Bethesda, Maryland
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Abstract
BACKGROUND In 2003, work-hour regulations were implemented by the Accreditation Council for Graduate Medical Education. Much has been published regarding resident rest and quality of life as well as patient safety. There has been no examination on the effect of work-hour restrictions on academic productivity of fellows in training. Paediatric subspecialty fellows have a scholarly requirement mandated by the American Board of Pediatrics. We have examined the impact of work-hour restrictions on the scholarly productivity of paediatric cardiology fellows during their fellowship. METHODS We conducted a literature search for all paediatric cardiology fellows between 1998 and 2007 at a single academic institution as first or senior authors on papers published during their 3-year fellowship and 3 years after completion of their categorical fellowship (n=63, 30 fellows before 2003 and 33 fellows after 2003). The numbers of first- or senior-author fellow publications before and after 2003 were compared. We also collected data on final paediatric cardiology subspecialty career choice. RESULTS There was no difference in the number of fellow first-author publications before and after 2003. Before work-hour restrictions, the mean number of publications per fellow was 2.1 (±2.2), and after work-hour restrictions it was 2.0 (±1.8), (p=0.89). By subspecialty career choice, fellows who select electrophysiology, preventative cardiology, and heart failure always published within the 6-year time period. CONCLUSIONS Since the implementation of work-hour regulations, total number of fellow first-authored publications has not changed. The role of subspecialty choice may play a role in academic productivity of fellows in training.
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A multi-institution analysis of general surgery resident peer-reviewed publication trends. J Surg Res 2016; 210:92-98. [PMID: 28457346 DOI: 10.1016/j.jss.2016.11.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 11/02/2016] [Accepted: 11/04/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND The process of taking a research project from conception to publication is one way to encourage surgeons to communicate hypothesis, critically assess literature and data, and defend research conclusions to a broad audience. The goal of this study was to define surgery resident publishing epidemiology and identify characteristics of residents and residency programs that might predict increased publication productivity. MATERIALS AND METHODS A survey was administered to eight general surgery residency programs to collect residency and resident variables from 1993-2013. The primary endpoint was the number of first-author publications produced per resident. Secondary endpoints included clinical setting at which the former resident was practicing, fellowship pursued, and manuscript quality. RESULTS Between 1993 and 2013, 676 residents graduated, median age was 33 years (range: 29-43 years) and 182 (27%) were female. Three hundred and sixty-six (54%) residents produced 1229 first-author publications. Of these, 112 (31%) residents produced one manuscript, 125 (34%) produced two-three manuscripts, 107 (29%) produced four-nine manuscripts, and 22 (6%) produced 10 or more manuscripts. Publishing ≥1 manuscript in residency was associated with a 1.5 (P = 0.01) increased odds of having attended a top-tier research institution for medical school and a 2.3 (P < 0.001) increased odds of having dedicated research years incorporated into residency. Surgeons practicing at academic centers had 1.7 (P = 0.003) greater odds of having attended top-tier medical schools, and 1.5 (P = 0.02) greater odds of publishing during residency. CONCLUSIONS Additional research directed at identifying interventions promoting resident publishing and scholastic achievement should benefit all surgery training programs looking to cultivate the next generation of critically thinking surgeons.
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Abstract
INTRODUCTION To date, no study has reported on the public's opinion of orthopaedic resident duty-hour requirements (DHR). METHODS A survey was administered to people in orthopaedic waiting rooms and at three senior centers. Responses were analyzed to evaluate seven domains: knowledge of duty hours; opinions about duty hours; attitudes regarding shift work; patient safety concerns; and the effects of DHRs on continuity of care, on resident training, and on resident professionalism. RESULTS Respondents felt that fatigue was unsafe and duty hours were beneficial in preventing resident physician fatigue. They supported the idea of residents working in shifts but did not support shifts for attending physicians. However, respondents wanted the same resident to provide continuity of care, even if that violated DHRs. They were supportive of increasing the length of residency to complete training. DHRs were not believed to affect professionalism. Half of the respondents believed that patient opinion should influence policy on this topic. DISCUSSION Orthopaedic patients and those likely to require orthopaedic care have inconsistent opinions regarding DHRs, making it potentially difficult to incorporate their preferences into policy.
