| 1. |
- Ameryoun, Ahmad, et al.
(författare)
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Effectiveness of an In-Service Education Program to Improve Patient Safety Directed at Surgical Residents : A Randomized Controlled Trial
- 2019
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Ingår i: Journal of Surgical Education. - ;HHJ : Elsevier. - 1931-7204 .- 1878-7452. ; 76:5, s. 1309-1318
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patient safety is a critical issue in healthcare services particularly in surgical units and operation rooms because of the high prevalence and risk of medical errors in such settings. This study was conducted to determine whether a 1-day educational intervention can change the attitude and behavior of surgical residents regarding patient safety.Methods: A total of 90 surgical residents were recruited from 6 university hospitals located in Tehran and Qazvin, Iran, and were randomized to either the intervention or a control group. Those in the intervention group participated in a 1-day workshop on patient safety, whereas the control group received no intervention. Both groups were followed for 3 months after the intervention was completed. The Safety Attitude Questionnaire and Oxford Non-Technical Skills scale were administered at 3 points in time (baseline, 1 month after the intervention, and 3 month later). The data were analyzed using repeated measures analysis of variance.Results: Total score on the Safety Attitude Questionnaire improved from 54.5 (SD = 14.4) at baseline to 58.3 (SD = 13.8) 3 months after the intervention in the intervention group; all dimensions, with the exception of working condition, showed significant changes. In addition, the Oxford Non-Technical Skills scale – as assessed by attending surgeons – improved significantly in all domains (p < 0.05). More than 60% of participants in the intervention group scored in the positive range for items assessing safety and teamwork climate.Conclusions: A 1-day interactive educational workshop may be effective in changing the attitude and practice of surgical residents regarding patient safety. Further assessment of this intervention in other healthcare settings involving health professionals from various specialties and use of an objective measure such as number of reported medical errors are needed to corroborate these findings.
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| 2. |
- Anderson, Geoffrey A., et al.
(författare)
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Development of a Novel Global Surgery Course for Medical Schools
- 2019
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Ingår i: Journal of Surgical Education. - : Elsevier BV. - 1931-7204. ; 76:2, s. 469-479
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We endeavored to create a comprehensive course in global surgery involving multinational exchange. Design: The course involved 2 weeks of didactics, 2 weeks of clinical rotations in a low-resource setting and 1 week for a capstone project. We evaluated our success through knowledge tests, surveys of the students, and surveys of our Zimbabwean hosts. Setting: The didactic portions were held in Sweden, and the clinical portion was primarily in Harare with hospitals affiliated with the University of Zimbabwe. Participants: Final year medical students from Lund University in Sweden, Harvard Medical School in the USA and the University of Zimbabwe all participated in didactics in Sweden. The Swedish and American students then traveled to Zimbabwe for clinical work. The Zimbabwean students remained in Sweden for a clinical experience. Results: The course has been taught for 3 consecutive years and is an established part of the curriculum at Lund University, with regular participation from Harvard Medical School and the University of Zimbabwe. Participants report significant improvements in their physical exam skills and their appreciation of the needs of underserved populations, as well as confidence with global surgical concepts. Our Zimbabwean hosts thought the visitors integrated well into the clinical teams, added value to their own students’ experience and believe that the exchange should continue despite the burden associated with hosting visiting students. Conclusions: Here we detail the development of a course in global surgery for medical students that integrates didactic as well as clinical experiences in a low-resource setting. The course includes a true multilateral exchange with students from Sweden, the United States and Zimbabwe participating regularly. We hope that this course might serve as a model for other medical schools looking to establish courses in this burgeoning field.
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| 3. |
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| 4. |
- Hagelsteen, Kristine, et al.
(författare)
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Identification of Warning Signs During Selection of Surgical Trainees
- 2019
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Ingår i: Journal of Surgical Education. - : Elsevier BV. - 1931-7204. ; 76:3, s. 684-693
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim was to document empirical observations about antecedents to and practices of unsuitable behaviours amongst surgical trainees and develop an interview guide that could be used for the selection process. Design: A mixed methods design was adopted combining a survey distributed to senior surgeons and heads of departments, followed by semi-structured interviews with experienced surgeons. Setting: All surgical departments and hospitals in The South Swedish Health Care Region. Participants: The survey was completed by 54 of 83 eligible surgeons above 50 years of age, and 4 of 7 heads of surgical departments. Semi-structured interviews with 13 surgeons representing local, regional, and university hospitals from the same cohort. Results: Forty-six (85%) surgeons and four of seven heads of departments responded that they had come across surgical trainees deemed unsuitable to train and work as a surgeon. All heads of department and 31 of 54 of the surgeons believed tendencies towards unsuitability are evident early during training. From the survey, 107 statements described reasons for finding a trainee unsuitable. Qualitative analysis of the interviews and free-text answers of the survey led to identification of 11 problem domains with associated “warning signs”. An interview guide to help detect unsuitability tendencies in candidates during selection procedures was constructed. Conclusions: Experienced surgeons have quite consistent views on what makes a person unsuitable as a surgeon. Their views have been systematized into 11 problem domains, and a set of ‘warning signs’ for unsuitable behaviours and traits has been developed. Early detection of these signs and traits is important for the individual, the work environment, and patient safety. A recommendation for a minimum framework for selection including the constructed interview guide is presented.
