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Gillis ME, Scott SA, Richardson CG, Oxner WM, Gauthier L, Wilson DA, Glennie RA. Developing and Assessing the Feasibility of Implementing a Surgical Objective Structured Clinical Skills Examination (S-OSCE). J Surg Educ 2020; 77:939-946. [PMID: 32179030 DOI: 10.1016/j.jsurg.2020.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 09/11/2019] [Revised: 01/04/2020] [Accepted: 02/17/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To1 describe the development and evaluate the feasibility of a surgical objective structured clinical examination (OSCE) for the purpose of competency assessment based on the Royal College of Canada's CanMEDS framework. DESIGN A unique surgical OSCE was developed to evaluate the clinical and surgical management of common orthopaedic problems using simulated patients and cadaveric specimens. Cases were graded by degree of difficulty (less complex, complex, more complex) Developing an assessment tool with significant resource utilization and good correlation with traditional methods is challenging. The feasibility of an OSCE that evaluates independent clinical and surgical decision making was evaluated. In addition, as part of establishing construct validity, correlation of OSCE scores with previously validated O-scores was performed. SETTING A tertiary level academic teaching hospital. PARTICIPANTS Thirty-four Postgraduate year 3-5 trainees of a 5-year Canadian orthopedic residency program creating 96 operative case performances available for final review. RESULTS The development of the OSCE cases involved a multistep process with attending surgeons, residents and a surgical education consultant. There were 4 different OSCE days, over a 3 year period (2016-2018) encompassing a variety of less complex and more complex procedures. Performance on the OSCE correlated strongly with the (O-SCORE, 0.89) and a linear regression analysis correlated moderately with year of training (r2 = 0.5737). The feasibility analysis demonstrated good financial practicality with solid programmatic integration. CONCLUSIONS The unique surgical OSCE scores correlate strongly with an established entrustability scale. Administering this OSCE to evaluate preoperative and intraoperative decision making to complement other forms of assessment is feasible. The financial burden to training programs is modest in comparison to the insight gained by both residents and faculty.
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Affiliation(s)
- Megan E Gillis
- Division of Orthopedics, Department of Surgery, Dalhousie University School of Medicine, Nova Scotia, Canada
| | - Stephanie A Scott
- Division of Orthopedics, Department of Surgery, Dalhousie University School of Medicine, Nova Scotia, Canada
| | - C Glen Richardson
- Division of Orthopedics, Department of Surgery, Dalhousie University School of Medicine, Nova Scotia, Canada
| | - William M Oxner
- Division of Orthopedics, Department of Surgery, Dalhousie University School of Medicine, Nova Scotia, Canada
| | - Luc Gauthier
- Division of Orthopedics, Department of Surgery, Dalhousie University School of Medicine, Nova Scotia, Canada
| | - David A Wilson
- Division of Orthopedics, Department of Surgery, Dalhousie University School of Medicine, Nova Scotia, Canada
| | - Raymond A Glennie
- Division of Orthopedics, Department of Surgery, Dalhousie University School of Medicine, Nova Scotia, Canada.
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Canizares M, Glennie RA, Perruccio AV, Abraham E, Ahn H, Attabib N, Christie S, Johnson MG, Nataraj A, Nicholls F, Paquet J, Phan P, Rasoulinejad P, Manson N, Hall H, Thomas K, Fisher CG, Rampersaud YR. Erratum to 'Patients' expectations of spine surgery for degenerative conditions: results from the Canadian Spine Outcomes and Research Network (CSORN)'. [Spine J. 2020;20(3):399-408]. Spine J 2020; 20:674. [PMID: 32081566 DOI: 10.1016/j.spinee.2020.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- M Canizares
- The Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.
