Surgery Commons^™

Changing The Surgical Residency: A Mixed-Methods Study Of Residents’ And Faculty Experiences One Year After Implementation, Sarah B. Cairo, Wendy Craig, Caitlin Gutheil, Paul K. J. Han, Kristiina Hyrkas, Lynda Macken, Jim Whiting

Journal of Maine Medical Center

Objective: To evaluate a reformed surgical residency curriculum aimed at addressing emerging practice models, enhancing residents’ educational experience, and improving the quality/continuity of patient care by reducing the service size and enhancing attending-resident interactions.

Methods: A mixed-methods study of the surgical training program following curriculum reform including: 1) focus group and individual qualitative interviews with residents, attendings, nurses, and advanced practice providers to explore stakeholder perspectives on curriculum reform, 2) time study of surgical resident activities, and 3) quantitative assessment of surgical case logs.

Results: Qualitative interviews demonstrated disparate knowledge and attitudes regarding the goals of the curriculum with emergence …

Getting Rid Of Stupid Stuff (Gross) Committee: Residents Dedicated To Streamlining Epic-Related Workflow, Nkosi H. Alvarez, Md, Christina L. Jacovides, Md, Brian M. Till, Md, Walker Lyons, Md, Keyur Patel, Md, Richard Zheng, Md, Adam Johnson, Md, John Kairys, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Objectives

• Identify specific mechanisms for submitting and implementing improvements to the Epic environment
• Standardize high-use order sets
• Incorporate high-value modular components into existing order sets
• Create new order sets to streamline resident workflows
• Improve communication between stakeholders

Lymphocytic Lobulitis Presenting In An Adolescent Female: A Case Report, Kevin Meilak Md

Research Days

No abstract provided.

Operative Times In Adolescent Idiopathic Scoliosis Surgery. What Do They Mean?, Joanne Abby Marasigan

Research Days

No abstract provided.

Download Entire Issue: Gibbon Surgical Review, Volume 2, Issue 1, 2019

Gibbon Surgical Review

Table of Contents

4 - The Gibbon Surgical Externship: A Student’s Perspective

6 - Invited Article: The PCOM Wisely Surgical Association and the Philadelphia Surgery Conference

8 - Interview With Thomas Jefferson Cardiothoracic Surgeon, H. Todd Massey, MD

12 - The Life of a Rwandan Surgical Resident

14 - Role Of Technological Advancement In The Context Of Surgical Planning And Execution: Perspective Of Jefferson Surgical Faculty

16 - Interview with William B. Hughes, MD, Director of the Thomas Jefferson University Hospital Burn Center

19 - Women in Surgery: An Interview with Dr. Karen Chojnacki, Vice Chair of Surgical Education at …

Assessing The Operative Log Data Of Traditional (5+2) Vs. Integrated (0+5) Vascular Training Programs, Ernest Gillan, Bs, Anthony Feghali, Md, Tuong Nguyen, Md, Dawn Salvatore, Md, Paul Dimuzio, Md, Babak Abai, Md

Phase 1

Introduction: In 2006, the Accreditation Council for Graduate Medical Education (ACGME) approved an integrated 5 year vascular surgery residency program. Operative experience can be used as a surrogate marker for success in the evolving field of vascular surgery training.

Objective: The purpose of this study is to compare the operative experience of those graduating from the traditional (5+2) vascular training program with the integrated (0+5) program.

Methods: National operative case log data supplied by the ACGME was gathered and organized for vascular surgery residents graduating between 2013 and 2018. Mean case numbers were compared between integrated vascular residents and traditional …

Opioid-Prescribing Practices For Post-Operative Patients In Otolaryngology: A Multiphasic Quality Improvement Project In A Single Large Institution, Zachary Gandee, Sophia Dang, Alexander N. Duffy, Jonathan C. Li, Tanvi Rana, Brittany Gunville, Tingting Zhan, Elizabeth Cottrill, Md, David Cognetti, Md

Phase 1

Objectives:

In otolaryngology, postoperative pain management lacks evidence-based guidelines. We investigated opioid prescription and consumption for common procedures to develop prescribing guidelines at our institution.

Study Design:

Prospective, survey study.