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Chan JY, Narasimhalu K, Goh O, Xin X, Wong TY, Thumboo J, Phua GC. Resident research: why some do and others don't. Singapore Med J 2016; 58:212-217. [PMID: 26976220 DOI: 10.11622/smedj.2016059] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Although research is widely considered to be a relevant and essential skill to resident development, the actual participation rate of residents in research remains low, and the factors associated with participation are unclear. METHODS We examined the participation rate of junior residents in research, and their attitudes and perceived barriers toward research, via an anonymised survey carried out from October to November 2013. The residents were from an established Accreditation Council for Graduate Medical Education-accredited internal medicine residency training programme in Singapore. RESULTS The overall response rate was 64.1% (82/128 residents). The most frequently cited barrier was lack of time. Only a third of the residents surveyed were actively participating in research. Those with postgraduate qualifications were more likely to be involved in research (odds ratio 4.71, p = 0.015). Among the 82 residents, 40.2% reported an interest in research as part of their career; these were mainly graduates from overseas universities or postgraduates. A belief that research is an intrinsically valuable activity distinguished residents who chose research as a career path from those who were undecided (p = 0.004). The belief that research is a means to better clinical practice also divided those who chose research from those who rejected it (p = 0.02). CONCLUSION Our findings suggest that specific beliefs determine the level of research activity and career interest among residents. Novel strategies may be incorporated in training programmes to improve the interest and participation of residents in research, and to facilitate the development of academic clinicians.
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Affiliation(s)
| | | | - Orlanda Goh
- Department of Internal Medicine, Singapore General Hospital, Singapore
| | - Xiaohui Xin
- Division of Medicine, Singapore General Hospital, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, National University of Singapore, Singapore
| | - Julian Thumboo
- Duke-NUS Medical School, National University of Singapore, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
| | - Ghee Chee Phua
- Duke-NUS Medical School, National University of Singapore, Singapore.,Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore
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Otorhinolaryngology residency in Spain: training satisfaction, working environment and conditions. Eur Arch Otorhinolaryngol 2016; 273:1619-27. [DOI: 10.1007/s00405-016-3935-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 02/10/2016] [Indexed: 10/22/2022]
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Chassagnon G, Dangouloff-Ros V, Vilgrain V, Ronot M. Academic productivity of French radiology residents: Where do we stand? Diagn Interv Imaging 2016; 97:211-8. [DOI: 10.1016/j.diii.2015.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/02/2015] [Accepted: 08/06/2015] [Indexed: 11/24/2022]
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Mauser NS, Michelson JD, Gissel H, Henderson C, Mauffrey C. Work-hour restrictions and orthopaedic resident education: a systematic review. INTERNATIONAL ORTHOPAEDICS 2015; 40:865-73. [PMID: 26572881 DOI: 10.1007/s00264-015-3045-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/02/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE The ACGME (US) and The European Working Time Directive (UK) placed work-hour restrictions on medical trainees with the goal of improved patient safety. However, there has been concern over a potential decrease in medical education. Orthopaedic training is the focus of this study. We examined previously published subjective and objective data regarding education and work-hour restrictions and developed the questions: Do specific perceptions emerge within the subjective studies examined? Are there objective differences in educational measures before and after work-hour restrictions? Is there a difference between the subjective and objective data? METHODS A systematic review was conducted via MedLine, regarding orthopaedic studies in the USA and UK, with reference to work-hour restrictions and education. RESULTS Subjective survey studies demonstrate that residents and attending physicians have a negative response to work-hour restrictions because of the perceived impact on their overall education and operating room experience. Conversely, limited objective studies demonstrated no change in operative volume before or after implementation of restrictions. CONCLUSIONS This review highlights the need for more objective studies on the educational implications of work-hour restrictions. Studies to date have not demonstrated a measurable difference based on case logs or training scores. Opinion-based surveys demonstrate an overall negative perception by both residents and attending physicians, on the impact of work-hour restrictions on orthopaedic education. Current published data is limited and stronger evidence-based data are needed before definitive conclusions can be reached.
