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Article ; Online: Recruitment & Retainment of Vascular Surgeons: Prophylactic Measures to Improve the Current Workforce Crisis.

Jackson, Theresa N / Wheeler, Tiffany P / Truitt, Michael S / Nelson, Peter / Kempe, Kelly

2022 Volume 85, Page(s) 219–227

Abstract: Background: The vascular surgery workforce is in jeopardy with the current and increasing shortages. This study explores target populations for recruitment and aims to identify potential modifiable and nonmodifiable risk factors associated with reduced ... ...

Abstract	Background: The vascular surgery workforce is in jeopardy with the current and increasing shortages. This study explores target populations for recruitment and aims to identify potential modifiable and nonmodifiable risk factors associated with reduced job satisfaction among practicing vascular surgeons to improve retention and prevent early retirement. Methods: A cross-sectional national survey of surgeons (n = 1,043) was conducted from September 2016 to May 2017. Data included, demographic and occupational characteristics, as well as psychological, work-life balance, work-environment, and job-satisfaction variables. Surgeons were grouped into general surgery (n = 507), obstetrics and gynecology (n = 272), surgical subspecialties (n = 212), and vascular surgery (n = 52). Vascular surgeons were recategorized as more satisfied and less satisfied, and potential risk factors for job dissatisfaction were identified. Results: As compared with general surgeons, obstetrics and gynecology, as well as other surgical subspecialties, vascular surgery tended to be male-dominated with higher rates of non-white, minority groups (P < 0.05). Less vascular surgery respondents were found in the Midwest (P < 0.001). Vascular surgeons worked more hours on average than other surgical fields and were less satisfied with work (P < 0.05). Potential job dissatisfaction risk factors among vascular surgeons include: unhealthy work-life balance, poor camaraderie/coworker dissatisfaction, insufficient hospital support, hostile hospital culture, discontent with supervision, minimal patient diversity, dissatisfaction with work in general, and unhappiness with career choice (P < 0.05). Conclusions: Recruiting new vascular surgery trainees while simultaneously preventing early retirement and attrition is critical to combatting the current workforce crisis. Potential interventions include (1) re-branding of the field with prioritization of work-life balance, (2) increasing hospital administration's support, (3) creating a collaborative work environment, and (4) facilitating personal accomplishment in work.
MeSH term(s)	Cross-Sectional Studies ; Humans ; Job Satisfaction ; Male ; Surgeons/psychology ; Surveys and Questionnaires ; Treatment Outcome ; Workforce
Language	English
Publishing date	2022-03-07
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2022.02.011
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Article ; Online: Recruitment of General Surgery Residents into Vascular Surgery.

Jackson, Theresa N / Wheeler, Tiffany P / Truitt, Michael S / Nelson, Peter R / Kempe, Kelly

Journal of surgical education

2021 Volume 79, Issue 1, Page(s) 165–172

Abstract: Background: Vascular surgery fellowship applications among general surgery residents have declined. Given this steady downward trend in vascular applicants in conjunction with a predicted critical shortage of vascular surgeons, a call to action for ... ...

