Residents In Surgical Specialties Research Articles

Microlearning in Complex Surgical Oncology: Proof of Concept and Impact on Surgical Skills Acquisition During Residency.

Recent structural changes to residency programs, such as workforce shortages and work-hour restrictions, have reduced operating room exposition for residents in surgical specialties. Complementary strategies need to be developed to support surgical educators and provide residents with the optimal learning environment. This study aimed to assess the feasibility of integrating microlearning in a general surgery residency program and to evaluate its impact on surgical skills acquisition in surgical oncology. An online module structured in six different microlearning units was created. Each unit was designed to present key concepts of a specific surgical procedure, including anatomic landmarks, series of standardized steps, and a narrated video. The procedures included were right and left hepatectomy, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, total/subtotal gastrectomy, pancreatoduodenectomy, and distal pancreatectomy. The study included 20 general surgery residents completing a 3-month rotation in complex surgical oncology, 10 of whom had access to the online module. The participants in both groups completed a self- assessment survey at the conclusion of the study. The residents who had access to the online module exhibited greater comfort regarding theoretical aspects of the procedures (p = 0.0322) and increased confidence performing procedural steps of the procedures (p = 0.0433) at the end of their rotation. Most of the residents considered the module to be highly beneficial to their learning. All the residents considered the online module helpful in preparing for real-life scenarios. The study demonstrated the feasibility and potential benefits of introducing a microlearning environment to enhance residents' knowledge and behavior in complex surgical oncology.

Are women residents of surgical specialties at a higher risk of developing imposter syndrome?

BackgroundImposter syndrome is a chronic feeling of doubt leading to a sense of incompetence, which is common among trainees. However, little is known about the effect of gender on imposter syndrome among surgical trainees. MethodsAn online national survey was distributed to the surgical subspecialty residents between March and September 2022, including demographics, validated Clance Imposter Scale and a short questionnaire evaluating depression and anxiety. ResultsOf the participants self identified as women (264, 69.1%) and men (118, 30.9%) (response rate 36.4%), the prevalence of imposterism was higher among women trainees (97% vs. 86%; p ​< ​0.0001). Risk factors were being a gynecologist (156, 59%, p ​< ​0.0001), single (157, 59.7% p ​= ​0.007), having no dependents (233, 88.3% p ​= ​0.001), being a foreign graduate (24, 9.1%, p ​= ​0.024) and having feelings of anxiety (82, 31.1% p ​= ​0.012). When using multivariate logistic regression to adjust for these factors, the prevalence of imposter syndrome remained significantly higher among women. ConclusionWomen trainees belonging to various surgical fields are affected by Imposter syndrome. Residency programs should develop wellness programs and provide mentorship to address this condition.

