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Absence of a "July Effect" on Hospital Length of Stay After Primary Total Hip or Knee Arthroplasty.

Orthopedics 2021 Jul-Aug;44(4):e503-e508. Epub 2021 Jul 1.

There is a commonly held belief in a "July effect" resulting in suboptimal outcomes as residents begin or advance in their training each summer. Previous studies have shown an absence of a July effect on clinical outcomes after total hip arthroplasty (THA) or total knee arthroplasty (TKA). However, it remains unknown whether there is a July effect on hospital length of stay (LOS) after primary THA/TKA. Read More

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Neurosurgical performance between experts and trainees: Evidence from drilling task.

Int J Med Robot 2021 Jul 20:e2313. Epub 2021 Jul 20.

Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.

Background: Lumbar laminectomy is a common neurosurgery that requires precise manipulation of power drills. We examined the fine movement controls of novice neurosurgeons in drilling tasks and compared its accuracy to expert surgeons' performance.

Methods: Four experts and three novice neurosurgeons performed a lumbar laminectomy on a three-dimensional printed spine model. Read More

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Immersive Virtual Reality for Surgical Training: A Systematic Review.

J Surg Res 2021 Jul 16;268:40-58. Epub 2021 Jul 16.

Division of Orthopaedic Surgery, Department of Surgery, McMaster University, ON, Hamilton, Canada. Electronic address:

Background: Immersive virtual reality (iVR) simulators provide accessible, low cost, realistic training adjuncts in time and financially constrained systems. With increasing evidence and utilization of this technology by training programs, clarity on the effect of global skill training should be provided. This systematic review examines the current literature on the effectiveness of iVR for surgical skills acquisition in medical students, residents, and staff surgeons. Read More

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The "STARS-CASCADE" Study: Virtual Reality Simulation as a New Training Approach in Vascular Neurosurgery.

World Neurosurg 2021 Jul 17. Epub 2021 Jul 17.

Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico "C. Besta", Milan, Italy; Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico Nazionale "C. Besta", Milan, Italy; EANS Training Committee; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurological Surgery, Johns Hopkins Medical School, Baltimore, MD, USA.

Objective: Surgical clipping has become a relatively rare procedure in comparison to endovascular exclusion of cerebral aneurysms. Consequently, there is a declining number of cases where young neurosurgeons can practice clipping. For this reason, we investigated the application of a new 3D simulation and rehearsal device, Surgical Theater™, in vascular neurosurgery. Read More

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Presence of Orthopedic Residency Decreases Emergency Physician's Confidence in Orthopedic Procedures.

Cureus 2021 Jun 9;13(6):e15551. Epub 2021 Jun 9.

Emergency Medicine, OhioHealth Doctors Hospital, Columbus, USA.

Introduction: At present, there exists no standard orthopedic training for emergency medicine (EM) residency programs. Varying residency environments including but not limited to volume, acuity, and competing residency programs will dictate the number of orthopedic procedures a resident is exposed to, ultimately dictating a graduate's comfort level with orthopedic procedures. Our study set out to investigate further whether training alongside an orthopedic residency affects an attending physician's perceived procedural comfort. Read More

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Impact of the COVID-19 pandemic on surgical skills training in pediatric surgery residents.

Pediatr Surg Int 2021 Jul 16. Epub 2021 Jul 16.

Division of Pediatric Surgery and Urology, Department of Pediatrics, Hospital Italiano de Buenos Aires, Potosí, 4060, Buenos Aires, Argentina.

Purpose: To analyze the initial impact of the SARS-CoV-2 pandemic on surgical skills training and performance of Pediatric Surgery Residents.

Methods: Retrospective study considering the modifications on the Pediatric Surgery Residency training from March 1st-May 31st, 2020. Exposure to OR learning opportunities was compared to the same 2018-2019 trimesters. Read More

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Benchmarking of Neurosurgery Training in Pakistan.

Asian J Neurosurg 2021 Apr-Jun;16(2):300-306. Epub 2021 May 28.

