Fellow Participants Research Articles

Assessing the informational credibility of conspiracy theories: online discussion about the Nord Stream damage

PurposeTo elaborate the picture of credibility assessment by examining how participants of online discussion evaluate the informational credibility of conspiracy theories.Design/methodology/approachDescriptive quantitative analysis and qualitative content analysis of 2,663 posts submitted to seven Reddit threads discussing a conspiracy operation, that is, the damage of the Nord Stream gas pipelines in September 2022. It was examined how the participants of online discussion assess the credibility of information constitutive of conspiracy theories speculating about (1) suspected actors responsible for the damage, (2) their motives and (3) the ways in which the damage was made. The credibility assessments focussed on diverse sources offering information about the above three factors.FindingsThe participants assessed the credibility of information by drawing on four main criteria: plausibility of arguments, honesty in argumentation, similarity to one's beliefs and provision of evidence. Most assessments were negative and indicated doubt about the informational believability of conspiracy theories about the damage. Of the information sources referred to in the discussion, the posts submitted by fellow participants, television programmes and statements provided by governmental organizations were judged most critically, due to implausible argumentation and advocacy of biased views.Research limitations/implicationsAs the study focuses on a sample of posts dealing with conspiracy theories about a particular event, the findings cannot be generalized to concern the informational credibility conspiracy narratives.Originality/valueThe study pioneers by providing an in-depth analysis of the nature of credibility assessments by focussing on information constitutive of conspiracy theories.

Impact of Coronavirus Disease 2019 on Clinical Outcomes of Robotic Cholecystectomy.

The coronavirus disease 2019 (COVID-19) pandemic strained the health care sector, putting severe constraints on surgical departments. In this study, we evaluate the impact of the pandemic on the outcomes of patients undergoing robotic cholecystectomy (RC). Patients who underwent RC 1 year before and after March 2020 were included in this retrospective study and assigned accordingly to the pre or post-COVID group. Pre, intra, and postoperative variables were compared between groups. In total, 110 patients were assigned to the pre-COVID group versus 80 in the post-COVID group. There were no differences in the demographics, except for a higher rate of previous gallbladder disease in the pre-COVID group (35.5% vs 13.8,% P < 0.001). The post-COVID group had a higher rate of emergent RCs (62.5% vs 39.1%, P = 0.002). Operative times were greater in the post-COVID group due to the more frequent participation of clinical fellows in the cases. The median hospital length of stay for both groups was 1 day, with higher rates of same-day discharge (pre-COVID 40.9% vs post-COVID 57.5%, P = 0.028). Complications were comparable between both groups, with no recorded cases of COVID-19 contraction within the virus incubation period. The median follow-up was 10 months for the entire cohort. During the COVID-19 pandemic, an increase in emergent cases, as well as higher rates of same-day discharge, were recorded, with no impact on postoperative outcomes in patients undergoing RC.

Qualitative insights from a randomized clinical trial of a mother–child emotional preparation program for preschool-aged children

BackgroundEarly life stress and adversity conveys risk for emotional, behavioral, and developmental disorders. To address this risk in the preschool population, Mother–Child Emotional Preparation (MCEP) was tested as an in-school dyadic intervention for facilitating mother–child emotional connection through mother–child calming cycles. In a computer-generated block randomized controlled trial enrolling preschool-aged children and their mothers, in partnership with an early childhood learning center, we at Columbia University Irving Medical Center tested effects of MCEP across multiple domains. Within this RCT we designed a qualitative sub-study to understand how MCEP aligns with calming cycle theory and its impact on mothers and the mother–child relationship.MethodsA qualitative researcher observed 14 group MCEP sessions consisting of nurture specialists facilitating reciprocal calming interactions through shared emotional expression between mothers and their preschool-aged children. We conducted two waves of participant interviews in English or Spanish, per participant preference. Participants (n = 8) were majority Hispanic at or below the federal poverty level. Group session observations were coded and analyzed for frequency, co-occurrence, variance by session, and alignment with calming cycle theory, incorporating demographic variables and attendance. Interview transcripts were translated from Spanish to English if needed, then coded and analyzed using thematic analysis.ResultsQualitative analysis revealed mothers’ experiences of MCEP. Data demonstrated that calming position and emotional expression were mutually supportive, and that barriers to connection were calming cycle entry-points, not barriers. At the group level, supported by nurture specialists, fellow participants helped each other progress through calming cycles. Moreover, MCEP adapted to meet individual dyad needs, and mothers described its far-reaching impact.ConclusionsQualitative methods show that MCEP helps mother–child dyads emotionally connect through the calming cycle and fills a gap in early childhood education services. This study generated insights for quantitative studies and suggested implications for MCEP dissemination.Trial registrationClinicalTrials.gov, NCT03908268, Registered April 9, 2019—Retrospectively registered.

