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Tay T, James KS. Exploring the Experiences of Undergraduate Medical Students on Surgical Placement - A Qualitative Study. J Surg Educ 2024; 81:671-679. [PMID: 38556437 DOI: 10.1016/j.jsurg.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/25/2024] [Accepted: 02/03/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVE Multiple elements in the clinical learning environment have been found to influence medical students' learning experiences. A rich area of research, many factors are already known to influence students' experiences of learning which go on to impact later training choices. However, there is a knowledge gap specifically related to undergraduate medical students' experiences of surgical placement. This study aims to explore the lived experiences of medical students in their surgery rotation(s). DESIGN A phenomenological study using semistructured interviews was conducted. Transcribed interview recordings were thematically analyzed using an iterative approach. SETTING Participants were studying in a large medical school in the north of England. PARTICIPANTS Fitting with the method, 6 undergraduate medical students, with at least 1 surgery placement took part in the study. RESULTS Participants described issues including knowing the details of clinical opportunities, the clinical environment, and the portfolio; having a sense of involvement and previous surgical experiences; teaching and assessments; observation; and interactions. These experiences were also found to influence later career aspirations. CONCLUSIONS The findings suggest that undergraduate surgical learning experiences can be influenced by various themes: knowing the details of progression, the clinical environment, having a sense of involvement and previous experiences, constructive alignment of teaching and assessment, and professional identity formation. Future studies can explore methods such as personalized learning outcomes to enhance the overall learning experience of medical students.
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Affiliation(s)
- Tricia Tay
- Royal Lancaster Infirmary, Lancaster University, Ashton Road, Lancaster, United Kingdom.
| | - Kirstin Stuart James
- Edinburgh Surgery Online: Clinical Sciences Teaching Organisation, The University of Edinburgh, Simon Laurie House, Edinburgh, United Kingdom; Edinburgh Medical School: Medical Education, The University of Edinburgh, Chancellor's Building, Little France Crescent, EH16 4SB, UK
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van Lieshout JH, Malzkorn B, Steiger HJ, Karadag C, Kamp MA, Vajkoczy P, Beck J, Peschillo S, Rohde V, Walsh D, Lukshin V, Korja M, Cenzato M, Raabe A, Gruber A, Hänggi D, Boogaarts HD. Defining activities in neurovascular microsurgery training: entrustable professional activities for vascular neurosurgery. Acta Neurochir (Wien) 2023; 165:27-37. [PMID: 36271161 PMCID: PMC9840588 DOI: 10.1007/s00701-022-05372-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 09/17/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Entrustable professional activities (EPAs) represent an assessment framework with an increased focus on competency-based assessment. Originally developed and adopted for undergraduate medical education, concerns over resident ability to practice effectively after graduation have led to its implementation in residency training but yet not in vascular neurosurgery. Subjective assessment of resident or fellow performance can be problematic, and thus, we aim to define core EPAs for neurosurgical vascular training. METHODS We used a nominal group technique in a multistep interaction between a team of experienced neurovascular specialists and a medical educator to identify relevant EPAs. Panel members provided feedback on the EPAs until they reached consent. RESULTS The process produced seven core procedural EPAs for vascular residency and fellowship training, non-complex aneurysm surgery, complex aneurysm surgery, bypass surgery, arteriovenous malformation resection, spinal dural fistula surgery, perioperative management, and clinical decision-making. CONCLUSION These seven EPAs for vascular neurosurgical training may support and guide the neurosurgical society in the development and implementation of EPAs as an evaluation tool and incorporate entrustment decisions in their training programs.
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Affiliation(s)
- Jasper Hans van Lieshout
- Department of Neurosurgery, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstraße 5, Düsseldorf, Germany.
