A survey of robotic surgery training curricula in general surgery residency programs: How close are we to a standardized curriculum?

Background

Robotic surgery is increasingly adopted into surgical practice, but it remains unclear what level of robotic training general surgery residents receive. The purpose of our study was to assess the variation in robotic surgery training amongst general surgery residency programs in the United States.

Resident experience in brachytherapy: An analysis of Accreditation Council for Graduate Medical Education case logs for intracavitary and interstitial brachytherapy from 2007 to 2018

PurposeWe sought to characterize temporal trends of radiation oncology resident–reported case experience with intracavitary brachytherapy (ICBT) and interstitial brachytherapy (ISBT).Methods and MaterialsSummarized, deidentified case logs for graduating radiation oncology residents (GRORs) between 2007 and 2018 were obtained from the Accreditation Council for Graduate Medical Education national summary data report. Cases were subdivided based on the site of treatment. Analysis of variance was used to determine differences, and strength of association was evaluated using the Pearson correlation.ResultsThe number of GRORs increased by 66% from 114 in 2007 to 189 in 2018 (p < 0.001). Average number of gynecologic ICBT cases per GROR increased, from 39.6 in 2007 to 48.7 in 2018 (p < 0.005). Average number of ISBT cases per GROR decreased, from 34.5 to 20.6 (p < 0.001), due to decreasing prostate volume, from 21.5 to 12 (p < 0.001). Experience with gynecologic ISBT cases remained low at an average of 4.5 cases per year.ConclusionsThe average number of ICBT cases per GROR has increased, although this does not differentiate between cylinder and tandem-based insertions currently. There has been a steady decline in ISBT experience. These findings may have implications for the development of Accreditation Council for Graduate Medical Education case minimums for residency programs.     

基于J2EE云平台大数据的居民健康管理服务体系构建与应用

目的:设计基于云平台、大数据的健康管理系统,以满足居民自身健康管理需求。方法:采用J2EE组合框架平台,利用Oracle数据库软件设计开发居民健康管理系统,建立基于云计算、大数据等新型数据深度融合于应用技术的智慧居民健康管理服务系统。系统由用户管理、健康数据、健康管家、家庭健康及网上医院等模块组成,以互联网为载体,为社区居民提供专业、便利、高品质的全数据和多元化智慧健康服务。结果:设计建立的居民健康管理服务系统可实现远程预约就诊,已有2000余名家庭医生完成居民健康管理平台注册,平台已服务居民>500万余人次,对居民健康进行系统化、网络化管理,利用有限的资源在社区居民疾病发生前了解家庭健康情况,有针对性地进行预防,并可提高慢性病管理效率,助力推动个性化医疗的发展。结论:基于J2EE云平台大数据的居民健康管理系统,对实现自我、动态、在线和集成健康管理以及完善居民健康管理信息化具有积极的参考价值,有利于促进居民健康。     

"以临床应用为导向"的住院医师心电图实践教学效果探析

目的探讨住院医师规范化培训(下文简称住培)中"以临床应用为导向"的心电图实践教学效果。方法本研究采用试验对照和问卷调查方法。选取2019年参加中山大学附属第五医院心电图课程的96名住培学员作为研究对象。将参加春季课程的49名住培学员设为对照组,采用传统教学方法;参加秋季课程的47名住培学员设为试验组,采用"以临床应用为导向"的实践教学方法。分析比较两组学员的课程考核成绩和对课程满意度的问卷调查结果。结果试验组学员过程考核成绩(86.16±20.21)分高于对照组学员的(71.49±23.86)分,试验组学员期末考核成绩(74.00±9.33)分高于对照组学员的(66.53±8.29)分,差异均具有统计学意义(均P<0.05)。对于授课内容和方法可以运用到临床工作中,试验组学员的满意度95.7%(45/47)高于对照组学员的83.7%(41/49);对于课程形式有助于增加学习心电图的兴趣和投入度,试验组学员的满意度87.2%(41/47)高于对照组学员的51.0%(25/49),差异均具有统计学意义(均P<0.05)。结论"以临床应用为导向"的心电图实践教学,有助于提高住培学员的学习成绩和对课程的满意度。     

可信赖式专业活动在神经内科住院医师规范化培训的应用

在以胜任力为导向的医学教育理念下,住院医师规范化培训的多种培养和评价模式都以提高规培医师的胜任力为目标。岗位胜任力是需要在实践中不断地获得,且通过规培医师执行的专业活动中来进行判断的。可信赖式专业活动(EPAs)作为评估医师胜任力的一种手段,是临床实践与胜任力的中枢纽带,用于评估住院医师在完成培训后能独立完成专业任务的程度。通过对规培医师执行专业活动程度的评估,可有目标地、有针对性地实施反馈及指导,促进医师胜任力的提高。     

Mini-CEX模拟教学联合DOPS评估演练在重症医学住院医师规范化培训中的应用

  目的  探讨迷你临床演练评量(Mini-CEX)模拟教学联合操作技能直接观察法(DPOS)评估演练在重症医学住院医师规范化培训中的价值。  方法  选择2019年6—12月在蚌埠医学院第一附属医院重症医学科轮转的40例住院医师规范化培训学员,入科后按随机数字法平均分入传统带教组(20例)和Mini-CEX联合DOPS教学组(MD教学组,20例),首先比较各组入科和出科时的理论成绩、技能操作成绩和病历书写质量是否有提高,再继续比较2组之间在出科时的学员成绩差异,最后对学员的教学满意度进行评价。  结果  经过传统教学培训后的学员出科时理论成绩和病历书写方面相较入科时有一定提升(均P < 0.05),而技能操作方面未见明显提升(P=0.166);经过Mini-CEX联合DOPS教学的学员出科时理论成绩、技能操作和病历书写方面相较入科时均有提升(均P < 0.05)。传统带教组和MD教学组比较,出科时2组之间的理论成绩和专业技能差异均有统计学意义(均P < 0.05)。2组学员对带教的满意度比较差异有统计学意义(P < 0.05)。  结论  在重症医学住院医师规范化培训中采用Mini-CEX模拟教学联合DOPS评估演练可以更好地提升学员的重症临床理论和操作技能,并且增加了学员对带教的满意度。      

Una estrategia para la formación en seguridad del paciente durante la residencia: desde el incidente crítico a la simulación. Parte 2

Patient safety training during residency contributes to the culture of safety and quality of care. Patient safety curriculum incorporates different activities throughout the specialty and appropriate to each moment: courses, workshops, critical incident sessions, safety rounds, which have been described above, and simulation. The simulation allows the safe training of complex clinical situations in multiprofessional teams. Structure the learning of human factor through the management of resources in crises, and provide feedback in debriefing improves competition. The simulation can be part of the objective formative evaluation of the residents. It has been shown to have results in the performance of health professionals, improves the quality of care and has effects on patients.     

Validation of the Simulated Vaginal Hysterectomy Trainer

Study Objective

To establish construct validity of the simulated vaginal hysterectomy trainer (SimVaHT).