LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 16

Search options

  1. Article ; Online: Misperceptions and Missed Opportunities: A Qualitative Analysis of Barriers to Evaluating Surgical Teachers.

    Flom, Emily A / Coppersmith, Nathan A / Yoo, Peter S

    Journal of surgical education

    2023  Volume 80, Issue 11, Page(s) 1663–1668

    Abstract: Objective: Teaching skills can be improved with written evaluations from learners. In addition to this primary purpose, teaching assessments are used in other aspects of faculty development including appointments, advancement and in some cases, ... ...

    Abstract Objective: Teaching skills can be improved with written evaluations from learners. In addition to this primary purpose, teaching assessments are used in other aspects of faculty development including appointments, advancement and in some cases, compensation. Surgical trainees' willingness to provide meaningful assessments of their teachers is variable but the reasons for this are ill-defined. This study aims to elucidate surgical residents' perceptions regarding barriers to providing useful feedback to their teachers.
    Design: A qualitative, semi-structured confidential interview approach was used. A demographically diverse cohort of surgical residents in an urban university-based program was invited to participate. Interviews explored experiences and perceptions of teaching assessments. Specific attention was paid to understand perceptions of barriers; topics including utility, anonymity, time burden, and others were explored. Interviews were transcribed verbatim with identifiers removed from transcripts before analysis. All data was double coded to ensure accuracy with the development of a codebook until thematic exhaustion was reached.
    Setting: Yale New Haven Hospital is an academic, university-based medical center with approximately 70 residents in the general surgery program and approximately 170 surgical faculty.
    Participants: A total of 21 residents completed individual or small group interviews. A theoretically driven sampling technique was used to recruit participants and maximize diversity. Individuals with varying backgrounds including PGY year, gender, age, IMG status, race, academic rank, research background and surgical division were asked to participate.
    Results: A total of 21 residents completed individual or small group interviews. Coding and analysis revealed 4 principal motifs: (1). Process- The process to complete assessment instruments is time-consuming and cumbersome to complete during the busy and acute surgical workday while failing to accurately address important aspects of surgical teaching. (2). Utility- Respondents reported uncertainty as to the downstream utility of the assessments, and a lack of confidence that the assessments would be used for faculty growth and improvement. (3). Resident Standing- Respondents described a lack of training, knowledge, skills, and empowerment to assess their teachers. (4). Perceived Consequences- Residents noted concern for identification, future autonomy, and other potential negative career consequences due to small resident sample sizes, recognizable experiences with attendings, and perceived power dynamics.
    Conclusions: This study elucidates the perceptions of surgical trainees regarding barriers to providing feedback and assessments of their faculty. Although limited to a single-institution study, residents observed the current system does not allow for honest and accurate evaluations of surgical teachers. The extensive overlap between motifs highlights the need for a holistic approach to address these interconnected themes before teaching evaluations can be honest and productive. Importantly, it is also the first to identify residents' perceived lack of skill and sense of disempowerment to provide constructive faculty assessment. Due to the limited scope of the single-institution study, further verification and studies are needed to improve the quality of faculty feedback and assessment of surgical teachers.
    MeSH term(s) Humans ; Internship and Residency ; Education, Medical, Graduate/methods ; Educational Measurement ; Academic Medical Centers
    Language English
    Publishing date 2023-06-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2023.05.013
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  2. Article ; Online: The Potential Application of Mindset Theory to Surgical Education.

    Coppersmith, Nathan A / Esposito, Andrew C / Yoo, Peter S

    Journal of surgical education

    2022  Volume 79, Issue 4, Page(s) 845–849

    Abstract: Mindset theory proposes that individuals hold a range of beliefs regarding the malleability of attributes such as intellect and skill. Within surgery, mindset theory has been discussed as a way of understanding achievement in both the cognitive and ... ...

    Abstract Mindset theory proposes that individuals hold a range of beliefs regarding the malleability of attributes such as intellect and skill. Within surgery, mindset theory has been discussed as a way of understanding achievement in both the cognitive and technical aspects of learning surgery. A review of the literature reveals a limited body of research that has addressed the mindsets of surgeons or by extension, tied those mindsets to outcomes. Within health professions education, mindset theory has been studied more broadly, but the benefits of mindset theory are largely assumed and drawn from education research regarding children and adolescents. Though mindset theory has gained traction, there has been debate regarding the traits associated with growth and fixed mindsets. The strongest evidence from primary and secondary education shows that low socioeconomic status and academically at-risk students can benefit the most from mindset interventions, and these findings may extend to surgical learning as well. Mindset theory offers an interesting lens to better understand surgical education, but more research is needed to characterize the mindsets of surgeons and understand how these mindsets influence performance and outcomes.
    MeSH term(s) Achievement ; Adolescent ; Child ; Educational Status ; Humans ; Income ; Learning ; Students
    Language English
    Publishing date 2022-04-25
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2022.03.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  3. Article ; Online: Video Coaching in Surgical Education: Utility, Opportunities, and Barriers to Implementation.

