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  1. Article ; Online: Development and design of a mobile application for prescription opioid clinical decision-making: a feasibility study in New York City, USA.

    Marziali, Megan E / Giordano, Mirna / Gleit, Zachary / Prigoff, Jake / Landau, Ruth / Martins, Silvia S

    BMJ open

    2023  Volume 13, Issue 2, Page(s) e066427

    Abstract: Objectives: Excessive opioid prescribing is a contributing factor to the opioid epidemic in the USA. We aimed to develop, implement and evaluate the usability of a clinical decision-making mobile application (app) for opioid prescription after surgery.!# ...

    Abstract Objectives: Excessive opioid prescribing is a contributing factor to the opioid epidemic in the USA. We aimed to develop, implement and evaluate the usability of a clinical decision-making mobile application (app) for opioid prescription after surgery.
    Methods: We developed two clinical decision trees, one for opioid prescription after adult laparoscopic cholecystectomy and one for posterior spinal fusion surgery in adolescents. We developed a mobile app incorporating the two algorithms with embedded clinical decision-making, which was tested by opioid prescribers. A survey collected prescription intention prior to app use and participants' evaluation. Participants included opioid prescribers for patients undergoing (1) laparoscopic cholecystectomy in adults or (2) posterior spinal fusion in adolescents with idiopathic scoliosis.
    Results: Eighteen healthcare providers were included in this study (General Surgery: 8, Paediatrics: 10). Intended opioid prescription before app use varied between departments (General Surgery: 0-10 pills (mean=5.9); Paediatrics: 6-30 pills (mean=20.8)). Intention to continue using the app after using the app multiple times varied between departments (General Surgery: N=3/8; Paediatrics: N=7/10). The most reported reason for not using the app is lack of time.
    Conclusions: In this project evaluating the development and implementation of an app for opioid prescription after two common surgeries with different prescription patterns, the surgical procedure with higher intended and variable opioid prescription (adolescent posterior spinal fusion surgery) was associated with participants more willing to use the app. Future iterations of this opioid prescribing intervention should target surgical procedures with high variability in both patients' opioid use and providers' prescription patterns.
    MeSH term(s) Adolescent ; Adult ; Humans ; Child ; Analgesics, Opioid/therapeutic use ; Feasibility Studies ; New York City ; Mobile Applications ; Practice Patterns, Physicians' ; Clinical Decision-Making ; Prescriptions
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2023-02-28
    Publishing country England
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S. ; Research Support, N.I.H., Extramural
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2022-066427
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  2. Article ; Online: Medical Student Assessment in the Time of COVID-19.

    Prigoff, Jake / Hunter, Madeleine / Nowygrod, Roman

    Journal of surgical education

    2020  Volume 78, Issue 2, Page(s) 370–374

    Abstract: Background: Medical student education in the era of the COVID-19 outbreak is vastly different than the standard education we have become accustomed to. Medical student assessment is an important aspect of adjusting curriculums in the era of increased ... ...

    Abstract Background: Medical student education in the era of the COVID-19 outbreak is vastly different than the standard education we have become accustomed to. Medical student assessment is an important aspect of adjusting curriculums in the era of increased virtual learning.
    Methods: Students took our previously validated free response clinical skills exam (CSE) at the end of the scheduled clerkship as an open-book exam to eliminate any concern for breaches in the honor code and then grades were adjusted based on historic norms. The National Board of Medical Examiners (NBME) shelf exam was taken with a virtual proctor. Students whose clerkship was affected by the COVID-19 pandemic were compared to the students from a similarly timed surgery block the previous 3 years. Primary outcomes included CSE and NBME exam scores. Secondary outcomes included clinical evaluations and the percentage of students who received grades of Honors, High Pass, and Pass. After the surgery clerkship was completed, we surveyed all students who participated in the surgery clerkship during the COVID-19 crisis.
    Results: There were 19 students during the COVID-interrupted clerkship and 61 students in similarly timed clerkships between 2017 and 2019. Prior to adjustment and compared to historic scores, the COVID-interrupted clerkship group scored higher on the CSE, NBME exam, and performance evaluations (median, CSE:75.2 vs 68.7, shelf:68.0 vs 64.0, performance evaluation mean: 2.96 vs 2.78). The percentage of students with an honors was marginally higher in the group affected by COVID (42% vs 32%). Out of 19 students surveyed, 9 students responded. Seven students stated they would have preferred a closed-book CSE, citing a few drawbacks of the open-book format such as modifying their exam preparation, being discouraged from thinking prior to searching online during the test, and second guessing their answers.
    Conclusions: During the initial outbreak of COVID-19, we found that an open book exam and a virtually proctored shelf exam was a reasonable option. However, to avoid adjustments and student dissatisfaction, we would recommend virtual proctoring if available.
    MeSH term(s) COVID-19/epidemiology ; Clinical Clerkship ; Clinical Competence ; Curriculum ; Education, Medical, Undergraduate ; Educational Measurement/methods ; Female ; Humans ; Male ; Pandemics ; SARS-CoV-2 ; United States/epidemiology ; Young Adult
    Keywords covid19
    Language English
    Publishing date 2020-07-30
    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.2020.07.040
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  3. Article ; Online: General surgery trainee perception of early specialization programs.