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Affiliation(s)
- Nathan S Mauser
- Department of Orthopaedics and Rehabilitation, University of Vermont College of Medicine, Robert T. Stafford Hall, 4th Floor 95 Carrigan Drive, Burlington, VT, 05405-0084, USA
| | - James D Michelson
- Department of Orthopaedics and Rehabilitation, University of Vermont College of Medicine, Robert T. Stafford Hall, 4th Floor 95 Carrigan Drive, Burlington, VT, 05405-0084, USA
| | - Hannah Gissel
- Department of Orthopaedics, Denver Health Medical Center, 777 Bannock Street, Denver, CO, 80204, USA
| | - Corey Henderson
- Department of Orthopaedics, Denver Health Medical Center, 777 Bannock Street, Denver, CO, 80204, USA
| | - Cyril Mauffrey
- Department of Orthopaedics, Denver Health Medical Center, 777 Bannock Street, Denver, CO, 80204, USA.
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Pausch NC, Neff A, Subbalekha K, Dhanuthai K, Sirintawat N, Pitak-Arnnop P. Factors affecting scientific productivity of German oral-maxillofacial surgery training centers: a retrospective cohort study. Oral Maxillofac Surg 2015; 19:259-265. [PMID: 25707775 DOI: 10.1007/s10006-015-0489-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 02/15/2015] [Indexed: 06/04/2023]
Abstract
PURPOSE To identify factors associated with scientific productivity (SP) of German oral-maxillofacial surgery (OMFS) training centers. MATERIALS AND METHODS This retrospective cohort study was composed of a set of data from German OMFS training centers. A total of eight predictor variables were grouped into demographic, structural, and personal categories. The outcome variables were average publications in 2013 per senior staff, and percentage of OMFS trainees with >1 publications. Descriptive and univariate statistics were computed using P < 0.05. RESULTS The sample included outputs from 62 OMFS departments (34 [54.8 %] university-based; 46 [74.2 %] in large cities). Average publications were 2.4 ± 3 per senior staff (range, 0-27), and 160 trainees (31.7 %) published >1 papers. The number of publications and productive trainees was not linked to department name and number of female senior staffs, but publication count was significantly increased when the hospital was in a metropolis (P = 0.018) or university-based (P < 0.0001), the OMFS' chairperson and >3 staffs within the department had a postdoctoral degree (German "Habilitation") (P = 0.013 and <0.0001), and the chairperson had h-index >10 or the first/last authorship in 2013 (P < 0.0001). Female senior surgeons were less scientifically productive than the male ones (P = 0.01). CONCLUSION SP of German OMFS training centers is greatly different across the country and influenced by city size, university base, educational backgrounds, and research activities of chairpersons and senior staffs. This helps students, trainees, and young surgeons to reach the career choice that is personally appropriate. The involved organizations may need to encourage research output of less productive surgeons/centers. Increasing postdoctoral-qualified staffs will increase SP of the department.
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Affiliation(s)
- Niels Christian Pausch
- Research Group for Clinical and Psychosocial Research, Evidence-Based Surgery and Ethics in Oral and Maxillofacial Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany,
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Chen JX, Kozin ED, Sethi RKV, Remenschneider AK, Emerick KS, Gray ST. Increased Resident Research over an 18-Year Period. Otolaryngol Head Neck Surg 2015; 153:350-6. [DOI: 10.1177/0194599815587908] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 04/30/2015] [Indexed: 11/15/2022]
Abstract
Objectives (1) To evaluate changes in the resident publications over time, including before and after duty hour restrictions, and (2) to identify factors statistically associated with publications during residency. Study Design Retrospective review of bibliometric data. Subjects and Methods Residents who graduated from an otolaryngology residency program from 1996 to 2013 were evaluated. Thomson Reuters Web of Science was searched to determine the number of indexed peer-reviewed publications before and after implementation of resident duty hour restrictions in 2003. Resident demographics, PhD degrees, training tracks, and postgraduation plans were collected to determine factors associated with publication rate using multivariable regression analysis. Results During the studied period, 75 residents completed otolaryngology residency training and published a total of 294 papers, averaging 3.92 publications per resident during training. After work hour restrictions were implemented, the mean number of publications increased from 1.21 to 5.10 ( P < .0001). First author publications, clinical publications, and basic science publications all increased ( P < .001). In regression analysis, T32 grants (β = 6.98, standard error [SE] = 1.87, P = .0004) and the time period after duty hour restrictions were introduced (β = 4.72, SE = 1.73, P = .0083) were positively associated with resident publications. Gender, PhD degree, and pursuit of fellowship training were not associated with increased publications ( P > .05). Conclusion There has been a significant increase in resident publications over time, coinciding with the implementation of work hour restrictions. T32 grants were most predictive of increased resident publications, while PhD degrees were not significantly associated.