Racial and Sex Disparities in Resident Attrition Among Surgical Subspecialties

Racial and sex disparities are prevalent in surgical trainees. Although retrospective studies on resident attrition have been conducted for individual specialties, this study analyzes racial and sex differences in resident attrition among all surgical subspecialties over an 18-year period. To evaluate the racial and sex differences in resident attrition among surgical specialties over an 18-year period. This was a large, cross-sectional, database study that analyzed program-reported resident censuses (program information, resident demographics, and attrition status) obtained by the Association of American Medical Colleges from 2001 to 2018 for trainees in surgical residency programs. Data were analyzed from March 20, 2021, to June 8, 2022. Demographic trends (including race and ethnicity and sex) for all surgical subspecialty training programs over an 18-year period. Resident attrition includes all-cause withdrawals, dismissals, and transfers to another specialty. Unintended attrition encompasses all withdrawals, dismissals, and transfers except for changing career plans. This study included 407 461 program-reported resident years collected from 112 205 individual surgical residents (67 351 male individuals [60.0%]). The mean percentage of female trainees was 40.0% (44 835) and increased over the study period. Sex disparity remained greatest in orthopedic surgery. Residents who were underrepresented in medicine (URiM) comprised 14.9% (16 695) of all surgical trainees but demonstrated a 2.1% decrease over the study period. Overall attrition rate among all specialties was 6.9% (7759), with an unintended attrition rate of 2.3% (2556). Female residents had a significantly higher relative risk (RR) of attrition (RR, 1.16; 95% CI, 1.11-1.22; P < .001) and unintended attrition (RR, 1.17; 95% CI, 1.08-1.26; P < .001) compared with their male counterparts. URiM residents were at significantly higher RR for attrition (RR, 1.40; 95% CI, 1.32-1.48; P < .001) and unintended attrition (RR, 1.92; 95% CI, 1.75-2.11; P < .001) compared with non-URiM residents. The highest attrition (10.6% [746 of 7043]) and unintended attrition (5.2% [367 of 7043]) rates were in Black/African American residents. The lowest attrition and unintended attrition rates were seen in White residents at 6.2% (4300 of 69 323) and 1.8% (1234 of 69 323), respectively. Black/African American residents were at disproportionate risk for attrition (RR, 1.66; 95% CI, 1.53-1.80; P < .001) and unintended attrition (RR, 2.59; 95% CI, 2.31-2.90; P < .001) compared with all other residents. Orthopedic surgery had the highest attrition (RR, 3.80; 95% CI, 2.84-5.09; P < .001) and unintended attrition (RR, 7.20; 95% CI, 4.84-10.71; P < .001) for Black/African American residents. Results of this cross-sectional study suggest that the percentage of female residents in surgical specialties has improved over the last 18 years, and the percentage of URiM residents has remained relatively unchanged. Risk for attrition and unintended attrition was significantly elevated for female and URiM residents, specifically Black/African Americans. These results highlight current racial and sex disparities in resident attrition and demonstrate the importance of developing strategies to recruit, retain, and support residents.

The PERCEPTION OF THE APPLICABILITY OF CAD / CAM TECHNOLOGY IN CRANIOFACIAL SURGERY IN A PLASTIC SURGERY POSTGRADUATE PROGRAM

Abstract: Introduction: Multiple technologies help the development of reconstructive surgical procedures in craniofacial surgery, Surgeon's perception of this type of diagnostic and treatment aids has not been widely studied. Methods and Materials: A workflow is proposed for the management of craniofacial bone defects, then the results are showed to the staff in charge for the treatment of these patients. A survey was subsequently applied, evaluating the degree of satisfaction and perception the perception of the staff regarding applicability, usefulness, impact on different process factors of treatment. Descriptive analysis was performed. Results: 30 people were interviewed: specialists, residents of surgical specialties, general practitioners, medical students. The majority did not have experience with CAD / CAM technology (77%), but considered useful (67%), the considered disadvantages were: technical difficulty, administrative procedures to access, costs, lack of information, need for specific training. The benefits were: Improvement in diagnosis and treatment accuracy, specificity, help in planning, innovation, and versatility. Discussion: Tools such as 3D printing, CAD / CAM technology, facilitate the process of anatomical understanding, planning of the surgical procedure and execution of surgery, implementing the Survey in our service we could show that the perception of the majority of the participants agrees with these data, where the impact and utility of the application of this technology in the treatment of patients is evident, both for graduate surgeons and those in training. Conclusions: The application of technologies in the practice of medicine is useful, facilitates the technical execution of the procedure precision, reduces surgical time and costs. Information and studies that evaluate the surgeon's perception regarding the applicability of CAD / CAM technology in the treatment of craniofacial bone defects are not enough, which represents a novelty of our study.

Sex diversity within U.S. residencies: a cross-sectional study of trends from 2011 to 2019

BackgroundDespite females comprising 50.8% of the U.S. population, the percentage of females in the physician workforce is only 36.3%. Studies have examined sex trends within select specialties, however there is insufficient literature studying trends across all specialties. In this study, the authors examined trends in the proportion of female residents from 2011 to 2019 across all specialties, including both surgical and non-surgical. MethodsData on the proportion of female residents from 2011 to 2019 in all specialties was extracted from the Accreditation Council for Graduate Medical Education (ACGME) Data Resource Books and analyzed with the chi-square test for trend.ResultsFrom 2011 to 2019, there was a statistically significant increase in the percentage of female residents in surgical specialties (p < 0.001) and no significant change in the percentage of female residents in non-surgical specialties. In the same time period, the specialty with the highest percentage of females was Obstetrics & Gynecology (81.3%), and the specialty with the lowest percentage of females was Orthopedic Surgery (13.8%).ConclusionsAlthough there has been a positive overall trend in the percentage of females entering medical and surgical specialties, the percentage of females in medicine overall still lies below that of the entire population. Increased efforts are needed to increase female representation in medicine, especially in the U.S. in specialties where they are traditionally underrepresented.