Methods:

Patients who underwent surgery between July and September were given surveys upon discharge and at first follow-up visit. We assessed opioid usage and pain using the visual analog scale and opioid consumption throughout the postoperative period. Opioid prescriptions were converted to a standardized unit of 5 mg Oxycodone pills for reporting. Four procedures (transoral robotic surgery resection [TORS], sialendoscopy, parathyroidectomy/thyroidectomy, and parotidectomy) were selected for isolated analysis.

Results: …

Download Entire Issue: Gibbon Surgical Review, Volume 1, Issue 2, 2018

Gibbon Surgical Review

Table of Contents

• Forward by Charles J. Yeo, MD, FACS
• PERSPECTIVE - An Interview with Dr. Theresa Yeo, Co-Director of the Jefferson Pancreas Tumor Registry (JPTR)
• A PGY-1's Perspective: Conducting Pancreatic Cancer Research as a Medical Student
• INTERVIEW - Jonathan Brody, PhD - Pancreatic Cancer Specialist
• RESEARCH SPOTLIGHT - The Journal of Pancreatic Cancer
• Pancreatic Cancer Research at Jefferson: The Mary Halinski Pancreatic Cancer Research Fund
• The Gibbon Surgical Society
• Contributors
• Samuel D. Gross Professor of Surgery: Charles J. Yeo, MD, FACS

Heparin Bridging Therapy Is Not Necessary For Patients With Atrial Fibrillation Undergoing Temporary Interruption Of Warfarin Therapy For Elective Invasive Procedures Or Surgery, Shannon Paquette

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Douketis JD, Spyropoulos AC, Kaatz S, et al. Perioperative bridging anticoagulation in patients with atrial fibrillation. New Engl J Med. Aug 2015;373(9):823-833. doi: 10.1056/NEJMoa1501035

Educational Prevention Program Of Surgical Site Infections (Ssi), Carena Leung

Master's Projects and Capstones

Surgical site infections (SSI) cause negative health care effects to patients and hospitals. SSI is one of the most common types of healthcare-associated infections (HAI) accounting for 31% among hospitalized patients (Centers for Disease Control and Prevention [CDC], 2012). It is associated with prolonged length of stays (LOS), higher morbidity and mortality, and increased healthcare costs. The purpose of this quality improvement project is to decrease SSI rates by enhancing patient education and engagement in preoperative care and hygiene before surgery. In a metropolitan pediatric hospital, a microsystem analysis of the preoperative unit was conducted before generating the SSI Prevention …

Transabdominal Versus Transvaginal, Kyla Camille Gray

Grace Peterson Nursing Research Colloquium

Background: In the United States, there has been a 21% increase in the occurrence of premature births within the last two decades. These children are also more likely to require lifelong therapies, assistive technologies, mobility devices, and more supportive services throughout their time in school. Globally, preterm births, and their preventions, have become a topic of interest. One method that has had significant success rates is placing a cerclage to prevent cervical dilation; while simultaneously treating prophylactically for early delivery.

Objectives: The purpose of this integrative literature review was to focus on which placement of cerclages, transabdominal or transvaginal, …

Download Entire Issue: Gibbon Surgical Review, Volume 1, Issue 1, 2018

Gibbon Surgical Review

Table of Contents

• A First Year's Perspective on JeffMD, Somnath Das, MS1
• Spotlight on TJUH's Quality and Safety Group, Samantha L. Savitch, MS1
• Medical Student Involvement in Quality Improvement Research, Tyler M. Bauer, MS3
• Global Surgery: A Shift in the Global Health Paradigm, Myles S. Dworkin, MS3
• Thomas Jefferson University Design Vault, Victor B. Hsue, MS2
• Physician Spotlight: Ernest (Gary) L. Rosato, MD, FACS, Carrie E. Andrews, MS3
• The SCALPELS Program, Emily Papai, MS1

Teaching Third-Year Medical Students To Address Patients’ Spiritual Needs In The Surgery/Anesthesiology Clerkship, Holly G. Atkinson, David Fleenor, Susan M. Lerner, Edward Poliandro, Joseph Truglio

Publications and Research

Introduction: Despite many patients wanting physicians to inquire about their religious/spiritual beliefs, most physicians do not make such inquiries. Among physicians who do, surgeons are less likely than family and general practitioners and psychiatrists to do so.

