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Gogalniceanu P, Kunduzi B, Ruckley C, Kaafarani H, Sevdalis N, Mamode N. Surgical leadership in a culture of safety: An inter-professional study of metrics and tools for improving clinical practice. Am J Surg 2024; 228:32-42. [PMID: 37709628 DOI: 10.1016/j.amjsurg.2023.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/01/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Leadership in a safety culture environment is essential in avoiding patient harm. However, leadership in surgery is not routinely taught or assessed. This study aims to identify a framework, metrics and tools to improve surgical leadership and safety outcomes. METHODS Qualitative interviews were performed with leadership experts from safety-critical professions. Non-probability-based sampling was undertaken in major international airlines. Data underwent thematic analysis and clinical adaptation by multiple surgeon-analysts using the framework method. RESULTS 583 codes were synthesised into 10 themes. Leaders were identified as 'threat and error managers' who placed safety first. Their core attribute was humble confidence. This allowed them to set the tone for high standards of practice, whilst empowering individuals to speak up about safety issues. Safety-oriented leaders assumed complete responsibility and applied their authority discerningly to obtain optimal outcomes. Finally, effective leaders rallied support for their mission by instilling confidence, building collaborations and managing conflict. CONCLUSIONS Surgical leadership requires the ability to manage risk, opportunity and people. The study provides an assessment matrix and deliverable tools for improving surgical safety.
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Affiliation(s)
- Petrut Gogalniceanu
- Guy's and St.Thomas' NHS Foundation Trust, London, UK; King's College London, UK.
| | - Basir Kunduzi
- Guy's and St.Thomas' NHS Foundation Trust, London, UK
| | | | - Haytham Kaafarani
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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2
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Eidt JF, Gucwa AL, Ali A. How I do it: The neoaortoiliac system for treatment of aortoduodenal fistula after endovascular aortic repair. J Vasc Surg Cases Innov Tech 2022; 8:830-839. [PMID: 36561355 PMCID: PMC9763360 DOI: 10.1016/j.jvscit.2022.11.001] [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: 10/18/2022] [Accepted: 11/07/2022] [Indexed: 11/17/2022] Open
Abstract
The term neoaortoiliac system (NAIS) was coined by Clagett in 1993 to describe the use of the deep veins in the thigh to replace the aorta and iliac arteries in the setting of graft infection. Since that time, the NAIS procedure has been used to treat a wide array of both infectious and noninfectious conditions affecting the aortoiliac segment. In this article, we present a 10-step description of the NAIS procedure to treat an aortoduodenal fistula in a patient with an infected endovascular aneurysm repair.
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Affiliation(s)
- John F. Eidt
- Department of Surgery, Texas A&M College of Medicine, Bryan, TX,Department of Vascular Surgery, Baylor Scott and White Heart and Vascular Hospital, Dallas, TX,Correspondence: John F. Eidt, MD, Baylor Scott and White Heart and Vascular Hospital, 621 N Hall St, Ste H-030, Dallas, TX
| | - Angela L. Gucwa
- Department of Cardiothoracic and Vascular Surgery, Luminis Health Doctors Community Medical Center, Lanham, MD
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Crisis recovery in surgery: Error management and problem solving in safety-critical situations. Surgery 2022; 172:537-545. [PMID: 35469650 DOI: 10.1016/j.surg.2022.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/19/2022] [Accepted: 03/03/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND Surgical crises, both clinical and executive, carry risk of harm to patients, staff, and organizations. Once stabilized and contained, crisis recovery requires complex decision-making and problem-solving to address primary failures (errors) and their consequences. In contrast to other safety-critical professions, surgeons may lack access to crisis recovery strategies and tools that go beyond the technical aspects of clinical practice. This study aims to develop a framework for surgical crisis recovery based on problem-solving interventions used by pilots in commercial aviation. METHODS This study undertook observational fieldwork, semistructured interviews, and focus groups with senior airline pilots and health care safety experts. Thematic analysis using the framework method identified key interventions applicable to surgical crisis recovery. Subsequently, expert group consensus adapted and content validated this model for clinical use. RESULTS Qualitative data from 22 aviation and health care safety experts informed surgical crisis resolution. This consisted of 3 strategies: (1) building cognitive capacity by improving situational awareness and workload management; (2) using checklists in abnormal situations to implement emergency operating procedures; (3) undertaking structured decision-making using analysis-based problem-solving cycles (eg, T-DODAR framework). Twelve tools were validated and adapted to aid implementation of these strategies. CONCLUSION Once stabilized, surgical crises may be resolved using 3 sequential strategies derived from commercial aviation.