You are not lab rats at teaching hospitals: A systematic review of resident and fellow participation leads to improved colonoscopy.

Participation in colonoscopies is an essential aspect of endoscopic training. The purpose of this study was to explore the impact of fellow/trainee participation on colonoscopy outcomes. This meta-analysis was registered on the International Prospective Register of Systematic Reviews (PROSPERO). From database inception to July 2022, studies investigating fellow involvement and colonoscopy outcomes were searched across Cochrane library, PubMed, and other databases. The random-effects model was applied to generate more conservative estimates. Sensitive analysis was conducted to explore whether the result would depend on a particular study. Egger's test and Begg's test were used to estimate the potential for publication bias. Seventeen studies including 30,062 participants were included. We found that fellow/trainee involvement enhanced the overall rates of adenoma detection and polyp detection (OR=1.26, 95% CI=1.14-1.40, p<0.001; OR=1.29, 95% CI=1.02-1.63, p=0.020, respectively). The mean number of adenoma/polyps per colonoscopy was also higher with fellow/trainee participation (MD=0.12, 95% CI=0.08-0.17, p<0.001; MD=0.15, 95% CI=0.02-0.28, p=0.020, respectively). In addition to its educational purpose, fellow or trainee involvement is associated with beneficial effects on colonoscopy outcomes.

Access to Firearms: Initiation of Firearm Screening Amongst Psychiatric Patients in a Pediatric Emergency Department.

Increase provider screening rates for firearm access among patients presenting to the pediatric emergency department (PED) for a psychiatric chief complaint. In this resident-driven quality improvement (QI) project, a retrospective chart review examined firearm access screening rates among patients presenting to the PED with the chief complaint of "psychiatric evaluation." After establishing our baseline screening rate, the first phase of our Plan, Do, Study, Act (PDSA) cycle included implementing Be SMART education for pediatric residents. We made Be SMART handouts available in the PED, created electronic medical record (EMR) templates to facilitate documentation, and emailed routine reminders to residents during their PED block. In the second PDSA cycle, the pediatric emergency medicine (PEM) fellows expanded our efforts to increase project awareness from a supervisory role. The baseline screening rate was 14.7% (50/340). After PDSA 1, a center line shift occurred, and screening rates increased to 34.3% (297/867). After PDSA 2, screening rates increased to 35.7% (226/632). In the intervention phase, providers who received training screened 39.5% (238/603) of encounters versus providers who did not receive training screened 30.8% (276/896) of encounters. Of all encounters screened, 39.2% (205/523) screened positive for in-home firearms. We improved firearm access screening rates in the PED using provider education, EMR prompts, and PEM fellow participation. Opportunities remain to promote firearm access screening and secure storage counseling in the PED.

Prosumers of Hybrid Entertainment-Educational Communication in a Media Convergence Environment