Methods: To address this gap, we developed a 60-minute curriculum that follows the Kolb cycle of experiential learning for third-year medical students on their surgery/anesthesiology clerkship. The session includes definitions of religion/spirituality, an overview of the literature on spirituality in surgery, a review of the FICA Spiritual History Tool, discussion of the role of the chaplain and the process of initiating a chaplain …

Interdepartmental Rounding, Peggy Anderson, Carrie Strick, R3 Med-Surg Unit, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Maine Medical Center Operational Excellence

MaineHealth Maine Medical Center

STRATEGIES FOR IMPROVING COMMUNICATION BETWEEN DOCTORS AND NURSES IN AN ACUTE CARE HOSPITAL

Effective interdisciplinary communication is imperative for safe patient care in an acute care hospital environment.

A surgical unit used their HCAHPs scores to assess how often patients perceived there was good communication between different doctors and nurses during their hospital stays. The data demonstrated that this occurred 22% less often than the national average.

As a result of a root cause analysis, a number of countermeasures were initiated with the goal of achieving scores greater than the national average. Post KPI inception in the second quarter of …

The Utilization Of High Flow Oxygen To Administer Inhaled Pulmonary Vasodilators In Post-Operative Left Ventricular Assist Patient Population To Facilitate Extubation, Kenneth Miller Med, Rrt-Accs, Ae-C;, Timothy S. Misselbeck, Barbara A. Ebert Crnp, Robert Allman Rrt, Linda Cornman Bs, Rrt-Nps, Rrt-Accs, Ae-C

Patient Care Services / Nursing

No abstract provided.

La Cesárea Y El Parto Natural: Las Opiniones De Profesionales De La Salud En La Provincia De Buenos Aires / Cesarean Section And Natural Birth: The Opinions Of Health Provinces In The Province Of Buenos Aires, Jacqueline Chipkin

Independent Study Project (ISP) Collection

Introduction: The ways in which women of society give birth have the power to influence maternal-infant health and shape the economy of the healthcare system. Today, the rates of cesarean sections are increasing throughout the world. In Argentina, on average, more than 35% of pregnant women received cesarean sections in 2008, with large differences observed in the rates between the public and private health sectors. The World Health Organization (WHO) has established that healthcare systems should only employ a cesarean section if labor cannot progress safely. According to this standard, the organization estimates that cesarean sections should only be utilized …

Surgeon Practices And Attitudes Toward The Control Of Surgical-Site Infections In Jordan, Sara Ali Mater

Independent Study Project (ISP) Collection

The purpose of this study was to determine the attitudes and practices of Jordanian surgeons on the control of surgical-site infections, evaluated by the Center of Disease Control’s guidelines toward the prevention of surgical-site infections, in addition to gaining respondents opinions on infection control in Jordan. This study was conducted through the distribution of 75 questionnaires given to surgeons at five hospitals in Jordan. Additional insight on SSI infection control was gained through interviews with two cardiac surgeons and three infection control directors. The results of the survey were compared with the Center for Disease Control’s guide to surgical-site infection …

Improving Anatomical Knowledge Retention In Medical Students Entering The Surgery And Obstetrics And Gynecology Clinical Rotations By Nesting Interactive Modules, Samantha Ahle, Jill Krapf, Kirsten Marie Brown, Juliet Lee, Gisela Butera, Ellen Goldman, Myriam Ferzli, Rosalyn A. Jurjus

GW Research Days 2014

Background: It is well documented in the medical education literature that students retain minimal anatomy knowledge when transitioning from pre-clinical didactics to clinical application on the wards. In a previous study at our own institution we were able to quantify this knowledge deficit in students on surgical clerkships, specifically surgery and obstetrics and gynecology (OB/GYN). Using our previous data, we designed an integrated, nested clinical teaching model utilizing e-modules to review clinically relevant surgical anatomy during their clinical rotations.

Objective: The goal of this study is to evaluate the impact of a newly designed method of teaching clinically relevant anatomy …

The Community As A Learner Group, Cathyann Feher Rn,Msn, Karen L. Kutner Mba, Robert Ruhf, Charles Scagliotti Md,Facs, Michael M. Badellino Md

Department of Surgery

No abstract provided.

