The Association for Surgical Education

Impacting Surgical Education Globally

 

 

Thinking Out of the Box - Videos Only

 

“SHOULD I CONSULT SURGERY?” INSTITUTIONAL GUIDELINES AT THE TAP OF A CELL PHONE
Rodrigo G Gerardo, MD, Dayton Children’s Hospital; Dayton Children’s Hospital

What problem in education is addressed by this work? Institutional guidelines are essential in assisting providers with the tools they need to make clinical decisions but these guidelines are often difficult to view or documented on paper files which make instantaneous care impossible to provide. Describe the intervention: We digitalized the pediatric surgery guidelines from our institution and provided accessibility via a QR code that was readily available at resident work areas. Describe the improvement/outcome of the intervention. Residents from various specialties are able to make clinical decisions swiftly and without the assistance of the pediatric surgical team leading to more efficient disposition and/complete work up at the time of surgical consultation. Since the implementation of the QR code, our institution moved to secured guidelines on proprietary intranet. Describe how this intervention could be applied at other institutions. Please specifically comment on identified barriers that could exist and how they could be overcome. This pilot model for quickly accessible surgical guidelines and algorithms can be applied to any institution with minimal effort and no financial cost at all with the utilization of free applications for data storage and QR code creation. During our presentation, we will highlight our process.

 

 

DEVELOPMENT OF A ROBOTIC VENTRAL HERNIA TRAINING MODEL AND CURRICULUM
Rebecca Elizabeth Wu, MD, Houston Methodist Hospital; Houston Methodist Hospital

What problem in education is addressed by this work? The traditional “see one, do one, teach one” training method can pose a threat to patient safety and decrease operating room efficiency. As we transition away from this method, new teaching approaches are required to allow residents to practice skills, develop efficiency, and model safety prior to encountering a patient in the operating room. Describe the intervention: We developed an easily reproducible ventral abdominal hernia model with affordable, reusable materials. No live tissue, cadavers, or expensive medical models are required for this simulator. Prior to model use, an educational training video is distributed for resident review of procedural steps with fundamental techniques and advanced tips for efficiency demonstrated in the video that are translatable to in-vivo operating room experiences. Describe the improvement/outcome of the intervention. The primary outcomes of this trainer are to teach the basic steps of ventral abdominal hernia repair as well as tips and tricks to be successful, safe, and efficient in the operating room. Repetitive practice on the model prior to entering the operating room will allow resident confidence in the steps of the procedure, as well as autonomy in the OR because their model repetitions allow them to easily demonstrate efficiency and safety during the operation. Describe how this intervention could be applied at other institutions. Please specifically comment on identified barriers that could exist and how they could be overcome. The materials for the model are easily attainable and affordable to allow reproducibility with minimal cost. Acquiring a robotic console and its associated instruments and the robotic thorax model is the largest barrier for institutional practice and may require assistance from a robotic industry representative. However, we do note that the practice model is readily transportable and can be moved easily to access robotic consoles or trainers wherever they are available within a practice institution.

 

 

EVOLVING MOCK ORALS AS A TOOL FOR TEACHING, EVALUATION, AND PREPARATION
Noelle Bertelson, MD, MPH, Saint Joseph Hospital; Saint Joseph Hospital

What problem in education is addressed by this work? Mock oral exams have been used primarily for preparation for the American Board of Surgery Certifying Exam (CE). This may consume valuable and scarce education time in order to prepare chief residents for the CE. Commonly utilized mock oral strategies do not provide adequate, frequent assessment nor feedback for large numbers of multi-level residents over the course of each year. Describe the intervention: In 2024, we transitioned from a monthly mock oral practice session with three senior residents completing faculty-prepared scenarios in front of the entire resident body to a comprehensive monthly plan using a small group format with scenarios designed and scripted for each postgraduate year (PGY) level. Multiple residents of all levels complete scenarios, receive feedback on content and oral exam skills, and are subsequently evaluated based on their demonstration of knowledge. We also conduct formal multi-institution mock oral exams biannually for PGY 4 and 5 residents, formatted to simulate the CE and utilizing a scripted exam with a checklist of key points to pinpoint knowledge deficits, assess oral board strategies, and assist preparation for the CE. Describe the improvement/outcome of the intervention. This dual strategy of monthly program-wide mock oral examinations and biannual senior resident mock oral examinations provides an opportunity for residents and faculty to identify individual knowledge deficits, provide teaching on key points of surgical knowledge, and prepare for the CE. It has been met with widespread approval by all levels of participating residents, and it has allowed the program to provide more frequent formal assessment and feedback on academic progression instead of relying primarily on yearly ABSITE (American Board of Surgery In Training Exam) scores. Describe how this intervention could be applied at other institutions. Please specifically comment on identified barriers that could exist and how they could be overcome. This two-pronged approach is adaptable to most programs, with a monthly format for resident education, evaluation, and feedback and a multi-institution exam for oral board preparation. The greatest barrier to implementation in many programs is the time commitment to prepare the monthly exams and the biannual multi-institution exam. Enlisting the help of non-core faculty and outside institution surgeons and developing a repository of scenarios for multiple institutions or Association of Program Directors in Surgery members are strategies to mitigate the time burden.