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Pedersen H, Ståhl D, Ekelund M, Anderberg M, Bäckström M, Bergenfelz A, Hagelsteen K. Visuospatial ability is associated to 2D laparoscopic simulator performance amongst surgical residents. Surg Open Sci 2022; 11:56-61. [PMID: 36545373 PMCID: PMC9761372 DOI: 10.1016/j.sopen.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 11/05/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
Background The technical skills of a surgeon influence surgical outcome. Testing technical aptitude at point of recruitment of surgical residents is only conducted in a few countries. This study investigated the impact of visuospatial ability (VSA), background factors, and manual dexterity on performance in two different laparoscopic surgical simulators amongst applicants and 1st year surgical residents. Method Applicants from general surgery, pediatric surgery, and urology were included from seven hospitals in Sweden between 2017 and 2021. Some 73 applicants were invited and 50 completed. Participants filled out a background form, and were tested for manual dexterity, and visuospatial ability. Two laparoscopic simulators were used, one 2D video box trainer and one 3D Virtual Reality Simulator. Results A significant association was found between the visuospatial ability test and 2D video box laparoscopic performance (95 % CI: 1.028-1.2, p-value <0.01). For every point on the visuospatial test the odds of accomplishing the task increased by 11 %. No association was found between VSA and performance in a laparoscopic VR simulator using 3D vision. No other background factors were associated with performance in the two laparoscopic simulators. Conclusion Visuospatial ability in applicants to surgical residency positions is associated to performance in a 2D video box trainer. Knowledge of a resident's visuospatial ability can be used to tailor individualized laparoscopic training programs, and in the future might function as a selection tool concerning laparoscopic ability. Key message Visuospatial ability differs greatly amongst applicants for surgical residency and is associated to laparoscopic simulator performance. Testing applicants' visuospatial ability could possibly be used to tailor individualized laparoscopic training programs or in the future as a selection tool concerning laparoscopic ability.
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Affiliation(s)
- Hanne Pedersen
- Practicum Clinical Skills Centre, Skåne University Hospital, Lund, Sweden
- Corresponding author at: Practicum Clinical Skills Centre, Barngatan 2, Skåne University Hospital, SE-221 85 Lund, Sweden.
| | - Darya Ståhl
- Practicum Clinical Skills Centre, Skåne University Hospital, Lund, Sweden
| | - Mikael Ekelund
- Practicum Clinical Skills Centre, Skåne University Hospital, Lund, Sweden
- Lund University, Skåne University Hospital, Department of Clinical Sciences, Surgery, Malmö, Sweden
| | - Magnus Anderberg
- Practicum Clinical Skills Centre, Skåne University Hospital, Lund, Sweden
- Lund University, Skåne University Hospital, Department of Clinical Sciences, Paediatrics, Lund, Sweden
| | - Martin Bäckström
- Practicum Clinical Skills Centre, Skåne University Hospital, Lund, Sweden
- Department of Psychology, Lund University, Sweden
| | - Anders Bergenfelz
- Practicum Clinical Skills Centre, Skåne University Hospital, Lund, Sweden
- Lund University, Skåne University Hospital, Department of Clinical Sciences, Surgery, Lund, Sweden
| | - Kristine Hagelsteen
- Practicum Clinical Skills Centre, Skåne University Hospital, Lund, Sweden
- Lund University, Skåne University Hospital, Department of Clinical Sciences, Surgery, Lund, Sweden
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Mikhail A, Connor AA, Ahmed N. Impact of Research Training on Performance in General Surgery Residency. J Surg Educ 2022; 79:342-348. [PMID: 34824045 DOI: 10.1016/j.jsurg.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 09/07/2021] [Accepted: 10/14/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION It is common for North American surgical trainees to interrupt clinical training to complete 2 or more years of research training. The impact of this practice on surgical aptitudes is unknown. The University of Toronto has large general surgery and surgeon scientist training programs. We compared the examination scores of general surgery residents in continuous clinical training with those of residents whose training was interrupted by research. METHODS We collected anonymized scores obtained at written and oral annual in-training examinations by general surgery residents at the University of Toronto from 2011 to 2016, inclusive. The written exam assessed knowledge, while the oral exam assessed judgment. Residents were dichotomized into continuous versus non-continuous clinical training streams. We compared performance prior to, during, and following divergence for research training both within and between the 2 groups. RESULTS At the junior resident level, future enrollment in research training was associated with higher examination performance (Pwritten = .003). Annual scores plateaued during research training, while scores of residents who continued in continuous clinical training improved year over year (Pwritten = .009). Non-continuous stream resident exam scores remained stagnant after 1 year then improved in the second year after return to clinical training (Pwritten = .00007). Scores obtained in the final year of residency training did not significantly differ between residents who underwent continuous versus non-continuous clinical training. Results from written and oral exams trended concordantly. CONCLUSIONS We demonstrate that interruption of clinical training for 2 or more years of research is associated with a stagnation of performance on annual in-training examinations assessing both knowledge and judgment. This phenomenon is followed by an eventual catching-up after at least 2 years return to full-time clinical training. This may inform residency program curriculum design.
