Role of Surgeons in Determining Outcome of Histopathology ...

African Journals Online (AJOL)

Conclusion: To ensure the quality of histopathological diagnosis with minimal turnaround time, the surgeon plays a vital role by ensuring adequate and prompt fixation of tissue biopsies, put in the right container and accompanied by well labeled request cards. Keywords: Formalin, fixative, outcome, pathologist, surgeon ...

Novice supervisors' tasks and training - a descriptive study

DEFF Research Database (Denmark)

Nielsen, Jan; Jacobsen, Claus H.; Mathiesen, Birgit Bork

development, experience, and practice. In this presentation we focus on the tasks and training of the respondents as novice supervisors. The results show, that a majority of novice supervisors were confronted with complicated jobs, e.g., group, internal and interdisciplinary supervision, but were not prepared......There is a lack of data on the influence of the debut as a supervisor on the later career. However, extrapolating data from therapist development, we assume that the first years as novice supervisor are important for the following career as supervisor in particular. The first job as novice......, i.e. trained, prior to these tasks. These findings imply that more training is needed for novice supervisors. Preferably, this training should be introduced before, or at least parallel to, the first supervisor tasks, preparing the novice supervisors for the often complicated tasks they are meeting....

Novice Mathematics Teachers Create Themselves

Science.gov (United States)

Schatz Oppenheimer, Orna; Dvir, Nurit

2018-01-01

This study presents a qualitative research based on three narratives written by novice mathematics teachers. We examine their unique professional world during their first year of work. The methodology of narrative framework, on which this article is based, helps to gain better understanding of the need for novice mathematics teachers to have…

Development and Validation of a Novice Teacher and Supervisor Survey

Science.gov (United States)

Finster, Matthew

2017-01-01

This brief presents initial evidence about the reliability and validity of a novice teacher survey and a novice teacher supervisor survey. The novice teacher and novice teacher supervisor surveys assess how well prepared novice teachers are to meet the job requirements of teaching. The surveys are designed to provide educator preparation programs…

Does training novices to criteria and does rapid acquisition of skills on laparoscopic simulators have predictive validity or are we just playing video games?

Science.gov (United States)

Hogle, Nancy J; Widmann, Warren D; Ude, Aku O; Hardy, Mark A; Fowler, Dennis L

2008-01-01

To determine whether LapSim training (version 3.0; Surgical Science Ltd, Göteborg, Sweden) to criteria for novice PGY1 surgical residents had predictive validity for improvement in the performance of laparoscopic cholecystectomy. In all, 21 PGY1 residents performed laparoscopic cholecystectomies in pigs after minimal training; their performance was evaluated by skilled laparoscopic surgeons using the validated tool GOALS (global operative assessment of laparoscopic operative skills: depth perception, bimanual dexterity, efficiency, tissue handling, and overall competence). From the group, 10 residents trained to competency on the LapSim Basic Skills Programs (camera navigation, instrument navigation, coordination, grasping, lifting and grasping, cutting, and clip applying). All 21 PGY1 residents again performed laparoscopic cholecystectomies on pigs; their performance was again evaluated by skilled laparoscopic surgeons using GOALS. Additionally, we studied the rate of learning to determine whether the slow or fast learners on the LapSim performed equivalently when performing actual cholecystectomies in pigs. Finally, 6 categorical residents were tracked, and their clinical performance on all of the laparoscopic cholecystectomies in which they were "surgeon, junior" was prospectively evaluated using the GOALS criteria. We found a statistical improvement of depth perception in the operative performance of cholecystectomies in pigs in the group trained on the LapSim. In the other 4 domains, a trend toward improvement was observed. No correlation between being a fast learner and the ultimate skill was demonstrated in the clinical performance of laparoscopic cholecystectomies. We did find that the fast learners on LapSim all were past or current video game players ("gamers"); however, that background did not translate into better clinical performance. Using current criteria, we doubt that the time and effort spent training novice PGY1 Surgical Residents on the basic

Lived Experience: Perceptions of Competency of Novice Teachers

Directory of Open Access Journals (Sweden)

Pauline Swee Choo Goh

2017-01-01

Full Text Available This study bridges the gap of an outsider-insider perspective of competency and captures the essence of what constitutes competency among 18 novice teachers in their own actions performed in real classrooms. In this study, relevant aspects of the novice teachers’ ‘lived-experience’ in their schools make up their conceptions of competency. Novice teachers’ talk about achieving their aims of competency in strategically different ways and in each of these ways, the novice teachers’ strategies are critical to their understanding of the novice teacher-student roles. Five identified conceptions are: controls in the classroom and behaviour of students, methodical preparation, uses of sound in pedagogical knowledge and skills, understanding and empowering their students to take charge of their own learning, and an awareness of themselves as teachers. The conceptions of competency are represented diagrammatically and are discussed with respect to levels of complexity. Variation exists in the way novice teachers conceive of their competency. Teacher educators should be cognizant of the diversity in practices of teachers and not limit that to say that there is just one acceptable conception of competency.

Snapchat media retrieval for novice device users

CSIR Research Space (South Africa)

Khan, ZC

2015-03-01

Full Text Available procedures that are easily enough for novice smartphone users to employ: not necessarily hackers or information security specialists, but an average smartphone user. The results indicate that, it is indeed possible for novices to retrieve Snapchat data...

Novice designers’ use of prototypes in engineering design

Science.gov (United States)

Deininger, Michael; Daly, Shanna R.; Sienko, Kathleen H.; Lee, Jennifer C.

2017-01-01

Prototypes are essential tools in product design processes, but are often underutilized by novice designers. To help novice designers use prototypes more effectively, we must first determine how they currently use prototypes. In this paper, we describe how novice designers conceptualized prototypes and reported using them throughout a design project, and compare reported prototyping use to prototyping best practices. We found that some of the reported prototyping practices by novice designers, such as using inexpensive prototypes early and using prototypes to define user requirements, occurred infrequently and lacked intentionality. Participants’ initial descriptions of prototypes were less sophisticated than how they later described using them and only upon prompted reflection did participants recognize more specific benefits of using prototypes. PMID:29398740

Administrative Context and Novice Teacher-Mentor Interactions

Science.gov (United States)

Pogodzinski, Ben

2015-01-01

Purpose: Mentoring can improve novice teacher effectiveness and reduce teacher attrition, yet the depth and breadth of mentoring can vary greatly within and between schools. The purpose of this paper is to identify the extent to which a school's administrative context is associated with the focus and frequency of novice teacher-mentor…

Concerns of the Novice Physical Education Teacher

Science.gov (United States)

Gordon, Evelyn J.