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Affiliation(s)
| | - Haytham Kaafarani
- Massachusetts General Hospital, Harvard Medical School, Boston, MA. https://twitter.com/hayfarani
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Gogalniceanu P, Calder F, Callaghan C, Sevdalis N, Mamode N. Surgeons Are Not Pilots: Is the Aviation Safety Paradigm Relevant to Modern Surgical Practice? JOURNAL OF SURGICAL EDUCATION 2021; 78:1393-1399. [PMID: 33579654 DOI: 10.1016/j.jsurg.2021.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/10/2021] [Accepted: 01/23/2021] [Indexed: 06/12/2023]
Abstract
Error in surgery is common, although not always consequential. Surgical outcomes are often compared to safety data from commercial aviation. This industry's performance is frequently referenced as an example of high-reliability that should be reproduced in clinical practice. Consequently, the aviation-surgery analogy forms the conceptual framework for much patient safety research, advocating for the translation of aviation safety tools to the healthcare setting. Nevertheless, overuse or incorrect application of this paradigm can be misleading and may result in ineffective quality improvement interventions. This article discusses the validity and relevance of the aviation-surgery comparison, providing the necessary context to improve its application at the bedside. It addresses technical and human factors training, as well as more novel performance domains such as professional culture and optimization of operators' condition. These are used to determine whether the aviation-surgery analogy is a valuable source of cross-professional learning or simply another safety cliché.
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Affiliation(s)
- Petrut Gogalniceanu
- Guy's and St. Thomas' NHS Foundation Trust; King's College London, London, England.
| | | | - Chris Callaghan
- Guy's and St. Thomas' NHS Foundation Trust; King's College London, London, England
| | | | - Nizam Mamode
- Guy's and St. Thomas' NHS Foundation Trust; King's College London, London, England
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Gogalniceanu P, Kessaris N, Karydis N, Loukopoulos I, Sevdalis N, Mamode N. Crisis Containment: Tools for Harm Mitigation in Surgery. J Am Coll Surg 2021; 233:698-708.e1. [PMID: 34438080 DOI: 10.1016/j.jamcollsurg.2021.08.676] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/02/2021] [Accepted: 08/02/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Surgical crises represent unrecognized opportunities for improving patient safety and adding value in healthcare. The first step in a crisis response is to contain and mitigate harm. While the principles of damage control are well established in surgery, methods of containing harm on broader clinical and organizational levels are not clearly defined. STUDY DESIGN A multimethods qualitative study identified crisis containment strategies and tools in commercial aviation. These were translated and clinically adapted in 3 stages: semi-structured observational fieldwork with commercial airlines, interviews with senior pilots, and focus groups with both healthcare and aviation safety experts. Thematic analysis and expert consensus methods were used to derive a framework for crisis containment. RESULTS Fieldwork with 2 commercial airlines identified 2 crisis containment concepts: the detrimental impact of surprising or startling events on operator performance; and the use of prioritization tools to take basic but critical actions (Aviate, Navigate and Communicate model). Twenty-two experts in aviation and healthcare practice informed the topic of crisis containment in 17 interviews and 3 focus groups. Three strategies were identified and used to form a crisis containment algorithm: 1. Manage the operators' startle response to facilitate meaningful mitigating actions (STOP tool); 2. Take priority actions to secure core functions. These included managing patients' physiologic shock, optimizing environmental risks, and mobilizing resources (Perfuse, Move and Communicate tool); 3. Deploy well-rehearsed drills targeting case-specific harms or errors (Memory Actions). This model requires validation in clinical practice. CONCLUSIONS Crisis containment can be achieved by controlling operators' startle response, applying prioritization tools, and deploying drills against specific failures. The application of this model may extend to healthcare areas outside surgery.