    Prigoff, Jake G / Nowygrod, Roman / Lee-Kong, Steven / Kim, Michael

    American journal of surgery

    2020  Volume 220, Issue 4, Page(s) 863–864

    MeSH term(s) Adult ; Attitude ; Cross-Sectional Studies ; Female ; General Surgery/education ; Humans ; Internship and Residency ; Male ; Specialization ; Students, Medical/psychology ; Time Factors
    Language English
    Publishing date 2020-06-05
    Publishing country United States
    Document type Editorial
    ZDB-ID 2953-1
    ISSN 1879-1883 ; 0002-9610
    ISSN (online) 1879-1883
    ISSN 0002-9610
    DOI 10.1016/j.amjsurg.2020.06.004
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  4. Article ; Online: Navigating the Infinite Number of Educational Resources: The Development of a Publicly Available Surgical Educational Digital Resource Library.

    Titan, Ashley L / Jadi, Jihane / Prigoff, Jake G / Lewis, Jaime D / Adams, Sasha / Brownstein, Michelle

    Journal of surgical education

    2021  Volume 78, Issue 6, Page(s) 1796–1802

    Abstract: Objective: There has been an explosion of digital resources available for general surgical education and board preparation. This makes it difficult for a new learner, regardless of their training level, to determine which resources best fit their needs. ...

    Abstract Objective: There has been an explosion of digital resources available for general surgical education and board preparation. This makes it difficult for a new learner, regardless of their training level, to determine which resources best fit their needs. The uncertainty surrounding resource selection due to the large number of options causes stress, anxiety, and inefficiency for surgical learners. Our objective was to develop a digital surgical educational resource library to assist with selection.
    Design: A needs assessment via multi-center focus groups encompassing all levels of learners from various subspecialties and training levels (medical students, trainees, junior surgeons, and senior surgeons) was performed to determine what information is desired in a surgical resource library. We conducted follow-up interviews and surveys to learn which resources were most commonly used for studying throughout training.
    Setting: Multi-institutional RESULTS: The initial needs assessment detailed requests for an expansive array of surgical resources characterized by media type and price. We identified 104 resources that met these criteria. There were 33 resources used by medical students, 37 by residents, 16 used specifically for surgical boards preparation, and 25 by attending surgeons. These resources were composed of textbooks, review books, question banks, audio resources, video resources, and review courses. The prices of the resources ranged from free to greater than 400 dollars.
    Conclusions: A digital resource library should be broad and must address needs that change along a learner's career. Changes and improvements are required not only to meet the changing needs of the learners, but also to ensure the library remains current with the ever-growing number of resources. We plan to incorporate reviews of the resources from those surveyed to help visitors of the online library determine which resources may best suit their needs. Development of a digital resource library may assist learners by helping them easily identify what is available and has been peer reviewed allowing them to determine what best meets their educational needs.
    MeSH term(s) Clinical Competence ; Curriculum ; Humans ; Learning ; Students, Medical ; Surgeons
    Language English
    Publishing date 2021-05-26
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2021.04.019
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  5. Article ; Online: Shaves off the Cavity or Specimen in Lumpectomy for Breast Cancer.

    Iwai, Yoshiko / Prigoff, Jake G / Sun, Luona / Wiechmann, Lisa / Taback, Bret / Rao, Roshni / Ugras, Stacy K

    The Journal of surgical research

    2022  Volume 277, Page(s) 296–302

    Abstract: Introduction: Re-excision for positive margins (margins where tumor is positive) after breast conserving surgery (BCS) is common and burdensome for breast cancer patients. Routine shave margins can reduce positive margins and re-excision rates. Cavity ... ...