| | - R A Glennie
- Canadian Spine Outcomes and Research Network, Canada; Dalhousie University, Halifax, Nova Scotia, Canada
| | - A V Perruccio
- The Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - E Abraham
- Canadian Spine Outcomes and Research Network, Canada; Dalhousie University, Saint John, New Brunswick, Canada
| | - H Ahn
- Canadian Spine Outcomes and Research Network, Canada; University of Toronto, Toronto, Ontario, Canada
| | - N Attabib
- Canadian Spine Outcomes and Research Network, Canada; Dalhousie University, Saint John, New Brunswick, Canada
| | - S Christie
- Canadian Spine Outcomes and Research Network, Canada; Dalhousie University, Halifax, Nova Scotia, Canada
| | - M G Johnson
- Canadian Spine Outcomes and Research Network, Canada; University of Manitoba, Winnipeg, Manitoba, Canada
| | - A Nataraj
- Canadian Spine Outcomes and Research Network, Canada; University of Alberta, Edmonton, Alberta, Canada
| | - F Nicholls
- Canadian Spine Outcomes and Research Network, Canada; University of Calgary, Calgary, Alberta, Canada
| | - J Paquet
- Canadian Spine Outcomes and Research Network, Canada; Universite Laval, Quebec City, Quebec, Canada
| | - P Phan
- Canadian Spine Outcomes and Research Network, Canada; The Ottawa Hospital - Civic Campus, Ottawa, Ontario, Canada
| | - P Rasoulinejad
- Canadian Spine Outcomes and Research Network, Canada; Western University, London Health Sciences, London, Ontario, Canada
| | - N Manson
- Canadian Spine Outcomes and Research Network, Canada; Dalhousie University, Saint John, New Brunswick, Canada
| | - H Hall
- Canadian Spine Outcomes and Research Network, Canada; University of Toronto, Toronto, Ontario, Canada
| | - K Thomas
- Canadian Spine Outcomes and Research Network, Canada; University of Calgary, Calgary, Alberta, Canada
| | - C G Fisher
- Canadian Spine Outcomes and Research Network, Canada; University of British Columbia, Vancouver, British Columbia, Canada
| | - Y R Rampersaud
- The Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Canadian Spine Outcomes and Research Network, Canada; University of Toronto, Toronto, Ontario, Canada
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Glennie RA, Korczak A, Naudie DD, Bryant DM, Howard JL. MONOCRYL and DERMABOND vs Staples in Total Hip Arthroplasty Performed Through a Lateral Skin Incision: A Randomized Controlled Trial Using a Patient-Centered Assessment Tool. J Arthroplasty 2017; 32:2431-2435. [PMID: 28438450 DOI: 10.1016/j.arth.2017.02.042] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 11/18/2016] [Revised: 02/01/2017] [Accepted: 02/14/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND There are various possible methods of skin closure in total hip arthroplasty (THA) through a lateral skin incision. The cost and time required for each can vary between techniques. The objective of this study was to determine whether there is a difference in patient and surgeon rating of scar outcome using a combination of subcuticular suture and skin adhesive (subcuticular MONOCRYL and DERMABOND [SMD]) vs staples for skin closure after THA. METHODS Patients undergoing THA were recruited from a university hospital. Patients were randomized to staples or SMD. Patient and Observer Scar Assessment Scale data were collected postoperatively. In addition, visual analog scale pain scores, wound drainage, length of stay, time to closure, and total cost were collected. RESULTS One hundred twenty-nine patients were available for final analysis. There was no significant difference in Patient and Observer Scar Assessment Scale scores at 6 weeks or 3 months (P = .71). There was no difference in visual analog scale pain scores (P = .64, P = .49). The staple group had a higher rate of discharge on postoperative days 1 and 3 (P < .001, P < .001) but had a 1.6-minute shorter time of closure (P < .001). There was no significant difference in length of stay or total cost (P = .5). CONCLUSION Although there are some small initial advantages to each method of skin closure, there is little difference in scar outcome when comparing SMD and staples.
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Affiliation(s)
- Raymond A Glennie
- Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Abigail Korczak
- Department of Surgery, Western University, London Health Sciences Center, University Hospital, London, Ontario, Canada
| | - Douglas D Naudie
- Department of Surgery, Western University, London Health Sciences Center, University Hospital, London, Ontario, Canada
| | - Dianne M Bryant
- Department of Surgery, Western University, London Health Sciences Center, University Hospital, London, Ontario, Canada
| | - James L Howard
- Department of Surgery, Western University, London Health Sciences Center, University Hospital, London, Ontario, Canada
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