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Affiliation(s)
- Petrut Gogalniceanu
- Transplant Surgery Unit, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust.
| | - Nicos Kessaris
- Transplant Surgery Unit, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust
| | - Nikolaos Karydis
- Transplant Surgery Unit, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust
| | - Ioannis Loukopoulos
- Transplant Surgery Unit, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust
| | - Nick Sevdalis
- Centre for Implementation Science, King's College London, UK
| | - Nizam Mamode
- Transplant Surgery Unit, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust
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Gogalniceanu P, Karydis N, Loukopoulos I, Kessaris N, Sevdalis N, Mamode N. Avoid, Trap, and Mitigate: Development of an Evidence-Based Crisis Management Framework in Surgery. J Am Coll Surg 2021; 233:526-536.e1. [PMID: 34265426 DOI: 10.1016/j.jamcollsurg.2021.06.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/06/2021] [Accepted: 06/09/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Increasingly, surgeons are adopting broader roles in emergency response, on both clinical and executive levels. These have highlighted the need to develop healthcare-specific crisis management systems. Cross-professional research between safety-critical industries is a valuable method for learning crisis control. Commercial aviation, in particular, has been used to drive innovation in surgical safety. This study aimed to identify, adapt, and operationalize a surgical crisis management framework based on current practice in commercial aviation. STUDY DESIGN A multimethod qualitative study interrogated safety experts in commercial aviation and healthcare. Stage I used immersive observational fieldwork in commercial aviation practice. Stage II performed semi-structured interviews with senior airline pilots. "Snowball" sampling targeted professional networks, recruiting 17 pilots from 4 airlines. Thematic analysis was used to derive a model of crisis management. Stage III undertook 3 focus groups with 5 pilots and 5 healthcare safety specialists. Expert consensus methods were used to adapt the model to clinical practice. RESULTS Interview data provided 2,698 verbatim quotes on crisis management from aviation experts with a combined flying experience of 188,000 hours. Aviation crisis management was structured in 3 phases: avoid, trap, and mitigate. Adapted to clinical practice, these translated to crisis preparedness, recovery, and containment interventions. Additionally, the study identified 7 types of implementation tools and 9 crisis management skills that could be used to operationalize this framework in surgical practice. CONCLUSIONS Surgical crisis management can follow the avoid, trap, and mitigate framework used in commercial aviation. Implementation relies on the combined use of crisis skills and performance tools. Crisis management should be delivered as part of a systems-based approach that relies on well-integrated failure management models. Simulation and in-situ validation of this framework is needed.
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Affiliation(s)
- Petrut Gogalniceanu
- Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, United Kingdom; King's College London, United Kingdom.
| | - Nikolaos Karydis
- Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, United Kingdom
| | | | - Nicos Kessaris
- Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, United Kingdom
| | | | - Nizam Mamode
- Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, United Kingdom; King's College London, United Kingdom
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Lu J, Cuff RF, Mansour MA. Simulation in surgical education. Am J Surg 2020; 221:509-514. [PMID: 33358139 DOI: 10.1016/j.amjsurg.2020.12.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/07/2020] [Indexed: 01/23/2023]
Abstract
Simulation is becoming an important tool in surgical education. Surgical faculty have been forced to modify how they teach technical skills. Instead of a complete reliance on teaching in the operating room, a structured curriculum and dedicated time in the simulation center are being used in many centers. Some of the advantages of this approach include the ability to learn and practice new procedures in a safe and nurturing environment. The disadvantages include the significant cost of virtual reality simulators and the competition, between various training programs, to gain access to simulation.
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Affiliation(s)
- Joyce Lu
- Spectrum Health Medical Group, Department of Surgery, Michigan State University College of Human Medicine, United States
| | - Robert F Cuff
- Spectrum Health Medical Group, Department of Surgery, Michigan State University College of Human Medicine, United States
| | - M Ashraf Mansour
- Spectrum Health Medical Group, Department of Surgery, Michigan State University College of Human Medicine, United States.