Abstract	Background: Vascular surgery fellowship applications among general surgery residents have declined. Given this steady downward trend in vascular applicants in conjunction with a predicted critical shortage of vascular surgeons, a call to action for increased recruitment is needed. To improve recruitment efforts, a subgroup analysis of general surgery residents was performed to explore factors that influence interest in vascular surgery. Methods: A cross-sectional national survey of residents (n = 467) was conducted from September 2016 to May 2017. In addition to collection of demographic and occupational characteristics, assessment of psychological, work-life balance, and job-satisfaction variables were obtained. Residents were grouped based on their interest in pursuing a fellowship. Chi-squared and Fisher's exact test was performed to determine significant variables. Results: Residents were grouped into "interest in non-vascular fellowship" (n = 350), "interest in vascular fellowship" (n = 21), and "not interested in fellowship" (n = 96). Significant variables between the groups included age, geographic location, residency size, and type of institution (p < 0.05). Those interested in vascular surgery tended to be older. Residents not interested in fellowship were more commonly located in the Midwest and at smaller, community residencies. No significant difference was found between mental wellness and work-life balance variables. Those residents interested in a vascular surgery fellowship were more dissatisfied with their current salary as compared to other residents (p = 0.021). Conclusions: There is a predicted critical shortage in the vascular surgery workforce making recruitment of the best and brightest residents into the specialty vital to its future. In order to invigorate and broaden our group of vascular surgeons, focused recruitment of younger, Midwest, general surgery residents at smaller, community programs may provide the most yield. Publicizing the strengths of a vascular surgery career including the diversity of patients, continuity of care, proficiency in technical skill, and higher monetary rewards should be emphasized in recruiting these target populations.
MeSH term(s)	Career Choice ; Cross-Sectional Studies ; Fellowships and Scholarships ; General Surgery/education ; Humans ; Internship and Residency ; Surveys and Questionnaires ; Vascular Surgical Procedures
Language	English
Publishing date	2021-07-21
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.2021.07.001
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Article ; Online: Appropriate Imaging for Geriatric Trauma.

Pearcy, Christopher / Grossman Verner, Heather M / Figueroa, Brian A / Burris, Jennifer / Truitt, Michael S / Karpisek, Andrew

The American surgeon

2022 Volume 89, Issue 11, Page(s) 4531–4535

Abstract: Background: Trauma is the leading cause of preventable death in the United States. Early detection of life-threatening injuries leads to improved survival. Computed tomography (CT) scanning has become the modality of choice for early detection of ... ...

Abstract	Background: Trauma is the leading cause of preventable death in the United States. Early detection of life-threatening injuries leads to improved survival. Computed tomography (CT) scanning has become the modality of choice for early detection of injuries in the stable patient. Some studies have associated selective imaging (Selective-CT) with equivalent outcomes compared to whole body imaging (Pan-CT) with lower costs and radiation exposure. Within the geriatric population, however, the utility of Pan-CT remains controversial. Therefore, the aim of this study was to determine if a difference exists between Selective-CT and Pan-CT imaging in the geriatric trauma patient. Methods: A retrospective analysis of Level 3 (G60) trauma activations presenting to our urban Level I trauma center between June 2016 and June 2019 was performed. Pan-CT was defined by ICD-10 codes indicating a head, cervical spine, chest, abdomen, and pelvis CT series. Patients with missing images and those who were transferred from other institutions were excluded. Logistic regression controlling for age, gender, injury type, severity, and Glasgow Coma Score was performed. Results: A total of 1014 patients met inclusion criteria. Of these, 30.9% underwent Pan-CT (n = 314), 48.9% had Selective-CT (n = 497), and 20.2% received no CT imaging (n = 203). After logistic regression, no clinically significant variations in emergency department length of stay (LOS), hospital LOS, ICU LOS, ventilator days, discharge disposition, missed injury rate, or mortality rate were observed between imaging strategies. Conclusions: Pan-CT provides no clinically significant advantage over Selective-CT in the geriatric trauma patient.
MeSH term(s)	Aged ; Humans ; Retrospective Studies ; Emergency Service, Hospital ; Trauma Centers ; Tomography, X-Ray Computed/methods ; Radiation Exposure ; Injury Severity Score ; Wounds, Nonpenetrating
Language	English
Publishing date	2022-08-18
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	10.1177/00031348221121545
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Article ; Online: Biologic Keyhole Mesh in Hiatal Hernia Repair.

Watkins, Jeffrey R / Truitt, Michael S / Osman, Houssam / Jeyarajah, Rohan D

JSLS : Journal of the Society of Laparoendoscopic Surgeons

2018 Volume 22, Issue 1

Abstract: Background and objectives: Laparoscopic paraesophageal hernia repair (LPEHR) is the new standard, but the use of mesh is still debated. Biologic mesh has shown great promise, but only the U-shaped onlay has been extensively studied. Postoperative ... ...

