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Grome LJ, Reul RM, Agrawal N, Abu-Ghname A, Winocour S, Buchanan EP, Maricevich RS, Reece EM. A Systematic Review of Wellness in Plastic Surgery Training. Aesthet Surg J 2021; 41:969-977. [PMID: 32596712 DOI: 10.1093/asj/sjaa185] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Physician and resident wellness has been increasingly emphasized as a means of improving patient outcomes and preventing physician burnout. Few studies have been performed with a focus on wellness in plastic surgery training. OBJECTIVES The aim of this study was to systematically review what literature exists on the topic of wellness in plastic surgery training and critically appraise it. METHODS A PubMed search was performed to identify journal articles related to wellness in plastic surgery residency. Seventeen studies (6 cohort and 11 cross-sectional) met inclusion criteria and were appraised with the Newcastle-Ottawa Quality Assessment Scale (NOQAS) to determine the quality of the studies based on selection, comparability, and outcome metrics. RESULTS Critical assessment showed that the studies were highly variable in focus. Overall, the quality of the data was low, with an average NOQAS score of 4.1. Only 2 studies focused on plastic surgery residents, examining work hours and social wellness, respectively; they were awarded NOQAS scores of 3 and 4 out of 10. CONCLUSIONS The results of this systematic review suggest that little research has been devoted to wellness in surgery training, especially in regard to plastic surgery residents, and what research that has been performed is of relatively low quality. The available research suggests a relatively high prevalence of burnout among plastic surgery residents. Evidence suggests some organization-level interventions to improve trainee wellness. Because outcomes-based data on the effects of such interventions are particularly lacking, further investigation is warranted.
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Affiliation(s)
- Luke J Grome
- Division of Plastic Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Ross M Reul
- Division of Plastic Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Nikhil Agrawal
- Division of Plastic Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Amjed Abu-Ghname
- Division of Plastic Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Sebastian Winocour
- Division of Plastic Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Edward P Buchanan
- Division of Plastic Surgery, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
| | - Renata S Maricevich
- Division of Plastic Surgery, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
| | - Edward M Reece
- Division of Plastic Surgery, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
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Hallet J, Wallace D, El-Sedfy A, Ahmed N, Smith AJ, Nathens AB, Conn LG, Coburn NG. Defining Communication Improvement Needs in General Surgery: An Analysis of Pages, Communications, Patterns, and Content☆?>. JOURNAL OF SURGICAL EDUCATION 2016; 73:959-967. [PMID: 27886968 DOI: 10.1016/j.jsurg.2016.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 05/05/2016] [Accepted: 05/09/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To describe patterns of pages communication to general surgery (GS) residents, identify the need for and develop strategies to improve interprofessional communication. DESIGN Retrospective cohort study. SETTING General surgery (GS) service at a tertiary care academic institution, Sunnybrook Health Sciences Centre, in Toronto, Ontario, Canada. PARTICIPANTS All pages sent to GS residents over 4 weeks at an academic institution. Timing, training level of receiver and content of pages were captured. RESULTS Communication priority was assigned by 2 independent reviewers-low (121+ min), medium (31-120min), high (6-30min), and immediate (0-5min) priority. Overall, 2 independent reviewers analyzed pages' content through an inductive process, and generated themes. Of 2025 pages retrieved, 963 (47.5%) contained exclusively a call back number. A median of 74 pages per day (range: 43-116) were received, with median page interval of 9.4 minutes (range: 0-640). Junior residents received 79.5% of pages. Timing of the pages was 43.9% weekday shift, 31.8% weeknight shift, and 24.3% weekend call. Communication priority was deemed low for 35.4% of pages, medium for 32.3%, high for 12.4%, and immediate for 0.7%. Content analysis of 1062 pages generated 5 major themes: nonurgent medical issue (54.0%), administrative (15.3%), communication (13.5%), emergencies (4.8%), and GS consultation requests (4.0%). Priority and content of pages varied according to training level and page timing. CONCLUSIONS Pages to GS residents were frequent and most often of low priority. They were seldom related to urgent medical matters. Education and new communication strategies are warranted to reduce low priority pages.