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Smith BK, Davies MG, Harris IB. The Current State of the 0+5 Integrated Vascular Surgery Residency Training Paradigm: A Scoping Review of the Literature. JOURNAL OF SURGICAL EDUCATION 2019; 76:990-1004. [PMID: 30713138 DOI: 10.1016/j.jsurg.2019.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 01/08/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The 0+5 integrated vascular surgery residency program (IVSR) was introduced as a training model toward board certification in vascular surgery over 10 years ago. The pros and cons of this training model have been debated. OBJECTIVE The purpose of this review is to investigate, using qualitative methods, what is known about the development, implementation, and outcomes of the IVSR paradigm. DESIGN A systematic search of the literature pertaining to the IVSR training model was conducted to include literature from 2005 to 2016. A search strategy involving use of 4 literature databases, 4 search terms, and 4 inclusion criteria was used. Three independent reviewers screened titles and abstracts for inclusion. Data abstraction was performed by 1 reviewer. Qualitative content analysis was completed using the method of constant comparative analysis associated with a grounded theory design by all 3 reviewers. RESULTS Of 890 articles initially identified, 33 articles were found to meet inclusion criteria for full review. Nineteen (57%) were research articles with an average Medical Education Research Study Quality Instrument score of 6.3 out of 18. The remaining articles were categorized as editorials, presidential addresses, invited commentaries, and historical summaries. Three major themes related to the IVSR program were identified: context of program development, processes of the program once implemented, and outcomes. CONCLUSIONS The literature on the IVSR paradigm reflects contextual, process, and outcome issues. Research articles are of generally low quality and there is a paucity of analyses of outcome issues. Further research is recommended to identify and understand the outcomes of the model.
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Affiliation(s)
- Brigitte K Smith
- Department of Surgery, University of Utah, Division of Vascular Surgery, Salt Lake City, Utah.
| | - Mark G Davies
- University of Texas Health Sciences Center - San Antonio, Division of Vascular/Endovascular Surgery, San Antonio, Texas
| | - Ilene B Harris
- University of Illinois - Chicago, Department of Medical Education and Department of Pathology, Chicago, Illinois
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Dall Jensen R, Ravn S, Krogh Christensen M. Identification and development of talent in surgery. EUROPEAN JOURNAL OF TRAINING AND DEVELOPMENT 2019. [DOI: 10.1108/ejtd-07-2018-0070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Education of the surgeon and development of surgical expertise have been debated for centuries. Today, research in surgical education applies terms and methods from other performance domains such as sport and music. However, there still seems to be a lack of consensus as to how talent may be brought into the discourse about surgical education. Especially, when it comes to identifying and developing trainees who in the future will perform better than the average surgeon.
Design/methodology/approach
This five-step scoping study aims to map existing literature about talent identification, talent development and development of expertise in the domains of surgery, sport and music in the period of 1985-2014.
Findings
A total of 242 studies, divided in the four domains of surgery (69 studies), sport (115 studies), music (34 studies) and cross-disciplinary studies (24 studies) published in the period 1985-2014 were included.
Originality/value
Informed by the performance domains of sports and music and their inclusion of a holistic, ecological approach to research, this study suggests that research in surgical education may benefit from broadening its view on talent by including psychosocial variables and environmental, demographic and structural influencers when considering how surgical talent may be identified and developed.
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Sadasivan C, Lieber BB, Woo HH. Physical Simulators and Replicators in Endovascular Neurosurgery Training. COMPREHENSIVE HEALTHCARE SIMULATION: NEUROSURGERY 2018. [DOI: 10.1007/978-3-319-75583-0_3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Belykh EG, Lei T, Oliveira MM, Almefty RO, Yagmurlu K, Elhadi AM, Sun G, Bichard WD, Spetzler RF, Preul MC, Nakaji P. Carotid Endarterectomy Surgical Simulation Model Using a Bovine Placenta Vessel. Neurosurgery 2015; 77:825-9; discussion 829-30. [DOI: 10.1227/neu.0000000000000924] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Abstract
BACKGROUND:
Carotid endarterectomy (CEA) is a common, well-developed surgical procedure. Although surgical simulation is gaining in importance for residency training, CEA practice opportunities for surgical residents are limited.
OBJECTIVE:
To describe a new haptic CEA model.
METHODS:
Six bovine placentas were used to create the model. Each placenta provided about 6 large arterial and venous bifurcations. In total, 36 large-vessel bifurcations were dissected and prepared for the CEA simulation. Bovine placenta vessels were arranged to simulate the common carotid artery (CCA), internal carotid artery (ICA), and external carotid artery (ECA). The diameters and wall thicknesses were measured and compared with human CCA, ICA, and ECA parameters.