    Abstract Introduction: Re-excision for positive margins (margins where tumor is positive) after breast conserving surgery (BCS) is common and burdensome for breast cancer patients. Routine shave margins can reduce positive margins and re-excision rates. Cavity shaving margin (CSM) removes margins from the lumpectomy cavity edges, whereas specimen shave margin (SSM) requires ex vivo removal of margins from the resected specimen.
    Methods: We assessed breast cancer patients undergoing BCS who received CSM or SSM procedures from 2017 to 2019. CSM and SSM techniques were compared by analyzing positive rates of primary and final shaved margins, re-excision rates, and tissue volumes removed.
    Results: Of 116 patients included in this study, 57 underwent CSM and 59 underwent SSM. Primary margins were positive or close in 19 CSM patients and 21 SSM patients (33% versus 36%; P = 0.798). Seventeen CSM patients had a tumor in shaved margin specimens, compared to four patients for SSM (30% versus 7%; P < 0.001); however, final shave margins were similar (5% versus 5%; P = 0.983). Volumes of shave specimens were higher with SSM (40.7 versus 13.4 cm
    Conclusions: CSM and SSM are effective techniques for achieving low re-excision rates. Our findings suggest that surgeons performing either CSM or SSM may maintain operative preferences and achieve similar results.
    MeSH term(s) Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Carcinoma, Ductal, Breast/pathology ; Carcinoma, Ductal, Breast/surgery ; Female ; Humans ; Margins of Excision ; Mastectomy, Segmental/methods ; Reoperation ; Retrospective Studies
    Language English
    Publishing date 2022-05-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2022.04.027
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  6. Article: Medical Student Assessment in the Time of COVID-19

    Prigoff, Jake / Hunter, Madeleine / Nowygrod, Roman

    J. surg. educ

    Abstract: BACKGROUND: Medical student education in the era of the COVID-19 outbreak is vastly different than the standard education we have become accustomed to. Medical student assessment is an important aspect of adjusting curriculums in the era of increased ... ...

    Abstract BACKGROUND: Medical student education in the era of the COVID-19 outbreak is vastly different than the standard education we have become accustomed to. Medical student assessment is an important aspect of adjusting curriculums in the era of increased virtual learning. METHODS: Students took our previously validated free response clinical skills exam (CSE) at the end of the scheduled clerkship as an open-book exam to eliminate any concern for breaches in the honor code and then grades were adjusted based on historic norms. The National Board of Medical Examiners (NBME) shelf exam was taken with a virtual proctor. Students whose clerkship was affected by the COVID-19 pandemic were compared to the students from a similarly timed surgery block the previous 3 years. Primary outcomes included CSE and NBME exam scores. Secondary outcomes included clinical evaluations and the percentage of students who received grades of Honors, High Pass, and Pass. After the surgery clerkship was completed, we surveyed all students who participated in the surgery clerkship during the COVID-19 crisis. RESULTS: There were 19 students during the COVID-interrupted clerkship and 61 students in similarly timed clerkships between 2017 and 2019. Prior to adjustment and compared to historic scores, the COVID-interrupted clerkship group scored higher on the CSE, NBME exam, and performance evaluations (median, CSE:75.2 vs 68.7, shelf:68.0 vs 64.0, performance evaluation mean: 2.96 vs 2.78). The percentage of students with an honors was marginally higher in the group affected by COVID (42% vs 32%). Out of 19 students surveyed, 9 students responded. Seven students stated they would have preferred a closed-book CSE, citing a few drawbacks of the open-book format such as modifying their exam preparation, being discouraged from thinking prior to searching online during the test, and second guessing their answers. CONCLUSIONS: During the initial outbreak of COVID-19, we found that an open book exam and a virtually proctored shelf exam was a reasonable option. However, to avoid adjustments and student dissatisfaction, we would recommend virtual proctoring if available.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #689018
    Database COVID19

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  7. Article ; Online: Medical Student Assessment in the Time of COVID-19

    Prigoff, Jake / Hunter, Madeleine / Nowygrod, Roman

    Journal of Surgical Education ; ISSN 1931-7204

    2020  

    Keywords Surgery ; Education ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    DOI 10.1016/j.jsurg.2020.07.040
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Surgical Education and the Longitudinal Model at the Columbia-Bassett Program.

    Charak, Gregory / Prigoff, Jake G / Heneghan, Steven / Cooper, Shelby / Weil, Henry / Nowygrod, Roman

    Journal of surgical education

    2020  Volume 77, Issue 4, Page(s) 854–858

    Abstract: Objective: The aim of this study is to evaluate a longitudinal medical student surgical curriculum.: Design: This is a case-controlled study of students who participated in a longitudinal surgical curriculum compared to students who participated in a ...