| | - Bastian Malzkorn
- Medical Education, Office of the Deanery of the Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Hans-Jakob Steiger
- Department of Neurosurgery, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstraße 5, Düsseldorf, Germany
| | - Cihat Karadag
- Department of Neurosurgery, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstraße 5, Düsseldorf, Germany
| | - Marcel A Kamp
- Department of Neurosurgery, Medical Faculty, Friedrich Schiller University, Jena, Germany
| | - Peter Vajkoczy
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jürgen Beck
- Department of Neurosurgery, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Simone Peschillo
- Department of Surgical Medical Sciences and Advanced Technologies "G.F. Ingrassia" - Endovascular Neurosurgery, University of Catania, Catania, Italy
- Endovascular Neurosurgery, Pia Fondazione Cardinale Giovanni Panico Hospital, Tricase, LE, Italy
| | - Veit Rohde
- Department of Neurosurgery, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Daniel Walsh
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust and Department of Clinical Neurosciences, Institute of Psychiatry, King's College London, London, UK
| | - Vasiliy Lukshin
- N.N. Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia
| | - Miikka Korja
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Marco Cenzato
- Neurosurgery Unit, Department of Neuroscience, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Andreas Raabe
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Gruber
- Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Daniel Hänggi
- Department of Neurosurgery, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstraße 5, Düsseldorf, Germany
| | - H D Boogaarts
- Department of Neurosurgery, Radboudumc Medical Center, Nijmegen, the Netherlands
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Daniel R, McKechnie T, Kruse CC, Levin M, Lee Y, Doumouras AG, Hong D, Eskicioglu C. Video-based coaching for surgical residents: a systematic review and meta-analysis. Surg Endosc 2023; 37:1429-1439. [PMID: 35739431 PMCID: PMC9225812 DOI: 10.1007/s00464-022-09379-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/03/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Video-based coaching (VBC) is used to supplement current teaching methods in surgical education and may be useful in competency-based frameworks. Whether VBC can effectively improve surgical skill in surgical residents has yet to be fully elucidated. The objective of this study is to compare surgical residents receiving and not receiving VBC in terms of technical surgical skill. METHODS The following databases were searched from database inception to October 2021: Medline, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and PubMed. Articles were included if they were randomized controlled trials (RCTs) comparing surgical residents receiving and not receiving VBC. The primary outcome, as defined prior to data collection, was change in objective measures of technical surgical skill following implementation of either VBC or control. A pairwise meta-analyses using inverse variance random effects was performed. Standardized mean differences (SMD) were used as the primary outcome measure to account for differences in objective surgical skill evaluation tools. RESULTS From 2734 citations, 11 RCTs with 157 residents receiving VBC and 141 residents receiving standard surgical teaching without VBC were included. There was no significant difference in post-coaching scores on objective surgical skill evaluation tools between groups (SMD 0.53, 95% CI 0.00 to 1.01, p = 0.05, I2 = 74%). The improvement in scores pre- and post-intervention was significantly greater in residents receiving VBC compared to those not receiving VBC (SMD 1.62, 95% CI 0.62 to 2.63, p = 0.002, I2 = 85%). These results were unchanged with leave-one-out sensitivity analysis and subgroup analysis according to operative setting. CONCLUSION VBC can improve objective surgical skills in surgical residents of various levels. The benefit may be most substantial for trainees with lower baseline levels of objective skill. Further studies are required to determine the impact of VBC on competency-based frameworks.
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Affiliation(s)
- Ryan Daniel
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Tyler McKechnie
- Division of General Surgery, Department of Surgery, St. Joseph’s Healthcare Hamilton, McMaster University, 50 Charlton Avenue East, Hamilton, ON L8N 4A6 Canada
| | - Colin C. Kruse
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON Canada
| | - Marc Levin
- Division of Head and Neck, Otolaryngology Surgery, Department of Surgery, University of Toronto, Toronto, ON Canada
| | - Yung Lee
- Division of General Surgery, Department of Surgery, St. Joseph’s Healthcare Hamilton, McMaster University, 50 Charlton Avenue East, Hamilton, ON L8N 4A6 Canada
| | - Aristithes G. Doumouras
- Division of General Surgery, Department of Surgery, St. Joseph’s Healthcare Hamilton, McMaster University, 50 Charlton Avenue East, Hamilton, ON L8N 4A6 Canada ,Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON Canada ,Division of General Surgery, Department of Surgery, St. Joseph’s Healthcare Hamilton, Hamilton, ON Canada
| | - Dennis Hong
- Division of General Surgery, Department of Surgery, St. Joseph’s Healthcare Hamilton, McMaster University, 50 Charlton Avenue East, Hamilton, ON L8N 4A6 Canada ,Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON Canada ,Division of General Surgery, Department of Surgery, St. Joseph’s Healthcare Hamilton, Hamilton, ON Canada
| | - Cagla Eskicioglu
- Division of General Surgery, Department of Surgery, St. Joseph's Healthcare Hamilton, McMaster University, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada. .,Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada. .,Division of General Surgery, Department of Surgery, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
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McKinley SK, Hashimoto DA, Mansur A, Cassidy D, Petrusa E, Mullen JT, Phitayakorn R, Gee DW. Feasibility and Perceived Usefulness of Using Head-Mounted Cameras for Resident Video Portfolios. J Surg Res 2019; 239:233-241. [PMID: 30856516 DOI: 10.1016/j.jss.2019.01.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/21/2018] [Accepted: 01/11/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND There is limited guidance on how to longitudinally administer simulation materials or to incorporate video recordings into assessment portfolios of simulated surgical skills. MATERIALS AND METHODS We launched a longitudinal weekly simulation curriculum for PGY1-PGY3 surgical residents based on the ACS/APDS Curriculum. Residents underwent monthly objective structured assessment of technical skills (OSATS) while wearing head-mounted cameras. Videos of OSATS performance accrued into individual online video portfolios. Residents were surveyed about their attitudes toward video recording. RESULTS Twenty-seven general surgical residents participated, completing 161 OSATS encompassing 11 distinct skills and generating 258 videos of simulated skills performance. The overall survey response rate was 88%. Residents viewed the curriculum favorably overall, and 36.4% of residents accessed their videos. Of those who did not watch their videos, 78.6% cited not having enough time, whereas 28.6% did not think the videos would be useful. Over 95% of surveyed residents expressed interest in having a video library of attending-performed procedures, 59.1% were interested in having their own operations recorded, and 45.5% were interested in video-based coaching. CONCLUSIONS Residents viewed longitudinal administration of the ACS/APDS Curriculum positively. Although video recording in simulation is feasible, resident interest may be higher for intraoperative recordings than for simulated skills.