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| 5. |
- Ihse, Ingemar, et al.
(författare)
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Practicum-Lund Clinical Skills Center.
- 2010
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Ingår i: Journal of Surgical Education. - : Elsevier BV. - 1878-7452 .- 1931-7204. ; 67:6, s. 468-469
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Tidskriftsartikel (refereegranskat)
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| 6. |
- Rufai, Sohaib R, et al.
(författare)
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A National Survey of Undergraduate Suture and Local Anesthetic Training in the United Kingdom.
- 2016
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Ingår i: Journal of Surgical Education. - : Elsevier BV. - 1931-7204 .- 1878-7452. ; 73:2, s. 181-4
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Suturing is a skill expected to be attained by all medical students on graduation, according to the General Medical Council's (GMC) Tomorrow's Doctors. There are no GMC recommendations for the amount of suture training required at medical school nor the level of competence to be achieved. This study examines the state of undergraduate suture training by surveying a sample of medical students across the United Kingdom.METHODS: We distributed a survey to 17 medical schools to be completed by undergraduates who have undergone curricular suture training. The survey included questions relating to career intention, hours of curricular suture training, hours of additional paid training, confidence in performing various suture techniques and knowledge of their indications. We also asked about the students' perceived proficiency at injecting local anesthetic and their overall opinion of medical school suture training.RESULTS: We received responses from 705 medical students at 16 UK medical schools. A total of 607 (86.1%) medical students had completed their scheduled curricular suture training. Among them, 526 (86.5%) students reported inadequate suture training in medical school and 133 (21.9%) students had paid for additional training. Results for all competence markers were significantly lower than the required GMC standards (p < 0.001). Students who had paid for additional training were significantly more confident across all areas examined (p < 0.001).CONCLUSIONS: Our study identified a deficiency in the curricular suture training provided to the medical students surveyed. These findings suggest that medical schools should provide more opportunities for students to develop their suturing skills to achieve the GMC standard.
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| 7. |
- Zetlitz, Elisabeth, et al.
(författare)
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Objective Assessment of Surgical Training in Flexor Tendon Repair : The Utility of a Low-Cost Porcine Model as Demonstrated by a Single-Subject Research Design
- 2012
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Ingår i: Journal of Surgical Education. - : Elsevier BV. - 1931-7204. ; 69:4, s. 504-510
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This study evaluated the utility of a porcine flexor tendon model and standard biomechanical testing procedures to quantify the acquisition of surgical skills associated with Zone II flexor tendon repair in a trainee by benchmarking task performance outcomes relative to evidence-based standards. STUDY DESIGN: Single-subject repeated measures research design. Bench-top set-up of apparatus undertaken in a University Research laboratory. After initial directed learning, a trainee repaired 70 fresh flexor digitorum profundus tendons within the flexor sheath using either a Pennington or ventral-locking-loop modification of a two-strand Kessler core repair. Tendon repairs were then preconditioned and distracted to failure. Key biomechanical parameters of the repair, including the ultimate tensile strength (UTS), yield strength, 3 mm gap force and stiffness, were calculated. Repairs were divided into 3 categories, early (first 10 days), intermediate (ensuing 10 days), and late repairs (final 10 days), and potential changes in repair properties over the training period were evaluated using a general linear modeling approach. RESULTS: There was a significant change in the mechanical characteristics of the repairs over the training period, evidencing a clear learning effect (p < 0.05). Irrespective of the repair technique employed, early and intermediate repairs were characterized by a significantly lower UTS (29% and 20%, respectively), 3 mm gap (21% and 16%, respectively), and yield force (18% and 23%, respectively), but had a higher stiffness (33% and 38%, respectively) than late repairs (p < 0.05). The UTS of late repairs (47-48 N) were comparable to those published within the literature (45-51 N), suggesting surgical competence of the trainee. CONCLUSIONS: This simple, low-cost porcine model appears to be useful for providing preclinical training in flexor tendon repair techniques and has the potential to provide a quantitative index to evaluate the competency of surgical trainees. Further research is now required to identify optimal training parameters for flexor tendon repair and to develop procedure-specific standards for adequate benchmarking.
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