RESULTS:
All bovine placentas provided vessels suitable for modeling carotid artery bifurcations and CEA training. Mean ± SD diameters of simulated CCAs, ECAs, and ICAs were 11.2 ± 1.8, 4.3 ± 0.5, and 9.8 ± 3.0 mm, respectively, from nondilated veins and 8.7 ± 1.4, 4.4 ± 1.3, and 7.2 ± 1.7 mm, respectively, from nondilated arteries. Mean vessel wall thicknesses were 2.0 ± 0.6 mm for arteries and 1.4 ± 0.5 mm for veins. Placental vessel tissue had dimensions and handling characteristics similar to those of human carotid arteries. The CEA procedure and its subtasks, including vessel-tissue preparation and surgical skills performance, could be reproduced with high fidelity.
CONCLUSION:
A bovine placenta training model for CEA is inexpensive and readily available and closely resembles human carotid arteries. The model can provide a convenient and valuable simulation and practice addition for vascular surgery training.
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Affiliation(s)
- Evgenii G. Belykh
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
- Scientific Center of Reconstructive and Restorative Surgery, Laboratory of Neurosurgery, Scientific Center of Reconstructive and Restorative Surgery, Siberian Branch of the Russian Academy of Medical Sciences, Irkutsk, Russia
| | - Ting Lei
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Magaldi M. Oliveira
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
- Department of Surgery, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Rami O. Almefty
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Kaan Yagmurlu
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Ali M. Elhadi
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Guozhu Sun
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - William D. Bichard
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Robert F. Spetzler
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Mark C. Preul
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Peter Nakaji
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
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Chin CJ, Roth K, Rotenberg BW, Fung K. Emergencies in otolaryngology-head and neck surgery bootcamp: a novel Canadian experience. Laryngoscope 2014; 124:2275-80. [PMID: 24913639 DOI: 10.1002/lary.24754] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Revised: 04/14/2014] [Accepted: 05/05/2014] [Indexed: 11/05/2022]
Abstract
OBJECTIVES/HYPOTHESIS A 1-day intensive course (bootcamp) was developed, to teach junior otolaryngology-head and neck surgery (OTO-HNS) residents emergency procedural skills, clinical reasoning, and communication skills. This learning paradigm utilized a number of novel task trainers, panel discussions, and emergency simulations. The study objective was to assess the educational value of this bootcamp. STUDY DESIGN Prospective cohort survey. METHODS Residents were recruited from regional teaching centers within a 2000-km radius of the simulation center. Preceptors fluent in English and in French were in attendance. Pre-bootcamp outcome measures included the Kolb Learning Style Inventory and a self-administered survey measuring confidence levels in performing specific OTO-HNS tasks. Post-bootcamp outcome measures included a survey evaluating the bootcamp experience and a structured follow-up telephone interview. RESULTS Twenty-eight residents participated in the bootcamp from across the United States and Canada. When asked if they felt that "overall, the educational day was an effective learning process," the average score was 4.75/5.0. The vast majority of participants (92.9%) felt they would recommend the bootcamp to a future junior resident. Kolb learning styles that prefer active experimentation (acting, initiating, and deciding) were more common than those that utilize reflective observation (imagining, analyzing, reflecting), which favors a hands-on model of learning. CONCLUSION This first Canadian OTO-HNS bootcamp demonstrated the feasibility and effectiveness of conducting a centralized bootcamp for regional training centers spanning multiple states/provinces and languages. Future bootcamps will be held annually and will ideally continue the natural evolution of surgical, hands-on training.
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Affiliation(s)
- Christopher J Chin
- Department of Otolaryngology-Head & Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Eckstein HH, Schmidli J, Schumacher H, Gürke L, Klemm K, Duschek N, Meile T, Assadian A. Rationale, scope, and 20-year experience of vascular surgical training with lifelike pulsatile flow models. J Vasc Surg 2013; 57:1422-8. [DOI: 10.1016/j.jvs.2012.11.113] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2012] [Revised: 10/24/2012] [Accepted: 11/25/2012] [Indexed: 01/22/2023]
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Recruiting women to vascular surgery and other surgical specialties. J Vasc Surg 2013; 57:262-7. [DOI: 10.1016/j.jvs.2012.07.029] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Revised: 06/29/2012] [Accepted: 07/15/2012] [Indexed: 11/16/2022]
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