2016-01-01

The purpose of this case study was to examine novice physical education teachers in the first and second year of teaching. Participants included two novice physical education teachers, John in Year 1 and Mark in Year 2. Methodology included observations, semistructured interviews, and documents. Data were analyzed using open coding and constant…

Novice teen driving : education and training administrative standards.

Science.gov (United States)

2009-10-09

The Novice Teen Driver Education and Training Administrative Standards set forth in this document serve to guide all novice teen driver education and training programs in States striving to provide quality, consistent driver education and training. W...

The kinds of questions asked by novice teachers in learning mathematics

Science.gov (United States)

Zahra, L.; Kusmayadi, T. A.; Usodo, B.

2018-05-01

This study describes the kinds of questions asked by novice teachers during mathematics learning process in senior high school. This study used descriptive analysis. The subjects of this study were two novice teachers who teach mathematics in 10th grade. The result showed that the frequently asked questions by novice teachers based on the objective were compliance questions, rethorical questions and sometimes prompting questions and probing questions. The frequently questions asked by novice teacher based on the cognitive process dimension of Revised Bloom’s Taxonomy were questions of remembering, questions of understanding, questions of applying, questions of analyzing and questions of evaluating. The novice teachers asked the routine questions which had same thinking level. The question with the highest level of thinking did not asked by the novice teachers.

Initial experience using a robotic-driven laparoscopic needle holder with ergonomic handle: assessment of surgeons' task performance and ergonomics.

Science.gov (United States)

Sánchez-Margallo, Juan A; Sánchez-Margallo, Francisco M

2017-12-01

The objective of this study is to assess the surgeons' performance and ergonomics during the use of a robotic-driven needle holder in laparoscopic suturing tasks. Six right-handed laparoscopic surgeons with different levels of experience took part in this study. Participants performed a set of three different intracorporeal suturing tasks organized in ten trials during a period of five weeks. Surgeons used both conventional (Conv) and robotic (Rob) laparoscopic needle holders. Precision using the surgical needle, quality of the intracorporeal suturing performance, execution time and leakage pressure for the urethrovesical anastomosis, as well as the ergonomics of the surgeon's hand posture, were analyzed during the first, fifth and last trials. No statistically significant differences in precision and quality of suturing performance were obtained between both groups of instruments. Surgeons required more time using the robotic instrument than using the conventional needle holder to perform the urethrovesical anastomosis, but execution time was significantly reduced after training ([Formula: see text] 0.05). There were no differences in leakage pressure for the anastomoses carried out by both instruments. After training, novice surgeons significantly improved the ergonomics of the wrist ([Formula: see text] 0.05) and index finger (Conv: 36.381[Formula: see text], Rob: 30.389[Formula: see text]; p = 0.024) when using the robotic instrument compared to the conventional needle holder. Results have shown that, although both instruments offer similar technical performance, the robotic-driven instrument results in better ergonomics for the surgeon's hand posture compared to the use of a conventional laparoscopic needle holder in intracorporeal suturing.

A Learning Partnership: Exploring Preceptorship through Interviews with Registered and Novice Nurses

Science.gov (United States)

Ockerby, Cherene M.; Newton, Jennifer M.; Cross, Wendy M.; Jolly, Brian C.

2009-01-01

Novice nurses encounter numerous factors that impact on their learning in the complex healthcare workplace. Registered nurses often work one-on-one with novices as preceptors to facilitate the development of novices' clinical skills and socialisation into the profession. This paper explores the concept of preceptorship from novice nurses' and…

Use of analogies by novice and experienced design engineers

DEFF Research Database (Denmark)

Ahmed, Saeema; Christensen, Bo T.

2008-01-01

industry. The findings indicate a significant difference in both the functions and reasoning by novices and experienced designers. Novices were found to predominantly transfer information without explicit reference to design issues, whereas experienced designers tended to either solve or identify problems....... Experienced designers were found to reason about the function of a component and to some degree the predicted behaviour of the component, whereas the novices seem to lack such reasoning processes....

Everybody's Problem: Novice Teachers in Disadvantaged Mexican Schools

Science.gov (United States)

Martínez, Nora H.

2014-01-01

This paper explores the difficulties that novice teachers confront at two economically, socially, and academically disadvantaged schools in the state of Nuevo Leon, Mexico. The researchers employed the action research tradition. Problems were identified using participant observation during reflexive workshops conducted with novice teachers and…

Administrative support of novice science teachers: A multiple case study

Science.gov (United States)

Iacuone, Leann

Novice science teachers leave the confines of colleges and universities to embark on a new adventure in education where they aim to influence young minds, make a difference in the world, and share their love for their content. They have learned their pedagogical skills with the support and assistance of fellow classmates, a supporting professor, and a cooperating teacher. These teachers enter their new place of employment and are met with many unexpected challenges, such as a lack of resources, no one to ask questions of, and a busy staff with already established relationships, causing them to feel an overall lack of support and resulting in many new teachers rethinking their career choice and leaving the field of education within 5 years of entering. This multiple-case study investigated the administrative support 4 novice science teachers received during an academic year and the novice teachers' perceptions of the support they received to answer the following research question: How do novice science teachers who have consistent interactions with administrators develop during their first year? To answer this question, semistructured interviews, reflection journals, observations, resumes, long-range plans, and student discipline referrals were collected. The findings from this study show novice science teachers who had incidents occur in the classroom requiring administrative assistance and guidance felt more confident in enforcing their classroom management policies and procedures as the year progressed to change student behavior. The novice science teachers perceived administrators who provided resources including technology, office supplies, science supplies, and the guidance of a mentor as supportive. Novice science teachers who engaged in dialogue after administrative observations, were provided the opportunity to attend professional development outside the district, and had a mentor who taught the same discipline made more changes to their instructional

THE ROLE OF MENTORING IN PROFESSIONAL SOCIALIZATION OF NOVICE TEACHERS

Directory of Open Access Journals (Sweden)