Development of an Open-Access Webinar Series on Pathways for Global Surgery Engagement for Applicants to US Residency Programs.

Global surgery (GS) training pathways in residency are unclear and vary by specialty and program. Furthermore, information on these pathways is not always accessible. To address this gap, we produced a collection of open-access webinars for senior medical students focused on identifying GS training pathways during residency. The Global Surgery Student Alliance (GSSA) is a national nonprofit that engages US students and trainees in GS education, research, and advocacy. GSSA organized nine one-hour, specialty-specific webinars featuring residents of surgical specialties, anesthesia, and OBGYN programs. Live webinars were produced via Zoom from August to October 2020, and all recordings were posted to the GSSA YouTube channel. Medical students moderated webinars with predetermined standardized questions and live questions submitted by attendees. Participant data were collected in mandatory registration forms. A total of 539 people were registered for 9 webinars. Among registrants, 189 institutions and 36 countries were represented. Registrants reported education/training levels from less than undergraduate education to attending physicians, while medical students represented the majority of registrants. Following the live webinars, YouTube recordings of the events were viewed 839 times. Webinars featuring otolaryngology and general surgery residents accrued the greatest number of registrations, while anesthesia accrued the least. Medical students at all levels demonstrated interest in both the live and recorded specialty-specific webinars on GS in residency. To address the gap in developing global surgery practitioners, additional online, open-access education materials and mentorship opportunities are needed for students applying to US residencies.

IMPACT OF THE SARS-CoV-2 PANDEMIC ON TRAINING ACTIVITY: SURVEY OF SURGICAL RESIDENTS

Introduction. The global pandemic caused by the SARS-CoV-2 virus led to the restructuring of healthcare activity, modifying the training programs of medical interns. The objective of this article is to evaluate the impact of the pandemic on the training of medical interns in surgical specialties and the possible solutions to the detriment of training. Material and methods. Observational descriptive multicenter study base on a questionnaire of 20 items with multiple choice answers, completed by 232 surgical residents of the Valencian Community. Results. A response rate of 36.3% was obtained. 20.9% of those surveyed treated patients positive for COVID-19 and only 39.1% of them reported having the adequate personal protective equipment in all occasions. All those surveyed indicated a decrease in scheduled surgical activity and 85.5% reported having attended a reduced number of surgeries of their specialty because they were designated to perform other healthcare tasks derived from the pandemic. 99.1% of those surveyed considered that the situation triggered by the pandemic has meant less training in their surgical field. 65.5% of surgical residents consider that it is necessary to prolong the overall training time. Conclusion: The COVID-19 pandemic has had a negative impact on the training of residents of surgical specialties. For this reason, it is necessary to evaluate these formative setbacks and ensure the implementation of useful measures to reduce the negative effect on the acquisition of surgical skills.

Racial and Ethnic Diversity Within U.S. Residencies: Trends from 2011 to 2019

Examine trends in the proportion of underrepresented minority (URM) residents from 2011 to 2019 across all specialties and investigate differences between surgical and non-surgical specialties. Cross-sectional study. N/A. The authors extracted data on the proportion of URM residents in all specialties from the Accreditation Council for Graduate Medical Education yearly reports. There was a statistically significant decline in the proportion of URM residents in surgical specialties (p < 0.01) from 2011 (9.9%) to 2019 (9.1%) and a significant increase in the proportion of URM residents in non-surgical specialties (p < 0.01) from 2011 (9.6%) to 2019 (10.2%). This study emphasizes the need to increase recruitment of URMs in medicine, especially in surgical specialties. Findings from this study can inform much-needed initiatives to address barriers to entry for diverse applicants within specialties that lack diversity and have shown minimal improvement over time.