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Affiliation(s)
- Jenny X. Chen
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
- Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary/Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Elliott D. Kozin
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
- Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary/Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Rosh K. V. Sethi
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
- Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary/Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Aaron K. Remenschneider
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
- Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary/Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kevin S. Emerick
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
- Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary/Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Stacey T. Gray
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
- Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary/Massachusetts General Hospital, Boston, Massachusetts, USA
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Harris JD, Staheli G, LeClere L, Andersone D, McCormick F. What effects have resident work-hour changes had on education, quality of life, and safety? A systematic review. Clin Orthop Relat Res 2015; 473:1600-8. [PMID: 25269530 PMCID: PMC4385350 DOI: 10.1007/s11999-014-3968-0] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND More than 15 years ago, the Institute of Medicine (IOM) identified medical error as a problem worthy of greater attention; in the wake of the IOM report, numerous changes were made to regulations to limit residents' duty hours. However, the effect of resident work-hour changes remains controversial within the field of orthopaedics. QUESTIONS/PURPOSES We performed a systematic review to determine whether work-hour restrictions have measurably influenced quality-of-life measures, operative and technical skill development, resident surgical education, patient care outcomes (including mortality, morbidity, adverse events, sentinel events, complications), and surgeon and resident attitudes (such as perceived effect on learning and training experiences, personal benefit, direct clinical experience, clinical preparedness). METHODS We performed a systematic review of PubMed, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Google Scholar using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Inclusion criteria were any English language peer-reviewed articles that analyzed the effect(s) of orthopaedic surgery resident work-hour restrictions on patient safety, resident education, resident/surgeon quality of life, resident technical operative skill development, and resident surgeon attitudes toward work-hour restrictions. Eleven studies met study inclusion criteria. One study was a prospective analysis, whereas 10 studies were of level IV evidence (review of surgical case logs) or survey results. RESULTS Within our identified studies, there was some support for improved resident quality of life, improved resident sleep and less fatigue, a perceived negative impact on surgical operative and technical skill, and conflicting evidence on the topic of resident education, patient outcomes, and variable attitudes toward the work-hour changes. CONCLUSIONS There is a paucity of high-level or clear evidence evaluating the effect of the changes to resident work hours. Future research in this area should focus on objective measures that include patient safety as a primary outcome.
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Affiliation(s)
- Joshua D. Harris
- />Department of Orthopedic Surgery, The Methodist Hospital, Houston, TX USA
| | - Greg Staheli
- />Department of Orthopedic Surgery, Naval Medical Center San Diego, San Diego, CA USA
| | - Lance LeClere
- />Department of Orthopedic Surgery, Naval Medical Center San Diego, San Diego, CA USA
| | - Diana Andersone
- />Holy Cross Orthopedic Institute, 5597 N Dixie Highway, Fort Lauderdale, FL 33334 USA
| | - Frank McCormick
- />Holy Cross Orthopedic Institute, 5597 N Dixie Highway, Fort Lauderdale, FL 33334 USA
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Gurberg J, Lin JR, Akbari E, White P, Nunez DA. The Canadian contribution to the otolaryngology literature: a five year bibliometric analysis. J Otolaryngol Head Neck Surg 2014; 43:47. [PMID: 25416096 PMCID: PMC4251862 DOI: 10.1186/s40463-014-0047-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 11/03/2014] [Indexed: 11/15/2022] Open
Abstract
Objectives To assess the 2008–2012 Canadian contribution to the Otolaryngology literature. Methods All articles published from January 2008 - December 2012 in 5 Otolaryngology journals were reviewed. Nationality, number of authors, and study type were extracted. The output, number of authors, and study type of Canadian papers were compared to International papers using Mantel-Haenszel Common Odds Ratio Estimate, Pearson’s Chi-Squared or Fishers exact tests. Results 4519 papers were analyzed. There was a statistically significant decrease in Canadian authored papers from 12.8% in 2008–9 to 10.2% in 2011–12 (Fishers exact, p = .01). Multi-authorship increased in Canadian papers (χ2, p = .01). The types of studies published by Canadian Otolaryngologists did not change over the study period. Conclusions Canadian authored papers in a sample of Otolaryngology journals decreased from 2008 to 2012. The increase in multiauthorship, whilst indicating increasing collaboration, suggests reduced per capita publication productivity. These findings warrant further study.