Līga Paula

2018-06-01

Full Text Available Entering teaching profession is considered as the most determining stage in a teacher’s professional life. The aim of this research is to explore opinions of novice teachers in Latvia about the role of mentoring in their professional socialization. The following research questions were defined: (1 what difficulties novice teachers faced during their in-service experience? (2 what support novice teachers needed when they started teaching? (3 what the role of mentoring in teachers’ professional socialization is? Qualitative research design was developed for the research. Empirical data were obtained during the focus group discussion with ten teachers representing Council of young teachers (in age below 35 of the Latvian Trade Union of Education and Science Employees, nine semi-structured interviews with novice teachers, and interview with a mentor. Novice teachers face teaching reality which often differs from perceptions about the profession developed during the studies at university. The research shows that teachers from the sample faced following challenges during their first years of in-service: establishing teacher’s authority and self-positioning as a teacher, time management, problems with discipline in a classroom, lack of skills to develop curriculum and lesson plans, difficulties in communication with parents. During socialization novice teachers learned their responsibilities and acquired specific knowledge; appropriate support such as mentoring reduced level of stress and uncertainty while novice teachers adapted to school during the period of transition from pre-service period to in-service period. In relation to mentoring, novice teachers expected that a mentor would introduce them to school traditions and internal rules and would advise on discipline in a classroom as well as would help to develop curriculum. Policy makers should focus on teachers’ support guidelines at national level, which would allow schools to ensure the

Expert and novice categorization of introductory physics problems

Science.gov (United States)

Wolf, Steven Frederick

Since it was first published 30 years ago, Chi et al.'s seminal paper on expert and novice categorization of introductory problems led to a plethora of follow-up studies within and outside of the area of physics [Chi et al. Cognitive Science 5, 121 -- 152 (1981)]. These studies frequently encompass "card-sorting" exercises whereby the participants group problems. The study firmly established the paradigm that novices categorize physics problems by "surface features" (e.g. "incline," "pendulum," "projectile motion,"... ), while experts use "deep structure" (e.g. "energy conservation," "Newton 2,"... ). While this technique certainly allows insights into problem solving approaches, simple descriptive statistics more often than not fail to find significant differences between experts and novices. In most experiments, the clean-cut outcome of the original study cannot be reproduced. Given the widespread implications of the original study, the frequent failure to reproduce its findings warrants a closer look. We developed a less subjective statistical analysis method for the card sorting outcome and studied how the "successful" outcome of the experiment depends on the choice of the original card set. Thus, in a first step, we are moving beyond descriptive statistics, and develop a novel microscopic approach that takes into account the individual identity of the cards and uses graph theory and models to visualize, analyze, and interpret problem categorization experiments. These graphs are compared macroscopically, using standard graph theoretic statistics, and microscopically, using a distance metric that we have developed. This macroscopic sorting behavior is described using our Cognitive Categorization Model. The microscopic comparison allows us to visualize our sorters using Principal Components Analysis and compare the expert sorters to the novice sorters as a group. In the second step, we ask the question: Which properties of problems are most important in problem

Young novice drivers.

NARCIS (Netherlands)

2013-01-01

In The Netherlands, young novice drivers (18-24 years of age) show a crash rate that is five times higher than that of experienced drivers (30-59 years of age). The rate of young males is even seven times as high. The main reasons are lack of driving experience and hazardous behaviour typical of

Experts and novices use the same factors--but differently--to evaluate pearl quality.

Directory of Open Access Journals (Sweden)

Yusuke Tani

Full Text Available Well-trained experts in pearl grading have been thought to evaluate pearls according to their glossiness, interference color, and shape. However, the characteristics of their evaluations are not fully understood. Using pearl grading experiments, we investigate the consistency of novice (i.e., without knowledge of pearl grading and expert participants' pearl grading skill and then compare the novices' grading with that of experts; furthermore, we discuss the relationship between grading, interference color, and glossiness. We found that novices' grading was significantly less concordant with experts average grading than was experts' grading; more than half of novices graded pearls the opposite of how experts graded those same pearls. However, while experts graded pearls more consistently than novices did, novices' consistency was relatively high. We also found differences between the groups in regression analyses that used interference color and glossiness as explanatory variables and were conducted for each trial. Although the regression coefficient was significant in 60% of novices' trials, there were fewer significant trials for the experts (20%. This indicates that novices can also make use of these two factors, but that their usage is simpler than that of the experts. These results suggest that experts and novices share some values about pearls but that the evaluation method is elaborated for experts.

Simultaneous development of laparoscopy and robotics provides acceptable perioperative outcomes and shows robotics to have a faster learning curve and to be overall faster in rectal cancer surgery: analysis of novice MIS surgeon learning curves.

Science.gov (United States)

Melich, George; Hong, Young Ki; Kim, Jieun; Hur, Hyuk; Baik, Seung Hyuk; Kim, Nam Kyu; Sender Liberman, A; Min, Byung Soh

2015-03-01

Laparoscopy offers some evidence of benefit compared to open rectal surgery. Robotic rectal surgery is evolving into an accepted approach. The objective was to analyze and compare laparoscopic and robotic rectal surgery learning curves with respect to operative times and perioperative outcomes for a novice minimally invasive colorectal surgeon. One hundred and six laparoscopic and 92 robotic LAR rectal surgery cases were analyzed. All surgeries were performed by a surgeon who was primarily trained in open rectal surgery. Patient characteristics and perioperative outcomes were analyzed. Operative time and CUSUM plots were used for evaluating the learning curve for laparoscopic versus robotic LAR. Laparoscopic versus robotic LAR outcomes feature initial group operative times of 308 (291-325) min versus 397 (373-420) min and last group times of 220 (212-229) min versus 204 (196-211) min-reversed in favor of robotics; major complications of 4.7 versus 6.5 % (NS), resection margin involvement of 2.8 versus 4.4 % (NS), conversion rate of 3.8 versus 1.1 (NS), lymph node harvest of 16.3 versus 17.2 (NS), and estimated blood loss of 231 versus 201 cc (NS). Due to faster learning curves for extracorporeal phase and total mesorectal excision phase, the robotic surgery was observed to be faster than laparoscopic surgery after the initial 41 cases. CUSUM plots demonstrate acceptable perioperative surgical outcomes from the beginning of the study. Initial robotic operative times improved with practice rapidly and eventually became faster than those for laparoscopy. Developing both laparoscopic and robotic skills simultaneously can provide acceptable perioperative outcomes in rectal surgery. It might be suggested that in the current milieu of clashing interests between evolving technology and economic constrains, there might be advantages in embracing both approaches.