Abstract	Background and objectives: Laparoscopic paraesophageal hernia repair (LPEHR) is the new standard, but the use of mesh is still debated. Biologic mesh has shown great promise, but only the U-shaped onlay has been extensively studied. Postoperative dysphagia has historically been a concern with the use of synthetic keyhole mesh and subsequently slowed its adoption. The purpose of our study was to identify the incidence of postoperative dysphagia in a series of patients who underwent laparoscopic paraesophageal hernia repair with novel placement of keyhole biologic mesh. Methods: Thirty consecutive patients who underwent hernia repair with primary suture cruroplasty and human acellular dermal matrix keyhole mesh reinforcement were reviewed over a 2-year period. All procedures were performed at a single institution. Postoperative symptoms were retrospectively identified. Any postoperative hernia on imaging was defined as radiographic recurrence. Results: Of the 30 consecutive patients who underwent hernia repair, 3 (10%) had mild preoperative dysphagia. The number remained unchanged after LPEHR with keyhole mesh. Return of mild reflux symptoms occurred in 6 (20%) patients. Repeat imaging was performed in 11 patients (37%) at an average of 8 months with 2 slight recurrences. All hernias were classified on preoperative imaging as large hiatal hernias. There were no postoperative complications. Conclusion: Laparoscopic paraesophageal hernia repair with biologic keyhole mesh reinforcement has a low recurrence rate and no increase in postoperative dysphagia. The traditional belief that keyhole mesh has a higher incidence of dysphagia was not evident in this series.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Biological Products ; Deglutition Disorders/epidemiology ; Female ; Hernia, Hiatal/surgery ; Herniorrhaphy/adverse effects ; Herniorrhaphy/instrumentation ; Herniorrhaphy/methods ; Humans ; Laparoscopy ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Recurrence ; Retrospective Studies ; Surgical Mesh/adverse effects
Chemical Substances	Biological Products
Language	English
Publishing date	2018-03-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2011211-7
ISSN	1938-3797 ; 1086-8089
ISSN (online)	1938-3797
ISSN	1086-8089
DOI	10.4293/JSLS.2017.00086
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Article ; Online: Perception versus reality: elucidating motivation and expectations of current fellowship council minimally invasive surgery fellows.

Watkins, Jeffrey R / Pryor, Aurora D / Truitt, Michael S / Jeyarajah, D Rohan

Surgical endoscopy

2018 Volume 32, Issue 11, Page(s) 4422–4427

Abstract: Background: The aim of our study is to determine minimally invasive trainee motivation and expectations for their respective fellowship. Minimally Invasive Surgery (MIS) is one of the largest non-ACGME post-residency training pathways though little is ... ...