Residency training for minimally invasive surgery.

to develop a training program in minimally invasive surgery, based on simulation and with an emphasis on the acquisition of laparoscopic competences. this was a prospective, observational study carried out at a university hospital in Belo Horizonte, Brazil, between April 2020 and January 2021. We recruited residents of surgical specialties for structured, progressive training according to instructional principles to promote learning, such as motivation, activation, demonstration, application, and integration. We filmed the skill tests at the program's beginning, middle, and end, which were then anonymously evaluated by a surgical education expert. Individual performances were scored using the global assessment tools "GOALS" and "specific checklist for suture". At the end, all participants received individual feedback and completed a questionnaire to assess the impact of training on the Kirkpatrick model. 43 residents completed the program. The evolution of performances was evident and grew between tests. The average achievements were 29% in the initial test, 43% in the intermediate test, and 88% in the final test, with significant differences between all mean scores, with H=97.59, GL=2, p<0.0001. The program evaluation and learning perceptions were excellent, but only 10.7% of residents felt fully capable of performing unsupervised, low-complexity laparoscopic surgery at the end of training. the training program developed in this study proved to be feasible and promising as a strategy for teaching laparoscopic surgery.

The Sociotechnical Factors Associated With Burnout in Residents in Surgical Specialties: A Qualitative Systematic Review

The consequences of burnout remain prevalent within general surgery training programs, yet there is no comprehensive description of the factors associated with burnout. Using sociotechnical systems theory, this review aims to qualitatively evaluate the factors associated with burnout in surgical residents. A systematic review of the literature was performed according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review was conducted using PubMed, Web of Science, Scopus, and Embase. Two reviewers independently selected studies, extracted data, and assessed quality, with a third reviewer acting as a moderator to resolve conflicts. The Systems Engineering Initiative for Patient Safety framework was utilized to categorize factors as either contributing to or mitigating burnout. The study was registered with PROSPERO (CRD42021237448). Included studies were conducted within the United States and published prior to November 11, 2020. Included studies were peer-reviewed primary data, that were written in English and evaluated the sociotechnical factors associated with burnout in surgical residents. A total of 4387 articles were identified and after review, 15 studies were included for analysis. Reported burnout rates ranged from 17 to 94%, with a total mean rate of 57%. Factors found to contribute to burnout include financial stress, work-life imbalance, excessive charting, insufficient job resources, poor social support, and mistreatment. Mitigating factors include having time away from work, increased didactics, supportive faculty, attending social events, and the presence of program-based wellness initiatives. Consequences of burnout include depression, substance abuse, and decreased job satisfaction. Reported burnout rates among surgical residents are high. A complex number of sociotechnical factors were found to contribute to burnout, yet many factors are also shown to mitigate burnout. Surgical residencies may address burnout by making changes based on the presence or absence of these factors within their program.

A Qualitative Study of Developing Competency in Thyroid Surgery: A Resident's Perspective With 5 Year Follow Up.

The Accreditation Council for Graduate Medical Education has guidelines on assessing surgical qualifications based on experience. Attending surgeons have various assumptions on how their trainees learn and acquire surgical skills. This study primarily investigates the resident's perspective on gaining experience and achieving competency in thyroid surgical procedures. A qualitative study using semi-structured interviews was designed to derive themes that discuss the acquisition of competency in thyroid surgery. After IRB approval, data was collected from 2012 to 2014 at 4 academic centers in the Washington, DC area. Fourteen chief residents specializing in either general surgery or otolaryngology were interviewed until saturation was achieved. These semi-structured interviews were transcribed and broken up into codes utilizing Moustakas' analysis. A comprehensive list of master themes in regards to achieving competency in thyroid surgery was developed. A follow up survey of the surgeons was undertaken at 5 years to determine if the perceptions during residency persisted in practice. Surgical specialty residents experience and learn thyroid surgery in 5 learning themes:1. Self-directed learning is significant during residency.2. Repetition with graduated autonomy is key.3. Effective mentors are competent surgeons who challenge residents and use positive teaching techniques.4. Residents employ active learning through the "see one, do one, teach one" philosophy.5. Learning from complexity is of importance to residency training.After several years in practice, the most important theme in learning after residency was repetition of cases. This study demonstrates how residents progress in approaching competency in thyroid surgery. Adult learning strategies are preferred, and programs should incorporate tailored techniques to meet the individual needs of the residents. Perceptions of what is most important shifted in long-term follow up. Further study is needed to assure competency in residency and in practice.