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Affiliation(s)
- Joshua Gurberg
- Division of Otolaryngology, Diamond Health Care Centre, The University of British Columbia, 4th Floor, 2775 Laurel Street, Vancouver, BC Canada V5Z 1 M9
| | - June Rj Lin
- Division of Otolaryngology, Diamond Health Care Centre, The University of British Columbia, 4th Floor, 2775 Laurel Street, Vancouver, BC Canada V5Z 1 M9
| | - Elaheh Akbari
- Division of Otolaryngology, Diamond Health Care Centre, The University of British Columbia, 4th Floor, 2775 Laurel Street, Vancouver, BC Canada V5Z 1 M9
| | - Paul White
- Department of Engineering Design and Mathematics, The University of the West of England, Bristol, UK
| | - Desmond A Nunez
- Division of Otolaryngology, Diamond Health Care Centre, The University of British Columbia, 4th Floor, 2775 Laurel Street, Vancouver, BC Canada V5Z 1 M9
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Samora JB, Bashook P, Jones A, Milbrandt T, Mazzocca AD, Quinn RH. Orthopaedic Graduate Medical Education: A Changing Paradigm. JBJS Rev 2014; 2:01874474-201411000-00001. [DOI: 10.2106/jbjs.rvw.n.00005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Manring MM, Panzo JA, Mayerson JL. A framework for improving resident research participation and scholarly output. JOURNAL OF SURGICAL EDUCATION 2014; 71:8-13. [PMID: 24411416 DOI: 10.1016/j.jsurg.2013.07.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 06/25/2013] [Accepted: 07/19/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVES The Accreditation Council for Graduate Medical Education requires that "faculty should encourage and support residents in scholarly activities." There are no guidelines, however, to illustrate how this should be done, and only a small number of published reports offer examples of successful efforts to spur resident research. We sought to improve our residents' participation in scholarly activities. DESIGN We describe a multifaceted program to quickly build resident scholarship at an orthopaedic department. SETTING Large academic medical center in the Midwestern United States. PARTICIPANTS An experienced medical editor was recruited to assist faculty and mentor residents in coordinating research projects and to direct publishing activity. Additional publishing requirements were added to the resident curriculum beyond those already required by the Accreditation Council for Graduate Medical Education. Residents were required to select a faculty research mentor to guide all research projects toward a manuscript suitable for submission to a peer-reviewed journal. Activities were monitored by the editor and the resident coordinator. RESULTS Over 4 years, total department peer-reviewed publications increased from 33 to 163 annually. Despite a decrease in resident complement, the number of peer-reviewed publications with a resident author increased from 6 in 2009 to 53 in 2012. CONCLUSIONS The addition of an experienced medical editor, changes in program requirements, and an increased commitment to promotion of resident research across the faculty led to a dramatic increase in resident publications. Our changes may be a model for other programs that have the financial resources and faculty commitment necessary to achieve a rapid turnaround.
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Affiliation(s)
- M M Manring
- Department of Orthopaedics, The Ohio State University, Columbus, Ohio
| | - Julia A Panzo
- Department of Orthopaedics, The Ohio State University, Columbus, Ohio
| | - Joel L Mayerson
- Department of Orthopaedics, The Ohio State University, Columbus, Ohio.