Clinical decision-making of rural novice nurses.

Science.gov (United States)

Seright, T J

2011-01-01

Nurses in rural settings are often the first to assess and interpret the patient's clinical presentations. Therefore, an understanding of how nurses experience decision-making is important in terms of educational preparation, resource allocation to rural areas, institutional cultures, and patient outcomes. Theory development was based on the in-depth investigation of 12 novice nurses practicing in rural critical access hospitals in a north central state. This grounded theory study consisted of face-to-face interviews with 12 registered nurses, nine of whom were observed during their work day. The participants were interviewed a second time, as a method of member checking, and during this interview they reviewed their transcripts, the emerging themes and categories. Directors of nursing from both the research sites and rural hospitals not involved in the study, experienced researchers, and nurse educators facilitated triangulation of the findings. 'Sociocentric rationalizing' emerged as the central phenomenon and referred to the sense of belonging and agency which impacted the decision-making in this small group of novice nurses in rural critical access hospitals. The observed consequences, which were conceptualized during the axial coding process and were derived from observations and interviews of the 12 novice nurses in this study include: (1) gathering information before making a decision included assessment of: the credibility of co-workers, patients' subjective and objective data, and one's own past and current experiences; (2) conferring with co-workers as a direct method of confirming/denying decisions being made was considered more realistic and expedient than policy books and decision trees; (3) rural practicum clinical experiences, along with support after orientation, provide for transition to the rural nurse role; (4) involved directors of nursing served as both models and protectors of novice nurses placed in high accountability positions early in

Comparison expert and novice scan behavior for using e-learning

Science.gov (United States)

Novita Sari, Felisia; Insap Santosa, Paulus; Wibirama, Sunu

2017-06-01

E-Learning is an important media that an educational institution must have. Successful information design for e-learning depends on its user's characteristics. This study explores differences between novice and expert users' eye movement data. This differences between expert and novice users were compared and identified based on gaze features. Each participant must do three main tasks of e-learning. This paper gives the result that there are differences between gaze features of experts and novices.

The role of the plastic surgeon in dealing with soft tissue injuries: experience from the second Israel-Lebanon war, 2006.

Science.gov (United States)

Sharony, Zach; Eldor, Liron; Klein, Yuval; Ramon, Yitzchak; Rissin, Yaron; Berger, Yosef; Lerner, Alexander; Ullmann, Yehuda

2009-01-01

During the 2006 war between Israel and Lebanon, 282 Israeli soldiers were evacuated to Rambam Health Care Campus. Of these, 210 were admitted for observation or treatment, and 15 of these were admitted to the Department of Plastic and Reconstructive Surgery. Thirty-five other soldiers, hospitalized in other departments, required the care of Plastic Surgeons, either for conservative or surgical treatment. The injury profile observed was consistent with data from previous low-intensity warfare, which demonstrated that over 80% of injuries were produced by fragmentation weapons, such as artillery, mortarshells, rockets, and missiles. It differs, however, from our experience in previous wars and our expectations regarding burn wounds, both in incidence and severity, which were significantly lower as compared with the past. This article presents our management of extensive soft tissue injuries, and details 3 representative cases. It highlights the role of the Plastic Surgeon as part of the whole treatment in this type of injury and helps to predict the needs of the medical system in preparation for the future.

Seromuscular Colonic Flap for Intrapelvic Soft-Tissue Coverage: A Reconstructive Option for Plastic Surgeons When Traditionally Used Flaps Are Not Available

Directory of Open Access Journals (Sweden)

Johnathon Aho

2015-01-01

Full Text Available Background. Reconstruction of intrapelvic defects can be a challenging problem in patients with limited regional muscle flap options and previously resected omentum. In such situations, alternative methods of mobilizing vascularized tissue may be required. Methods. A case of a patient that underwent pelvic extirpation for recurrent rectal cancer who had limited donor sites for flap reconstruction is presented. The mucosa was removed from a blind loop of colon, and a pedicled seromuscular flap based on the colonic mesentery was placed into the pelvis for vascularized soft-tissue coverage and elimination of dead space. Results. The postoperative course was only complicated by a small subcutaneous fluid collection beneath the sacrectomy skin incision, which was drained with radiological assistance. The patient recovered without any major postoperative complications. Conclusion. Seromuscular colonic flap is a useful option for soft-tissue coverage after pelvic extirpation and should be considered by plastic surgeons when other reconstruction options are not available.

A Content Analysis of Images of Novice Teacher Induction: First-Semester Themes

Science.gov (United States)

Curry, Jennifer R.; Webb, Angela W.; Latham, Samantha J.

2016-01-01

The powerful nature of novice teachers' experiences in their first years of teaching has been well documented. However, the variance in novices' initial immersion in the school environment is largely dependent on perceived personal and professional support as well as the environmental inducements that lend to novice teachers' success in the…

Differences of ballet turns (pirouette) performance between experienced and novice ballet dancers.

Science.gov (United States)

Lin, Chia-Wei; Chen, Shing-Jye; Su, Fong-Chin; Wu, Hong-Wen; Lin, Cheng-Feng

2014-09-01

This study investigated the different postural control strategies exhibited by experienced and novice dancers in ballet turns (pirouettes). Thirteen novice and 13 experienced dancers performed ballet turns with dominant-leg support. The peak push force was measured in the double-leg support phase. The inclination angles of rotation axis with respect to vertical axis were calculated in the early single-leg support phase as well as the initiation sequence of ankle, knee, and hip joints on the supporting leg. Moreover, the anchoring index of the head was computed in the transverse plane during turning. The novice dancers applied a greater push force, an increased inclination angle of rotation axis, and an insufficient proximal-to-distal extension sequence pattern. The novice dancers also had a smaller head-anchoring index compared with experienced dancers, which meant novice dancers were not using a space target as a stability reference. A poorer performance in novice dancers could result from higher push force in propulsion, lack of a "proximal-to-distal extension sequence" pattern, and lack of visual spotting for postural stability. Training on sequential initiation of lower-extremity joints and rehearsal of visual spotting are essential for novice dancers to obtain better performance on ballet turns.

