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165 records – page 1 of 17.

Source
Ugeskr Laeger. 1998 Dec 7;160(50):7282-3
Publication Type
Article
Date
Dec-7-1998
Author
M. Andersen
Source
Ugeskr Laeger. 1998 Dec 7;160(50):7282-3
Date
Dec-7-1998
Language
Danish
Publication Type
Article
Keywords
Aged
Clinical Competence
Denmark
General Surgery - education - standards
Humans
Male
Suture Techniques - standards
PubMed ID
9859734 View in PubMed
Less detail

Abolishment of 24-hour continuous medical call duty in quebec: a quality of life survey of general surgical residents following implementation of the new work-hour restrictions.

https://arctichealth.org/en/permalink/ahliterature114387
Source
J Surg Educ. 2013 May-Jun;70(3):296-303
Publication Type
Article
Author
Fadi T Hamadani
Dan Deckelbaum
Alexandre Sauve
Kosar Khwaja
Tarek Razek
Paola Fata
Author Affiliation
McGill University Health Centre, Division of Trauma Surgery, Montreal, Quebec, Canada.
Source
J Surg Educ. 2013 May-Jun;70(3):296-303
Language
English
Publication Type
Article
Keywords
Adult
Education, Medical, Graduate - standards
Female
General Surgery - education
Humans
Internship and Residency
Male
Patient Safety
Quality of Life
Quebec
Questionnaires
Work Schedule Tolerance
Workload - standards - statistics & numerical data
Abstract
The implementation of work hour restrictions across North America have resulted in decreased levels of self injury and medical errors for Residents. An arbitration ruling in Quebec has led to further curtailment of work hours beyond that proposed by the ACGME. This may threaten Resident quality of life and in turn decrease the educational quality of surgical residency training.
We administered a quality of life questionnaire with an integrated education quality assessment tool to all General Surgery residents training at McGill 6 months after the work hour restrictions.
Across several strata respondents reveal a decreased sense of educational quality and quality of life.
The arbitration argued that work- hour restrictions would be necessary to improve quality of life for trainees and hence improve patient safety. Results from this study demonstrate the exact opposite in a large majority of respondents, who report a poorer quality of life and a self-reported inability on their part to provide continuous and safe patient care.
PubMed ID
23618437 View in PubMed
Less detail

Acute general surgery in Canada: a survey of current handover practices.

https://arctichealth.org/en/permalink/ahliterature113607
Source
Can J Surg. 2013 Jun;56(3):E24-8
Publication Type
Article
Date
Jun-2013
Author
Amanda M Johner
Shaila Merchant
Nava Aslani
Anneke Planting
Chad G Ball
Sandy Widder
Giuseppe Pagliarello
Neil G Parry
Dennis Klassen
S Morad Hameed
Author Affiliation
Department of Surgery, University of British Columbia, 3669 Commercial St., Vancouver BC V5N 4G1, Canada. amanda.johner@gmail.com
Source
Can J Surg. 2013 Jun;56(3):E24-8
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Canada
Communication
General Surgery - education - organization & administration
Hospitalization
Humans
Internship and Residency
Patient Handoff - organization & administration
Patient Safety
Physician's Practice Patterns - organization & administration
Abstract
Today's acute care surgery (ACS) service model requires multiple handovers to incoming attending surgeons and residents. Our objectives were to investigate current handover practices in Canadian hospitals that have an ACS service and assess the quality of handover practices in place.
We administered an electronic survey among ACS residents in 6 Canadian general surgery programs.
Resident handover of patient care occurs frequently and often not under ideal circumstances. Most residents spend less than 5 minutes preparing handovers. Clinical uncertainty owing to inadequate handover is most likely to occur during overnight and weekend coverage. Almost one-third of surveyed residents rate the overall quality of the handovers they received as poor.
Handover skills must be taught in a systematic fashion. Improved resident communication will likely decrease loss of patient information and therefore improve ACS patient safety.
Notes
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Cites: J Hosp Med. 2006 Jul;1(4):257-6617219508
PubMed ID
23706854 View in PubMed
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The Advanced Trauma Life Support Program in Manitoba: a 5-year review.