    Esposito, Andrew C / Coppersmith, Nathan A / White, Erin M / Yoo, Peter S

    Journal of surgical education

    2021  Volume 79, Issue 3, Page(s) 717–724

    Abstract: Objective: This review discusses the literature on Video-Based Coaching (VBC) and explores the barriers to widespread implementation.: Design: A search was performed on Scopus and PubMed for the terms "operation," "operating room," "surgery," " ... ...

    Abstract Objective: This review discusses the literature on Video-Based Coaching (VBC) and explores the barriers to widespread implementation.
    Design: A search was performed on Scopus and PubMed for the terms "operation," "operating room," "surgery," "resident," "house staff," "graduate medical education," "teaching," "coaching," "assessment," "reflection," "camera," and "video" on July 27, 2021, in English. This yielded 828 results. A single author reviewed the titles and abstracts and eliminated any results that did not pertain to operative VBC or assessment. All bibliographies were reviewed, and appropriate manuscripts were included in this study. This resulted in a total of 52 manuscripts included in this review.
    Setting/participants: Original, peer-reviewed studies focused on VBC or assessment.
    Results: VBC has been both subjectively and objectively found to be a valuable educational tool. Nearly every study of video recording in the operating room found that subjects, including surgical residents and seasoned surgeons alike, overwhelmingly considered it a useful, non-redundant adjunct to their training. Most studies that evaluated skill acquisition via standardized assessment tools found that surgical residents who underwent a VBC program had significant improvements compared to their counterparts who did not undergo video review. Despite this evidence of effectiveness, fewer than 5% of residency programs employ video recording in the operating room. Barriers to implementation include significant time commitments for proposed coaching curricula and difficulty with integration of video cameras into the operating room.
    Conclusions: VBC has significant educational benefits, but a scalable curriculum has not been developed. An optimal solution would ensure technical ease and expediency, simple, high-quality cameras, immediate review, and overcoming entrenched surgical norms and culture.
    MeSH term(s) Clinical Competence ; Education, Medical, Graduate/methods ; Humans ; Internship and Residency ; Mentoring/methods ; Video Recording
    Language English
    Publishing date 2021-12-29
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2021.12.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  4. Article ; Online: Quality Informatics: The Convergence of Healthcare Data, Analytics, and Clinical Excellence.

    Coppersmith, Nathan A / Sarkar, Indra Neil / Chen, Elizabeth S

    Applied clinical informatics

    2019  Volume 10, Issue 2, Page(s) 272–277

    MeSH term(s) Data Analysis ; Delivery of Health Care ; Humans ; Medical Informatics/standards
    Language English
    Publishing date 2019-04-24
    Publishing country Germany
    Document type Letter ; Research Support, N.I.H., Extramural
    ISSN 1869-0327
    ISSN (online) 1869-0327
    DOI 10.1055/s-0039-1685221
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  5. Article ; Online: Proxy Detection of Resident Burnout by Program Directors and Domestic Partners.

    Esposito, Andrew C / White, Erin M / Coppersmith, Nathan A / Huot, Stephen J / Asnes, Andrea G / Yoo, Peter S / Solomon, Daniel G

    Journal of the American College of Surgeons

    2022  Volume 234, Issue 6, Page(s) 1111–1117

    Abstract: Background: Resident burnout is associated with increased incidence of depression, suicide, and poor patient outcomes, yet identification of it is difficult. This study was designed to compare how well program directors (directors) and a resident's ... ...