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Namdari S, Jani S, Baldwin K, Mehta S. What is the relationship between number of publications during orthopaedic residency and selection of an academic career? J Bone Joint Surg Am 2013; 95:e45. [PMID: 23553308 DOI: 10.2106/jbjs.j.00516] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Although many residents partake in academic pursuits, including the publication of clinical studies, laboratory research, case reports, and review articles, it is uncertain whether such experiences are associated with a career-long interest in an academic orthopaedic career. METHODS This single-institution study was conducted with use of data from an urban academic university-based residency program. An academic career was defined as attainment of a teaching title signifying inclusion in, or affiliation with, a teaching department. Additionally, an academic career was subclassified as either full academic or semi-academic on the basis of employment characteristics. A PubMed search was conducted for publications by all 130 orthopaedic surgery residents who began their training in our residency program during the 1987-1988 through 2003-2004 academic years. An analysis was performed to determine whether the number or type of publications during residency or demographic variables were associated with selection of an academic career on completion of training. RESULTS The mean total number of publications during residency was greater for individuals who chose an academic career (4.8) than for those who chose a nonacademic career (2.4). When the year of residency graduation was considered, a greater number of publications during residency correlated with a more recent year of graduation in residents who selected an academic position. There were no differences with regard to sex, possession of advanced degrees, or completion of an additional research year between individuals who selected an academic compared with a nonacademic career. CONCLUSIONS Graduates of our orthopaedic residency program who pursued an academic career were likely to have published more articles during residency compared with their nonacademic peers.
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Affiliation(s)
- Surena Namdari
- Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 2 Silverstein Building, Philadelphia, PA 19104, USA
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Ahmad S, De Oliveira GS, McCarthy RJ. Status of Anesthesiology Resident Research Education in the United States. Anesth Analg 2013; 116:205-10. [PMID: 23223116 DOI: 10.1213/ane.0b013e31826f087d] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Atesok KI, Hurwitz SR, Egol KA, Ahn J, Owens BD, Crosby LA, Pellegrini VD. Perspective: Integrating research into surgical residency education: lessons learned from orthopaedic surgery. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2012; 87:592-597. [PMID: 22450176 DOI: 10.1097/acm.0b013e31824d2b57] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Orthopaedic research has advanced tremendously in parallel with accelerated progress in medical science. Possession of a fundamental understanding of basic and clinical science has become more essential than previously for orthopaedic surgeons to be able to translate advances in research into clinical practice. The number of medical graduates with prior education in scientific research who choose to pursue careers in orthopaedic surgery is small. Therefore, it is important that a core of research education be included during residency training to ensure the continued advancement of the clinical practice of orthopaedics. The authors examine some of the challenges to a comprehensive research experience during residency, including deficient priority, inadequate institutional infrastructure, financial strain on residency budgets, restricted time, and an insufficient number of mentors to encourage and guide residents to become clinician-scientists. They also present some strategies to overcome these challenges, including development and expansion of residency programs with clinician-scientist pathways, promotion of financial sources, and enhancement of opportunities for residents to interact with mentors who can serve as role models. Successful integration of research education into residency programs will stimulate future orthopaedic surgeons to develop the critical skills to lead musculoskeletal research, comprehend related discoveries, and translate them into patient care. Lessons learned from incorporating research training within orthopaedic residency programs will have broad application across medical specialties-in both primary and subspecialty patient care.
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Affiliation(s)
- Kivanc I Atesok
- University of Toronto, Institute of Medical Science, Ontario, Canada
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Dy CJ, Cross MB, Osbahr DC, Parks ML, Green DW. What opportunities are available for resident involvement in national orthopedic and subspecialty societies? Orthopedics 2011; 34:e669-73. [PMID: 21956064 DOI: 10.3928/01477447-20110826-13] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
As physician involvement in health policy grows, there will be an increasing need for future leaders in orthopedics. Interested orthopedic residents may be unaware of opportunities for leadership involvement in professional and subspecialty organizations. This article investigates whether national and subspecialty organizations offer membership to residents, allow residents to participate in committees, and provide opportunities for scholarly activity and mentorship. The authors surveyed 20 national orthopedic professional and subspecialty societies to evaluate the availability and cost of resident membership, meeting attendance and participation, research funding, committee membership, and mentorship opportunities. Each society's Web site was reviewed, and societies were contacted by phone if further inquiry was needed. Of the 20 orthopedic societies surveyed, 11 allowed resident membership. Five of 20 societies allowed residents to serve on committees, with a total of 14 total positions for residents. Four organizations provided formalized mentorship programs to residents. Although opportunities for resident involvement in subspecialty and professional societies are available in the majority of groups surveyed, the Orthopaedic Trauma Association and American Society for Surgery of the Hand provided the most comprehensive collection of opportunities. Residents should also pursue involvement in other organizations that may be more readily accessible, such as local, state, and regional orthopedic and medical societies. Increased resident participation in these organizations may help in increasing the 14 nationally available committee positions for orthopedic residents. Our orthopedic profession and societies should encourage motivated residents to pursue involvement and leadership at the national level.
