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Joel M, Iosif L, Grenda T, Tholey R. A Mentorship-Based Surgery Clerkship: A Prospective Study Investigating Student Satisfaction. J Surg Res 2024; 295:41-46. [PMID: 37980827 DOI: 10.1016/j.jss.2023.10.005] [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: 02/21/2023] [Revised: 09/12/2023] [Accepted: 10/16/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Interest in general surgery has steadily decreased among medical students due to negative perceptions of surgeons, a lack of meaningful clerkship involvement, and inadequate mentorship. We implemented a novel mentorship-based surgery clerkship (MBSC) in which each student was matched with a resident mentor with the goals of enhancing student learning experience, meaningfulness, and interest in surgery. We hypothesized that students participating in the MBSC would report increased confidence in surgical competencies, exposure to surgical faculty, and positive perception of surgery, with no detriment to clerkship grades. METHODS Mentors were instructed to provide the following when asked by the student: (1) weekly feedback; (2) personalized goals; (3) daily cases; (4) specific videos; (5) presentation subjects; (6) operating room skills coaching. A 5-point Likert Scale survey was distributed to the students pre and post clerkship, and median differences in Likert Scale Score pre and post mentorship were compared between mentored and control groups using the unpaired Wilcoxon's test. This was a two-arm, nonrandomized trial comparing traditional curriculum with the mentored program. RESULTS The total sample size was n = 84. When comparing mentored to control, Wilcoxon's analysis showed greater post clerkship increases in confidence in operating room etiquette (P = 0.03), participating in rounds (P = 0.02), and suturing (P < 0.01). There were greater increases in perceived surgeon compassion (P = 0.04), respectfulness (P < 0.01), and teaching ability (P < 0.01). Median scores for meaningfulness overall (P = 0.01) and as measured as a feeling of positively impacting a patient (P = 0.02) were also increased when comparing mentored to control. More students were encouraged by a surgeon to pursue surgery (P = 0.01) and consider a surgery career themselves (P = 0.02). CONCLUSIONS An MBSC increases meaningfulness, confidence, skills, and exposure in various surgical competencies. Compared to nonmentored students, MBSC students have more positive perceptions of surgeons and are more likely to pursue surgery.
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Affiliation(s)
- Marisa Joel
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Leah Iosif
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Tyler Grenda
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Renee Tholey
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.
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Rogers-Vizena CR, Saldanha FYL, Sideridis GD, Allan CK, Livingston KA, Nussbaum L, Weinstock PH. High-Fidelity Cleft Simulation Maintains Improvements in Performance and Confidence: A Prospective Study. JOURNAL OF SURGICAL EDUCATION 2023; 80:1859-1867. [PMID: 37679288 DOI: 10.1016/j.jsurg.2023.08.010] [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: 06/16/2023] [Revised: 08/03/2023] [Accepted: 08/14/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE High-fidelity simulation has a growing role in plastic surgical education. This study tests the hypothesis that cleft lip repair simulation followed by structured debriefing improves performance and self-confidence and that gains are maintained. DESIGN Prospective, single-blinded interventional study with repeated measures. Trainees performed cleft lip repair on a high-fidelity simulator followed by debriefing, immediately completed a second repair, and returned 3 months later for a third session. Anonymized simulation videos were rated using the modified Objective Structured Assessment of Technical Skills (OSATS) and the Unilateral Cleft Lip Repair competency assessment tool (UCLR). Self-assessed cleft lip knowledge/confidence and procedural self-confidence were surveyed after each simulation. SETTING Boston Children's Hospital, a tertiary care academic hospital in Boston, MA, USA. PARTICIPANTS All trainees rotating through the study setting were eligible. Twenty-six participated; 21 returned for follow-up. RESULTS Significant improvements (p < 0.05) occurred between the first and second simulations for OSATS, UCLR, and procedural self-confidence. Significant improvement occurred between the second and third simulations cleft lip knowledge/confidence. Compared to the first simulation, improvements were maintained at the third simulation for all variables. Training level moderately correlated with score for UCLR for the first simulation (r = 0.55, p < 0.01), deteriorated somewhat with the second (r = 0.35, p = 0.08), and no longer corelated by the third (r = 0.02, p = 0.92). CONCLUSIONS Objective performance and subjective self-assessed knowledge and confidence improve with high-fidelity simulation plus structured debriefing and improvement is maintained. Differences in procedure-specific performance seen with increasing training level are reduced with simulation, suggesting it may accelerate knowledge and skill acquisition.
