Innovative introduction to surgery in the preclinical years

BACKGROUND: Lack of exposure to surgery in the preclinical years of medical school contributes to students' negative opinions of the field and to low application rates to categorical surgical programs. METHODS: Forty preclinical medical students attended a series of 16 seminars and practice sessions covering the gamut of surgical specialties and basic technical skills. Students were given a Likert format survey before and after taking the course. RESULTS: Students gave high ratings to course content (4.26/5) and lecturers (4.54/5). Students' confidence in their surgical skills doubled (1.45/5 to 3/5, P < .0001), and their perceived readiness for the surgical clerkship increased by 73% (1.63/5 to 2.82/5, P = .007). CONCLUSIONS: The preclinical years offer a promising venue for improving medical student interest and performance in surgery.     

The Abdominal Transplant Surgery Workforce: Current state and future trends

Transplant surgical workforce concerns have arisen in the last 5 years as reflected in challenges securing job opportunities for new fellows. The present survey was designed by the ASTS Membership and Workforce Committee to describe the current practice characteristics of transplant centers in order to estimate changes in the workforce. The survey questionnaire requested information about the transplant programs, the transplant surgeons involved in the program, and the estimated changes in the staffing of the program over the next 3 years. Seventy‐one transplant centers responded from a total of 235 identified and queried (30.2% response rate), with median responding centers per UNOS region of 7 (IQR 4.5‐8.5). The recruitment outlook for the next 3 years forecasts a positive inflow of surgeons at a 2:1 rate (incoming:leaving). The new female transplant workforce within the responding cohort has increased from 3.7% in 1980 to 18.4% in 2010. Currently, 13.1% of practicing US transplant surgeons in this survey are female which is higher than many other surgical specialties. This report represents the most up‐to‐date view into the abdominal transplant surgical workforce. The positive job recruitment outlook for transplant surgeons and the narrowing gender gap are new findings from this study.     

Can face-to-face patient education be replaced by computer-based patient education?

In plastic surgery patient education is important but time consuming. It can be performed face-to-face or it can be computer based. In order to examine the merits of computer-based patient education, a research of the literature was carried out. The results of this search show that computer-based education is of great potential benefit. Especially in retaining information, informed consent and time management in the medical practice.The Isala Klinieken supported this research project with a grant for medical careAn invited commentary to this paper is available at     

American College of Surgeons/Association for Surgical Education medical student simulation-based surgical skills curriculum needs assessment

Background

Simulation can enhance learning effectiveness, efficiency, and patient safety and is engaging for learners.

Methods

A survey was conducted of surgical clerkship directors nationally and medical students at 5 medical schools to rank and stratify simulation-based educational topics. Students applying to surgery were compared with others using Wilcoxon's rank-sum tests.

Results

Seventy-three of 163 clerkship directors (45%) and 231 of 872 students (26.5%) completed the survey. Of students, 28.6% were applying for surgical residency training. Clerkship directors and students generally agreed on the importance and timing of specific educational topics. Clerkship directors tended to rank basic skills, such as examination skills, higher than medical students. Students ranked procedural skills, such as lumbar puncture, more highly than clerkship directors.

Conclusions

Surgery clerkship directors and 4th-year medical students agree substantially about the content of a simulation-based curriculum, although 4th-year medical students recommended that some topics be taught earlier than the clerkship directors recommended. Students planning to apply to surgical residencies did not differ significantly in their scoring from students pursuing nonsurgical specialties.     

An assessment of the methodologic quality of medical education research studies published in The American Journal of Surgery

Background

This study examined the methodologic quality of medical education research published in The American Journal of Surgery (AJS) relative to other journals and in AJS itself over time.

Methods

Medical Education Research Study Quality Instrument (MERSQI) scores were determined for 198 education studies published in 2003 in 13 peer-reviewed journals including AJS and all 38 AJS education studies published in 2007.

Results

In 2003, the mean (standard deviation) MERSQI scores of AJS studies were 11.03 (2.12) compared with 9.83 (2.37) for studies published in the other 12 journals (P = .03). AJS studies received higher scores for response rate (P < .001) and content validity (P = .03) than other journals. The mean MERSQI scores among AJS studies remained constant between 2003 and 2007 (12.03 [2.35] vs 11.03 [2.12], P = .13).

Conclusions

Education studies published in AJS compared favorably with those published in other journals, and this quality was maintained over time. Nonetheless, there is room for improvement with respect to study designs and outcome assessment.     

ARE YOU WASTING YOUR TIME WITH JOURNALS? SOME GUIDELINES FOR SELECTIVE READING

Regular journal reading is an important part of continuing medical education. Because time for study is limited we should concentrate on reading only those articles that are relevant, valid and applicable. Some guidelines for this selection are discussed.     