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Affiliation(s)
- Julie Hallet
- Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Research Institute, Evaluative Clinical Sciences, Toronto, Ontario, Canada.
| | - David Wallace
- Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Abraham El-Sedfy
- Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Najma Ahmed
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of General Surgery, St Michael's Hospital, Toronto, Ontario, Canada
| | - Andrew J Smith
- Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Avery B Nathens
- Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Research Institute, Evaluative Clinical Sciences, Toronto, Ontario, Canada
| | - Lesley Gotlib Conn
- Sunnybrook Research Institute, Evaluative Clinical Sciences, Toronto, Ontario, Canada
| | - Natalie G Coburn
- Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Research Institute, Evaluative Clinical Sciences, Toronto, Ontario, Canada
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O'Brien BC, May W, Horsley T. Scholarly Conversations in Medical Education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2016; 91:S1-S9. [PMID: 27779504 DOI: 10.1097/acm.0000000000001378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This supplement includes the eight research papers accepted by the 2016 Research in Medical Education Program Planning Committee. In this Commentary, the authors use "conversations in medical education" as a guiding metaphor to explore what these papers contribute to the current scholarly discourse in medical education. They organize their discussion around two domains: the topic of study and the methodological approach. The authors map the eight research papers to six "hot topics" in medical education: (1) curriculum reform, (2) duty hours restriction, (3) learner well-being, (4) innovations in teaching and assessment, (5) self-regulated learning, and (6) learning environment, and to three purposes commonly served by medical education research: (1) description, (2) justification, and (3) clarification. They discuss the range of methods employed in the papers. The authors end by encouraging educators to engage in these ongoing scholarly conversations.
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Affiliation(s)
- Bridget C O'Brien
- B.C. O'Brien is associate professor, Department of Medicine and Educational Researcher, Center for Faculty Educators, University of California, San Francisco, San Francisco, California. W. May is professor, Department of Medical Education, Keck School of Medicine of the University of Southern California, Los Angeles, California. T. Horsley is associate director, Research Unit, Royal College of Physicians and Surgeons of Canada and School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Hallet J, Wallace D, El-Sedfy A, Hall TN, Ahmed N, Bridge J, Taggar R, Smith AJ, Nathens AB, Coburn NG, Gotlib-Conn L. Optimizing inter-professional communications in surgery: protocol for a mixed-methods exploratory study. JMIR Res Protoc 2015; 4:e8. [PMID: 25745882 PMCID: PMC4376151 DOI: 10.2196/resprot.3623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 09/23/2014] [Accepted: 09/27/2014] [Indexed: 11/13/2022] Open
Abstract
Background Effective nurse-physician communication is critical to delivering high quality patient care. Interprofessional communication between surgical nurses and surgeons, often through the use of pagers, is currently characterized by information gaps and interprofessional tensions, both sources of workflow interruption, potential medical error, impaired educational experience, and job satisfaction. Objective This study aims to define current patterns of, and understand enablers and barriers to interprofessional communication in general surgery, in order to optimize the use of communication technologies, teamwork, provider satisfaction, and quality and safety of patient care. Methods We will use a mixed-methods multiphasic approach. In phase 1, a quantitative and content analysis of alpha-numeric pages (ANP) received by general surgery residents will be conducted to develop a paging taxonomy. Frequency, timing (on-call vs regular duty hours), and interval between pages will be described using a 4-week sample of pages. Results will be compared between pages sent to junior and senior residents. Finally, using an inductive analysis, two independent assessors will classify ANP thematically. In Phase 2, a qualitative constructivist approach will explore stakeholders’ experiences with interprofessional communication, including paging, through interviews and shadowing of 40 residents and 40 nurses at two institutions. Finally, a survey will be developed, tested, and administered to all general surgery nurses and residents at the same two institutions, to evaluate their attitudes about the effectiveness and quality of interprofessional communication, and assess their satisfaction. Results Describing the profile of current pages is the first step towards identifying areas and root causes of IPC inefficiency. This study will identify key contextual barriers to surgical nurse-house staff communication, and existing interprofessional knowledge and practice gaps. Conclusions Our findings will inform the design of a guideline and tailored intervention to improve IPC in order to ensure high quality patient care, optimal educational experience, and provider satisfaction.
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Affiliation(s)
- Julie Hallet
- Sunnybrook Health Sciences Centre, Division of General Surgery, Toronto, ON, Canada
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