Qualitative Thematic Analysis of Knowledge and Practices of Surgical Antimicrobial Prophylaxis at a Tertiary Care Teaching Hospital.

Background: Surgical antimicrobial prophylaxis (SAP) refers to the utilization of antibiotic agents for the prevention of surgical site infections (SSI), to prevent SSI-associated morbidity and mortality, reduce duration and cost of healthcare, and cause minimal adverse drug effects. The adherence rate among surgeons for the available international and national guidelines and optimal practice remains considerably low in many hospitals, especially in developing countries. The objective of this study was to assess the knowledge and compliance rate for SAP guidelines among various surgical specialties and those involved in providing SAP. Methods: An institution-based exploratory, multi-specialty, collective, mixed method approach (qualitative and quantitative) was used to assess the knowledge and compliance rate for SAP guidelines among the consultants and residents of surgical specialties. Quantitative analysis was performed using a pre-tested questionnaire. For qualitative analysis, focus group discussions were conducted. Thematic analysis was conducted by the Theoretical Domains Framework (TDF) and the Capabilities, Opportunities, Motivation and Behaviour (COM-B) model. Results: Twenty-eight focus groups and 16 paired interviews were undertaken. On thematic analysis six significant themes were noted and mapped to the COM-B model, and subthemes mapped to the relevant TDF domains in a combined framework. Key themes recognized were: (1) solitary focus on surgical skills; (2) following the hierarchy is more important than guideline compliance; (3) doubts and overcautious attitude of surgeons hinders appropriate SAP prescribing; (4) non-availability in-hospital supply of antimicrobial agents; (5) patient characteristics and type of surgery play a role in prescribing SAP; and (6) lack of national and local guidelines. Conclusions: The knowledge and attitudes of surgeons toward appropriate SAP prescribing are crucial factors for execution of guidelines. Including them in policy making decisions can help in strong execution of the same.

Construct validity of the SurgForce system for objective assessment of laparoscopic suturing skills.

Laparoscopic surgery requires a new set of skill to be learned by the surgeons, of which the most relevant is tissue manipulation. Excessive forces applied to the tissue can cause rupture during manipulation or ischemia when confronting both sides of the tissue. The aim of this study is to establish the construct validity of the SurgForce system for objective assessment of advanced laparoscopic skills, based on the force signal generated during suture tasks, and the development of force parameters for evaluating tissue handling interaction. The SurgForce system, a tissue handling training device that measures dynamic force, was used to capture the force generated by surgeons with different levels of laparoscopic experience. For construct validity, 37 participants were enrolled in this study: 19 medical students, 12 residents of surgical specialties and 6 expert surgeons. All participants performed an intracorporeal knotting suture task over a synthetic tissue pad with a laparoscopic box-trainer. The force performance of the participants was analyzed using 11 force-based parameters with the application of the SurgForce system. Statistical analysis was performed between novice, intermediate, and expert groups using a Kruskal-Wallis test, and between the pairs of groups using a Mann-Whitney U-test. Overall, 9 of the 11 force-related parameters showed significant differences between the three study groups. Results between the pairs of groups presented significant differences in 5 force parameters proposed. Construct validity results demonstrated that the SurgForce system was able to differentiate force performance between surgeons with different levels of laparoscopic experience. The SurgForce system was successfully validated. This force system showed its potential to measure the force exerted on tissue for objective assessment of tissue handling skills in suturing tasks. Furthermore, its compact design allows the use of this device in conventional laparoscopic box-trainers.