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Affiliation(s)
- Sophia K McKinley
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Daniel A Hashimoto
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Arian Mansur
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Douglas Cassidy
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Emil Petrusa
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - John T Mullen
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Roy Phitayakorn
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Denise W Gee
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
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Gostlow H, Marlow N, Babidge W, Maddern G. Systematic Review of Voluntary Participation in Simulation-Based Laparoscopic Skills Training: Motivators and Barriers for Surgical Trainee Attendance. J Surg Educ 2017; 74:306-318. [PMID: 27836238 DOI: 10.1016/j.jsurg.2016.10.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/06/2016] [Accepted: 10/06/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To examine and report on evidence relating to surgical trainees' voluntary participation in simulation-based laparoscopic skills training. Specifically, the underlying motivators, enablers, and barriers faced by surgical trainees with regard to attending training sessions on a regular basis. DESIGN A systematic search of the literature (PubMed; CINAHL; EMBASE; Cochrane Collaboration) was conducted between May and July 2015. Studies were included on whether they reported on surgical trainee attendance at voluntary, simulation-based laparoscopic skills training sessions, in addition to qualitative data regarding participant's perceived barriers and motivators influencing their decision to attend such training. Factors affecting a trainee's motivation were categorized as either intrinsic (internal) or extrinsic (external). RESULTS Two randomised control trials and 7 case series' met our inclusion criteria. Included studies were small and generally poor quality. Overall, voluntary simulation-based laparoscopic skills training was not well attended. Intrinsic motivators included clearly defined personal performance goals and relevance to clinical practice. Extrinsic motivators included clinical responsibilities and available free time, simulator location close to clinical training, and setting obligatory assessments or mandated training sessions. The effect of each of these factors was variable, and largely dependent on the individual trainee. The greatest reported barrier to attending voluntary training was the lack of available free time. CONCLUSION Although data quality is limited, it can be seen that providing unrestricted access to simulator equipment is not effective in motivating surgical trainees to voluntarily participate in simulation-based laparoscopic skills training. To successfully encourage participation, consideration needs to be given to the factors influencing motivation to attend training. Further research, including better designed randomised control trials and large-scale surveys, is required to provide more definitive answers to the degree in which various incentives influence trainees' motivations and actual attendance rates.
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Affiliation(s)
- Hannah Gostlow
- Division of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia; Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S), Royal Australasian College of Surgeons, North Adelaide, South Australia, Australia
| | - Nicholas Marlow
- Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S), Royal Australasian College of Surgeons, North Adelaide, South Australia, Australia
| | - Wendy Babidge
- Division of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia; Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S), Royal Australasian College of Surgeons, North Adelaide, South Australia, Australia
| | - Guy Maddern
- Division of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia; Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S), Royal Australasian College of Surgeons, North Adelaide, South Australia, Australia.
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Colbert CY, Graham L, West C, White BA, Arroliga AC, Myers JD, Ogden PE, Archer J, Mohammad ZTA, Clark J. Teaching metacognitive skills: helping your physician trainees in the quest to 'know what they don't know'. Am J Med 2015; 128:318-24. [PMID: 25446293 DOI: 10.1016/j.amjmed.2014.11.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 11/04/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Colleen Y Colbert
- Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio; Texas A&M HSC College of Medicine, Temple, Tex.
| | - Lori Graham
- Texas A&M HSC College of Medicine, Temple, Tex
| | | | | | - Alejandro C Arroliga
- Texas A&M HSC College of Medicine, Temple, Tex; Scott & White Healthcare, Temple, Tex
| | - John D Myers
- Texas A&M HSC College of Medicine, Temple, Tex; Scott & White Healthcare, Temple, Tex
| | | | - Julian Archer
- Plymouth University Peninsula Schools of Medicine & Dentistry, Plymouth, UK
| | | | - Jeffrey Clark
- Texas A&M HSC College of Medicine, Temple, Tex; Scott & White Healthcare, Temple, Tex
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