https://arctichealth.org/en/permalink/ahliterature221346
Source
Can J Surg. 1993 Apr;36(2):181-3
Publication Type
Article
Date
Apr-1993
Author
J. Ali
M. Howard
Author Affiliation
Department of Surgery, University of Manitoba, Winnipeg.
Source
Can J Surg. 1993 Apr;36(2):181-3
Date
Apr-1993
Language
English
Publication Type
Article
Keywords
Education, Medical, Continuing
Emergency Service, Hospital
Family Practice - education
General Surgery - education
Hospitals, Rural
Hospitals, Urban
Humans
Life Support Care
Manitoba
Program Evaluation
Questionnaires
Time Factors
Abstract
Twenty Advanced Trauma Life Support (ATLS) courses were conducted at the University of Manitoba between 1982 and 1987. There were 302 registrants, 95 of whom were from rural communities. Twelve registrants failed the course. The impact of the program was assessed by questionnaire (68.8% response overall). The response from department heads of surgery in urban hospitals was 87.5% and from surgeons in rural areas 50%. Fifty-eight percent of rural surgeons, 62.5% of urban surgeons and 75% of urban emergency-department directors claimed they could identify those who had attended an ATLS course by the increased confidence demonstrated and the use of more timely and appropriate consultation and treatment. Thirty percent of rural surgeons, 37% of urban surgeons and 42% of emergency-department directors claimed that mortality and morbidity were decreased when care was provided by ATLS-trained physicians. The remainder were undecided because of lack of information. Ninety-three percent of respondents indicated that the course increased their confidence, trauma capability and ability to communicate with consultant trauma surgeons. Fifty-two percent thought the course should be mandatory for all physicians, and 100% thought it should be mandatory for all emergency-department physicians. The data suggest that although most physicians treat fewer trauma patients 5 years after their ATLS training, the course is still highly recommended, and it has improved trauma care. Although the ATLS program was intended primarily for rural physicians, more urban-based physicians registered for it.
PubMed ID
8472232 View in PubMed
Less detail

Analysis of clinical bioethics teaching in pediatric surgery residency.

https://arctichealth.org/en/permalink/ahliterature206321
Source
J Pediatr Surg. 1998 Feb;33(2):373-7
Publication Type
Article
Date
Feb-1998
Author
M L Robin
D A Caniano
Author Affiliation
Department of Surgery, The Ohio State University College of Medicine, and Children's Hospital, Columbus 43205, USA.
Source
J Pediatr Surg. 1998 Feb;33(2):373-7
Date
Feb-1998
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Bioethics
Canada
Child
Curriculum
Ethics, Medical - education
Female
General Surgery - education
Humans
Infant
Internship and Residency
Male
Pediatrics - education
Physicians - psychology
Questionnaires
Teaching - methods
United States
Abstract
Although clinical bioethics teaching (CBT) is not a required component of the essential curriculum for pediatric surgery residency, ethical considerations often accompany surgical decision making for infants and children. This study was designed to quantitate CBT during pediatric surgery residency (PSR) and to determine preferences about formal bioethics instruction.
An 80-item questionnaire was mailed to 140 graduates of accredited PSR in the United States and Canada. Questions included demographic data, experience in CBT during and after PSR, preferred topics and teaching methods, and self-assessed and objective competency in bioethics.
The response rate was 78% (n = 109); 72% completed PSR between 1990 and 1995 (mean, 1991). Formal CBT within the curriculum of PSR was reported by 9% of respondents; lecture and consultation with an ethicist were the most frequent teaching methods. Informal CBT was noted by 88% of pediatric surgeons; observation of patient cases with ethical dilemmas was the primary mode of instruction. Quality of life, withholding/withdrawal of care, informed consent, child abuse, and economics ranked highest for most important CBT topics, while euthanasia, clinical research trials, and cultural diversity were given low priority. The preferred teaching methods were case-based discussions and consultation with an ethicist. Although 97% favored additional CBT in all postgraduate training, respondents who completed advanced study in medical ethics (P
PubMed ID
9498421 View in PubMed
Less detail

Are Canadian general surgery residents ready for the 80-hour work week? A nationwide survey.