Family Medicine, Liaquat National Hospital and Medical College, Karachi, Pakistan.

Introduction: Neurosurgery is a challenging field of surgery. A neurosurgeon has to be trained with the finest skills, knowledge, and competencies necessary to provide high-quality patient care. Maintaining postgraduate training standards is a challenge in Pakistan due to low budget allocation to the health sector. Read More

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Play and Learn for Surgeons: A Serious Game to Educate Medical Residents in Uterine Artery Ligation Surgery.

Games Health J 2021 Jul 14. Epub 2021 Jul 14.

Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Postpartum hemorrhage (PPH) is a leading cause of maternal mortality. Surgical interventions, such as uterine artery ligation and utero-ovarian arteries ligation (UAL and UOAL), are considered as effective methods to control PPH. Owing to PPH's severe outcomes, various educational tools have been developed to train surgical residents. Read More

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Consumer Awareness and Comfort with Resident-run Cosmetic Clinics: A Crowdsourcing Study.

Plast Reconstr Surg Glob Open 2021 Jul 12;9(7):e3681. Epub 2021 Jul 12.

Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Medical Center, Winston Salem, N.C.

Background: Resident cosmetic clinics (RCCs) are the training modality of choice among both residents and faculty and are a mainstay at most residency programs. Despite this, knowledge of RCCs among plastic surgery consumers remains untested. We hypothesize that the public would be aware of and receptive to RCCs. Read More

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Surgical experience and patient morbidity after third molar removal.

J Stomatol Oral Maxillofac Surg 2021 Jul 11. Epub 2021 Jul 11.

OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium.

Objectives: The present study aimed to assess differences in patients' postoperative morbidity after third molar removal in relation to the surgeon's level of experience and other intraoperative factors.

Material And Methods: Patients admitted for prophylactic removal of asymptomatic third molars were prospectively followed up on day 3 and 10 after surgery in the context of the M3BE-study. Uni- and multivariable logistic regression was performed to assess the associations between surgeon's (in)experience and postoperative discomfort. Read More

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Effects of a Resident's Reputation on Laparoscopic Skills Assessment.

Obstet Gynecol 2021 Jul;138(1):16-20

Department of Obstetrics and Gynecology, University of Toronto, and the Department of Obstetrics and Gynaecology, Sinai Health System, Toronto, Ontario, the Department of Obstetrics and Gynaecology, Cumberland Regional Health Care Centre, Amherst, Nova Scotia, and the Biostatistics Research Unit, University Health Network, Toronto, Ontario, Canada.

Objective: To quantify the effect of a resident's reputation on the assessment of their laparoscopic skills.

Methods: Faculty gynecologists were randomized to receive one of three hypothetical resident scenarios: a resident with high, average, or low surgical skills. All participants were then asked to view the same video of a resident performing a laparoscopic salpingo-oophorectomy that differed only by the resident description and provide an assessment using a modified OSATS (Objective Structured Assessment of Technical Skills) and a global assessment scale. Read More

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Assessing exposure to dermoscopy in plastic surgery training programs.

JPRAS Open 2021 Sep 18;29:178-183. Epub 2021 May 18.

Department of Surgery, Divisions of Plastic Surgery and Surgical Oncology, University of Calgary, Tom Baker Cancer Centre, 1331 29 Street NW, Calgary, Alberta T2A 4N2, Canada.

Background: Dermoscopy is a noninvasive tool that improves the diagnostic accuracy of melanoma and other cutaneous malignancies; yet, it is not widely used by plastic surgeons, who commonly manage skin lesions. Thus, the purpose of this study was to explore current practice patterns and knowledge of dermoscopy among plastic surgeons and postgraduate plastic surgery trainees. Additionally, interest to establish a formal dermoscopy curriculum as part of plastic surgery residency training was evaluated. Read More

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September 2021

Designing an Intimate Partner Violence Screening Program for Surgical Residents in Trauma.

J Surg Res 2021 Jul 9. Epub 2021 Jul 9.

