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Predictors for resident success in otolaryngology

JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS 2006年第4期202卷 649-654页

作者： Daly, KA Levine, SC Adams, GL Univ Minnesota Dept Otolaryngol Minneapolis MN 55455 USA

BACKGROUND: This study aimed to determine predictors for otolaryngology resident success using data available at the time candidates are interviewed (eg, medical school attended, letters of recommendation, test scores) and data that emerge during residency. STUDY DESIGN: We performed a retrospective cohort Study of 36 residents who entered our program between 1983 and 1993. RESULTS: Seventy percent of Alpha Omega Alpha (AOA) members and 13% of nonmembers were in the highest tertile based on faculty ranking (p < 0.01), and candidates with an exceptional trait were more likely than those without an exceptional trait to rank in the highest tertile (57% versus 10%, p < 0.01). AOA membership was also related to current academic appointment (p = 0.02). Significant correlations included United States Medical Licensing Examination (USMLE) I score, year 2 In-training score (0.48, p = 0.03), and years 3 and 4 in-training score and faculty ranking (minus 0.39, minus 0.50, respectively, p <= 0.01). Having more than one peer-reviewed publication was associated with higher USMLE I scores and being favored for selection by > 50% of the interviewers (p < 0.05 for both). CONCLUSIONS: In our program designed to train academic otolaryngologists, postresident success was strongly predicted by having an exceptional trait and AOA membership. Success during residency was predicted by interviewer's impression of the candidate and a USMLE I score > 570. Knowledge of these factors at the time of the resident interview could increase the likelihood of selecting the most appropriate candidates for academic otolaryngology. Resident success is a complex outcome, and other unmeasured and unexamined characteristics can provide additional insight into choosing successful residents.

关键词： Internship and Residency Otolaryngology 实习医师和住院医师职务耳鼻咽喉科学 Cohort Studies Internship and Residency Residency Time Factors Laryngology

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Clinical forensic medicine

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ANNALS OF EMERGENCY MEDICINE 2000年第3期36卷 271-273页

作者： Ryan, MT Univ Louisville Sch Med Dept Emergency Med Louisville KY 40292 USA

[Ryan MT. Clinical forensic medicine . Ann Emerg Med. September 2000;36:271-273.]

关键词：咬伤人/诊断衣物文献工作急救医学/教育法医学/教育实习医师和住院医师职务病史记录模式识别视觉体格检查暴力创伤和损伤/诊断创伤和损伤/治疗人类

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State-of-the-art phacoemulsification performed by residents in Buenos Aires, Argentina

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JOURNAL OF CATARACT AND REFRACTIVE SURGERY 1999年第12期25卷 1651-1655页

作者： Badoza, DA Jure, T Zunino, LA Argento, CJ Univ Buenos Aires Hosp Clin Jose de San Martin Sch Med Dept Ophthalmol Buenos Aires DF Argentina

Purpose: To analyze the learning curve for state-of-the-art phacoemulsification performed by residents. Setting: Department of Ophthalmology, Hospital de Clinicas Jose de San Martin, University of Buenos Aires, Buenos Aires, Argentina. Methods: The records of patients having phacoemulsification performed by residents from June 1996 to January 1998 were reviewed for preoperative and postoperative best corrected visual acuities and the occurrence of complications. The phacoemulsification technique used for the first 35 surgeries of each resident was compared with that of their last 35 surgeries. Results: The records showed 249 cases of phacoemulsification by residents. Mean preoperative best corrected visual acuity was 0.19 +/- 0.19 (SD). One month postoperatively, it wa 0.86 +/- 0.2. Nuclear fracture was performed in a mean of 28.33 +/- 5.0 of the first 35 surgeries by each resident, whereas chopping techniques were used in a man of 23.33 +/- 1.5 of the last 35 cases. Vitreous loss occurred in 2.8% of cases. Conclusion: Residents learned cracking and chopping phacoemulsification techniques safely with satisfactory outcomes. J Cataract Refract Surg 1999;25:1651-1655 (C) 1999 ASCRS and ESCRS.