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Affiliation(s)
| | - Ashton A Connor
- Department of Surgery, Houston Methodist Hospital, Houston, USA
| | - Najma Ahmed
- University of Toronto, Toronto, Ontario, Canada; St. Michael's Hospital, Toronto, Ontario, Canada.
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Booth KK, Stewart KE, Lewis SL, Garwe T, Kempenich JW, Lees JS. Correlation of Supervised Independence and Performance with Procedure Difficulty amongst Surgical Residents Stratified by Post Graduate Year. J Surg Educ 2021; 78:e47-e55. [PMID: 34526256 DOI: 10.1016/j.jsurg.2021.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/01/2021] [Accepted: 08/03/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE This study investigates the role of procedure difficulty on attending ratings of supervised levels of independence and procedural performance amongst general surgery residents, while accounting for case complexity. METHODS Attending ratings for residents were obtained from System for Improving and Measuring Procedural Learning (SIMPL) database. Current procedural terminology (CPT) codes were used to match procedures to a corresponding work relative value unit (wRVU) as a surrogate for procedure difficulty. Three categories of wRVU (<13.07, 13.07-22, >22) were identified using recursive partitioning. Procedures were also divided into 'Core' or 'Advanced' as defined by the American Board of Surgery Surgical Council on Resident Education (SCORE). Temporal advancement in resident skill was accounted for through academic quarterly analysis. A generalized estimating equations (GEE) approach was used to form separate multivariable logistic regression models for meaningful autonomy (MA) and satisfactory performance (SP) adjusted for potential clustering by program, subject, and rater. Models were further adjusted for core/advanced procedures, attending rated complexity, and academic quarter. RESULTS A total of 33,281 ratings were analyzed. Overall, 51.6% were rated as MA and 44.4% as SP. For core procedures, surgical residents rated as MA (53.5%) and SP (45.7%), which was twice as high as those for advance procedures (MA-29.2%, SP-29.0%). MA and SP both decreased with increasing wRVU (Figure 2 &3). Using a wRVU<13.07 as a reference, the adjusted odds ratios of MA and SP were significantly lower with increasing procedure difficulty, 0.44 for wRVU 13.07-22.0 and 0.24 for wRVU >22.00 (Table 3). Post graduate year (PGY) 5 residents in the final quarter of training obtain MA in 95.5% and SP 92.9% for core procedures with wRVU <13.07 (Table 4). CONCLUSION Increasing procedural difficulty is independently associated with decreases in meaningful autonomy and satisfactory performance. As residents approach graduation the level of meaningful autonomy and satisfactory performance both reach high levels for common core procedures but decrease as procedural difficulty increases.
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Affiliation(s)
- Kristina K Booth
- Department of Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
| | - Kenneth E Stewart
- Department of Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Samara L Lewis
- Department of Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Tabitha Garwe
- Department of Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Jason W Kempenich
- Department of Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Jason S Lees
- Department of Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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Tseng JR, Kang YS, Youm J, Pandit R. Radiology resident selection factors predict resident performance. Clin Imaging 2021; 80:225-228. [PMID: 34352495 DOI: 10.1016/j.clinimag.2021.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/04/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To determine selection factors that predict radiology resident performance. METHODS 59 consecutive radiology residents from 2002 to 2015 were ranked on performance during residency. Correlations and multiple regression analyses were performed to predict resident performance from the following selection factors: United States Medical Licensing Exam (USMLE) Step 1 score, medical school rank, Alpha Omega Alpha (AOA) membership, honors in clinical rotations, Medical Student Performance Evaluation (MSPE), and interview score. Results were compared against predictions from Match rank position. RESULTS Five selection factors showed significant or marginally significant correlations with resident performance (r = 0.2 to 0.3). The interview score was not significantly correlated. A multiple regression model comprised of the USMLE Step 1 score, medical school rank, AOA membership, and interview score predicted resident performance, with an adjusted R2 of 0.19. The interview score was included in the model but did not achieve statistical significance. Match rank did not predict resident performance, with an R2 of 0.01. CONCLUSIONS A multiple regression model comprised of the USMLE Step 1 score, medical school rank, and AOA membership predicted radiology resident performance and may assist with resident selection.