Development of Surgical Scrubbing, Gowning and Gloving Checklist using the Delphi Method

This article was migrated. The article was not marked as recommended. Background Competency in surgical scrubbing, gowning and gloving (scrubbing-in) procedures is necessary to participate in surgery, but difficult for trainees to learn due to the fast pace of the operating room and limited availability of experts to provide training. Current methods of scrubbing-in procedures are antiquated. Simulation-based education aligns with the paradigm shift occurring in medical education as we transition from passive models. This study utilized the Delphi technique to identify necessary items to include in a scrubbing-in checklist that can be used in future simulation and assessment tools.MethodsSurgeon experts participated in three rounds of a Delphi process. The panel consisted of surgical specialty residents, fellows and attending surgeons from gynecology, urology, general surgery, plastic, orthopedic and neurosurgery.ResultsFrom January 2018 to September 2018, 39 experts from 6 different surgical subspecialties participated in three Delphi survey rounds. Of the 43 items identified during the first round, 30 (70%) resulted with an importance rating &gt; 4.0. During the final round, a consensus of &gt; 85% was reached for 22 total items (73%).ConclusionWe developed a 22-step checklist for scrubbing-in procedures utilizing the Delphi technique. This checklist will enhance undergraduate medical education simulation curriculums and assessments.

Professionalism among medical residents in a young second-level university in Iran: a cross-sectional study.

Professionalism is a set of behaviors that build trust in physicians’ relationships with patients and the public. The aim of this study was to assess professionalism among residents in Kashan University of Medical Sciences, Kashan, Iran. This cross-sectional study was conducted on 139 residents recruited through the census method. Data were collected using the American Board of Internal Medicine Professionalism Questionnaire. The first part of the questionnaire was on residents’ personal characteristics, and the second part contained fifteen items in the three domains of professionalism, namely excellence, honor/integrity, and altruism/respect. The mean scores of the questionnaire and its domains were calculated and their relationships with residents’ personal characteristics were evaluated.The mean scores (± SD) of professionalism and its excellence, honor/integrity, and altruism/respect domains were 4.93 ± 2.4, 5.92 ± 1.85, 4.94 ± 3.39, and 4.35 ± 3.27, respectively (in a range of 0-10). Professionalism had significant relationships only with residents’ specialty and gender.The level of professionalism in residents was low, which requires the attention of educational authorities. Moreover, the mean score of professionalism among residents in surgical specialties was significantly lower than non-surgical specialties. Various factors can be considered in this regard and it cannot be concluded that the lower score means worse professional behavior.

Operating Room Educational Climate Scale for Surgical Specialty Residents: Scale Development and Validation.

To develop a scale in Turkish language for evaluating the surgical specialty residents? perceptions of educational climate in the operating room, with an emphasis on learning in the operating suite and planning the relevant change for improved and standardized training. Three surgeons from different disciplines provided expert opinions and a focus group meeting was held on the necessity, scope, and specificity of the items. The 5-point Likert type draft scale consisted of 28 items including ten negative statements scored reversely and having total scores ranging between 28-140 points. There were 5 subscales: educational process, teamwork, communication, operating room infrastructure, and surgical skills education. For assessing the validity and reliability, 172 surgical specialty residents from three hospitals in different locations were asked to answer the paper-based scale items anonymously. Confirmatory factor analysis (CFA) was used to test validity, whereas Cronbach?s alpha reliability coefficients were calculated for internal consistency. CFA revealed a chi-square, standard deviation, chi-square/standard deviation, and a p-value of 783.73, 340, 2.27, and 0.001, respectively. Cronbach?s alpha coefficient for educational process, teamwork, communication, operating room infrastructure, and surgical skills education subscales were calculated to be 0.61, 0.61, 0.63, 0.70, and 0.72, respectively. Cronbach?s alpha coefficient for all items was 0.89. Results indicated acceptable construct validity and internal consistency of the scale. The newly developed scale was proven as a reliable and valid measurement instrument that can be used within the Turkish health system setting for assessing and improving the educational climate in the operating room.

