The Art and Science of Mentorship in Cardiothoracic Surgery: A Systematic Review of the Literature

Reconfiguration of low-voltage distributed power sources within electric power's distribution network based on improved particle swarm-fish swarm fusibility algorithm

With the development of distributed power sources in the distribution network, the algorithm of distribution network reconfiguration is gaining attention from experts and scholars. Its goal is to reduce the power loss during power transmission, so as to reduce the power grid loss during power transmission. And weaken the electric heating effect in the process of electric energy transmission, thus maintaining the safety of the surrounding residents. Due to the wire impedance effect, a lot of electric energy of the circuit is lost to electric heating, which is easy to cause local overheating and lead to fire. This will not only cause power loss, but also endanger the safety of surrounding residents. To address the issue, experiments on distribution grid reconstruction are performed using the enhanced particle swarm-fish swarm algorithm with the Elecgrid self-constructed dataset. Initially, low-voltage distributed power sources in parallel are connected to the circuit, thereby decreasing internal resistance and electrical heat. Then, by controlling the circuit in the system, the double separation relay adjusts the inductance and capacitance of the conductor, thus reducing the reactance length. Additionally, particle swarm particles are mutated to enable them to jump out of the local optimum, and elite fish approach is used to expand the search area. Finally, the proposed fusion algorithm is applied to the self-built data set of Elecgrid and compared with the other three algorithms. The fusion algorithm serves as the standard test system for this comparison. The active power loss of the hybrid algorithm is 63 kW at an operating voltage of 0.74 V. The loss work of the other three algorithms is 74 kW, 97 kW and 109 kW respectively. The mixed algorithm has the lowest loss among the four algorithms. The experiments are repeated for six times, and the linear fitting degrees of the four algorithms are 0.9804, 0.9527, 0.9612 and 0.9503, respectively. The experimental results show that the application of this algorithm can effectively reduce the active loss in the process of distribution network reconfiguration, thus reducing energy consumption; At the same time, it can reduce the electric heating in the process of electric energy transmission, and then prevent the occurrence of fire. There are three main contributions of this study. Firstly, the resistance in the transmission path is reduced by using this algorithm, so that the power transmission efficiency can be analyzed more accurately. Secondly, the new algorithm enriches the power safety maintenance method; Finally, the fire caused by local overheating of the line is reduced by fusion algorithm.

Finding the Right Mentor

Quality mentorship is essential for a successful career in cardiothoracic surgery. From the premedical phase to the position of senior faculty, there are many benefits to having mentors who can provide insight, promote career advancement and facilitate professional opportunities. It is important to distinguish between a mentor and sponsor in seeking this career guidance because both are beneficial but serve different purposes. By being clear about one's professional goals, the mentor-mentee relationship can be optimized and lead to a fulfilling and productive career.

Diversity in the Cardiothoracic Surgery Workforce: What I Can Do

Within the cardiothoracic surgery workforce, there are significant gaps in the numbers of women and underrepresented in medicine minorities, but some progress has been made in gender diversity at the resident level. Individual surgeons play an important role in combatting discrimination and harassment, while also promoting women and minorities through mentorship and sponsorship. More importantly, a multifaceted and structured approach is needed to increase diversity at the institutional level with strategies to create a culture of inclusion, working to retain underrepresented minority and female surgeons, and eliminating bias in the recruitment process.

The Growing Years: Promoting Yourself in the First 5 Years

There are several transitions that must be made to define your new role as an attending surgeon. Establishing these transitions can be difficult but trying to promote yourself while undergoing these awkward transitions can be taxing but nevertheless crucial. Whether you are in private practice trying to obtain referrals to build your practice or in an academic setting where you are trying to find your niche, promoting yourself along the way is imperative for your future growth. There are 3 core transitions in the first 5 years: (1) clinical, (2) professional, and (3) personal.

A scoping review of mentorship in allied health: Attributes, programs and outcomes

BACKGROUND

Mentorship is a mutually beneficial voluntary relationship between mentor and mentee. In principle, the mentee trusts in the mentor for guiding career development and acquiring new knowledge and skills while the mentor finds giving back to the profession rewarding. Mentorship is beneficial at every career stage, but little is known about current programs and processes.

OBJECTIVE

To review the literature about mentorship in allied health to inform programs and practices in occupational therapy. Scoping focused on barriers, facilitators and reported outcomes of programs and attributes of mentors and mentees.