An Analysis Of The Educational Value And Impact Of A Dual, Versus Single, Robotic Surgical Console In The Training Of Obgyn Residents, Joseph E. Patruno Md, Hubert K. Huang Ms, Med, Michelle W. Huang Md, Thomas Hutchinson Md, Martin A. Martino Md

Department of Obstetrics & Gynecology

No abstract provided.

Enhancing Resident Education By Empowering The Learner Through The Creation Of Smartphone Applications, Christine W. Du Md, Dale A. Dangleben Md, Judith A. Olenwine Ms, C-Tagme, Michael M. Badellino Md

Department of Surgery

No abstract provided.

Evaluation Of Stress On Laparoscopic Skills Of Surgical Residents In Simulation-Based Education, William C. Boyer Dhsc, Ms, Hubert K. Huang Ms,Med, Charles Scagliotti Md,Ffacs, Robert Ruhf

Department of Education

No abstract provided.

“I Think, Therefore I Count”: Changing The Count Process While Encouraging Critical Thinking, Marlene H. Leidy, Hope L. Johnson Msn, Rn, Cnor

Patient Care Services / Nursing

No abstract provided.

A Networkwide, Multidisciplinary Approach To Improving Perioperative Medication Safety, Diane Kimsey Rn, Ms, Cnor, Jeanne P. Luke Msn, Rn, Cnor

Patient Care Services / Nursing

No abstract provided.

Developing A Multidisciplinary Perioperative Safety Course, William Bond Md, Ms, Hope L. Johnson Msn, Rn, Cnor, Michael Pasquale Md, Facs, Fccm, Melissa B. Walsh Bs, Deborah Arnold Msn, Rn, Cmsrn, Matthew W. Leclair, Kelly L. Lago Ms, Jeanne P. Luke Msn, Rn, Cnor

Department of Emergency Medicine

No abstract provided.

Impact Study Of A Central Lines Simulation Training Program Using Kirkpatrick’S Four-Level Evaluation Model, James P. Orlando Edd, Andrew C. Miller Do, William Bond Md, Ms, Valerie A. Rupp Rn, Bsn, Bryan G. Kane Md, Cindy Umbrell Rn, Msn, Michael Pasquale Md

Department of Emergency Medicine

No abstract provided.

Blepharophimosis-Ptosis-Epicanthus Inversus Syndrome In A Pakistani Pedigree, Tanveer Anjum Chaudhry, Mirza Umair Khalid, Taimur Saleem, Khabir Ahmad

Section of Ophthalmology

Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is a rare developmental ocular disorder. We report this condition affecting 4 members of a Pakistani family across three generations. A 2-year-old girl was brought to the clinic by her father for the correction of her shortened palpebral fissures. Examination findings were consistent with BPES. The girl's father, paternal grandfather and paternal aunt also had identical features. The distance between the medial canthi of the index case was 30 mm, and the lengths of vertical and horizontal palpebral fissure were 6 mm and 20 mm, respectively. BPES must be considered an important differential diagnosis in patients …

Impact Of An Interprofessional Central Venous Catheter Insertion Training Program, James P. Orlando Edd, Andrew Miller Do, William Bond Md, Ms, Valerie A. Rupp Rn, Bsn, Bryan G. Kane Md, Cindy Umbrell Rn, Msn, Michael Pasquale Md, Elizabeth Verheggen Phd, Elliot J. Sussman Md, Mba

Department of Emergency Medicine

No abstract provided.

Effects Of Provider Education On Documentation Compliance In The O.R., Brenda Kingdon

UNF Graduate Theses and Dissertations

Knowledge of The Joint Commission's National Patient Safety Goals and an effective provider cooperative practice involving communication and teamwork are essential for the delivery of safe and compliant patient care in the surgical setting. The purpose of this study was to assess the impact of an educational intervention for physicians and nurses designed to increase documentation of compliance with national patient safety standards. As events of noncompliance have impacted patient safety at the hospital where this project was conducted, measures were needed to assess barriers to compliance with standards of practice and to focus educational session plans on identified knowledge-base …