    Abstract Background: Resident burnout is associated with increased incidence of depression, suicide, and poor patient outcomes, yet identification of it is difficult. This study was designed to compare how well program directors (directors) and a resident's spouse or domestic partner (partner) can serve as a proxy to identify burnout in the resident.
    Study design: An electronic survey, including the Maslach Burnout Inventory, was distributed to residents, their partners, and directors of all ACGME-accredited residencies at a single university-affiliated hospital. Burnout rates were compared with McNemar's test. Emotional exhaustion and depersonalization rates were compared with Spearman's correlation.
    Results: The response rate by respondent type was 33% (292 of 876) for residents, 48% (55 of 114) for partners, and 57% (13 of 23) for directors. Residents' self-reported burnout rate was 51% (148 of 292), while partners' proxy predicted burnout rate was 25% (14 of 55), and directors' was 5% (9 of 174). There was moderate correlation of partners' prediction of resident emotional exhaustion (ρ = 0.537, p < 0.01), depersonalization (ρ = 0.501, p < 0.01), and personal accomplishment (ρ = 0.416, p < 0.01). There was poor correlation of directors' prediction of residents' emotional exhaustion (ρ = 0.361, p < 0.01) and depersonalization (ρ = 0.223, p < 0.01). Partners had a 50% sensitivity, 94% specificity, 86% positive predictive value, and 71% negative predictive value in predicting resident burnout. Directors had a 6% sensitivity, 96% specificity, 56% positive predictive value, and 54% negative predictive value in predicting resident burnout.
    Conclusions: Directors are not skilled in detecting burnout in their trainees. Partners are an underused group for detecting burnout and may represent an important target audience for awareness of available resources to benefit residents.
    MeSH term(s) Burnout, Professional/diagnosis ; Burnout, Professional/epidemiology ; Burnout, Professional/psychology ; Burnout, Psychological/epidemiology ; Humans ; Internship and Residency ; Spouses ; Surveys and Questionnaires
    Language English
    Publishing date 2022-03-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1181115-8
    ISSN 1879-1190 ; 1072-7515
    ISSN (online) 1879-1190
    ISSN 1072-7515
    DOI 10.1097/XCS.0000000000000169
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  6. Article ; Online: Surgical Residents' Awareness of the Costs of Common Operating Room Supplies.

    White, Erin M / Hernandez, Alee / Coppersmith, Nathan A / Esposito, Andrew C / Paranjpe, Ashwini A / Yoo, Peter S

    The American surgeon

    2022  Volume 89, Issue 11, Page(s) 4640–4643

    Abstract: Background: The Accreditation Council for Graduate Medical Education mandates that residency programs incorporate cost awareness into patient care. This presents a challenge for surgical residents because they must understand operating room costs in ... ...

    Abstract Background: The Accreditation Council for Graduate Medical Education mandates that residency programs incorporate cost awareness into patient care. This presents a challenge for surgical residents because they must understand operating room costs in addition to other expenses. Trainees' understanding of operating room supply costs is not well understood.
    Methods: A survey was distributed to surgical residents (N = 73) at an urban, university-based residency program. Residents estimated the costs of 21 single-use operating room items. Descriptive statistics and a regression analysis were calculated.
    Results: The response rate was 62%. Respondents accurately estimated costs for a median of 7/21 items, with error ranging from 26% to 5438%. They substantially underestimated the three highest-cost items. Increasing post-graduate year did not improve estimation accuracy (β = .233,
    Discussion: Residents have a poor understanding of single-use item costs, and this does not improve with post-graduate training, suggesting inefficiencies. There is opportunity to educate residents and ultimately decrease surgical health care costs.
    MeSH term(s) Humans ; Internship and Residency ; Operating Rooms ; Education, Medical, Graduate ; Surveys and Questionnaires ; Accreditation
    Language English
    Publishing date 2022-09-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
    DOI 10.1177/00031348221126953
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  7. Article ; Online: Learning Environment is the Prevailing Factor in Surgical Residents' Favorite Rotations.

    Esposito, Andrew C / Brandt, Whitney S / Coppersmith, Nathan A / White, Erin M / Chung, Mark / Rujeedawa, Tanzil / Yoo, Peter S

    Journal of surgical education

    2022  Volume 79, Issue 6, Page(s) 1454–1464

    Abstract: Objective: Understand the characteristics of residents' favorite rotations to improve the ability of educators to maximize positive learning experiences.: Design: Novel cross-sectional survey developed through thematic analysis of focus groups with ... ...