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Picarella EA, Simmons JD, Borman KR, Replogle WH, Mitchell ME. "Do one, teach one" the new paradigm in general surgery residency training. JOURNAL OF SURGICAL EDUCATION 2011; 68:126-129. [PMID: 21338969 DOI: 10.1016/j.jsurg.2010.09.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Accepted: 09/29/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE There is literature examining the total number of procedures performed by surgery residents before and after duty hour restrictions (DHR). There is insufficient literature addressing the effect of DHR on the number of procedures in which residents directly participate as an assistant, rather than as the primary operating surgeon. METHODS The operative experience of general surgery residents completing training at the University of Mississippi Medical Center from 2002 to 2008 was retrospectively examined. Data collected included all procedures entered into the General Surgery Operative Log of the American Council on Graduate Medical Education web site in each of the following categories: Surgeon Chief (SC), Surgeon Junior (SJ), Teaching Assistant (TA), and First Assistant (FA). RESULTS A total of 31 residents completed the program during the study period. Linear regression analysis revealed a significant decrease in the total number of operative procedures (p < 0.05, slope = -55.23, r = -0.99) and the number of procedures reported as FA (p < 0.05, slope = -75, r = -0.89) over the 7-year period. The number of procedures in which residents functioned as the primary surgeon (SJ and SC) or TA remained constant. CONCLUSIONS Since the implementation of DHR at our institution, the number of procedures in which residents participate as a FA has declined. A surgeon is the sum of his or her cumulative operative experience, whether as the operating surgeon or assistant surgeon; one must conclude that the surgical residents' total operative experience at our institution has declined since the inception of the DHR.
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Affiliation(s)
- Emile A Picarella
- Department of Surgery, The University of Mississippi Medical Center, Jackson, Mississippi 39216, USA
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Kramer M. Sleep loss in resident physicians: the cause of medical errors? Front Neurol 2010; 1:128. [PMID: 21188260 PMCID: PMC3008836 DOI: 10.3389/fneur.2010.00128] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 09/03/2010] [Indexed: 11/15/2022] Open
Abstract
This review begins with the history of the events starting with the death of Libby Zion that lead to the Bell Commission, that the studied her death and made recommendations for improvement that were codified into law in New York state as the 405 law that the ACGME essentially adopted in putting a cap on work hours and establishing the level of staff supervision that must be available to residents in clinical situations particularly the emergency room and acute care units. A summary is then provided of the findings of the laboratory effects of total sleep deprivation including acute total sleep loss and the consequent widespread physiologic alterations, and of the effects of selective and chronic sleep loss. Generally the sequence of responses to increasing sleep loss goes from mood changes to cognitive effects to performance deficits. In the laboratory situation, deficits resulting from sleep deprivation are clearly and definitively demonstrable. Sleep loss in the clinical situation is usually sleep deprivation superimposed on chronic sleep loss. An examination of questionnaire studies, the literature on reports of sleep loss, studies of the reduction of work hours on performance as well as observational and a few interventional studies have yielded contradictory and often equivocal results. The residents generally find they feel better working fewer hours but improvements in patient care are often not reported or do not occur. A change in the attitude of the resident toward his role and his patient has not been salutary. Decreasing sleep loss should have had a positive effect on patient care in reducing medical error, but this remains to be unequivocally demonstrated.
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Affiliation(s)
- Milton Kramer
- College of Medicine, University of Illinois at Chicago Chicago, IL, USA
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