DATA SOURCES

A search was applied to six databases on 8 February 2022 in Ovid MEDLINE, Ovid Embase, Scopus, PUBMED and CINAHL Complete. Search terms were developed in consultation with an academic librarian and using the population, concept and context mnemonic.

METHODS

We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and the JBI Manual for Evidence Synthesis. Data extraction forms were piloted with two reviewers and dual extraction occurred with a portion of papers. Where conflicts arose, discussion occurred until a consensus was reached.

FINDINGS

Sixty-two papers were included from eleven countries. The papers arose from ten allied health disciplines, with five in occupational therapy. One-on-one mentoring was most common followed by groups and the use of online platforms. Structured approaches were often used, with the support of professional associations. Trust and willingness to share expertise were required attributes of mentors. Mentees appreciate self-selecting their mentor and having protected time for mentorship.

CONCLUSION AND SIGNIFICANCE

This synthesis provides a description of the available literature on mentorship in allied health. Benefits of mentorship were recorded with the acquisition of skills and knowledge being the most prominent. This synthesis provides ideas for future development and refinement of mentorship in occupational therapy.

Global cardiothoracic surgery: A survey of trainees' interests and barriers

Background

More than 5 billion people lack access to surgical care, disproportionately in low- and middle-income countries. The emerging literature demonstrates high interest in global surgery across specialties; however, participation in global cardiothoracic surgical care remains low. To date, there has been no research quantifying the attitudes of cardiothoracic surgeons about global surgery. Our study aimed to acquire a broader understanding of cardiothoracic surgical trainees' interest in global surgery to address barriers and promote cardiac healthcare worldwide.

Methods

An online survey was sent to all North American cardiothoracic surgical residents via the Thoracic Surgery Residents Association email listserv. The survey was designed in the REDCap database and administered twice, in 2021 and 2022. Data were analyzed by descriptive and chi-square analysis using Stata.

Results

Seventy-three cardiothoracic surgical trainees responded to our survey, of whom 95.3% considered increasing cardiothoracic surgical access to be important, and 67.2% identified this as a future career priority. Most respondents (82.8%) would participate in global surgery if opportunities were available through their home institution. Lack of opportunities (70.0%) and finances (66.7%) were the primary barriers to participation. Respondents identified funding (85%) and institutional support (83.3%) as the most significant incentives to increase involvement.

Conclusions

There is strong interest in global surgery among cardiothoracic trainees; however, involvement remains low. A consensus among the North American cardiothoracic surgical community is needed to address barriers to global volunteerism within surgical residency and improve access to cardiac surgery worldwide.

The Impact of Congenital Cardiac Surgery Fellowship on Training and Practice

BACKGROUND

In 2007, congenital cardiac surgery became a recognized fellowship by the American Council of Graduate Medical Education (ACGME). Beginning in 2023, the fellowship transitioned from a 1-year to a 2-year program. Our objective is to provide current benchmarks by surveying current training programs and assessing characteristics contributing to career success.

METHODS

This was a survey-based study in which tailored questionnaires were distributed to program directors (PDs) and graduates of the ACGME accredited training programs. Data collection included responses to multiple-choice and open-ended questions relevant to didactics, operative training, training center characteristics, mentorship, and employment characteristics. Results were analyzed using summary statistics and subgroup and multivariable analyses.

RESULTS

The survey yielded responses from 13 of 15 PDs (86%) and 41 of 101 graduates (41%) from ACGME accredited programs. Perceptions among PDs and graduates were somewhat discordant, with PDs more optimistic than graduates. Of PDs, 77% (n = 10) believed current training adequately prepares fellows and is successful in securing employment for graduates. The responses from graduates demonstrated 30% (n = 12) were dissatisfied with operative experience and 24% (n = 10) with overall training. Being supported during the first 5 years of practice was significantly associated with retention in congenital cardiac surgery and greater practicing case volumes.

CONCLUSIONS

Dichotomous views exist between graduates and PDs regarding success in training. Mentorship during the early career was associated with increased case volumes, career satisfaction, and retention in the congenital cardiac surgery field. Educational bodies should incorporate these elements during training and after graduation.

Early Barriers to Career Progression of Women in Surgery and Solutions to Improve Them: A Systematic Scoping Review

OBJECTIVE

This study aims to summarize the evidence concerning the barriers that exist to the career progression of women in surgery and to provide potential solutions to overcome these obstacles.