    Abstract Objective: Understand the characteristics of residents' favorite rotations to improve the ability of educators to maximize positive learning experiences.
    Design: Novel cross-sectional survey developed through thematic analysis of focus groups with residents using 4-point Likert scales ranked from "Not at all important" to "Extremely important."
    Setting: Single university-affiliated urban hospital PARTICIPANTS: Clinical surgical residents BACKGROUND: Resident assessments of learning experiences vary between rotations leading to the development of "favorite" rotations.
    Materials and methods: A novel survey instrument containing 31 characteristics divided into 4 thematic categories was developed following analysis of surgical resident focus groups. Clinical surgical residents were asked how important each characteristic was for determining their favorite rotation on a 4-point Likert Scale from "not at all important" to "extremely important." Two-sided independent sample T-tests were used.
    Results: The response rate was 59% (33/56) with proportional representation of postgraduate levels. Overall, 67% (22/33) of residents reported their favorite rotation was in their preferred specialty, 70% (23/33) reported their favorite rotation required >70 hours per week in the hospital, and 97% (32/33) of residents reported their favorite rotation required <2 days of clinic. Overall, the average ranking of the categories from most to least important was content (mean = 2.84, SD = 0.48), learning environment (mean = 2.67, SD = 0.57), working environment (mean = 2.38, SD = 0.56), and accomplishment (mean = 2.31, SD = 0.57). The only category with a statistically significant difference between junior and senior resident was content with seniors ranking it most important (mean = 3.35, SD = 0.93) compared to junior residents who ranked it least important (mean = 2.21, SD = 1.25), p = 0.01. Personal characteristics such as "Attendings cared about my learning" (mean = 3.56, SD = 0.50) and "I felt good at my job" (mean = 3.45, SD = 0.67), tended to be more important than structural characteristics such as "call schedule" (mean = 2.71, SD = 0.86), "formal didactics" (mean = 2.67, SD = 1.04), and "work-life balance" (mean = 2.70, SD = 0.99).
    Conclusions: This study demonstrates a novel understanding of the factors that contribute to resident preferences for certain rotations. Junior and senior residents attribute importance differently, which may provide the basis for level-appropriate improvements. Personal factors tended to be more contributory than structural factors, highlighting additional dimensions to examine when considering how to optimize certain rotations.
    MeSH term(s) Humans ; Internship and Residency ; Cross-Sectional Studies ; Learning
    Language English
    Publishing date 2022-07-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2022.07.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  8. Article ; Online: Sexual Harassment in Surgery-Is Operating Room Culture the Culprit?

    Freedman-Weiss, Mollie R / Coppersmith, Nathan A / Chiu, Alexander S / Heller, Danielle R / Cutler, Abigail S / Longo, Walter E / Oliveira, Kristen / Yoo, Peter S

    The American surgeon

    2023  Volume 89, Issue 12, Page(s) 6121–6126

    Abstract: Background: Sexual harassment is a known problem in surgical training and a focus of growing attention in recent years. However, the environments where sexual harassment in surgical training most commonly takes place are not yet described.: Methods: ... ...

    Abstract Background: Sexual harassment is a known problem in surgical training and a focus of growing attention in recent years. However, the environments where sexual harassment in surgical training most commonly takes place are not yet described.
    Methods: An anonymous, voluntary, electronic survey was distributed to surgical trainees, and all programs nationally were invited to participate.
    Results: Sixteen general surgery training programs elected to participate, and the survey achieved a response rate of 30%. 48.9% of respondents reported experiencing sexual harassment. The most common location for harassment was in the operating room (OR) (74% of harassed respondents). The second most common location for harassment was the wards (67.4% of harassed respondents). In the OR, attendings and nurses were the most common harassers. The most common harassment in the OR was being called a sexist slur or intimate nickname.
    Discussion: Surgical trainees report that the OR was the most common location for trainee harassment. Given that harassment is most commonly perpetrated by both attendings and nurses, harassment in surgical training may not entirely be due to hierarchies but may also be attributed to a flawed and permissive OR culture. Surgical training programs should vigilantly eliminate the circumstances that permit sexual harassment in the OR.
    MeSH term(s) Humans ; Sexual Harassment ; Operating Rooms ; Surveys and Questionnaires ; Internship and Residency ; Physicians, Women
    Language English
    Publishing date 2023-07-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
    DOI 10.1177/00031348231189832
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  9. Article ; Online: Early Predictors of Abscess Development after Perforated Pediatric Appendicitis.

    Dickinson, Catherine M / Coppersmith, Nathan A / Luks, Francois I

    Surgical infections

    2017  Volume 18, Issue 8, Page(s) 886–889

    Abstract: Background: Approximately one-third of children with appendicitis present with advanced disease or perforation. Whereas this increases the risk for post-operative complications and re-admission, it is not yet possible to predict early on who will ... ...