https://arctichealth.org/en/permalink/ahliterature127722
Source
Can J Surg. 2012 Feb;55(1):53-7
Publication Type
Article
Date
Feb-2012
Author
Monisha Sudarshan
Wael C Hanna
Mohammed H Jamal
Lily H P Nguyen
Shannon A Fraser
Author Affiliation
Department of General Surgery, McGill University, Montréal, Que.
Source
Can J Surg. 2012 Feb;55(1):53-7
Date
Feb-2012
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Canada
Female
General Surgery - education
Humans
Internship and Residency
Life Style
Male
Personnel Staffing and Scheduling
Questionnaires
Workload
Abstract
The purpose of this study was to describe Canadian general surgery residents' perceptions regarding potential implementation of work-hour restrictions.
An ethics review board-approved, Web-based survey was submitted to all Canadian general surgery residency programs between April and July 2009. Questions evaluated the perceived effects of an 80-hour work week on length of training, operative exposure, learning and lifestyle. We used the Fisher exact test to compare senior and junior residents' responses.
Of 360 residents, 158 responded (70 seniors and 88 juniors). Among them, 79% reported working 75-100 hours per week. About 74% of seniors believed that limiting their work hours would decrease their operative exposure; 43% of juniors agreed (p
Notes
Cites: Adv Surg. 2009;43:73-9019845170
Cites: J Am Coll Surg. 2009 Jul;209(1):47-54, 54.e1-219651062
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Cites: Am J Surg. 2009 Dec;198(6):811-619969134
Cites: Am Surg. 2009 Dec;75(12):1234-719999918
Cites: J Surg Educ. 2009 Nov-Dec;66(6):314-820142127
Cites: J Surg Educ. 2009 Nov-Dec;66(6):357-6020142135
Cites: J Surg Educ. 2010 Jan-Feb;67(1):25-3120421086
Cites: J Am Coll Surg. 2009 Apr;208(4):587-9119476794
Cites: JAMA. 2003 Sep 3;290(9):1179-8212953000
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Cites: Ann Surg. 2005 Jun;241(6):847-56; discussion 856-6015912034
Cites: Am J Surg. 2005 Dec;190(6):947-916307951
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Cites: Ann Surg. 2006 Jun;243(6):864-71; discussion 871-516772790
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Cites: Curr Surg. 2006 Nov-Dec;63(6):397-40017084768
Cites: Am J Surg. 2007 Mar;193(3):326-9; discussion 329-3017320528
Cites: J Gen Intern Med. 2007 Feb;22(2):205-917356987
Cites: Ann Intern Med. 2007 Jul 17;147(2):73-8017548403
Cites: Arch Surg. 2007 Aug;142(8):708-12; discussion 712-417709724
Cites: J Surg Educ. 2008 Jan-Feb;65(1):50-318308281
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Cites: Pediatrics. 2008 Aug;122(2):250-818676540
Cites: Can J Surg. 2008 Oct;51(5):371-718841235
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Cites: J Neurosurg. 2009 May;110(5):820-719409028
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Cites: J Surg Educ. 2009 Jul-Aug;66(4):216-21.e1-1019896627
PubMed ID
22269303 View in PubMed
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Assessing clinical judgment using the Script Concordance test: the importance of using specialty-specific experts to develop the scoring key.

https://arctichealth.org/en/permalink/ahliterature117995
Source
Am J Surg. 2013 Feb;205(2):137-40
Publication Type
Article
Date
Feb-2013
Author
Andrea M Petrucci
Thamer Nouh
Marylise Boutros
Robert Gagnon
Sarkis H Meterissian
Author Affiliation
Department of Surgery, McGill University, Montreal, Quebec, Canada.
Source
Am J Surg. 2013 Feb;205(2):137-40
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adult
Clinical Competence
Decision Making
Female
General Surgery - education - manpower - statistics & numerical data
Humans
Internship and Residency - manpower - statistics & numerical data
Judgment
Male
Middle Aged
Problem Solving
Problem-Based Learning
Quebec
Questionnaires - standards
Reproducibility of Results
Abstract
The Script Concordance test (SCT) assesses clinical judgment. The purpose of this study was to determine whether a specialty-specific scoring key improves the validity of the SCT.
Thirty experts from 6 general surgery disciplines answered questions pertaining to their area of expertise. We created a scoring key of 5 amalgamated expert panel members. The answers of 227 general surgery residents were analyzed.
The optimized test had a reliability level (Cronbach a) of .81. Scores increased progressively throughout all levels of training, with R5s scoring higher than R4s (R1, 42.7 ± 7.1; R2, 47.6 ± 7.5; R3, 48.7 ± 6.7; R4, 49.8 ± 7.7; R5, 52.9 ± 9.3). The average score of juniors (R1s + R2s, 45.1 ± 7.6) was significantly lower (P
PubMed ID
23246286 View in PubMed
Less detail