Communication technology is changing the way of interacting by combining face-to-face classroom and online meetings. The YouTube channel is an alternative learning center where participants can share educational content. Participants act as producers and consumers of all knowledge products and simple technology. This paper discusses the involvement and characteristics of producers-consumers (prosumers) in producing, distributing, and consuming entertainment-educational content on Social Network Sites (SNS), especially YouTube. This paper also discusses changes in the educational landscape from and for fellow participants in online media as a consequence of media convergence by promoting a hybrid-learning alternative education model that combines informal contexts and formal education. Systematic Literature Review (SLR) is used as a research method to analyze several dimensions related to entertainment education, such as student and teacher knowledge and skills, antecedents, hybrid-learning cycles, Bloom's level of taxonomy, enactment, and prosumer outcomes in a model. YouTube content for prosumers is an entertaining sharing of knowledge for a safer, healthier, and happier life. Specifically, prosumers make YouTube and other social media as online classroom channels for completing school and university assignments and as fun learning centers to achieve the best academic performance. The existence of prosumers in hybrid education refers to the Flipped model by considering Bloom's taxonomy as practice and reflection in the cycle. The highest level in Bloom's is "creating" after prosumers did "evaluating," "analyzing," "applying," "understanding," and "remembering" as the lower levels. The implications of this research reflects the importance of development of entertainment-education contents as an alternative educational channel.

In-servıce EFL teachers’ well-beıng durıng onlıne teacher professıonal development program ın Indonesıa: An ecologıcal perspectıve.

This paper intends to scrutinize the personal and systemic factors affecting the well-being of in-service EFL teachers participating in a three-month online teacher professional education (OTPE) program in Indonesia. Moreover, it seeks to explore the resources that the teachers draw on to maintain their well-being. Six EFL teachers attending the OTPE program participated in this study. Semi-structured interviews were conducted with six focal participants. The data were qualitatively analyzed to find the emerging themes. The findings revealed that personal and systemic factors influenced the participants' well-being in the OTPE program. The personal factors included motivation, marital status, and spirituality, while the systemic factors encompassed the national policy on EFL teacher certification, teacher education institution, home school, and family. Moreover, the participants drew on personal resources, i.e., motivation and spirituality, and social resources, i.e., family members, colleagues, students, instructors, and fellow participants, to maintain their well-being during the OTPE program. Hence, the interplay between personal and systemic factors was quintessential to the EFL teachers' well-being in the program.

The impact of a dedicated operating room team on robotic transplant program growth and fellowship training.

Despite considerable interest in robotic surgery, successful incorporation of robotics into transplant programs has been challenging. Lack of a dedicated OR team with expertise in both robotics and transplant is felt to be a major barrier. This paper assesses the impact of a dedicated robotic transplant team (DART) on program growth and fellowship training at one of the largest robotic transplant programs in North America. This is a single center, retrospective review of all robotic operations performed on the transplant surgery service from October 2017 to October 2022. DART was incorporated in February 2020 and included transplant first assists (RFAs), scrub technologists and circulating nurses who received robotic training. Robotic experience before and after DART was compared to assess its impact on program growth and training. Four hundred and two robotic cases were performed by five transplant surgeons: 63 pre-DART and 339 post-DART. 40% of cases were transplant-related and 59.5%, HPB. There was a significant increase in case volume (2.5-10.6 cases/month, p<.0001) and complexity (36.5% vs. 70.3% high complexity cases, p<.0001) post-DART. RFA case coverage increased from 17% to 95%, and participation of transplant fellows as primary surgeons increased from 17% to 95% post-DART period (both p<.05). Conversion rates (9.5% vs. 4.1%) and room turn-around-times (TAT) (58.4 vs. 40.3min) were lower post-DART (p<.05). There were no emergent conversions, conversions in transplant patients, or robot-related complications in either group. OR teams with expertise in robotics and transplant surgery can accelerate growth of robotic transplant programs while maintaining patient safety.

Empowering English Learning beyond Borders: Challenges and Benefits of Extracurricular Activities in a Non-Anglosphere Context

English language assumes a pivotal position in the socioeconomic advancement of Vietnam. The adoption of extracurricular mechanisms for English language acquisition is recognized as an innovative and potent overhaul of the pedagogical framework for English learners in Vietnam. This study was executed employing a quantitative methodology to ascertain the perceptions of tertiary level students regarding the advantages and obstacles encountered in their engagement with extracurricular activities directed at English language acquisition. Data was accumulated from 1,032 students pursuing higher education in an institution situated in the Mekong delta, facilitated by a questionnaire. The findings highlighted significant expectations students harbored for these activities. Particularly, they anticipated that engagement in these extracurricular endeavors would yield a positive influence on their linguistic competencies, while also fostering a conducive and collaborative environment for English language acquisition, thereby expanding their social networks with fellow participants. Nevertheless, the participants also acknowledged potential drawbacks. They expressed concern that participation in these activities might be time-consuming and could potentially diminish their motivation to partake, especially if the activities were not in alignment with their individual competencies and areas of interest. The findings of this study propose implications for enhancing the effectiveness of extracurricular activities for English language acquisition. Specifically, adequate financial and human capital investment is crucial, and the activities need to be meticulously planned to avoid an excessive time commitment from the students.