Department of Surgery, University of California, San Francisco, California. Electronic address:

Background: Intimate partner violence (IPV) commonly affects surgical patients, particularly trauma patients. However, baseline knowledge of IPV is poor among surgeons and screening is variable. We designed a project to educate surgical residents on IPV and standardize screening in all trauma patients. Read More

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Long-Term Survival in High-Risk Older Adults Following Emergency General Surgery Admission.

J Trauma Acute Care Surg 2021 Jul 9. Epub 2021 Jul 9.

Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada Department of Surgery, University of Toronto, Toronto, Ontario, Canada Interdepartmental Division of Critical Care Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada Sunnybrook Research Institute, Toronto, Ontario, Canada American College of Surgeons, Chicago, IL ICES, Toronto, Ontario, Canada.

Background: Emergency general surgery (EGS) conditions are increasingly common among nursing home residents. While such patients have a high risk of in-hospital mortality, long-term outcomes in this group are not well described, which may have implications for goals of care discussions. In this study, we evaluate long-term survival among nursing home residents admitted for EGS conditions. Read More

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Forensic Implications of Anatomical Education and Surgical Training With Cadavers.

Front Surg 2021 23;8:641581. Epub 2021 Jun 23.

Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.

Anatomical education and surgical training with cadavers are usually considered an appropriate method of teaching, above all for all surgeons at various levels. Indeed, in such a way they put into practice and exercise a procedure before performing it live, reducing the learning curve in a safe environment and the risks for the patients. Really, up to now it is not clear if the nonuse of the cadavers for anatomical education and surgical training can have also forensic implications. Read More

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Open Cholecystectomy for the New Learner-Obstacles and Challenges.

JSLS 2021 Apr-Jun;25(2)

Department of General Surgery, Henry Ford Wyandotte Hospital, Wyandotte, Michigan.

Background: Laparoscopy has become the standard of care in most general surgery procedures. This has led to a decrease in the number of open surgical procedures for surgical training, particularly as senior surgeons retire. The aim of this study was to evaluate the impact of retiring senior surgeons on our residents' operative experience. Read More

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Teaching on Rounds and in Small Groups.

Surg Clin North Am 2021 Aug;101(4):555-563

Medical University of South Carolina, Department of Surgery, 96 Jonathan Lucas Street, Charleston, SC 29425, USA. Electronic address:

Bedside teaching plays a vital role the training future physicians, allowing for instruction in history taking, physical examination skills, differential diagnosis development, professionalism, teamwork integration, effective communication, and discussions of medical ethics. Due to changes in the health care system, accreditation bodies, and shortened admittance of patients, rates of bedside teaching have declined. Attending surgeons feel increased external pressures to meet performance metrics while resident physicians adhere to duty hour restrictions. Read More

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Evaluation of the Reproducibility of Lauge-Hansen, Danis-Weber, and AO Classifications for Ankle Fractures.

Rev Bras Ortop (Sao Paulo) 2021 Jun 18;56(3):372-378. Epub 2020 Dec 18.

Departamento de Ortopedia e Traumatologia, Hospital Regional do Gama, Brasília, DF, Brasil.

 The present study aims to analyze the intra- and interobserver reproducibility of the Lauge-Hansen, Danis-Weber, and Arbeitsgemeinschaft für Osteosynthesefragen (AO) classifications for ankle fractures, and the influence of evaluators training stage in these assessments.  Anteroposterior (AP), lateral and true AP radiographs from 30 patients with ankle fractures were selected. All images were evaluated by 11 evaluators at different stages of professional training (5 residents and 6 orthopedic surgeons), at 2 different times. Read More

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Diagnostic Failure Rate in Detecting Perilunate Carpal Fractures and Dislocations Using Plain Wrist X-Rays.

Rev Bras Ortop (Sao Paulo) 2021 Jun 25;56(3):340-345. Epub 2020 Sep 25.

Divisão de Cirurgia da Mão, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (HC-FMRP-USP), Ribeirão Preto, SP, Brasil.