EXPERIENCE IN ORGANIZING A FAST-PROTOCOL TRAINING COURSE FOR SURGICAL DOCTORS

This work is devoted to the problem of introducing the FAST protocol course for doctors and residents of surgical specialties into the curriculum. The study proves that the confident application of the method is possible only with repeated reproduction of the acquired skill, which can only be realized in simulated conditions.

Residents' knowledge in transfusion medicine and educational programs: A pilot study.

Residents' knowledge in transfusion medicine significantly impacts the optimal use of blood and patient safety. Little is known regarding this topic in France in particular. The objectives were to evaluate their basic knowledge, to determine whether the objectives of the curricula were attained and subsequently to suggest ways for improvement. A cross-sectional study was conducted on 50 first year medical and surgical specialty residents rotating in a French university hospital. Major gaps in the knowledge were noted among residents of various specialties, equally between those with low and sustained transfusion practice. The majority of these young doctors expressed difficulties in prescribing and handling transfusions, identifying and managing its complications and understanding their responsibilities. The roles of hemovigilance practitioners were further somehow unclear for participants. Given these results, action plans appear needed to limit consequences. A special transfusion medicine educational program should be added to the currently available medical education curriculum in order to ensure physicians have adequate knowledge of transfusion basics; at least a practical assisted situation during residency would be of valuable interest.

Attitudes of faculty and residents of surgical specialties towards professionalism at a tertiary care hospital of Islamabad.

Objectives:To determine the attitudes of faculty and residents of surgical specialties towards professionalism and to test the validity and reliability of a tool developed in USA for Pakistan.Methods:An exploratory validation study was carried out at Pakistan Institute of Medical Sciences (PIMS), Islamabad from 01-Aug-2016 to 31-Jan-2017. Penn State College of Medicine Professionalism Questionnaire (PSCOM) was used, being a reliable and valid survey tools. Exploratory Factor Analysis of the inter-correlations of responses for 36 items was done using SPPS v 21 to give a factor solution to reflect the perceptions regarding attitudinal elements.Results:There were 209 respondents including 172 residents and 37 faculty members. Response rate was 81.32%. Exploratory Factor Analyses of responses gave a seven factor solution of professionalism: accountability, honour and integrity, excellence, duty, altruism, equity and respect. Six of the factors that emerged reflect the six elements of professionalism reported by American Board of Internal Medicine (ABIM), except for ‘equity’, which was the new factor that emerged. Cronbach’s alpha (Internal Consistency Reliability) for each element of professionalism was between 0.88-0.98.Conclusion:PSCOM is a valid, reliable, feasible and acceptable tool to assess attitudes of faculty and residents towards professionalism in Pakistan. ‘Equity’ emerged as a new factor which needs to be studied further.

The prevalence of sharp injuries in the operative room among surgical residents and their behavior to them in the southern region of Saudi Arabia

Background: Residents of surgical specialties have a high risk of sharp injuries. The reporting behaviors have a critical step in prophylaxis and early treatment. Aim: The aim of this study is to assess the prevalence of sharp injuries in the operative room among surgical residents and their behavior. Methodology: A descriptive cross-sectional study was conducted including 166 surgical specialty residents who involved in operating procedures from seven hospitals in the southern region of Saudi Arabia. A self-administrating questionnaire about sharp injuries, predisposing factors for sharp injuries, and practice of universal precautions during the surgical procedures was used for data collection. The study questionnaire was developed by the researchers after intensive literature review and another research tool from a previous similar study which was conducted in King Abdul-Aziz University Hospital in Jeddah city of Saudi Arabia. Results: About 64% of the residents have had at least one sharp injury in the last year. Most of these injuries (53.3%) occurred while suturing and 76.6% claimed the reason was due to fatigue. Most of the recent injuries (86%) were self-induced injuries caused with a solid needle (65.4%). The most common action post the injury was replacing the gloves and the needle (36.7%). Only 9% of them have reported all of their injuries to the concerned authorities, and 56% claimed the reason that they were not bothered. About 75.3% of them were aware of their local policies. Conclusion: Sharp injuries and needlestick are common among surgical residents, but they have weak reporting behavior. More educational training program about the sharp-related safety program may improve their attitude and behavior regarding sharp injuries.