    Abstract Background: Approximately one-third of children with appendicitis present with advanced disease or perforation. Whereas this increases the risk for post-operative complications and re-admission, it is not yet possible to predict early on who will develop an abdominal abscess. We sought to identify specific risk factors for this complication, in an attempt to streamline post-operative care.
    Patients and methods: We reviewed the records of all cases of perforated appendicitis over a 12-month period at a tertiary children's hospital. All patients who developed an abscess despite treatment minimum of seven days of antibiotic therapy were identified. Patients who presented or were re-admitted with an abscess were excluded from analysis. Records were reviewed for demographics, laboratory results, progression of oral intake, and vital signs.
    Results: Of 273 patients with appendicitis, we identified 59 cases of perforated appendicitis. Fifteen patients were excluded. Eight of the remaining 44 patients (18.2%) developed an abscess during their initial admission. Their mean length of stay was longer than that of patients without an abscess (13.4 ± 7.1 vs. 6.9 ± 1.9 d, p < 0.0001). Gender, leukocytosis, or diarrhea at presentation, maximum temperature on post-operative day 3, and maximum heart rate on post-operative day 3 were not statistically different. Diet progression was different between the two groups: none of the 21 patients who were tolerating a regular diet by post-operative day 3 developed an abscess, compared with 8 of the 23 patients who were not yet eating a regular diet on post-operative day 3 (p < 0.01). Late leukocytosis also correlated with the presence of an abscess: 7 of the 8 patients with an abscess had persistent leukocytosis at days 5 through 7, compared with 3 of 31 patients without abscess (p < 0.05). An ultrasound was obtained for these 3 patients and proved normal.
    Conclusions: Tolerating a regular diet three days after appendectomy for perforated appendicitis decreased the likelihood of a post-operative abscess. No other parameter was predictive of this complication early in the post-operative period. If confirmed in a larger prospective study, this finding may help decrease the length of stay for low-risk patients, and identify abscesses in high-risk patients in a timely fashion.
    Language English
    Publishing date 2017-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1440120-4
    ISSN 1557-8674 ; 1096-2964
    ISSN (online) 1557-8674
    ISSN 1096-2964
    DOI 10.1089/sur.2017.134
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  10. Article ; Online: So You Want to be a Program Director? Career Paths of Colon and Rectal Surgery Residency Program Directors.

    Esposito, Andrew C / Coppersmith, Nathan A / Flom, Emily A / Chung, Mark / Reddy, Vikram / Leeds, Ira / Longo, Walter / Pantel, Haddon / Yoo, Peter S / Mongiu, Anne

    Journal of surgical education

    2023  Volume 80, Issue 4, Page(s) 588–596

    Abstract: Background: The trajectory of colon and rectal surgery residency program director (PD) career paths has not been well described, leaving those who aspire for the position with minimal guidance. The goal of this study is to characterize their career ... ...

    Abstract Background: The trajectory of colon and rectal surgery residency program director (PD) career paths has not been well described, leaving those who aspire for the position with minimal guidance. The goal of this study is to characterize their career paths in the United States. By understanding their experiences, the path to train and educate the next generation of colon and rectal surgeons as a PD will be better illuminated.
    Study design: This study was an anonymous, cross-sectional survey of all junior and senior colon and rectal surgery residency PDs in the United States during April and May of 2022. PDs were divided into junior and senior PDs. Results were compared using 2-sided independent t-tests and Kruskall-Wallis tests.
    Results: Of 65 colon and rectal surgery PDs, 48% (31/65) completed the survey which encompassed demographics, leadership, education, research, and time utilization. Participants were primarily white and male, although increased female representation was identified among the junior PDs (50%). Junior PDs were also more likely to hold associate or assistant professor positions at time of appointment (p = 0.01) and a majority of all PDs (64%) previously or currently held a leadership position in a national or regional surgical association. When appointed, senior PDs reported increased teaching time.
    Conclusions: This multi-institutional analysis of colon and rectal surgery residency PDs identified a trend towards equal gender representation and diversity amongst upcoming junior PDs. All respondents were appointed to PD from within the institution. Other key experiences included previous leadership roles and associate or assistant professor positions at time of appointment. While it is impossible to create a single recommended template for every aspiring colon and rectal surgery educator to advance to a PD position, this study provides guideposts along that career path.
    MeSH term(s) Humans ; Male ; Female ; United States ; Internship and Residency ; Cross-Sectional Studies ; Education, Medical, Graduate ; Surveys and Questionnaires ; Colon
    Language English
    Publishing date 2023-01-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2022.12.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

To top