Bothered by abstractness or engaged by cohesion? Experts' explanations enhance novices' deep-learning.

Science.gov (United States)

Lachner, Andreas; Nückles, Matthias

2015-03-01

Experts' explanations have been shown to better enhance novices' transfer as compared with advanced students' explanations. Based on research on expertise and text comprehension, we investigated whether the abstractness or the cohesion of experts' and intermediates' explanations accounted for novices' learning. In Study 1, we showed that the superior cohesion of experts' explanations accounted for most of novices' transfer, whereas the degree of abstractness did not impact novices' transfer performance. In Study 2, we investigated novices' processing while learning with experts' and intermediates' explanations. We found that novices studying experts' explanations actively self-regulated their processing of the explanations, as they showed mainly deep-processing activities, whereas novices learning with intermediates' explanations were mainly engaged in shallow-processing activities by paraphrasing the explanations. Thus, we concluded that subject-matter expertise is a crucial prerequisite for instructors. Despite the abstract character of experts' explanations, their subject-matter expertise enables them to generate highly cohesive explanations that serve as a valuable scaffold for students' construction of flexible knowledge by engaging them in deep-level processing. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Effects of a novel mental skills curriculum on surgical novices' attention.

Science.gov (United States)

Anton, Nicholas E; Mulji, Neelam; Howley, Lisa D; Yurco, Ashley M; Tobben, Daniel; Bean, Eric; Stefanidis, Dimitrios

2017-11-01

Surgery is very cognitively demanding, particularly for novices. Novices are required to direct full attention on the procedure at hand, and additional demands can lead to cognitive overload. Through extensive practice, experts develop spare attentional capacity (SAC) for simultaneous tasks. However, little effort has been made to enhance novices' SAC. Mental skills may enhance attention management and increase SAC. The purpose of this study was to determine the efficacy of a novel mental skills curriculum (MSC) to enhance novices' attention management. Sixty novice volunteers were randomly stratified to a control or MSC group based on baseline laparoscopic skill and mental skill use (assessed with the Test of Performance Strategies version 2 [TOPS-2]). All participants received laparoscopic training, whereas the MSC group received additional mental skills training. At all sessions, participants completed a secondary task during laparoscopy, which assessed SAC. Participants also completed the D2 Test of Attention and the TOPS-2 attention control subscale, which are valid attention measures. Fifty-five novices completed the study. Both groups displayed significantly improved laparoscopic suturing ability (P attention control scores. However, only the MSC group displayed significantly improved hit rate on the secondary task (P attentional capacity is currently underway. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of anesthetic, tag size, and surgeon experience on postsurgical recovering after implantation of electronic tags in a neotropical fish: Prochilodus lineatus (Valenciennes, 1837 (Characiformes: Prochilodontidae

Directory of Open Access Journals (Sweden)

João M. Lopes

Full Text Available ABSTRACT Implantation of telemetry transmitters in fish can be affected by different parameters. This study aimed to evaluate the effect of type of anesthetic, tag size, and surgeon experience on surgical and postsurgical wound healing in the neotropical fish Prochilodus lineatus . In total, eighty fish were surgically implanted with telemetry transmitters and forty fish were kept as controls. Forty fish were implanted with a small tag and other forty were implanted with a large tag. Similarly, forty fish were anesthetized with eugenol and forty fish were anesthetized by electroanesthesia, and forty surgeries were performed by an expert surgeon and forty surgeries were performed by novice surgeons. At the end of the experimental period seventeen (21.3% tagged fish had postsurgical complications, including death (1.3%, tag expulsion (2.5%, antenna migration (2.5%, and infection (15%. Tag size was the key determinant for postsurgical complications. Surgical details and postsurgical wound healing were not affected by type of anesthetic. Incision size, duration of surgery, and wound area were significantly affected by tag size and surgeon experience, and the number of sutures was significantly affected by tag size only. The results indicate that successful implantation of telemetry transmitters is dependent upon surgeon experience and tag size.

Using videorecording to enhance the development of novice researchers´ interviewing skills

DEFF Research Database (Denmark)

Uhrenfeldt, Lisbeth; Paterson, Barbara; Hall, Elisabeth

2007-01-01

Abstract: Little has been written about how to teach novice researchers about qualitative research interviewing. In this article, the authors recognize qualitative research interviewing as a practice that one develops through reflexivity. They propose that novices can develop a reflexive...... to enhance the development of novice researchers as qualitative research interviewers....... interviewing practice by using a guided framework to review video records of the interviews they conduct. The authors discuss the framework and illustrate its use with an exemplar derived from the experience of a novice researcher. They conclude with a discussion of the need for further research about how best...

The Roles and Performance of Professional Driving Instructors in Novice Driver Education

Directory of Open Access Journals (Sweden)

Zulhaidi M. Jawi

2017-08-01

Full Text Available This review article aimed to analyse existing literature regarding the roles and performance of professional driving instructors (PDIs in novice driver education (DE. A systematic classification scheme was adopted to analyse identified articles to determine the study context of PDIs in novice DE, the competency level of PDIs in relation to experienced and learner drivers and the contributions of PDIs to the novice driver learning process. A total of 14 original research articles were identified, with no systematic reviews or meta-analyses available. Overall, all of the articles were found to be inadequate in providing an in-depth understanding of the roles and performance of PDIs in novice DE. There is an urgent need to improve current understanding of the roles of PDIs in novice DE and to work towards an internationally recognised PDI management approach.

The extent of soft tissue and musculoskeletal injuries after earthquakes; describing a role for reconstructive surgeons in an emergency response.