Coalition for medical education—A call to action: A proposition to adapt clinical medical education to meet the needs of students and other healthcare learners during COVID-19

With the ongoing coronavirus, journals and the media have extensively covered the impacts on doctors, nurses, physician assistants, and other healthcare workers. However, one group that has rarely been mentioned despite being significantly impacted is medical students and medical education overall. This piece, prepared by both a medical student and a cardiothoracic surgeon with a long career in academic medicine, discusses the recent history of medical education and how it has led to issues now with distance-based learning due to COVID-19. It concludes with a call to action for the medical education system to adapt so it can meet the needs of healthcare learners during COVID-19 and even beyond.     

理性情绪教育对护生情绪的影响

目的探讨理性情绪教育对护生的情绪影响。方法随机选取二年级2个自然班护生116人．实验班和对照班各58人。对照班常规开设《护理心理学》课程；实验班增设自行设计的理性情绪教育（REE）课程。结果实验班情绪稳定性、情绪表达性与情绪调节能力与课前比较．差异有显著性意义（P〈0．05。P〈0．01）；与对照班课后比较．除疑病因子外，其余各因子差异均有显著性意义（P〈0．05．P〈0．01）。对照班课前、课后各因子比较．情绪稳定性中强迫症、疑病症因子比较．差异有显著性意义（P〈0．05，P〈0．01）。其余各因子差异无显著性意义（均P〉0．05）。结论理性情绪教育对护生的情绪稳定性、情绪表达能力和情绪调节能力的改善具有重要的作用。     

Envisioning a global role for osteopathic medicine in the 21st century: Using Blue Ocean Strategy to promote osteopathic health care as the World's leader in healthcare education and do it more efficiently,effectively and at the lowest cost

Twenty-first century medical education will be dramatically improved by our rapidly evolving understanding of how to more efficiently, effectively and affordably train future health care providers. The following describes a paradigm that uses Blue Ocean Strategies in training osteopathic physicians and thus, rapidly differentiates osteopathic medical education from contemporary approaches to medical education. By replacing the current medical education system with this model, osteopathic medical education is provided an opportunity to emerge as the standard for training future health care providers.     

Response to COVID-19 pandemic: Beyond medical education in Brazil

We received a response to our Editorial from a group in Brazil that raised valuable concerns about the struggles in transforming medical education in low-income countries. Here, we address the concerns they raised that reinforce the global need for a "Coalition for Medical Education."     

护理学创客空间建设的构想

对创客空间概念、文化、价值、研究现状以及创建护理学创客空间的价值、特征进行分析,探讨护理专业领域创客空间建设的理论和实践方法,构想护理学创客空间框架及路径,提出创建护理学创客空间、实施创客教育有益于培养护生的创造性思维、学习兴趣以及学习能力等,对护理教育改革具有重要意义。     

The development of physician confidence during surgical and medical internship

BACKGROUND: While much research has addressed physician competency, the development of confidence has not been studied. We sought to identify which elements of internship residents feel most contributed to building their confidence. METHODS: By anonymous survey, University of Pennsylvania residents rated 104 internship elements for contribution to building physician confidence and reported their subjective confidence during and since internship. RESULTS: Two hundred ten residents in 18 specialties participated. Detailed ratings for all 104 elements are provided. Generally, independent decision-making items and good back-up support were equally highly valued, as was developing work efficiency. Poorly valued items included high patient loads, long hours, and abusive interactions. Surgical and medical residents agreed. Mean confidence increased during internship from 12 to 32 (1-100 scale) but remained in the 50s during residency for most specialties. CONCLUSIONS: Faculty should make informed, deliberate attempts to provide those elements identified as most fostering the development of physician confidence.     

Why do students choose careers in surgery?

BACKGROUND: Recent changes in medical education have emphasized primary care careers. This could have a negative impact on the number of applicants to surgical residencies. We hypothesized that experiences during the third year surgical clerkship are influential for students' subsequent residency choice. MATERIALS AND METHODS: Third year medical students who completed their surgical clerkship in the 2001-02 academic year were surveyed pre- and post-surgical clerkship. Responses were analyzed and correlated to the 2003 match results. RESULTS: The response rate of students surveyed was 98% (82 surveys/83 match results). Pre-clerkship, 6/82 students (7%) expressed an interest in surgery or surgical subspecialty careers. Post-clerkship, 34/84 students (40%) expressed an increased interest a surgical career; 13/84 (15%) expressed a decreased interest, and 37% of students expressed no change in career interest. Of those students expressing an increased interest in surgery, the clerkship experiences most noted to be influential were (1) number of cases participated/scrubbed (95%), (2) resident interaction (85%), (3) faculty interaction (80%), and (4) number of cases observed (65%). The number of hours spent on rotation (call, rounds) was the leading experience associated with a decreased interest in a surgical career. 12/83 students surveyed (14%) ultimately matched into a surgical program (NRMP 2003 match results). CONCLUSIONS: These data suggest that operative exposure and interaction with residents and faculty have a positive influence in students' choice of a surgical career. Although only 6% of students expressed an interest in surgery pre-clerkship, a 2-fold increase in this number was noted in choice of residency (14%). Work hours were the primary negative indicator for surgery residency. As medical curriculum is restructured and surgical exposure decreased, these data underscore the importance of quality exposure to both procedures and role models during the 3rd year surgical clerkship.