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Freudenberger DC, Riner AN, Herremans KM, Vudatha V, McGuire KP, Anand RJ, Trevino JG. A Gravid Situation: General Surgery Faculty Support for Pregnant Surgical Residents. J Surg Res 2024; 299:9-16. [PMID: 38677003 DOI: 10.1016/j.jss.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/05/2024] [Accepted: 03/11/2024] [Indexed: 04/29/2024]
Abstract
INTRODUCTION The perceptions of teaching faculty toward pregnant general surgery residents have been overlooked despite the daily interactions amongst these groups. METHODS A 32-question survey designed to measure general surgery teaching faculty perceptions toward pregnant residents was distributed electronically from March 2022 to April 2022 to general surgery teaching faculty in the United States. Descriptive statistics were used to characterize responses and differences in perceptions, and qualitative analysis identified recurring themes from free-text responses. RESULTS Among 163 respondents included in the final analysis, 58.5% were male and 41.5% were female. Despite 99.4% of surgeons feeling comfortable if a resident told them they were pregnant, 22.4% of surgeons disagreed that their institutions have supportive cultures toward pregnancy. Almost half (45.4%) have witnessed negative comments about pregnant residents and half (50.3%) believe that pregnant surgical residents are discriminated against by their coresidents. Nearly two-thirds of surgeons (64.8%) believe that someone should have a child whenever they wish during training. Given recent reports, 80.2% of surgeons recognized that female surgeons have increased risks of infertility and pregnancy complications. Recurring themes of normalizing pregnancy, improving policies, and creating a culture change were expressed. CONCLUSIONS In this national survey, although there appears to be positive perceptions of pregnancy in surgical training amongst those surveyed, there is acknowledged necessity of further normalizing pregnancy and improving policies to better support pregnant residents. These data provide further evidence that though perceptions may be improving, changes are still needed to better support pregnancy during training.
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Affiliation(s)
- Devon C Freudenberger
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Andrea N Riner
- Department of Surgery, University of Florida College of Medicine, Gainesville, Florida
| | - Kelly M Herremans
- Department of Surgery, University of Florida College of Medicine, Gainesville, Florida
| | - Vignesh Vudatha
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Kandace P McGuire
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Rahul J Anand
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Jose G Trevino
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
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Rabenstein AP, Santore LA, Starnes SL, Van Haren RM, Balaguer JM, Abdel-Misih S. Cardiac Surgery Exposure in General Surgery Residency-A Survey of General Surgery Residency Program Directors. JOURNAL OF SURGICAL EDUCATION 2023; 80:633-638. [PMID: 36774212 DOI: 10.1016/j.jsurg.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/05/2022] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Little is known regarding how much exposure general surgery residents have to cardiac surgery, despite cardiothoracic (CT) surgery being an offered postresidency fellowship and career. Exposure to a subspecialty is important in shaping residents' interests and career decisions. METHODS A survey was sent to all general surgery program directors via the Association of Program Directors in Surgery examining cardiac surgery exposure during training. The survey examined the presence of operative rotations in cardiac surgery and cardiac critical care, portions of cases residents were permitted to perform, cardiac surgery mentorship and education, and perceived biases in applying to cardiac surgery. Differences between programs with and without cardiothoracic training programs were analyzed. RESULTS In total, 44% (102/230) of program directors responded to the survey. Residents were involved in operative cardiac and cardiac ICU rotations in 61 programs (69.8%) and 39 programs (38.2%), respectively. Twenty programs (19.6%) had a dedicated cardiothoracic surgery training program and these programs had significantly more graduates who aspired to be cardiac surgeons (M = 2.75, SD = 2.47) compared to hospitals with no CT programs (M = 1.43, SD = 1.41; p = 0.031). 35.3% of program directors reported resident concern over family life. CONCLUSIONS There is a notable heterogeneity in general surgery resident exposure to cardiac surgery, cardiac ICU, and cardiac surgery mentorship. Increased exposure, mentorship and mitigating resident concern over the impact of social factors on cardiac surgical careers should be key areas of focus to ensure continued encouragement of future trainees and surgeons.
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Affiliation(s)
- Andrew P Rabenstein
- AHN Cardiovascular Institute at Allegheny General Hospital, Department of Thoracic and Cardiovascular Surgery, Pittsburgh, Pennsylvania.