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Affiliation(s)
- Carolyn R Rogers-Vizena
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts; Boston Children's Hospital Immersive Design Systems, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | - Francesca Y L Saldanha
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts
| | - Georgios D Sideridis
- Harvard Medical School, Boston, Massachusetts; Institutional Centers for Clinical & Translational Research, Boston Children's Hospital, Boston, Massachusetts
| | - Catherine K Allan
- Boston Children's Hospital Immersive Design Systems, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts
| | - Katie A Livingston
- Boston Children's Hospital Immersive Design Systems, Boston, Massachusetts
| | - Lisa Nussbaum
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts
| | - Peter H Weinstock
- Boston Children's Hospital Immersive Design Systems, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Anesthesia, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
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Pascarella L, Marulanda K, Duchesneau ED, Sanchez-Casalongue M, Kapadia M, Farrell TM. Preferred Feedback Styles Among Different Groups in an Academic Medical Center. J Surg Res 2023; 288:215-224. [PMID: 37028209 PMCID: PMC10681023 DOI: 10.1016/j.jss.2023.02.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 01/23/2023] [Accepted: 02/18/2023] [Indexed: 04/09/2023]
Abstract
INTRODUCTION Feedback is an essential component in complex work environments. Different generations have been shown to have different sets of values, derived from societal and cultural changes. We hypothesize that generational differences may be associated with preferred feedback patterns among medical trainees and faculty in a large academic institution. METHODS A survey was distributed to all students, residents/fellows, and faculty at a large academic medical institution from April 2020 through June 2020. Survey questions evaluated feedback methods for six domains: preparedness, performance, attitude, technical procedures, inpatient, and outpatient care. Participants selected a preferred feedback method for each category. Patient demographics and survey responses were described using frequency statistics. We compared differences in feedback preferences based on generation and field of practice. RESULTS A total of 871 participants completed the survey. Preferred feedback patterns in the medical field do not seem to align with sociologic theories of generational gaps. Most participants preferred to receive direct feedback after an activity away from their team, irrespective of their age or medical specialty. Individuals preferred direct feedback during an activity in front of their team only for technical procedures. Compared to nonsurgeons, surgeons were more likely to prefer direct feedback in front of team members for preparedness, performance, and attitude. CONCLUSIONS Generational membership is not significantly associated with preferred feedback patterns in this complex medical academic environment. Variations in feedback preferences are associated with field of practice that may be due to specialty-specific differences in culture and personality traits present within certain medical specialties, particularly surgery.
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Affiliation(s)
- Luigi Pascarella
- Department of Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Kathleen Marulanda
- Department of Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Emilie D Duchesneau
- Department of Epidemiology, Gillings School of Global Public Health, of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Manuel Sanchez-Casalongue
- Department of Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Muneera Kapadia
- Department of Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Timothy M Farrell
- Department of Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Sekkat H, Souadka A, Alaoui L, Rafik A, Belkhadir Z, Amrani L, Benkabbou A, Mohsine R, Majbar AM. The learning curve of laparoscopic rectal cancer surgery of millennial surgeons: Lessons for a safe implementation in low- and middle-income countries. J Minim Access Surg 2023; 19:296-304. [PMID: 37056092 PMCID: PMC10246625 DOI: 10.4103/jmas.jmas_78_22] [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: 02/19/2022] [Revised: 05/12/2022] [Accepted: 07/11/2022] [Indexed: 03/19/2023] Open
Abstract
Objective This study aimed to analyse the learning curve (LC) in laparoscopic rectal cancer resections of 2 millennial surgeons during the implementation of the first laparoscopic rectal cancer surgery programme in low- and middle-income country (LMIC) cancer centre. Methods All consecutive patients operated by two millennial surgeons for primary rectal adenocarcinoma between January 2018 and March 2020 were included. The LC was analysed for operative duration and conversion to open surgery using both cumulative sum (CUSUM) and/or variable life-adjusted display (VLAD) charts. Results Eighty-four patients were included, 45 (53.6%) men with a mean age of 57.3 years. Abdominoperineal resection was performed in 31 (36.9%) cases and resections were extended to other organs in 20 (23.8%) patients. Thirteen patients (15.5%) had conversion to open surgery. Using CUSUM, Learning curve based on conversion was completed at 12 cases for the first surgeon versus 10 cases for the second. While using VLAD and learning curve-CUSUM (LC-CUSUM), the cases needed were 26 vs 24 respectively. The median operative duration was 314 min with a LC completed at cases (17 vs. 26), and (18 vs. 29) using, respectively, standard and LC-CUSUM. Conclusions This study shows a safe and short LC of millennial surgeons during the implementation of a laparoscopic rectal cancer surgery in an LMIC cancer centre, and the valuable use of modern statistical methods in the prospective assessment of LC safety during surgical training.