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Affiliation(s)
- Jeffrey R Tseng
- Santa Clara Valley Medical Center, Department of Radiology, 751 South Bascom Avenue, San Jose, CA 95128, United States of America.
| | - Young S Kang
- Santa Clara Valley Medical Center, Department of Radiology, 751 South Bascom Avenue, San Jose, CA 95128, United States of America
| | - Jiwon Youm
- Santa Clara Valley Medical Center, Department of Radiology, 751 South Bascom Avenue, San Jose, CA 95128, United States of America
| | - Rajul Pandit
- Santa Clara Valley Medical Center, Department of Radiology, 751 South Bascom Avenue, San Jose, CA 95128, United States of America
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Redmann AJ, Tawfik KO, Myer CM. The impact of a resident-run review curriculum and USMLE scores on the Otolaryngology in-service exam. Int J Pediatr Otorhinolaryngol 2018; 104:25-28. [PMID: 29287874 DOI: 10.1016/j.ijporl.2017.10.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/19/2017] [Accepted: 10/20/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Describe the association of USMLE Step 1 scores and the institution of a dedicated board review curriculum with resident performance on the Otolaryngology training examination. STUDY DESIGN Retrospective cross sectional study. METHODS We reviewed American Board of Otolaryngology Training Examination (OTE) scores for an otolaryngology residency program between 2005 and 2016. USMLE Step 1 scores were collected. In 2011 a resident-run OTE review curriculum was instituted with the goal of improving test preparation. Scores were compared before and after curriculum institution. Linear regression was performed to identify predictors of OTE scores. RESULTS 47 residents were evaluated, 24 before and 23 after instituting the curriculum. There was a moderate correlation between USMLE step 1 scores and OTE scores for all years. For PGY-2 residents, mean OTE scores improved from 25th percentile to 41st percentile after institution of the review curriculum (p = 0.05). PGY 3-5 residents demonstrated no significant improvement. On multivariate linear regression, after controlling for USMLE step 1 scores, a dedicated board review curriculum predicted a 23-point percentile improvement in OTE scores for PGY-2 residents (p = 0.003). For other post-graduate years, the review curriculum did not predict score improvement. CONCLUSION USMLE step 1 scores are moderately correlated with OTE performance. A dedicated OTE review curriculum may improve OTE scores for PGY-2 residents, but such a curriculum may have less benefit for intermediate- and senior-level residents. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Andrew J Redmann
- Department of Otolaryngology - Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Kareem O Tawfik
- Department of Otolaryngology - Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Charles M Myer
- Department of Otolaryngology - Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, United States; Division of Pediatric Otolaryngology - Head & Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
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Mehta A, Patel S, Robison W, Senkowski T, Allen J, Shaw E, Senkowski C. Can teenage novel users perform as well as General Surgery residents upon initial exposure to a robotic surgical system simulator? J Robot Surg 2017; 12:165-171. [PMID: 28585104 DOI: 10.1007/s11701-017-0715-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 05/16/2017] [Indexed: 02/02/2023]
Abstract
New techniques in minimally invasive and robotic surgical platforms require staged curricula to insure proficiency. Scant literature exists as to how much simulation should play a role in training those who have skills in advanced surgical technology. The abilities of novel users may help discriminate if surgically experienced users should start at a higher simulation level or if the tasks are too rudimentary. The study's purpose is to explore the ability of General Surgery residents to gain proficiency on the dVSS as compared to novel users. The hypothesis is that Surgery residents will have increased proficiency in skills acquisition as compared to naive users. Six General Surgery residents at a single institution were compared with six teenagers using metrics measured by the dVSS. Participants were given two 1-h sessions to achieve an MScoreTM in the 90th percentile on each of the five simulations. MScoreTM software compiles a variety of metrics including total time, number of attempts, and high score. Statistical analysis was run using Student's t test. Significance was set at p value <0.05. Total time, attempts, and high score were compared between the two groups. The General Surgery residents took significantly less Total Time to complete Pegboard 1 (PB1) (p = 0.043). No significant difference was evident between the two groups in the other four simulations across the same MScoreTM metrics. A focused look at the energy dissection task revealed that overall score might not be discriminant enough. Our findings indicate that prior medical knowledge or surgical experience does not significantly impact one's ability to acquire new skills on the dVSS. It is recommended that residency-training programs begin to include exposure to robotic technology.
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Affiliation(s)
- A Mehta
- Department of Surgery, Memorial Health University Medical Center, Savannah, GA, USA
- Mercer University School of Medicine, Savannah, Georgia
| | - S Patel
- Department of Surgery, Memorial Health University Medical Center, Savannah, GA, USA.
| | - W Robison
- Department of Surgery, Memorial Health University Medical Center, Savannah, GA, USA
- Mercer University School of Medicine, Savannah, Georgia
| | - T Senkowski
- Department of Surgery, Memorial Health University Medical Center, Savannah, GA, USA
| | - J Allen
- Department of Surgery, Memorial Health University Medical Center, Savannah, GA, USA
| | - E Shaw
- Department of Surgery, Memorial Health University Medical Center, Savannah, GA, USA
- Mercer University School of Medicine, Savannah, Georgia
| | - C Senkowski
- Department of Surgery, Memorial Health University Medical Center, Savannah, GA, USA
- Mercer University School of Medicine, Savannah, Georgia
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