关键词： Clinical Competence Internship and Residency Ophthalmology Phacoemulsification 临床工作能力实习医师和住院医师职务眼科学超声乳化白内障吸除术 Residency Surgery Ophthalmology Phacoemulsification Clinical Competence Internship and Residency

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A method of teaching clinical research in a community hospital residency program

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AMERICAN JOURNAL OF SURGERY 1999年第1期177卷 83-85页

作者： Chung, R Diaz, J Li, P Meridia Huron Hosp Cleveland Clin Hlth Syst Dept Surg E Cleveland OH 44112 USA

BACKGROUND: TO provide clinical research experience in community hospital programs, we integrated research training with the daily work of surgical residency. METHODS: Teaching conferences and daily care of patients served as a source of projects. Emphasizing team work, high-yield projects are assigned to principal resident investigators, who lead a project team. Regular meetings with the faculty provides guidance and supervision, working to meet an abstract deadline. RESULTS: Over a 3-year period, 10 of 16 trainees participated in at least one project. Thirteen projects were presented at national meetings and 13 articles (including 6 from presentations) were published. Three projects were abandoned for lack of progress, and 5 manuscripts have been rejected. CONCLUSION: The integrated program trains multiple residents/projects with low requirements in space and funding, but high demands of organization and faculty time. Am J Surg. 1999;177: 83-85. (C) 1999 by Excerpta Medica, Inc.

关键词：课程医院社区实习医师和住院医师职务出版研究/教育外科学/教育人类

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Urology residency and research: Round table discussion and plea for innovation

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UROLOGY 2008年第5期71卷 762-765页

作者： Montie, James Faerber, Gary Schaeffer, Anthony Steers, William Liebert, Monica Stoll, Doris Macoska, Jill Univ Michigan Hlth Syst Dept Urol Ann Arbor MI USA Northwestern Univ Feinberg Sch Med Dept Urol Chicago IL 60611 USA Univ Virginia Hlth Syst Dept Urol Charlottesville VA USA Amer Urol Assoc Fdn Res Off Linthicum MD USA Accreditat Council Grad Med Educ Chicago IL USA

OBJECTIVES To evaluate the current and future states of resident research experience in,urology residencies in the United States. METHODS Round table discussion with leading educators and Urology faculty from a university urology residency. RESULTS Research exposure has rapidly diminished in urology residencies for a variety of reasons. There are multiple barriers to resident research and only a small number of residencies will be able to provide protected time. Nevertheless, an understanding of research methodology and biostatistics is required to be a successful clinician. CONCLUSIONS Some barriers to resident research can be addressed by better integration of residency and fellowships. Flexibility in the format of resident education may allow introduction of new methods to encourage resident research scholarship. An education program with a research curriculum is needed for all residencies.

关键词： Biomedical Research Internship and Residency United States Urology 实习医师和住院医师职务美国泌尿科学 Residency Biostatistics Education provision Urology Biomedical Research United States Technological Innovations Internship and Residency

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Do surgical residents rated as better teachers perform better on in-training examinations?

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AMERICAN JOURNAL OF SURGERY 1999年第1期177卷 33-37页

作者： Seely, AJE Pelletier, MP Snell, LS Trudel, JL McGill Univ Dept Gen Surg Div Gen Surg Montreal PQ Canada McGill Univ Dept Cardiothorac Surg Div Gen Surg Montreal PQ Canada McGill Univ Dept Internal Med Div Gen Surg Montreal PQ Canada McGill Univ Dept Gen Surg & Oncol Div Gen Surg Montreal PQ Canada

BACKGROUND: There have been no attempts to objectively compare resident teaching ability with resident knowledge level. METHODS: Resident teaching ability, as rated by medical students and junior surgical residents, was compared with resident knowledge level, estimated by in-training examination results, for 18 PGY5 and PGY4 surgical residents at McGill University (September 1996 to July 1997). RESULTS: There was a trend to suggest that greater teaching ability is associated with higher in-training examination scores;this did not achieve statistical significance. PGY4 residents were rated as better teachers than PGY4 residents. Resident self-evaluation revealed a high degree of interest in teaching;inadequate time was the principal deterrent to resident teaching;enjoyment and learning during teaching were found to be the most common incentives. CONCLUSIONS: Our results suggest an association between resident level of knowledge and teaching ability. The principal deterrent to teaching-inadequate time-must be addressed to effectively assist surgical resident teaching. Am J Surg. 1999;177:33-37. (C) 1999 by Excerpta Medica, Inc.