Abstract	Background: The aim of our study is to determine minimally invasive trainee motivation and expectations for their respective fellowship. Minimally Invasive Surgery (MIS) is one of the largest non-ACGME post-residency training pathways though little is known concerning the process of residents choosing MIS as a fellowship focus. As general surgery evolves, it is important to understand resident motivation in order to better prepare them for a surgical career. Methods: A survey invitation was sent to current trainees in the Minimally Invasive and related pathways through the Fellowship Council. The participants were asked to complete a web-based questionnaire detailing demographics, experiences preparing for fellowship, motivation in choosing an MIS fellowship, and expectations for surgical practice after fellowship. Results: Sixty-seven MIS trainees responded to the survey out of 151 invitations (44%). The Fellowship Council website, mentors, and other fellows were cited as the most helpful source of information when applying for fellowship. Trainees were active in surgical societies as residents, with 78% having membership in the ACS and 60% in SAGES. When deciding to pursue MIS as a fellowship, the desire to increase laparoscopic training was the most important factor. The least important reasons cited were lack of laparoendoscopic training in residency and desire to learn robotic surgery. The majority of trainees believed their laparoscopic skill set was above that of their residency cohort (81%). The most desired post-fellowship employment model is hospital employee (46%) followed by private practice (27%). Most fellows plan on marketing themselves as MIS surgeons (90%) or General Surgeons (78%) when in practice. Conclusions: Residents who choose MIS as a fellowship have a strong exposure to laparoscopy and want to become specialists in their field. Mentors and surgical societies including ACS and SAGES play a vital role in preparing residents for fellowship and practice.
MeSH term(s)	Attitude of Health Personnel ; Clinical Competence ; Fellowships and Scholarships ; General Surgery/education ; Humans ; Internship and Residency ; Laparoscopy/education ; Minimally Invasive Surgical Procedures/education ; Motivation ; Robotic Surgical Procedures/education ; Specialization ; Surgeons/psychology ; Surveys and Questionnaires ; United States
Language	English
Publishing date	2018-04-17
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-018-6184-2
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Article ; Online: Traumatized attendings - When the doctor has the disease.

Jackson, Theresa N / Jackson, Diane L / Nelson, Peter R / Kim, Dennis Y / Agrawal, Vaidehi / Truitt, Michael S

American journal of surgery

2021 Volume 223, Issue 4, Page(s) 626–632

Abstract: Background: This study aims to compare PTSD prevalence between seven medical specialties and to identify potential risk factors for PTSD.: Methods: A cross-sectional national survey of attending physicians (n = 2216) was conducted and screened for ... ...

Abstract	Background: This study aims to compare PTSD prevalence between seven medical specialties and to identify potential risk factors for PTSD. Methods: A cross-sectional national survey of attending physicians (n = 2216) was conducted and screened for PTSD using the Primary Care PTSD Screen. Stepwise multivariable regression analysis with backward elimination identified potential risk factors. Results: Overall prevalence of PTSD was 14% and ranged from 7% to 18% for psychiatrists and OBGYNs, respectively (p = 0.004). Six potential risk factors for PTSD included: emotional exhaustion, job dissatisfaction, lack of autonomy, working >60 h per week, poor camaraderie, and female gender (p < 0.05). Conclusions: The prevalence of PTSD in attending physicians is more than double that of the general population. Higher risk specialties include OBGYN and general surgery. Specialty-specific interventions targeted at reducing physician burnout and improving the physician work-environment are needed to improve physician wellness and reduce PTSD.
MeSH term(s)	Burnout, Professional/psychology ; Cross-Sectional Studies ; Female ; Humans ; Job Satisfaction ; Medical Staff, Hospital ; Physicians/psychology ; Stress Disorders, Post-Traumatic/etiology ; Surveys and Questionnaires
Language	English
Publishing date	2021-05-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2021.05.010
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Article ; Online: Common attributes of high/low performing general surgery programs as they relate to QE/CE pass rates.

Bankhead-Kendall, Brittany / Slama, Eliza / Truitt, Michael S

American journal of surgery

2016 Volume 212, Issue 6, Page(s) 1248–1250

Abstract: Purpose: This comparative study aims to identify the differences between high and low performing programs as defined by their ABS board pass rates.: Methods: We identified programs in the top 5% (TP) and lower 5% (LP) for 1st time QE/CE pass rates ... ...