Science.gov (United States)

Clover, A J P; Jemec, B; Redmond, A D

2014-10-01

Earthquakes are the leading cause of natural disaster-related mortality and morbidity. Soft tissue and musculoskeletal injuries are the predominant type of injury seen after these events and a major reason for admission to hospital. Open fractures are relatively common; however, they are resource-intense to manage. Appropriate management is important in minimising amputation rates and preserving function. This review describes the pattern of musculoskeletal and soft-tissue injuries seen after earthquakes and explores the manpower and resource implications involved in their management. A Medline search was performed, including terms "injury pattern" and "earthquake," "epidemiology injuries" and "earthquakes," "plastic surgery," "reconstructive surgery," "limb salvage" and "earthquake." Papers published between December 1992 and December 2012 were included, with no initial language restriction. Limb injuries are the commonest injuries seen accounting for 60 % of all injuries, with fractures in more than 50 % of those admitted to hospital, with between 8 and 13 % of these fractures open. After the first few days and once the immediate lifesaving phase is over, the management of these musculoskeletal and soft-tissue injuries are the commonest procedures required. Due to the predominance of soft-tissue and musculoskeletal injuries, plastic surgeons as specialists in soft-tissue reconstruction should be mobilised in the early stages of a disaster response as part of a multidisciplinary team with a focus on limb salvage.

Novice Teachers' Perspectives on Learning in Lesson Rehearsals in Second Language Teacher Preparation

Science.gov (United States)

Troyan, Francis John; Peercy, Megan Madigan

2016-01-01

Although scholars working in core practices have put forth lesson rehearsals as central to novice teachers' learning and development, there is little work on how novice teachers experience rehearsals. This qualitative research investigated learning opportunities for novice teachers of language learners during rehearsals. The analysis examines two…

Training on a virtual reality simulator--is it really possible a correct evaluation of the surgeons' experience?

Science.gov (United States)

Moldovanu, R; Târcoveanu, E; Lupaşcu, C; Dimofte, G; Filip, V; Vlad, N; Vasilescu, A

2009-01-01

Laparoscopic simulators provide a safe and efficient means of acquiring surgical skills. It is well known that virtual reality training improves the performance of young surgeons. Most of the virtual reality simulators have construct validity and can differentiate between novice and expert surgeons. However, for some training modules and trainees categories the possibility to distinguish the real surgeon's experience is still discussed. A total of 14 young surgeons were evaluated during a 5 days postgraduate laparoscopic course using a LapSim Basic Skills, v. 3.0 simulator and a Virtual Laparoscopic Interface (VLI) hardware. The best performances of the surgeons were included in a MS Access database and statistical analyzed. There were 6 males and 8 women with a mean age of 30.21 +/- 1.01 years old (range 26-38). Nine surgeons (64.28%) were young residents without any laparoscopic surgical experience (group I), and the other 5, had some laparoscopic surgical experience (10 to 30 laparoscopic procedures) (group II). During the instrument navigation task we found that both hands performances were significant better in group II--the navigation time was 12.43 +/- 1.31 vs 19.01 +/- 1.40 seconds for the left hand--p = 0.006 and 13.57 +/- 1.47 vs 22.18 +/- 3.16 seconds for the right hand--p = 0.032); the right instrument angular path degree was also shorter for experienced surgeons (153.17 +/- 16.72 vs 230.88 +/- 22.6 - p = 0.017). The same data were noted for the lifting and grasping module. However, the suturing module tasks revealed contradictory results: the group I residents recorded better performances then the group II surgeons: total time--677.06 +/- 111.48 vs 1122.65 +/- 166.62 seconds; p = 0.043; right instrument path (m)--15.62 +/- 2.47 vs 25.73 +/- 3.13; p = 0.028; right instrument angular path (degree)--3940.43 +/- 572.54 vs 6595.5597 +/- 753.26; p = 0.017. Laparoscopic simulators are useful to evaluate the surgeons' experience; the parameters of the

The First Five Years: Novice Teacher Beliefs, Experiences, and Commitment to the Profession

Science.gov (United States)

Michel, Heather Ann

2013-01-01

Novice teacher attrition is a valid concern for public education. Some studies have found that 40-50% of novice teachers will leave the profession before they reach their fifth year of teaching. Previous literature states that novice teachers leave because of job dissatisfaction, school conditions and feeling ineffective with their students. This…

Are the surgeon's movements repeatable? An analysis of the feasibility and expediency of implementing support procedures guiding the surgical tools and increasing motion accuracy during the performance of stereotypical movements by the surgeon.

Science.gov (United States)

Podsędkowski, Leszek Robert; Moll, Jacek; Moll, Maciej; Frącczak, Łukasz

2014-03-01

The developments in surgical robotics suggest that it will be possible to entrust surgical robots with a wider range of tasks. So far, it has not been possible to automate the surgery procedures related to soft tissue. Thus, the objective of the conducted studies was to confirm the hypothesis that the surgery telemanipulator can be equipped with certain routines supporting the surgeon in leading the surgical tools and increasing motion accuracy during stereotypical movements. As the first step in facilitating the surgery, an algorithm will be developed which will concurrently provide automation and allow the surgeon to maintain full control over the slave robot. The algorithm will assist the surgeon in performing typical movement sequences. This kind of support must, however, be preceded by determining the reference points for accurately defining the position of the stitched tissue. It is in relation to these points that the tool's trajectory will be created, along which the master manipulator will guide the surgeon's hand. The paper presents the first stage, concerning the selection of movements for which the support algorithm will be used. The work also contains an analysis of surgical movement repeatability. The suturing movement was investigated in detail by experimental research in order to determine motion repeatability and verify the position of the stitched tissue. Tool trajectory was determined by a motion capture stereovision system. The study has demonstrated that the suturing movement could be considered as repeatable; however, the trajectories performed by different surgeons exhibit some individual characteristics.

Psychomotor skills assessment by motion analysis in minimally invasive surgery on an animal organ.

Science.gov (United States)

Hofstad, Erlend Fagertun; Våpenstad, Cecilie; Bø, Lars Eirik; Langø, Thomas; Kuhry, Esther; Mårvik, Ronald

2017-08-01

A high level of psychomotor skills is required to perform minimally invasive surgery (MIS) safely. To be able to measure these skills is important in the assessment of surgeons, as it enables constructive feedback during training. The aim of this study was to test the validity of an objective and automatic assessment method using motion analysis during a laparoscopic procedure on an animal organ. Experienced surgeons in laparoscopy (experts) and medical students (novices) performed a cholecystectomy on a porcine liver box model. The motions of the surgical tools were acquired and analyzed by 11 different motion-related metrics, i.e., a total of 19 metrics as eight of them were measured separately for each hand. We identified for which of the metrics the experts outperformed the novices. In total, two experts and 28 novices were included. The experts achieved significantly better results for 13 of the 19 instrument motion metrics. Expert performance is characterized by a low time to complete the cholecystectomy, high bimanual dexterity (instrument coordination), a limited amount of movement and low measurement of motion smoothness of the dissection instrument, and relatively high usage of the grasper to optimize tissue positioning for dissection.