The Pursuing Excellence Collaborative: Engaging First-Year Residents and Fellows in Patient Safety Event Investigations.

Resident and fellow engagement in patient safety event investigations (PSEIs) can benefit both the clinical learning environment's ability to improve patient care and learners' problem-solving skills. The goals of this collaborative were to increase resident and fellow participation in these investigations and improve PSEI quality. This collaborative involved 18 sites-8 sites that had participated in a similar previous collaborative (cohort I) and 10 "new" sites (cohort II). The 18-month collaborative included face-to-face and virtual learning sessions, check-ins, and coaching calls. A validated assessment tool measured PSEI quality, and sites tracked the percentage of first-year residents and fellows included in a PSEI. Sixteen of the 18 sites completed the 18-month collaborative. Baseline was no first-year resident or fellow participation in a PSEI. Among these 16 clinical learning environments, 1237 early learners participated in a PSEI by the end of the collaborative. Six of these 16 sites (38%) reached the goal of 100% participation of first-year residents and fellows. As a percentage of total first-year residents and fellows, larger institutions had less resident and fellow participation. Six of the 9 cohort II sites submitted PSEIs for independent review at 6 months and again at the end of the collaborative. The PSEI quality scores increased from 5.9 ± 1.8 to 8.2 ± 0.8 ( P ≤ 0.05). It is possible to include all residents and fellows in PSEIs. Patient safety event investigation quality can improve through resident and fellow participation, use of standardized processes during training and investigations, and review of PSEI quality scores with a validated tool.

Development of a national Zoom-based lectureship for pediatric transplant hepatology trainees.

Previous publications identified a gap in standard education on topics related to advanced hepatology and liver transplantation for pediatric transplant hepatology trainees. The Society of Pediatric Liver Transplantation (SPLIT) Education Committee designed a Zoom-based lectureship series for all advanced pediatric transplant hepatology trainees. We aim to describe the educational series and feedback from fellow participants. Pediatric transplant hepatology trainees from across the United States and Canada were invited to attend 25 Zoom-based lectures on a broad list of topics pertaining to pediatric transplant hepatology. At the completion of the lectureship, a 53-item REDcap survey using single-answer, Likert-scale, and open-ended questions was distributed via email to all participants. A total of 16 fellows from broad geographic areas responded to the survey. Nineteen percent (n = 3/16) of fellows attended all 25 lectures and 31% (n = 5/16) attended 16-20 lectures. Majority of fellows (88%, n = 14/16) reported the lecture series increased knowledge of liver disease, increased confidence in managing children with liver disease, and aided with board preparation. Additionally, over half of the fellows (81%, n = 13/16) reported the series served as a platform for networking and mentoring from peers and experts in the field. All fellows recommended the lecture series for future fellows. The SPLIT educational lectureship for advanced pediatric transplant hepatology trainees provided a national education curriculum that not only led to increased knowledge and confidence in the diagnosis and management of common conditions encountered in pediatric transplant hepatology but also provided a unique networking and mentorship environment.

Participation in a multidisciplinary institutional committee, “RQUEST,” to enhance quality improvement education, project design, and implementation for hematology/oncology fellows.