 The present study aimed to evaluate the diagnostic failure rate in detecting perilunate fractures and dislocations using plain wrist radiographs by orthopedists and orthopedic residents. A secondary objective was to identify possible groups with a greater or lesser chance of establishing a correct diagnosis.  An online questionnaire was sent to several orthopedists through e-mail, social networks, and smartphone-based communication applications to assess the rate of diagnostic failure in detecting perilunate fractures and dislocations using plain radiographs. Read More

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Evaluation of a novel universal robotic surgery virtual reality simulation proficiency index that will allow comparisons of users across any virtual reality simulation curriculum.

Surg Endosc 2021 Jul 6. Epub 2021 Jul 6.

Mimic Technologies Inc., Seattle, WA, USA.

Study Objective: Evaluate a universal proficiency metric for Robotic Surgery Virtual Reality (VR) simulation that will allow comparison of all users across any VR curriculum.

Design: Retrospective analysis of VR Simulation metrics.

Setting: Two training institutions. Read More

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Telehealth Training for Surgeons to Empathetically Deliver Bad News Via Video-Mediated Communication.

Am Surg 2021 Jul 6:31348211030458. Epub 2021 Jul 6.

Department of Surgery, 6887Virginia Commonwealth University Health System, Richmond, VA, USA.

Background: The COVID-19 pandemic resulted in a sudden increase in the need to effectively use telehealth in all realms of health care communication, including the delivery of bad news.

Methods: A single arm, unblinded, feasibility study was performed at a tertiary care center located in Central Virginia to explore the value and utility of providing a telehealth training program based on SPIKES to teach surgical residents and faculty best practice for disclosing difficult news via video-mediated communication (VMC). Surgical interns (categorical and preliminary), surgical residents, and surgical faculty from General, Neuro, Pediatric, Plastics, Oncology, Urology, and Vascular surgical specialties were recruited via email to voluntarily participate in a telehealth simulation-based workshop, with 33 surgical learners participating in the training and 28 completing evaluation surveys. Read More

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The Effect of Plaster of Paris on Reliabilities of RUST and mRUST Scoring Systems.

Acta Chir Orthop Traumatol Cech 2021 ;88(3):222-228

Tepecik Training and Research Hospital, Izmir, Turkey.

PURPOSE OF THE STUDY The aim of our study is to investigate the reliabilities of the radiographic union score for tibial fracture (RUST) and modified RUST scoring systems in the evaluation of fracture healing in adult tibia fractures treated with intramedullary nailing and pediatric tibia fractures treated with closed reduction and cast immobilization and to compare the reliabilities between two groups. MATERIAL AND METHODS Between January 2016 and January 2020, the informations of patients (ages of 4-10) with tibia fractures treated with closed reduction and casting and patients (aged 18-65 years) with tibia fractures treated with intramedullary nailing were analyzed retrospectively. Forty-seven good quality AP and lateral radiographs (represent different healing stages) each for pediatric and adult fracture groups were selected and were included in two PPTs separately. Read More

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Outcomes in Laparoscopic Roux-en-Y Gastric Bypass and Implications for Surgical Resident Education.

J Surg Educ 2021 Jul 1. Epub 2021 Jul 1.

Boston University School of Medicine, Boston, MA; Department of Surgery, Boston Medical Center, Boston, Massachusetts. Electronic address:

Objectives: Some surgery residents feel inadequately prepared to perform advanced operations, partly due to losing operative opportunities to fellows. In turn, they are prompted to pursue fellowships. Allowing residents the opportunity to participate in advanced procedures and complex cases may alleviate this cycle, if their participation is safe. Read More

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Telemedicine in Neurosurgery: Standardizing the Spinal Physical Examination Using A Modified Delphi Method.

Neurospine 2021 Jun 30;18(2):292-302. Epub 2021 Jun 30.

Department of Neurological Surgery, University of California, San Francisco, CA, USA.

