Objectives Surgical education has shifted from the Halstedian model of “see one, do one, teach one” to a competency-based model of training. Otolaryngology residency programs can benefit from a fast and simple system to assess residents’ surgical skills. In this quality initiative, we hypothesize that a novel smartphone application called System for Improving and Measuring Procedural Learning (SIMPL) could be applied in an otolaryngology residency to facilitate the assessment of resident operative experiences. Methods The Plan Do Study Act method of quality improvement was used. After researching tools of surgical assessment and trialing SIMPL in a resident-attending pair, we piloted SIMPL across an otolaryngology residency program. Faculty and residents were trained to use SIMPL to rate resident operative performance and autonomy with a previously validated Zwisch Scale. Results Residents (n = 23) and faculty (n = 17) were trained to use SIMPL using a standardized curriculum. A total of 833 assessments were completed from December 1, 2017, to June 30, 2018. Attendings completed a median 20 assessments, and residents completed a median 14 self-assessments. All evaluations were resident initiated, and attendings had a 78% median response rate. Evaluations took residents a median 22 seconds to complete; 126 unique procedures were logged, representing all 14 key indicator cases for otolaryngology. Discussion This is the first residency-wide application of a mobile platform to track the operative experiences of otolaryngology residents. Implications for Practice We adapted and implemented a novel assessment tool in a large otolaryngology program. Future multicenter studies will benchmark resident operative experiences nationwide.

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Standardized interval evaluation with the CPI demonstrates improvement in qualitative diagnostic and management capabilities as PGY levels advance.

The ability to precisely label and visualize tumors in tissues can improve the accuracy of surgical resections compared to standard of care, which relies on visual inspection and palpation. While fluorescence intensity-based imaging is being evaluated for surgical guidance, variable tumor uptake and incomplete clearance of fluorescent probes reduces tumor vs. normal classification accuracy. Here we demonstrate that the fluorescence lifetime (FLT) of multiple types of solid tumors is longer than the FLT of healthy tissues in patients systemically injected with indocyanine green (ICG), an FDA approved near infrared dye. We show that this cancer-specific lifetime shift can distinguish tumor from normal tissue both at a cellular level using microscopy and in large specimens using wide-field imaging, with an accuracy of over 97% across multiple patients. Unlike intensity, which is a system-specific parameter that depends on tumor dye uptake and depth in tissue, FLT is a system-independent photophysical property that can be quantified in thick tissues. Our study suggests that FLT imaging with ICG can be immediately used to improve the accuracy of cancer surgeries.