The Influence of a Bout of Exertion on Novice Barefoot Running Dynamics.

Science.gov (United States)

Hashish, Rami; Samarawickrame, Sachithra D; Baker, Lucinda; Salem, George J

2016-06-01

Barefoot, forefoot strike (FFS) running has recently risen in popularity. Relative to shod, rear-foot strike (RFS) running, employing a FFS is associated with heightened triceps surae muscle activation and ankle mechanical demand. Novice to this pattern, it is plausible that habitually shod RFS runners exhibit fatigue to the triceps surae when acutely transitioning to barefoot running, thereby limiting their ability to attenuate impact. Therefore, the purpose was to determine how habitually shod RFS runners respond to an exertion bout of barefoot running, operationally defined as a barefoot run 20% of mean daily running distance. Twenty-one RFS runners performed novice barefoot running, before and after exertion. Ankle peak torque, triceps surae EMG median frequency, foot-strike patterns, joint energy absorption, and loading rates were evaluated. Of the 21 runners, 6 maintained a RFS, 10 adopted a mid-foot strike (MFS), and 5 adopted a FFS during novice barefoot running. In-response to exertion, MFS and FFS runners demonstrated reductions in peak torque, median frequency, and ankle energy absorption, and an increase in loading rate. RFS runners demonstrated reductions in peak torque and loading rate. These results indicate that a short bout of running may elicit fatigue to novice barefoot runners, limiting their ability to attenuate impact. Key pointsIn response to exertion, novice barefoot runners demonstrate fatigue to their soleus.In response to exertion, novice barefoot runners demonstrate a reduction in ankle energy absorptionIn response to exertion, novice barefoot runners demonstrate an increase in loading rate.

An easy to produce and economical three-dimensional brain phantom for stereotactic computed tomographic-guided brain biopsy training in the dog.

Science.gov (United States)

Sidhu, Deepinder S; Ruth, Jeffrey D; Lambert, Gregory; Rossmeisl, John H

2017-07-01

To develop and validate a three-dimensional (3D) brain phantom that can be incorporated into existing stereotactic headframes to simulate stereotactic brain biopsy (SBB) and train veterinary surgeons. Experimental study. Canine brain phantoms were fabricated from osteological skull specimens, agarose brain parenchyma, and cheddar and mozzarella cheese molds (simulating meningiomas and gliomas). The neuroradiologic and viscoelastic properties of phantoms were quantified with computed tomography (CT) and oscillatory compression tests, respectively. Phantoms were validated by experienced and novice operators performing SBB on phantoms containing randomly placed, focal targets. Target yield and needle placement error (NPE) were compared between operators. Phantoms were produced in brain parenchyma, and contrast-enhancing tumors of meningeal and glial origin, respectively. The complex moduli of the agarose and cheeses were comparable to the viscoelastic properties of in vivo brain tissues and brain tumors. The overall diagnostic yield of SBB was 88%. Although NPE did not differ between novice (median 3.68 mm; range, 1.46-14.54 mm) and experienced surgeons (median 1.17 mm, range, 0.78-1.58 mm), our results support the relevance of the learning curve associated with the SBB procedure. This 3D phantom replicates anatomical, CT, and tactile features of brain tissues and tumors and can be used to develop the technical skills required to perform SBB. © 2017 The American College of Veterinary Surgeons.

Are cellular phone blocking applications effective for novice teen drivers?

Science.gov (United States)

Creaser, Janet I; Edwards, Christopher J; Morris, Nichole L; Donath, Max

2015-09-01

Distracted driving is a significant concern for novice teen drivers. Although cellular phone bans are applied in many jurisdictions to restrict cellular phone use, teen drivers often report making calls and texts while driving. The Minnesota Teen Driver Study incorporated cellular phone blocking functions via a software application for 182 novice teen drivers in two treatment conditions. The first condition included 92 teens who ran a driver support application on a smartphone that also blocked phone usage. The second condition included 90 teens who ran the same application with phone blocking but which also reported back to parents about monitored risky behaviors (e.g., speeding). A third control group consisting of 92 novice teen drivers had the application and phone-based software installed on the phones to record cellular phone (but not block it) use while driving. The two treatment groups made significantly fewer calls and texts per mile driven compared to the control group. The control group data also demonstrated a higher propensity to text while driving rather than making calls. Software that blocks cellular phone use (except 911) while driving can be effective at mitigating calling and texting for novice teen drivers. However, subjective data indicates that some teens were motivated to find ways around the software, as well as to use another teen's phone while driving when they were unable to use theirs. Cellular phone bans for calling and texting are the first step to changing behaviors associated with texting and driving, particularly among novice teen drivers. Blocking software has the additional potential to reduce impulsive calling and texting while driving among novice teen drivers who might logically know the risks, but for whom it is difficult to ignore calling or texting while driving. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.

The relationship between social skills and early resignation in Japanese novice nurses.

Science.gov (United States)

Niitsuma, Mayuko; Katsuki, Takeshi; Sakuma, Yumiko; Sato, Chifumi

2012-07-01

The aim of this study was to reveal the relationship between social skills and early resignation in Japanese novice nurses. The early resignation of novice nurses has become increasingly prevalent in recent years. This study was conducted to investigate the relationship between the personal sociality of novice nurses and their early resignation. We surveyed 272 nurses with 1-3 years of experience. Instances of early resignation were studied by using a questionnaire, and their social skills were measured using Kikuchi's Scale of Social Skills:18 items (KiSS-18), a tool developed by Kikuchi to estimate sociality. Nurses with low sociality were more likely to resign than those with higher sociality. The lack of advanced social skills was closely associated with a higher likelihood of early resignation. The presence of advanced social skills appeared to potentially prevent resignation among novice nurses. Further investigation is needed to determine the causal relationship between sociality and early resignation. Social skills training for novice nurses may be of benefit in preventing early resignation. © 2011 Blackwell Publishing Ltd.

How Do Novice and Expert Learners Represent, Understand, and Discuss Geologic Time?