Objective: The use of telemedicine has dramatically increased due to the coronavirus disease 2019 pandemic. Many neurosurgeons are now using telemedicine technologies for preoperative evaluations and routine outpatient visits. Our goal was to standardize the telemedicine motor neurologic examination, summarize the evidence surrounding clinical use of telehealth technologies, and discuss financial and legal considerations. Read More

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Grit in Surgeons.

World J Surg 2021 Jul 3. Epub 2021 Jul 3.

Association of Women Surgeons, Chicago, IL, USA.

Background: Women in surgery are often told that they are not "tough enough" to be surgeons. A Grit Score provides a validated measure of passion and perseverance, which are aspects of "toughness."

Methods: Survey data were collected from residents and attendings in all surgical fields through multiple surgical societies. Read More

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Precision and accuracy of pre-surgical planning of non-cemented total hip replacement with calibrated digital images and acetates.

J Orthop Surg Res 2021 Jul 3;16(1):431. Epub 2021 Jul 3.

Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Cra. 7, No, 40-62, Bogotá, Colombia.

Background: When approaching a joint replacement procedure, pre-surgical planning is essential to predict an accurate estimation of implant size and position. There are currently two methods to achieve it, analog and digital. The present study aims to demonstrate how the hybrid technique is accurate and precise for pre-surgical planning in a non-cemented total hip replacement. Read More

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Effect of COVID-19 on Thoracic Oncology Surgery in Spain: A Spanish Thoracic Surgery Society (SECT) Survey.

Cancers (Basel) 2021 Jun 9;13(12). Epub 2021 Jun 9.

Thoracic Surgery, Hospital Clínico San Carlos, 28040 Madrid, Spain.

After the first wave of COVID-19, the Spanish Society of Thoracic Surgeons (SECT) surveyed its members to assess the impact of the pandemic on thoracic oncology surgery in Spain. In May 2020, all SECT members were invited to complete an online, 40-item, multiple choice questionnaire. The questionnaire was developed by the SECT Scientific Committee and sent via email. Read More

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National Evaluation of Surgical Resident Grit and the Association With Wellness Outcomes.

JAMA Surg 2021 Jun 30. Epub 2021 Jun 30.

Surgical Outcomes and Quality Improvement Center, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Importance: Grit, defined as perseverance and passion for long-term goals, is predictive of success and performance even among high-achieving individuals. Previous studies examining the effect of grit on attrition and wellness during surgical residency are limited by low response rates or single-institution analyses.

Objectives: To characterize grit among US general surgery residents and examine the association between resident grit and wellness outcomes. Read More

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Ten hours of simulator training in arthroscopy are insufficient to reach the target level based on the Diagnostic Arthroscopic Skill Score.

Knee Surg Sports Traumatol Arthrosc 2021 Jun 29. Epub 2021 Jun 29.

Zentrum für Orthopädie und Unfallchirurgie, Medizinische Hochschule Theodor Fontane, 14770, Brandenburg, Germany.

Purpose: Simulator arthroscopy training has gained popularity in recent years. However, it remains unclear what level of competency surgeons may achieve in what time frame using virtual training. It was hypothesized that 10 h of training would be sufficient to reach the target level defined by experts based on the Diagnostic Arthroscopic Skill Score (DASS). Read More

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Awareness among anesthesia residents pertaining to various intubation techniques in craniofacial surgery: A questionnaire study.

Natl J Maxillofac Surg 2021 Jan-Apr;12(1):62-66. Epub 2021 Mar 16.

Dental Surgeon, Bharti Vidyapeeth Dental College and Hospital, Sangli, Maharashtra, India.

Aim: This study was intended to evaluate the knowledge and clinical skill of anesthesia residents pertaining to various intubation techniques employed in craniofacial surgery.

Materials And Methods: A cross-sectional survey research design was employed in this study. A self-administered questionnaire survey was used to validate the knowledge and clinical skill of anesthesia residents pertaining to various intubation techniques employed in craniofacial surgery. Read More

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