e18733 Background: Participation in quality improvement (QI) projects allows medical trainees to develop an essential skillset to systematically analyze practice and implement changes with the goal of practice improvement. The ACGME designates QI education and participation as a core competency for all fellows. Training programs and institutions can vary significantly in QI educational format, participation, and direct support for project design and implementation. Here we present a description of the Resident Quality, Experience, and Safety Team (RQUEST) committee, which is being utilized by Hematology and Oncology fellows for QI project design and implementation at our institution. Methods: The first RQUEST committee was convened in August of 2021. RQUEST holds formal monthly meetings from August to June of each academic year. At the initial meetings, committee members are introduced to quality, safety, and patient experience structures and receive introductory training in QI tools and techniques. RQUEST members are then split into smaller project groups and work to select a QI project, perform current state analysis and baseline data collection, design and implement improvement interventions, and re-measure to determine the impact of the chosen interventions. The year concludes with each team presenting their project at a joint session to a larger audience of program directors, quality officers, service line directors, department chairs, graduate medical education staff, and hospital leadership RQUEST participation provides fellows with direct access to a multidisciplinary team and resources throughout project design and implementation. The timeline of monthly meetings provides both accountability and productive feedback. This facilitates the identification of system-specific opportunities for improvement and the most practical points of contact within the hospital, clinic, or EMR to design and apply quality interventions promptly and effectively. Results: We sent a voluntary survey to RQUEST participants, and 40% of participants responded to the survey. 100% of those who responded said participating in RQUEST has been beneficial in developing and implementing a QI project, and 100% said they would recommend participating in RQUEST to other medical trainees. The most common benefits listed were: · Structured approach/guidance · Institutional support and resources · A collaborative environment with a team of members from various departments, including IT. Conclusions: Fellow participation in a multidisciplinary QI committee at our institution has improved fellow QI education, participation, and project implementation. This engagement model has proven valuable to fellows and faculty in enhancing QI competency and clinical practice.

시민의 대학-지역사회 연계 협동학습 프로그램 참여 경험에 관한 질적 사례연구

The purpose of this study is to provide the program effectiveness and the possibility of university-region linkage according to the application of cooperative learning through the community-linked cooperative learning program conducted at D University in Gyeongbuk. In order to achieve the purpose of the study, interviews were conducted with 13 program participants. First, citizen participants preferred cooperative learning to lecture-type traditional learning, but class satisfaction was different depending on their liking for fellow participants. Second, participation in the program had a positive effect on the sense of belonging to the community and the formation of social networks. Third, the mutual feedback of cooperative learning was effective in strengthening activity participation and emotional bonding. Fourth, the experience of participating in the program helped change the perception of local universities. In short, the community connection program was a useful program for university and citizen participants, and cooperative learning acted as an effective learning method for all participants.

Continuing or withdrawing from endurance sport events under environmental uncertainty: athletes’ decision-making

ABSTRACT This paper seeks to answer the question: what impacts athletes’ decision-making to continue or withdraw from an endurance sport event under environmental uncertainty amid the rise of extreme weathers? Underpinned by prospect theory and the framework of risk information seeking, qualitative data were collected via 14 in-depth semi-structured interviews with amateur and professional athletes and coded using thematic analysis. Findings suggest that endurance sport athletes do consider withdrawal as an option before and during an event. The severity of weather and a lack of physical and psychological preparedness may lead to the decision of withdrawal. Additionally, different decisions can be made under an interplay between weather conditions and physical and psychological status. Event organisers, family, friends and fellow participants may also influence athletes’ decision-making. Finally, based on personal goals set for an event, both risk-seeking (continue) and risk-aversion (discontinue) behaviours may occur when facing the same environmental uncertainty. The paper calls attention to protecting athletes’ wellbeing by undertaking timely withdrawals under environmental uncertainty. By highlighting the vulnerability of endurance sport athletes to environmental uncertainty, this study encourages event organisers to evidence their ability to face environmental uncertainty and enhance/preserve their reputation in event risk management.

Measuring The Impact of a Twitter-Based Educational Initiative: The #EmoryNCCTweetorials Project (P7-2.005)