    Abstract Objective: The aim of this study is to evaluate a longitudinal medical student surgical curriculum.
    Design: This is a case-controlled study of students who participated in a longitudinal surgical curriculum compared to students who participated in a standard 12-week surgical clerkship. This study evaluates qualitative data including exam scores as well as qualitative data regarding student experience.
    Setting: All students were from Columbia College of Physicians and Surgeons in New York City. A portion of the students completed their clerkship at the main university campus and others performed their clerkship at an affiliate site including Bassett Health Network. The longitudinal curriculum was only at the Bassett Health Network.
    Participants: All medical students who completed their surgical curriculum from 2012 to 2015 were eligible. The survey response rate was 45% for a total of 128 students.
    Results: The students receiving the longitudinal curriculum outperformed the block students on the national shelf exam (77 vs 71, p = 0.001). The longitudinal students were also more likely to learn directly from attending surgeons and were more likely to have a greater interest in a surgical career after their surgery experience.
    Conclusions: The longitudinal approach to teaching surgery to medical students achieves non-inferior or superior testing outcomes when compared to the block model, and superior outcomes in terms of students' own attitudes and perceptions.
    MeSH term(s) Clinical Clerkship ; Curriculum ; Education, Medical, Undergraduate ; Humans ; New York City ; Students, Medical
    Language English
    Publishing date 2020-03-17
    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.2020.02.002
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  9. Article ; Online: Outcomes of resection for solitary ≤5 cm intrahepatic cholangiocarcinoma.

    Tarchi, Paola / Tabrizian, Parissa / Prigoff, Jake / Schwartz, Myron

    Surgery

    2017  Volume 163, Issue 4, Page(s) 698–702

    Abstract: Background: Resection remains the treatment of choice achieving 5-year survival rates of 22% to 40%. The aim of this analysis was to examine the outcomes of patients with solitary ≤5 cm intrahepatic cholangiocarcinoma.: Methods: A retrospective chart ...

    Abstract Background: Resection remains the treatment of choice achieving 5-year survival rates of 22% to 40%. The aim of this analysis was to examine the outcomes of patients with solitary ≤5 cm intrahepatic cholangiocarcinoma.
    Methods: A retrospective chart review was performed on 123 patients undergoing resection for primary intrahepatic cholangiocarcinoma from 1995 to 2013. Group 1 included patients with asymptomatic solitary intrahepatic cholangiocarcinoma measuring ≤5 cm.
    Results: Group 1 (n = 33, 27%) had a greater rate of underlying liver disease, cirrhosis, minor resection, favorable pathologic features including decreased rate of perineural invasion, vascular invasion, lymph node involvement, and satellite nodules (P < .05). Factors associated with overall poor outcome were patients in Group 2 (P=.025), positive margin (P=.04), presence of satellite nodules (P = .008), and multinodularity (P=.058). Factors associated with recurrence in Group 1 were presence of satellite nodules (P=.004), and tumor size ≥4 cm (P=.031). Factors associated with decreased survival in Group 1 was transfusion requirement (P = 0.018). The 5-year recurrence and survival rates were (39% vs 67%) and (71% vs 53%) in Group 1 versus Group 2, respectively (P=.111).
    Conclusion: Resection of solitary intrahepatic cholangiocarcinoma ≤5 cm can achieve 5-year survival rates up to 71%. Results were comparable to those of patients undergoing transplantation for hepatocellular cancer within the Milan criteria.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms/mortality ; Bile Duct Neoplasms/pathology ; Bile Duct Neoplasms/surgery ; Cholangiocarcinoma/mortality ; Cholangiocarcinoma/pathology ; Cholangiocarcinoma/surgery ; Disease-Free Survival ; Female ; Hepatectomy ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/pathology ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2017-12-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202467-6
    ISSN 1532-7361 ; 0039-6060
    ISSN (online) 1532-7361
    ISSN 0039-6060
    DOI 10.1016/j.surg.2017.09.058
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  10. Article ; Online: Ethical Recommendations for Video Recording in the Operating Room.

    Prigoff, Jake G / Sherwin, Marc / Divino, Celia M

    Annals of surgery

    2016  Volume 264, Issue 1, Page(s) 34–35

    MeSH term(s) Clinical Competence ; Humans ; Surgical Procedures, Operative/education ; Surgical Procedures, Operative/ethics ; Video Recording/ethics
    Language English
    Publishing date 2016-04-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000001652
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