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Affiliation(s)
- Hamza Sekkat
- Department of Digestive Surgical Oncology, National Institute of Oncology, IBN Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Amine Souadka
- Department of Digestive Surgical Oncology, National Institute of Oncology, IBN Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Leila Alaoui
- Department of Statistics, Cancer Research Institute, Fez, Morocco
| | - Ali Rafik
- Department of Digestive Surgical Oncology, National Institute of Oncology, IBN Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Zakaria Belkhadir
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
- Department of Anesthesiology and Intensive Care, National Institute of Oncology, IBN Sina University Hospital, Rabat, Morocco
| | - Laila Amrani
- Department of Digestive Surgical Oncology, National Institute of Oncology, IBN Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Amine Benkabbou
- Department of Digestive Surgical Oncology, National Institute of Oncology, IBN Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Raouf Mohsine
- Department of Digestive Surgical Oncology, National Institute of Oncology, IBN Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Anass Mohammed Majbar
- Department of Digestive Surgical Oncology, National Institute of Oncology, IBN Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
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Mitzman B, Smith BK, Varghese TK. Resident Training in Robotic Thoracic Surgery. Thorac Surg Clin 2023; 33:25-32. [DOI: 10.1016/j.thorsurg.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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A concept for adapting medical education to the next generations via three-staged digital peer teaching key feature cases. Wien Med Wochenschr 2022; 173:108-114. [PMID: 36542219 DOI: 10.1007/s10354-022-00990-7] [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: 02/18/2022] [Accepted: 11/09/2022] [Indexed: 12/24/2022]
Abstract
While the core principles of medical education remain the same, the students' socioecological backgrounds, values and learning requirements are constantly changing. Bridging the generation gap between teachers and students is a key challenge of medical didactics. To meet the demands of today's classroom, we piloted a novel three-stage peer teaching and key feature concept. First, an on-demand key feature video case was presented. Second a background video was launched, followed by a self-assessment tool. Third, a live case discussion webinar focusing on clinical reasoning was held. The contents were created by near-peers experienced in medical didactics and checked by clinical experts. The elective format resonated with 652 participating graduate students and 1250 interactions per webinar, suggesting that students' strengths and weaknesses were addressed adequately. We aim to provide educators with input for creating a flexible and integrative learning environment utilising modern technological and didactic tools that shape the healthcare workers of tomorrow.
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Medical Students and the Drive for a Single Right Answer: Teaching Complexity and Uncertainty. ATS Sch 2022; 3:27-37. [PMID: 35633993 PMCID: PMC9131886 DOI: 10.34197/ats-scholar.2021-0083ps] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 10/05/2021] [Indexed: 01/24/2023] Open
Abstract
The arrival of Generation Z, the next generation of medical learners, has been accompanied by efforts to adapt teaching practices for this new group of students. Many have identified challenges associated with addressing the needs of modern medical learners. One particular trend we have observed is that medical students are increasingly requesting an “answer key” for all aspects of their medical education. Students often expect to have the correct answers readily available to them to ensure they have reached the correct conclusion and to determine the precise knowledge they need to master. Yet, for much of medicine, and particularly in the care of critically ill patients with multisystem disease in intensive care units, answers are uncertain, and the body of knowledge is ever-growing. Students’ regular requests for solutions to be provided to them threaten to undermine their development into critically thinking, self-sufficient physicians. We outline three potential contributors to this multifactorial problem and offer corresponding pedagogical solutions. Specifically, we address how prioritizing outcomes over process, discomfort with uncertainty, and fear of faltering can cause students to seek excessive levels of support that may ultimately do more harm than good. Addressing students’ concerns in these three key areas will not only serve students well during their undergraduate medical training but will also equip them with the skills needed to succeed in the clinical realm. To produce physicians capable of navigating an increasingly uncertain world, medical educators will need to help students appreciate that finding the answer is more complex than being provided an answer key.
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Luc JGY, Reddy RM, Corsini EM, Carrott PW, David EA, Shemanski K, Fabian T, McCarthy DP, Okereke I, Oliver AL, Turner SR, Vaporciyan AA, Antonoff MB. Are Esophagectomy Board Requirements Achievable? A Multi-Institutional Analysis. Semin Thorac Cardiovasc Surg 2021; 33:1158-1168. [PMID: 33711460 DOI: 10.1053/j.semtcvs.2021.02.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 02/01/2021] [Indexed: 11/11/2022]
Abstract
Duty-hour restrictions have implications on trainee operative exposure necessary to meet minimum case-volume requirements. We utilized a previously validated simulation model to evaluate the effect of program volume, trainee numbers and complement, and rotation schedule on the probability of achieving adequate esophagectomy case numbers for cardiothoracic surgery trainees. A ProModel simulator centered on probabilistic distributions of operative cases was utilized. Historical data from five 2-year cardiothoracic surgery training programs were obtained from 2016-2018 and used as inputs to the simulator that generated 10,000 "trainee 2-year periods" per program. Programs varied in annual average esophagectomy volume (12-91 per year), with 2-4 trainees graduating over a 2-year training period. If esophagectomy cases were distributed solely based on scheduling and institutional volume, only 60% of evaluated programs could adequately expose all trainees in esophagectomy to meet case requirements. The 3 programs with adequate esophagectomy volumes had averaged 3.3 times (range 3.0-3.6) the minimum number of board-required cases for their programs' trainees. The ability of programs to provide trainees with adequate esophagectomy volume is challenging based on institutional volume and scheduling. Through simulation, we demonstrate that programs need >2 times the expected minimum number of esophagectomies to ensure that >90% of trainees meet case-volume requirements. Programs may consider strategies such as allowing trainees to select cases based on personal need, train fewer fellows, or enable trainees to seek subspecialty exposure externally to achieve minimum esophagectomy case-load requirements.