关键词：成就加拿大职业选择教育考核实习医师和住院医师职务职业满意外科学/教育成年人女(雌)性人类男(雄)性

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Survey of resident training in beating heart operations

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ANNALS OF THORACIC SURGERY 2000年第2期70卷 479-482页

作者： Ricci, M Karamanoukian, H D'Ancona, G DeLaRosa, J Karamanoukian, RL Choi, S Bergsland, J Salerno, TA Buffalo Gen Hosp Div Cardiothorac Surg Buffalo NY 14203 USA Buffalo Gen Hosp Ctr Minimally Invas Cardiac Surg Buffalo NY 14203 USA SUNY Buffalo Buffalo NY 14260 USA Univ Calif San Diego Dept Surg San Diego CA 92103 USA

Background. "Off-pump" coronary artery operations are done with increasing frequency in the treatment of coronary artery disease. As a result, residents in thoracic surgery have been confronted with the necessity of gaining experience in this innovative approach to coronary surgery. The aim of this study was to assess the importance of training in minimally invasive coronary revascularization as it was perceived by thoracic surgery residents. Methods. A postal, multiple-choice survey questionnaire was sent to all cardiothoracic surgery residents (n = 327) of accredited training programs in the United States. Responses were tabulated and analyzed. Results. The overall response rate was 68% (222 of 327 residents). The attending staff was very interested (37%), or had some interest (63%), in beating heart coronary revascularization. Ninety-eight percent of the programs had at least one surgeon performing off-pump procedures. Although 88% of the responding residents showed some interest in off-pump coronary operations, only 22% of them had performed more than 20 off-pump cases, and even less (12%) had performed more than 20 cases of off-pump complete revascularization, or off-pump circumflex revascularization (4%). Sixteen percent of them had no clinical experience with these techniques. Regarding career intentions, 88% of the residents indicated that off-pump coronary operations were expected to be part of the practice, and 58% of them were interested in pursuing additional training in less invasive heart procedures. Conclusions. The results of this survey suggest that training in off-pump coronary revascularization is variable across training programs, and that the majority of residents may not reach proficiency in coronary procedures on the beating heart during their residency. This may adversely affect their future expectations, as 88% of them would like to practice off-pump coronary surgery once the training is completed. (C) 2000 by The Society of Thoracic Surgeon

关键词：心肺转流术临床工作能力实习医师和住院医师职务心肌血管重建术/方法外科手术微创性胸外科学/教育美国人类

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Safety and efficacy of total thyroidectomy in hands of endocrine surgery trainees

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AMERICAN JOURNAL OF SURGERY 1999年第5期178卷 377-380页

作者： Mishra, A Agarwal, G Agarwal, A Mishra, SK Sanjay Gandhi Postgrad Inst Med Sci Dept Endocrine Surg Lucknow 226014 Uttar Pradesh India

BACKGROUND: Fear of a high complication rate of total thyroidectomy, especially in the hands of less experienced surgeons, limits its routine use. The results of total thyroidectomy in the hands of endocrine surgery trainees and consultants were compared to know whether this procedure can be performed effectively and safely by trainees. METHODS: Medical records of 232 patients who underwent total thyroidectomy from 1990 to 1997 were reviewed. Patients were put into groups A (operated by consultants) and B (trainees). Safety (postoperative hypoparathyroidism, recurrent laryngeal nerve palsy, and hemorrhage) and efficacy (postoperative radioactive iodine uptake) in the two groups were compared. RESULTS: There were 127 patients in group A and 105 in group B. Rates of occurrence of permanent hypoparathyroidism and recurrent laryngeal nerve palsy were comparable in the two groups. Postoperative radioactive iodine uptake in the two groups was not significantly different. CONCLUSIONS: Total thyroidectomy can be safely and effectively performed by endocrine surgical trainees. (C) 1999 by Excerpta Medica, Inc.