Abstract	Purpose: This comparative study aims to identify the differences between high and low performing programs as defined by their ABS board pass rates. Methods: We identified programs in the top 5% (TP) and lower 5% (LP) for 1st time QE/CE pass rates during the study period with resident and program related variables. All data was pooled and analyzed. Results: TP had more U.S. graduates, higher average USMLE Step 1/2 scores, and all residents took the exam within a year of graduation. TP were more likely to rotate at a Level 1 trauma center, spent more time with simulation, and had numerous fellowship programs. They ascribed their success to mock oral exams, mature curricula, and group educational activities. Graduates of TP chose general surgery twice as often (40% vs 19%). Conclusions: Program related factors (Level 1 trauma, excellent didactics, higher number of fellowships, increased group educational activities, higher percentage of graduates into general surgery) are associated with TP. Our data suggests there may be modifiable program related variables that positively impact QE/CE pass rates.
MeSH term(s)	Certification ; Educational Measurement ; General Surgery/education ; Humans ; Internship and Residency ; United States
Language	English
Publishing date	2016-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2016.08.024
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Article ; Online: Acute Care Surgery: Trauma, Critical Care, Emergency General Surgery… Improved Compliance with Preventative Health?

Gutierrez, Tim / Hambright, Greg / Mustafa, Tahir / Cahill, Anthony / Agrawal, Vaidehi / Truitt, Michael S

The American surgeon

2019 Volume 85, Issue 1, Page(s) e42–e44

MeSH term(s)	Aged ; Aged, 80 and over ; Critical Care ; Female ; General Surgery ; Guideline Adherence ; Humans ; Male ; Middle Aged ; Preventive Medicine ; Traumatology
Language	English
Publishing date	2019-02-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
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Article ; Online: Re: driving intoxicated: is hospital admission protective against legal ramifications?

Cheek, Susannah / Truitt, Michael / Dunn, Ernest

The journal of trauma and acute care surgery

2014 Volume 76, Issue 5, Page(s) 1335–1336

MeSH term(s)	Accidents, Traffic/statistics & numerical data ; Alcoholic Intoxication/complications ; Automobile Driving/legislation & jurisprudence ; Ethanol/blood ; Humans ; Police/legislation & jurisprudence ; Trauma Centers/statistics & numerical data ; Wounds and Injuries/etiology
Chemical Substances	Ethanol (3K9958V90M)
Language	English
Publishing date	2014-05
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	2651070-4
ISSN	2163-0763 ; 2163-0755
ISSN (online)	2163-0763
ISSN	2163-0755
DOI	10.1097/TA.0000000000000208
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Article: Delirium in the ICU: What About the Floor?

Cahill, Anthony / Pearcy, Christopher / Agrawal, Vaidehi / Sladek, Phillip / Truitt, Michael S

Journal of trauma nursing : the official journal of the Society of Trauma Nurses

2017 Volume 24, Issue 4, Page(s) 242–244

Abstract: Delirium was first described in the 1800s as acute, fluctuating confusion. Recent studies note an incidence of 15% in adult intensive care unit patients. Here we present the first prospective study to evaluate the incidence and risk factors for delirium ... ...

Abstract	Delirium was first described in the 1800s as acute, fluctuating confusion. Recent studies note an incidence of 15% in adult intensive care unit patients. Here we present the first prospective study to evaluate the incidence and risk factors for delirium in patients admitted to the trauma surgeon (TS) in non-critical care areas (NCCAs). Patients 18 years or older admitted to any TS in the designated NCCA were evaluated and consented for participation over a 3-month period. Participants were screened with the Confusion Assessment Method (CAM) every 12 hr. Those positive for delirium (CAM+) were administered the CAM-Severity. In addition, 69 other previously identified risk factors were evaluated. Over 3 months, 148 patients were evaluated, 12 of whom were CAM+ (8%). Of patients 65 years or older, 21% screened positive for delirium. Age, education level, presence of Foley catheter, respiratory distress, orthopedic operation, and lack of ambulation were risk factors associated with delirium (p < .05). Among all TS patients in the NCCA, we found delirium to be present in 8%. Our nurses identified a 21% incidence of delirium in patients 65 years or older. Given this significant incidence, screening at-risk patients in the NCCA should be considered.
Language	English
Publishing date	2017-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	1281159-2
ISSN	1078-7496
ISSN	1078-7496
DOI	10.1097/JTN.0000000000000298
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