| | - Lee Ann Santore
- Department of Surgery, Division of Cardiothoracic Surgery, Stony Brook University Hospital, Stony Brook, New York
| | - Sandra L Starnes
- Department of Surgery, Division of Thoracic Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Robert M Van Haren
- Department of Surgery, Division of Thoracic Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jorge M Balaguer
- Department of Surgery, Division of Cardiothoracic Surgery, Stony Brook University Hospital, Stony Brook, New York
| | - Sherif Abdel-Misih
- Department of Surgery, General Surgery Residency, Stony Brook University Hospital, Stony Brook, New York
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Breindahl N, Khan F, Skipper M, Nielsen AB, Friis ML, Paltved C, Jensen RD, Kurtzhals JAL, Konge L, Nayahangan LJ. Exploring training needs of newly graduated medical doctors to inform the undergraduate simulation-based curriculum: a national Delphi consensus study. Postgrad Med J 2023; 99:37-44. [PMID: 36947424 DOI: 10.1093/postmj/qgac002] [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: 07/25/2022] [Revised: 09/21/2022] [Accepted: 10/01/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE Mastering technical procedures is a key component in succeeding as a newly graduated medical doctor and is of critical importance to ensure patient safety. The efficacy of simulation-based education has been demonstrated but medical schools have different requirements for undergraduate curricula. We aimed to identify and prioritize the technical procedures needed by newly graduated medical doctors. METHODS We conducted a national needs assessment survey using the Delphi technique to gather consensus from key opinion leaders in the field. In the first round, a brainstorm was conducted to identify all potential technical procedures. In the second round, respondents rated the need for simulation-based training of each procedure using the Copenhagen Academy for Medical Education and Simulation Needs Assessment Formula (CAMES-NAF). The third round was a final elimination and prioritization of the procedures. RESULTS In total, 107 experts from 21 specialties answered the first round: 123 unique technical procedures were suggested. Response rates were 58% and 64% in the second and the third round, respectively. In the third round, 104 procedures were eliminated based on the consensus criterion, and the remaining 19 procedures were included and prioritized. The top five procedures were: (i) insert peripheral intravenous catheter, (ii) put on personal protection equipment, (iii) perform basic airway maneuvers, (iv) perform basic life support, and (v) perform radial artery puncture. CONCLUSION Based on the Delphi process a final list of 19 technical procedures reached expert consensus to be included in the undergraduate curriculum for simulation-based education.
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Affiliation(s)
- Niklas Breindahl
- Center for HR and Education, Copenhagen Academy for Medical Education and Simulation (CAMES), Copenhagen 2100, Denmark
| | - Farsana Khan
- Center for HR and Education, Copenhagen Academy for Medical Education and Simulation (CAMES), Copenhagen 2100, Denmark
| | - Mads Skipper
- Postgraduate Medical Education Region North, Viborg 8800, Denmark
| | - Anders Bo Nielsen
- SimC, Odense University Hospital, Region of Southern Denmark, Odense 5000, Denmark
| | | | | | - Rune Dall Jensen
- Corporate HR MidtSim, Central Denmark Region, Aarhus 8200, Denmark
| | - Jørgen A L Kurtzhals
- Department of Immunology and Microbiology, University of Copenhagen, Copenhagen 2100, Denmark
- Department of Clinical Microbiology, Copenhagen University Hospital (Rigshospitalet), Copenhagen 2100, Denmark
| | - Lars Konge
- Center for HR and Education, Copenhagen Academy for Medical Education and Simulation (CAMES), Copenhagen 2100, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2100, Denmark
| | - Leizl Joy Nayahangan
- Center for HR and Education, Copenhagen Academy for Medical Education and Simulation (CAMES), Copenhagen 2100, Denmark
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Anderson TN, Kearse LE, Shi R, Kaba A, Schmiederer IS, Huffman EM, Ritter EM, Korndorffer JR. Surgical endoscopy education research: how are we doing? Surg Endosc 2022; 36:8403-8407. [PMID: 35194666 DOI: 10.1007/s00464-022-09104-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 02/07/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Surgical endoscopy (SE), the official journal of the Society of American Gastrointestinal and Endoscopic Surgeons and the European Association for Endoscopic Surgery, is an important source of new evidence pertaining to surgical education in the field. However, qualitative deficiencies in medical education research have prompted medical education leaders to advocate for increased methodological rigor. The purpose of this study is to review the quality of education-focused research published through SE. METHODS A PubMed search examining all SE articles categorized as education-related research from 2010 to 2019 was conducted; studies not meeting inclusion criteria were excluded. Remaining publications were independently reviewed, classified, and scored by 7 raters using the medical education research study quality instrument (MERSQI). Intraclass correlation was calculated and data were examined with descriptive statistics. RESULTS A total of 227 studies met inclusion criteria. There was no significant difference in number of publications by year (average 25.88 [SD 5.6]); 60% were conducted outside of the United States, and 47% (n = 106) were funded. The average MERSQI was 12.5 (SD 2). Most studies used two-group non-random (42%, n = 96) or post/cross-sectional designs (29%, n = 65). Thirty-six (16%) were randomized controlled trials. Multi-institutional studies comprised 24% (n = 54). Of the manuscripts, 96% (n = 217) reported at least one measure of validity evidence and 28% (n = 67) described three levels of validity evidence. Studies primarily reported changes in skills or knowledge (45%, n = 103) or satisfaction or general facts (44%, n = 99), while patient-related outcomes encompassed 3% (n = 6) of studies. ICC between raters was 0.93 (CI 0.90-0.93, p < 0.001). CONCLUSIONS Based on publications to date, this journal's peer review process appears to facilitate the dissemination of education-related studies of moderate to good quality. However, there were uncovered deficits, ranging from validity evidence to study designs and level of outcomes. This journal's breadth of viewership offers a potential venue to advance education-related research.