BACKGROUND

Visible and invisible impediments can hinder female doctors' pursuit of a surgical career, from choosing a surgical specialty to training opportunities and all the way through career progression.

METHODS

Database search of original studies about barriers for female surgeons during choice of surgical career, residency, and career progression. A query including possible solutions such as mentorship and network was included.

RESULTS

Of 4618 total articles; 4497 were excluded as duplicates, having incorrect study focus, or not being original studies; leaving 120 studies meeting the inclusion criteria. Of the articles included, 22 (18%) focused on factors affecting the pursuit of a surgical career, such as surgical work hours and limited time for outside interests, 55 (46%) analyzed the main barriers that exist during surgical residency and fellowship training, such as discrimination and sexual harassment, 27 (23%) focused on barriers to career advancement, heavy workloads, ineffective mentorship, unclear expectations for advancement, inequality in pay or work-home conflicts. Among studies reporting on possible solutions, 8 (6.5%) articles reported on the role of effective mentorship to support career advancement and to provide moral support and 8 (6.5%) on the emerging role of social media for networking. Our analysis showed how different impediments hinder surgical career progression for women, with notable consequences on burnout and attrition.

CONCLUSIONS

Identification and recognition of obstacles to career progression is the first step to addressing the gender gap in surgery. Active strategies should be improved to promote a culture of diversity and to create equal opportunity for women in surgery, while implementing structured mentoring programs and investing on an adequate communication on social media to engage the future generations.

Demographic Landscape of Cardiothoracic Surgeons and Residents at United States Training Programs

BACKGROUND

Recruiting and promoting women and racial/ethnic minorities could help enhance diversity and inclusion in the academic cardiothoracic (CT) surgery workforce. However, the demographics of trainees and faculty at US training programs have not yet been studied.

METHODS

Traditional, integrated (I-6), and fast-track (4+3) programs listed in the Accreditation Council for Graduate Medical Education (ACGME) public database were analyzed. Demographics of trainees and surgeons, including gender, race/ethnicity, subspecialty, and academic appointment (if applicable), were obtained from ACGME Data Resource Books, institutional websites, and public profiles. Chi-square and Cochran-Armitage trend tests were performed.

RESULTS

In July 2020, 78 institutions had at least one CT surgery training program; 40 (51%) had only a traditional program, 20 (26%) traditional and I-6, 6 (8%) all three types of program, and 4 (5%) only I-6. The proportion of female trainees increased significantly from 2011 to 2019 (19% vs 24%, p<0.001), with female I-6 trainees outnumbering female traditional trainees since 2018. Significant increases by race/ethnicity were observed overall and by program type, notably for Asians and Hispanics in I-6 programs and Blacks in traditional programs. Finally, of the 1,175 CT surgeons identified, 633 (54%) were adult cardiac surgeons, 360 (37%) assistant professors, 116 (10%) women, and 33 (3%) Black.

CONCLUSIONS

The demographic landscape of CT surgery trainees and faculty across multiple training pathways reflects increasing representation by gender and race/ethnicity. However, we must continue to work toward equitable representation in the workforce to benefit the diverse patients we treat.

Showcasing Your Cardiothoracic Training Program in the Virtual Era

As part of the response to the coronavirus disease 2019 (COVID-19) pandemic, cardiothoracic training programs quickly transitioned midinterview season toward a virtual format. This monumental and rapid undertaking led to the adoption of novel virtual interviewing techniques, many of which have been developed and partially rolled out by other specialties for years. The COVID-19 pandemic is still here, and when the end will be in sight is unclear. However, most, if not all, of the novel interview techniques that were rapidly adopted by cardiothoracic training programs during the 2020 interview season will continue to be relevant even after the pandemic and need for social distancing subsides. In this literature review, we highlight techniques that can be used by cardiothoracic training programs to virtually showcase their attributes and strengths to give applicants as realistic of a view of the program as possible. Such efforts include developing and emphasizing a social media presence, expanding information within training program websites, broadcasting virtual educational content, and creating virtual tours. In addition, we will review approaches toward structuring a virtual interview day to provide candidates with a deeper glimpse into the inner workings of the program. We can use this opportunity provided by the COVID-19 pandemic to develop innovative methods of conducting fellowship interviews that may persist long into the future, as we consider limitations historically caused by finances, scheduling, clinical responsibilities, and family needs.