<h3>Objective:</h3> Analyze a Twitter-Based Educational Initiative for a Neurocritical Fellowship <h3>Background:</h3> “Tweetorials” are online tutorials published on Twitter. This style of microteaching is an innovative way to provide free, globally accessible online medication education. For trainees, authoring a Tweetorial is a novel way to distill specialized knowledge and reach a large academic audience while also receiving immediate feedback. Authoring a Tweetorial may be a way for trainees to network and engage in longitudinal conversations within the medical community. We present analytic data about the impact of our fellowship program’s Twitter teaching initiative. <h3>Design/Methods:</h3> The Twitter education project #EmoryNCCTweetorials was announced in the Summer of 2021 as optional participation for the neurocritical care fellows. Data was collected regarding the number of participating fellows and number of Tweetorials. An AI-driven platform for Twitter analytics, “Tweepsmap ®,” was utilized to analyze the number of tweets, impact, and various types of engagement from July 1, 2021 to September 28, 2022. Participants were surveyed about their opinions of writing Tweetorials and what they learned. <h3>Results:</h3> In a fifteen-month period, five of seven fellows participated in the initiative. Twenty-two Tweetorials were created by fellows, which in total garnered over 2.5 million impressions (cumulative number of views). Together the Tweetorials were retweeted (shared) over a thousand times and received nearly five thousand likes. The Tweetorials were viewed in 62 countries and most engagement was from healthcare-associated accounts (73.1%) with the remainder being characterized as students, education, science and technology and others. The fellows rated the experience positively. <h3>Conclusions:</h3> Social media-based educational initiatives are innovative strategies for teaching neurocritical care topics and may promote trainee engagement in the neurology community and have far-reaching networking effects. Further analyses are needed to investigate longitudinal participation, information retention and value-added aspects of social media education for trainees. <b>Disclosure:</b> Dr. Sigman has nothing to disclose. Dr. Pimentel has nothing to disclose. Dr. Kandiah has nothing to disclose. Dr. Lawson has nothing to disclose. Dr. Albin has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Continuum: Life Long Learning in Neurology. Dr. Albin has received research support from American Academy of Neurology. Dr. Albin has received publishing royalties from a publication relating to health care. Dr. Albin has received personal compensation in the range of $500-$4,999 for serving as a Instructor with Resuscitation Leadership Academy.

88 Assessing Perceptions of Institutional Inclusivity on Burnout, Intent to Continue Training, and Perceived Stress among Underrepresented Postdoctoral Fellows and Early Career Faculty

OBJECTIVES/GOALS: The Building Up Study tests the effectiveness of an intervention aimed to diversify the workforce using a two-arm cluster randomized trial. We examined how underrepresented (UR) participants’ perceptions of institutional inclusion affected burnout, intent to continue training, and perceived stress. METHODS/STUDY POPULATION: Building Up was conducted at 25 institutions with 225 UR post-doctoral fellow or early-career faculty participants. To assess perceived institutional inclusion, participants completed a 28-item survey in the first year of follow-up. We used descriptive statistics to describe age, race/ethnicity, and gender. We used exploratory factor analysis to extract factors or domains (survey questions that grouped together). We calculated mean domain scores and used correlations to assess associations between each domain and each dependent variable (burnout, intent to continue training, and perceived stress). Demographics, correlation coefficients and associated p-values are presented. RESULTS/ANTICIPATED RESULTS: 130 of 144 eligible participants completed all questions. The mean age was 39 years (SD = 6), 83% were female, 35% identified as non-Hispanic Black, and 36% identified as Hispanic. Greater inclusivity was associated with lower burnout across 5/6 identified domains: policies (-0.3, p DISCUSSION/SIGNIFICANCE: These findings suggest that institutional inclusion is associated with differences in capacity to function among UR postdocs and early-career faculty. Inclusivity of leaders was only associated with intent to continue training. Inclusion coupled with employee support and development are important for positive outcomes.

THE ROLE OF TRAINING IN IMPROVING THE ENTREPRENEURSHIP COMPETENCY OF SUSTAINABLE REHABILITATION PARTICIPANTS BNN WEST JAVA

Currently, the government is actively promoting empowerment programs for new entrepreneurs to boost the country's economy. However, for fellow participants in ongoing rehabilitation for clients assisted by BNN West Java Province, entrepreneurship activities can be a way to start a new life so that they can re- mingle and be well received by the community. This study aims to determine the effect of entrepreneurship training in improving entrepreneurial competence in sustainable rehabilitation participants for clients assisted by BNN West Java Province. The results of research using SPSS software show that entrepreneurship training has a significant effect on increasing entrepreneurial competence with an effect of 65.9%. The results of this study are expected to provide motivation for the government, the private sector, and other organizations to be able to organize entrepreneurship training with better quality so that this training can help fellow participants in sustainable rehabilitation in preparing themselves to become part of the community again through entrepreneurial activities.