关键词：甲状旁腺功能减退症/流行病学甲状旁腺功能减退症/病因学发病率实习医师和住院医师职务喉神经/损伤手术后并发症/流行病学专业能力回顾性研究外科学/教育甲状腺疾病/外科学甲状腺切除术/方法甲状腺切除术/标准治疗结果成年人女(雌)性人类男(雄)性中年人

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Teaching continuous curvilinear capsulorhexis using a postmortem pig eye with simulated cataract

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JOURNAL OF CATARACT AND REFRACTIVE SURGERY 2001年第6期27卷 814-816页

作者： Hashimoto, C Kurosaka, D Uetsuki, Y Keio Univ Sch Med Dept Ophthalmol Shinjuku Ku Tokyo 160 Japan Santen Pharmaceut Co Ltd Tokyo Japan

We modified an inexpensive, easily prepared model using a postmortem pig eye for training ophthalmology residents to perform continuous curvilinear capsulorhexis, To reduce the tension and elasticity of the porcine anterior lens capsule, 0.05 mL of formalin mixed with hydroxyethylcellulose or a viscoelastic material is injected into the anterior chamber via the corneal limbus to fix the surface of the central anterior lens capsule of the pig eye in situ. One or 2 minutes after the injection, only the anterior lens capsule is fixed and corneal transparency is maintained. The reduction in tension and elasticity of the anterior lens capsule caused by its fixation increases the resemblance of the simulated cataract to the human cataract. J Cataract Refract Surg 2001;27:814-816 (C) 2001 ASCRS and ESCRS.

关键词： Capsulorhexis Cataract Cellulose Internship and Residency Ophthalmology 晶体囊撕裂术白内障纤维素实习医师和住院医师职务眼科学教学 Cellulose Capsulorhexis Cataract Eye Crystalline Lens Capsule Ophthalmology elasticity Limbus Corneae hydroxyethylcellulose Anterior Capsule of the Lens Internship and Residency

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Assessment of a surgery clerkship's performance evaluation system

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AMERICAN JOURNAL OF SURGERY 2000年第2期179卷 145-149页

作者： DaRosa, DA Niehaus, AH Markwell, SJ Northwestern Univ Sch Med Dept Surg Chicago IL 60611 USA So Illinois Univ Sch Med Dept Surg Springfield IL 62794 USA So Illinois Univ Sch Med Dept Stat & Res Consulting Springfield IL USA

BACKGROUND: This study was designed to examine the validity of a surgery clerkship's performance evaluation system. The study also assessed faculty members' confidence in how clerks are evaluated and promotion decisions made. METHODS: Student files from five classes (n = 339) were analyzed. A 25-item published survey designed to study faculty perceptions of a student evaluation system was distributed. Chi-square tests of independence and descriptive statistics were used. RESULTS: Faculty survey results showed faculty perceptions of strengths and weaknesses in the evaluation system. Significant relationships were found with prior performance indicators and clerkship performance yielding evidence of concurrent and predictive validity. CONCLUSIONS: Findings provide guidance for enhancing how clerks are evaluated as well as specific profiles of students who may need special attention or additional challenges during the surgery clerkship. This study provides a model for other clerkships to assess their student evaluations systems. Am J Surg. 2000;179:145-149. (C) 2000 by Excerpta Medica, Inc.

关键词：成就麻醉学/教育医务工作者的态度卡方分布临床实习/标准课程决策教育考核/方法全体教工医学院校妇科学/教育内科学/教育实习医师和住院医师职务模型教育产科学/教育儿科学/教育精神病学/教育补习教学可重复性结果学生医科人类

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