Can a Structured, Video-Based Cadaver Curriculum Demonstrating Proficiency Enhance Resident Operative Autonomy?

Jajja, Mohammad Raheel; Lovasik, Brendan P.; Kim, Steven C.; Wang, Vivian L.; Hinman, Johanna M.; Delman, Keith A.; Srinivasan, Jahnavi K.

doi:10.1016/j.jsurg.2019.08.004

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…The cadaver procedural skills curriculum is an annual, longitudinal, simulation-based program for all general surgery residents in our program that has been previously described [8][9][10] A list of cadaver-based operative tasks was generated by a faculty panel, with increasing complexity of skills stratified by postgraduate year to reflect increasing experience (Supplemental Table 1A). Residents are recorded reciting a brief description of an assigned procedure and performing the task.…”

Section: Cadaver Procedural Skills Simulation Curriculummentioning

confidence: 99%

How We Do It: Remediation Pathways in a Surgical Simulation Curriculum for Competency Improvement

Lovasik

Fay

Hinman

et al. 2022

The American Surgeon™

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Objective Validated assessment of procedural knowledge and skills with formative remediation is a foundational part of achieving surgical competency. High-fidelity simulation programs provide a unique area to assess resident proficiency and independence, as well as to assist in identifying residents in need of further practice. While several studies have validated the use of simulation to attain proficiency of specific technical skills, few have validated remediation pathways for their trainees objectively. In this descriptive analysis, we review 2 remediation pathways within our simulation training curricula and how these are used in assessments of resident proficiency. Materials and Methods Two methods of remediation were formulated for use in high-fidelity simulation labs. One remediation pathway was a summative process, where ultimate judgment of resident competency was assessed through intra-operative assessments of a holistic skill set. The second remediation pathway was a formative “coaching” process, where feedback is given at several intervals along the pathway towards a specific technical skills competence. All general surgery residents are enrolled in the longitudinal, simulation curricula. Results Approximately one-third of surgical residents entered into a remediation pathway for either of the high-fidelity simulation curricula. Both residents and faculty expressed support for the summative and formative remediation pathways as constructed. Residents who entered remediation pathways believed it was a beneficial exercise, and the most common feedback was that remediation principles should be expanded to all residents. Interestingly, faculty demonstrated stronger support for the formative coaching feedback model than the summative assessment model. Conclusions Through the complementary use of both formative and summative remediation pathways, resident competence can be enriched in a constructive, nonpunitive method for self-directed performance improvement. Both trainees and faculty express high satisfaction with programs explicitly organized to ensure that skills are rated through a standardized process.

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Section: Cadaver Procedural Skills Simulation Curriculummentioning

confidence: 99%

How We Do It: Remediation Pathways in a Surgical Simulation Curriculum for Competency Improvement

Lovasik

Fay

Hinman

et al. 2022

The American Surgeon™

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“…Residents should realize that the patient on whom they are operating is someone's sibling, parent, or loved one, not just a person on whom to practice their skills. Thus, whenever possible, residents should be willing to put in the extra effort and hours that are necessary to hone their skills in cadaver laboratories or simulation centers before expecting to operate on a patient 27 . This ensures that residents acquire the surgical skills that are necessary to become an autonomous surgeon on completion of their residency without compromising patient care in the process.…”

Section: Understanding the Learnermentioning

confidence: 99%

Training the New Generations of Orthopaedic Surgery Residents

Sarac

Vajapey

Bosse

et al. 2021

Journal of Bone and Joint Surgery

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:Most of the current orthopaedic residents are considered Millennials (born between 1981 and 1996) and are often trained by attending surgeons who are from Generation X (born between 1965 and 1980) or the Baby Boomer generation (born between 1946 and 1964). The Generation X orthopaedic surgeons were largely trained by Baby Boomers who were very demanding of their trainees and expected excellence. The Baby Boomers had been inspired, mentored, and trained by the Greatest Generation (born between 1901 and 1927). Baby Boomers took nothing for granted and nothing was given to them on a silver platter. Generation X was trained under these premises and was expected to abide by similar values. Regarding the next generation of residents, current faculty hope to instill the same qualities that had been instilled in them during their training. This value transference sometimes presents a challenge because of the differences in attitudes and perspectives that may exist between Millennial residents and their predecessors regarding work-life balance, teaching styles, the regulation of duty hours, and feedback assessments. These differences require an evolution in the methods of surgical education to optimize the educational benefit and ensure good will and rapport between the generations. Trainees and faculty alike have a responsibility to understand each other’s differences and come together to ensure that knowledge, experience, values, and skill sets are effectively passed on to a new generation of orthopaedic surgeons.

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“…Multiple institutions have implemented a cadaver-based curriculum showing promising results. Srinivasan et al 3 and Askari et al 4 developed curriculums at their respective institutions with the goal of standardizing exposure to fundamental skills to improve resident autonomy. 3 , 4 They found that their cadaveric curriculum increased resident autonomy, as both residents and faculty had improved confidence in the trainee’s operative skills.…”

mentioning

confidence: 99%

“…Srinivasan et al 3 and Askari et al 4 developed curriculums at their respective institutions with the goal of standardizing exposure to fundamental skills to improve resident autonomy. 3 , 4 They found that their cadaveric curriculum increased resident autonomy, as both residents and faculty had improved confidence in the trainee’s operative skills. In addition, faculty observed an increase in knowledge of anatomy and in technical skill ability amongst all resident cohorts.…”

mentioning

confidence: 99%

“…Faculty members surveyed at the conclusion of the course also believed that the residency program should continue cadaver-based studies and simulations. 3 , 4 Additional benefits of surgical simulation or cadaver dissections include the potential to identify poor technical knowledge and poor surgical techniques early in training, which allows for individualized educational plans for struggling residents. 3 Conversely, skilled junior residents will obtain the opportunity to refine more complex surgical skills.…”

mentioning

confidence: 99%

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Importance of Cadaveric Dissections and Surgical Simulation in Plastic Surgery Residency

Attaluri

Wirth

Gander

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Can a Structured, Video-Based Cadaver Curriculum Demonstrating Proficiency Enhance Resident Operative Autonomy?

Cited by 6 publications

References 19 publications

How We Do It: Remediation Pathways in a Surgical Simulation Curriculum for Competency Improvement

How We Do It: Remediation Pathways in a Surgical Simulation Curriculum for Competency Improvement

Training the New Generations of Orthopaedic Surgery Residents

Importance of Cadaveric Dissections and Surgical Simulation in Plastic Surgery Residency

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