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Affiliation(s)
- Tiffany N Anderson
- Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, P.O. Box 100286, Gainesville, FL, 32610, USA.
| | - LaDonna E Kearse
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Robert Shi
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Aboubacar Kaba
- Department of Urology, David Geffen School of Medicine at the University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | | | - Elizabeth M Huffman
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - E M Ritter
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - James R Korndorffer
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Naples R, Shin TH, French JC, Lipman JM. Beyond Medical Knowledge and Patient Care: A Program Director's Perspective for the Role of General Surgery Subinternships. JOURNAL OF SURGICAL EDUCATION 2021; 78:83-90. [PMID: 32646813 DOI: 10.1016/j.jsurg.2020.06.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/02/2020] [Accepted: 06/25/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Established primary goals of general surgery subinternships are improvement in patient care and medical knowledge. However, the secondary gains such as obtaining recommendation letters and forming relationships are apparent but poorly defined. We sought the opinion of general surgery program directors (PDs) on the secondary purposes of subinternships. Our aim is to aide mentors and students to optimize the subinternship experience relative to the residency application process. DESIGN A survey was administered in July 2019. This questionnaire consisted of 11 items and was broken down into 3 sections: demographics, PD perspective on the secondary goals of a general surgery subinternship, and the role of general surgery subinternships on the students' residency application. SETTING An online, national survey through the Association for Program Directors listserv. PARTICIPANTS United States general surgery PDs affiliated with the Association for Program Directors listserv. RESULTS Sixty-one PDs completed the survey from 42 (69%) academic and 14 (23%) community programs. The majority of PDs (n = 33, 54%) reported that assessment of a subintern's suitability for their residency was the most important secondary purpose. Furthermore, PDs (n = 24, 39%) valued a letter of recommendation from faculty the student worked with during a subinternship as the most important criteria in the interview selection process. Away rotations were perceived as of equal value to subinternships completed at the student's home institution. Overall, PD opinions were similar at academic and community programs. CONCLUSIONS Our study suggests subinternships significantly impact a student's application to general surgery residency, clarifying a secondary role for these rotations. Subinternships are important for PDs to assess a student for ranking at their program. All students should pursue a letter of recommendation from subinternship faculty, when possible, as they can heavily influence the interview selection process. Away rotations should only be recommended for those students who need to strengthen their application.
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Affiliation(s)
- Robert Naples
- Department of General Surgery, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
| | - Thomas H Shin
- Department of General Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Judith C French
- Department of General Surgery, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
| | - Jeremy M Lipman
- Department of General Surgery, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
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Dunn AN, Walsh RM, Lipman JM, French JC, Jeyarajah DR, Schneider EB, Delaney CP, Augustin T. Can an Academic RVU Model Balance the Clinical and Research Challenges in Surgery? JOURNAL OF SURGICAL EDUCATION 2020; 77:1473-1480. [PMID: 32768381 DOI: 10.1016/j.jsurg.2020.05.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/25/2020] [Accepted: 05/25/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The purpose of this study is to identify perceptions of academic surgeons regarding academic productivity and assess its relationship to clinical productivity. We hypothesized that these perceptions would vary based on respondent characteristics including clinical activity and leadership roles. DESIGN This retrospective, survey-based study was performed from August 26, 2019 to September 26, 2019. SETTING The setting was academic surgical departments across the US. PARTICIPANTS The survey instrument was administered to faculty members of the Association of Program Directors in Surgery. A total of 105 academic surgeons responded. RESULTS Most respondents were Program Directors (59%) of general surgery programs. Of the participants, 30% identified as Professor, 36% as Associate Professor, and 15% as Assistant Professor. Respondents agreed that multiple academic pursuits or factors should count towards academic productivity including the following (in descending order): completing a first-authored manuscript (98.8%), completing a senior-authored manuscript (97.7%), chairing a national committee (94.1%), serving on a national committee (88.2%), completing a second-authored manuscript (88.0%), completing a first lecture (83.7%), completing a middle-authored manuscript (71.8%), completing a lecture (whether or not repeated) (70.9%), impact factor of journal (60.7%), and attendance at grand rounds (57.0%). Perspectives did not vary significantly based on surgeon demographics, clinical setting, or leadership role (p > 0.05). CONCLUSIONS Perceptions regarding what constitutes academic productivity and merit a reduction in clinical expectation are remarkably similar across multiple surgeon characteristics including demographics, academic title, leadership role, and practice environment.
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Affiliation(s)
- Aaron N Dunn
- Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| | - R Matthew Walsh
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jeremy M Lipman
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
| | - Judith C French
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
| | - D Rohan Jeyarajah
- Department of Surgery, Texas Christian University, Fort Worth, Texas
| | - Eric B Schneider
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Conor P Delaney
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
| | - Toms Augustin
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio.
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