A propensity score matching analysis: Impact of senior resident versus fellow participation on outcomes of complex surgical oncology

BackgroundTeaching hospitals that train both general surgery residents and fellows in complex general surgical oncology have become more common. This study investigates whether participation of a senior resident versus a fellow has an impact on outcomes of patients undergoing complex cancer surgery. MethodsPatients who underwent esophagectomy, gastrectomy, hepatectomy, or pancreatectomy between 2007 and 2012 with assistance from a senior resident (post-graduate years 4–5) or a fellow (post-graduate years 6–8) were identified from the ACS NSQIP. Based on age, sex, body mass index, ASA classification, diagnosis of diabetes mellitus, and smoking status, propensity-scores were created for odds of undergoing the operation assisted by a fellow. Patients were matched 1:1 based on propensity score. Postoperative outcomes including risk of major complication were compared after matching. ResultsIn total, 6934 esophagectomies, 13,152 gastrectomies, 4927 hepatectomies, and 8040 pancreatectomies were performed with assistance of a senior resident or fellow. After matching, overall rates of major complications were equivalent across all four anatomic locations between cases performed with the participation of a senior resident versus a surgical fellow: esophagectomy (37.0%% vs 31.6%, p = 0.10), gastrectomy (22.6% vs 22.3%, p = 0.93), hepatectomy (15.8% v 16.0%, p = 0.91), and pancreatectomy (23.9% vs 25.2%, p = 0.48). Operative time was shorter for gastrectomy (212 vs. 232 min; p = 0.004) involving a resident compared to a fellow, but comparable for esophagectomy (330 vs. 336 min; p = 0.41), hepatectomy (217 vs. 219 min; p = 0.85), and pancreatectomy (320 vs. 330 min; p = 0.43). ConclusionsSenior resident participation in complex cancer operations does not appear to negatively impact operative time or postoperative outcomes. Future research is needed to further assess this domain of surgical practice and education, particularly with regard to case selection and operative complexity.

Survey of fellowship program directors in minimally invasive gynecologic surgery: fellow participation in quality improvement and patient safety initiatives

Survey of fellowship program directors in minimally invasive gynecologic surgery: fellow participation in quality improvement and patient safety initiatives

Resident and Fellow Participation Does Not Affect Short Term Postoperative Complications after Distal Radius Fracture Fixation

AbstractBackground Complications after open reduction internal fixation (ORIF) for distal radius fractures (DRFs) are well documented, but the impact of trainee involvement on postoperative outcomes has not been studied.Questions Does trainee involvement affect postoperative complication rates and length of hospital stay?Methods The American College of Surgeons National Surgical Quality Improvement Program was queried from 2006 to 2012 for patients undergoing DRF ORIF. A 1:1 propensity score-matched resident/fellow involved cases to attending-only cases. Demographics, length of stay, and postoperative complications were compared between the two groups. Logistic regression was used to evaluate independent predictors of adverse events and to evaluate cases with and without trainee involvement.Results Overall, 3,003 patients underwent DRF ORIF from 2006 to 2012. After matching, 1,150 cases (50% with resident/fellow involvement) were included. The overall rate of adverse events was 4.4% (46/1,050). There were no significant differences in the short-term complication rate in trainee-involved (2.3%) versus attending-only cases (3.9%) (p = 0.461). For ORIF of DRF, there were no significant differences, between attending-only cases and resident/fellow-involved cases, with regards to short-term major complications (p = 0.720) or minor complications (p = 0.374). Length of hospital stay was similar between cohorts (1.22 vs. 0.98 days) (p = 0.723). On multivariate analysis, trainee involvement was not an independent predictor of minor, major, or any complication after DRF fixation after controlling for multiple independent factors (all p &gt; 0.364).Discussion Trainee participation in DRF ORIF is not associated with increased risk for short-term (30-day) medical or surgical postoperative complications.Level of Evidence IV case–control study.