Assessing the educational environment in the operating room-a measure of resident perception at one Canadian institution.

https://arctichealth.org/en/permalink/ahliterature170886
Source
Surgery. 2006 Feb;139(2):150-8
Publication Type
Article
Date
Feb-2006
Author
Jeanie Kanashiro
Sean McAleer
Sue Roff
Author Affiliation
Peter Lougheed Centre, Division of General Surgery, University of Calgary, Canada. jeanie.kanashiro@calgaryhealthregion.ca
Source
Surgery. 2006 Feb;139(2):150-8
Date
Feb-2006
Language
English
Publication Type
Article
Keywords
Canada
Data Collection
Environment
General Surgery - education
Humans
Internship and Residency - standards
Operating Rooms
Quality Control
Abstract
The educational experience in the operating room is considered the centerpiece of learning for surgical residents. The educational environment is defined as the "ethos" or "climate" that affects all aspects of learning within an educational setting. A measure of the educational environment in the operating room as perceived by residents would assist educators and trainees in gauging the quality of the learning occurring within this important venue. The Operating Room Educational Environment Measure (OREEM) was adapted from an inventory validated for use with basic surgical trainees in Scotland to determine whether an inventory specifically adapted to the specialized environment of the operating room can produce a valid assessment of trainee perception of the overall educational environment and the contributing factors therein at a North American institution.
The 40-item inventory was piloted on a group of general surgery residents at the University of Calgary from November 26, 2003, to January 31, 2004.
With a response rate of 96%, the OREEM was shown to be a relevant, internally consistent (Cronbach proportional, variant = .8656) and valid tool for assessing the overall educational environment in the operating room within a Canadian surgical residency program. Four subscales included teaching and training, learning opportunities, atmosphere, and workload/supervision/support. The overall mean score of 74% suggests the learning environment may be considered satisfactory; however, areas for potential improvement are identifiable. Results reveal strengths such as a nondiscriminatory operating room atmosphere on racial and gender grounds. However, differences were shown in male and female perceptions of learning opportunities and in junior versus senior perceptions of workload, supervision, and support.
The OREEM has potential to be applied further as a quality assessment tool whose results could be used by faculty and program directors to improve the learning experiences of residents in the operating room.
PubMed ID
16455322 View in PubMed
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Assessing the mini-Clinical Evaluation Exercise in comparison to a national specialty examination.

https://arctichealth.org/en/permalink/ahliterature167406
Source
Med Educ. 2006 Oct;40(10):950-6
Publication Type
Article
Date
Oct-2006
Author
Rose Hatala
Martha Ainslie
Barry O Kassen
Iain Mackie
J Mark Roberts
Author Affiliation
University of British Columbia, Canada. rhatala@mac.com
Source
Med Educ. 2006 Oct;40(10):950-6
Date
Oct-2006
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
British Columbia
Clinical Clerkship - standards
Clinical Competence - standards
Female
General Surgery - education
Humans
Male
Middle Aged
Abstract
To evaluate the reliability and validity of the Mini-Clinical Evaluation Exercise (mini-CEX) for postgraduate year 4 (PGY-4) internal medicine trainees compared to a high-stakes assessment of clinical competence, the Royal College of Physicians and Surgeons of Canada Comprehensive Examination in Internal Medicine (RCPSC IM examination).
Twenty-two PGY-4 residents at the University of British Columbia and the University of Calgary were evaluated, during the 6 months preceding their 2004 RCPSC IM examination, with a mean of 5.5 mini-CEX encounters (range 3-6). Experienced Royal College examiners from each site travelled to the alternate university to assess the encounters.
The mini-CEX encounters assessed a broad range of internal medicine patient problems. The inter-encounter reliability for the residents' mean mini-CEX overall clinical competence score was 0.74. The attenuated correlation between residents' mini-CEX overall clinical competence score and their 2004 RCPSC IM oral examination score was 0.59 (P = 0.01).
By examining multiple sources of validity evidence, this study suggests that the mini-CEX provides a reliable and valid assessment of clinical competence for PGY-4 trainees in internal medicine.
PubMed ID
16987184 View in PubMed
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165 records – page 1 of 17.