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Affiliation(s)
- Jessica G Y Luc
- Division of Cardiovascular Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada; Thoracic Education Cooperative Group, Thoracic Surgical Directors Association, Chicago, Illionis
| | - Rishindra M Reddy
- Thoracic Education Cooperative Group, Thoracic Surgical Directors Association, Chicago, Illionis; Section of Thoracic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Erin M Corsini
- Thoracic Education Cooperative Group, Thoracic Surgical Directors Association, Chicago, Illionis; Department of Thoracic and Cardiovascular Surgery, UT MD Anderson Cancer Center, Houston, Texas
| | - Philip W Carrott
- Thoracic Education Cooperative Group, Thoracic Surgical Directors Association, Chicago, Illionis; Division of General Thoracic Surgery, Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Elizabeth A David
- Thoracic Education Cooperative Group, Thoracic Surgical Directors Association, Chicago, Illionis; Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, California
| | - Kimberly Shemanski
- Thoracic Education Cooperative Group, Thoracic Surgical Directors Association, Chicago, Illionis; Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, California
| | - Thomas Fabian
- Thoracic Education Cooperative Group, Thoracic Surgical Directors Association, Chicago, Illionis; Division of Thoracic Surgery, Albany Medical Center, Department of Surgery, Albany Medical College, Albany, New York
| | - Daniel P McCarthy
- Thoracic Education Cooperative Group, Thoracic Surgical Directors Association, Chicago, Illionis; Section of Thoracic Surgery, Division of Cardiothoracic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Ikenna Okereke
- Thoracic Education Cooperative Group, Thoracic Surgical Directors Association, Chicago, Illionis; Division of Cardiothoracic Surgery, University of Texas Medical Branch, Galveston, Texas
| | - Aundrea L Oliver
- Thoracic Education Cooperative Group, Thoracic Surgical Directors Association, Chicago, Illionis; Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University Brody School of Medicine, Greenville, North Carolina
| | - Simon R Turner
- Thoracic Education Cooperative Group, Thoracic Surgical Directors Association, Chicago, Illionis; Division of Thoracic Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Ara A Vaporciyan
- Thoracic Education Cooperative Group, Thoracic Surgical Directors Association, Chicago, Illionis; Department of Thoracic and Cardiovascular Surgery, UT MD Anderson Cancer Center, Houston, Texas
| | - Mara B Antonoff
- Thoracic Education Cooperative Group, Thoracic Surgical Directors Association, Chicago, Illionis; Department of Thoracic and Cardiovascular Surgery, UT MD Anderson Cancer Center, Houston, Texas; Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, California.
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Mentorship Effectiveness: This Is Our Responsibility. Ann Thorac Surg 2020; 112:651. [PMID: 33253671 DOI: 10.1016/j.athoracsur.2020.08.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 08/29/2020] [Indexed: 11/23/2022]
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Do-Nguyen CC, Hong JC, Luc JGY. The importance of mentorship and sponsorship for thoracic surgery residency applicants during the coronavirus disease 2019 (COVID-19) pandemic. J Thorac Cardiovasc Surg 2020; 161:S0022-5223(20)32451-X. [PMID: 32981704 PMCID: PMC7515560 DOI: 10.1016/j.jtcvs.2020.08.064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/03/2020] [Accepted: 08/18/2020] [Indexed: 01/04/2023]
Affiliation(s)
| | - Jonathan C Hong
- Division of Cardiac Surgery, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital, Chicago, Ill
| | - Jessica G Y Luc
- Division of Cardiovascular Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
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Commentary: What we should know about our learners. J Thorac Cardiovasc Surg 2020; 162:342. [PMID: 32622574 PMCID: PMC7172926 DOI: 10.1016/j.jtcvs.2020.04.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 11/23/2022]
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Moffatt-Bruce SD, Kneuertz P. Commentary: The very real generation gap: Times are a-changing. J Thorac Cardiovasc Surg 2020; 162:343-344. [PMID: 32475497 PMCID: PMC7172828 DOI: 10.1016/j.jtcvs.2020.04.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 11/17/2022]
Affiliation(s)
| | - Peter Kneuertz
- Department of Surgery, The Ohio State University, Columbus, Ohio
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