Science.gov (United States)

Layow, Erica Amanda

This dissertation examined the representations novice and expert learners constructed for the geologic timescale. Learners engaged in a three-part activity. The purpose was to compare novice learners' representations to those of expert learners. This provided insight into the similarities and differences between their strategies for event ordering, assigning values and scale to the geologic timescale model, as well as their language and practices to complete the model. With a qualitative approach to data analysis informed by an expert-novice theoretical framework grounded in phenomenography, learner responses comprised the data analyzed. These data highlighted learners' metacognitive thoughts that might not otherwise be shared through lectures or laboratory activities. Learners' responses were analyzed using a discourse framework that positioned learners as knowers. Novice and expert learners both excelled at ordering and discussing events before the Phanerozoic, but were challenged with events during the Phanerozoic. Novice learners had difficulty assigning values to events and establishing a scale for their models. Expert learners expressed difficulty with determining a scale because of the size of the model, yet eventually used anchor points and unitized the model to establish a scale. Despite challenges constructing their models, novice learners spoke confidently using claims and few hedging phrases indicating their confidence in statements made. Experts used more hedges than novices, however the hedging comments were made about more complex conceptions. Using both phenomenographic and discourse analysis approaches for analysis foregrounded learners' discussions of how they perceived geologic time and their ways of knowing and doing. This research is intended to enhance the geoscience community's understanding of the ways novice and expert learners think and discuss conceptions of geologic time, including the events and values of time, and the strategies used

The Effects of Mentor Instruction on Teaching Visual Supports to Novice, Special Education Teachers

Science.gov (United States)

Mrstik, Samantha L.; Vasquez, Eleazar; Pearl, Cynthia

2018-01-01

The use of mentor teachers to sustain the longevity of a novice special education teacher is not a new tactic nor is the use of a mentor teacher's guidance in professional development for novice teachers. This study examines a new method of mentor teachers conducting professional development sessions for novice special educators through the use of…

Comparative assessment of surgeons' task performance and surgical ergonomics associated with conventional and modified flank positions: a simulation study.

Science.gov (United States)

Fan, Yu; Kong, Gaiqing; Meng, Yisen; Tan, Shutao; Wei, Kunlin; Zhang, Qian; Jin, Jie

2014-11-01

Flank position is extensively used in retroperitoneoscopic urological practice. Most surgeons follow the patients' position in open approaches. However, surgical ergonomics of the conventional position in the retroperitoneoscopic surgery is poor. We introduce a modified position and evaluated task performance and surgical ergonomics of both positions with simulated surgical tasks. Twenty-one novice surgeons were recruited to perform four tasks: bead transfer, ring transfer, continuous suturing, and cutting a circle. The conventional position was simulated by setting an endo-surgical simulator parallel to the long axis of a surgical desk. The modified position was simulated by rotating the simulator 30° with respect to the long axis of the desk. The outcome measurements include task performance measures, kinematic measures for body alignment, surface electromyography, relative loading between feet, and subjective ratings of fatigue. We observed significant improvements in both task performance and surgical ergonomics parameters under the modified position. For all four tasks, subjects finished tasks faster with higher accuracy (p ergonomics part: (1) The angle between the upper body and the head was decreased by 7.4 ± 1.7°; (2) The EMG amplitude collected from shoulders and left lumber was significantly lower (p ergonomics. With a simulated surgery, we demonstrated that our modified position could significantly improve task performance and surgical ergonomics. Further studies are still warranted to validate these benefits for both patients and surgeons.

Professional Development of Novice Special Education Teachers

Directory of Open Access Journals (Sweden)

Silmara de Oliveira Gomes Papi

2018-06-01

Full Text Available The professional development of novice teachers in the profession and in special education is poorly understood, despite its relevance to the improvement of teaching. This study analyzes the challenges faced by such teachers with a view to understanding their professional development. The participants in the research were teachers of classrooms equipped with multifunctional resources (SRM in state schools. The research follows a critical-dialectic approach and a qualitative focus. The results indicate deficiencies in the professional development of novices, who experience difficulties related to teaching and bureaucracy, despite having specific training in the area. They also feel alienated in the schools and seek alternatives to fill existing gaps related to their professional practice.

Instructional Leadership Challenges and Practices of Novice Principals in Rural Schools

Science.gov (United States)

Wiezorek, Douglas; Manard, Carolyn

2018-01-01

We report on a phenomenological study of the leadership experiences of six novice, rural public school principals in a midwestern U.S. state. We situated our analysis within existing research on leadership for learning, particularly how novice principals interpreted instructional leadership challenges in the context of rural school leadership. Our…

Transforaminal Percutaneous Endoscopic Discectomy using Transforaminal Endoscopic Spine System technique: Pitfalls that a beginner should avoid.

Science.gov (United States)

Kapetanakis, Stylianos; Gkasdaris, Grigorios; Angoules, Antonios G; Givissis, Panagiotis

2017-12-18

Transforaminal Percutaneous Endoscopic Discectomy (TPED) is a minimally invasive technique mainly used for the treatment of lumbar disc herniation from a lateral approach. Performed under local anesthesia, TPED has been proven to be a safe and effective technique which has been also associated with shorter rehabilitation period, reduced blood loss, trauma, and scar tissue compared to conventional procedures. However, the procedure should be performed by a spine surgeon experienced in the specific technique and capable of recognizing or avoiding various challenging conditions. In this review, pitfalls that a novice surgeon has to be mindful of, are reported and analyzed.

The laparoscopic performance of novice surgical trainees: testing for acquisition, loss, and reacquisition of psychomotor skills.

Science.gov (United States)

Windsor, J A; Zoha, F

2005-08-01

It has been suggested that virtual reality (VR) might be useful for the selection of surgical trainees and the measurement of technical performance during preoperative training and retraining. This study was designed to determine whether it is possible to define and measure the acquisition, loss, and reacquisition of psychomotor skills in novice surgical trainees. Novice surgical trainees (NSTs n = 10, junior surgical registrars with little or no prior experience with laparoscopic surgery) were tested and retested after 1 month using the Minimally Invasive Surgical Trainer-Virtual Reality. Two tasks were used: the simple task [stretch diathermy (SD)] and the more complex task [manipulation diathermy (MD)]. The score was derived from the time taken to complete the task and the number of errors that occurred. Acquisition is the difference between the first and last score of the first training session, loss is the difference in score that occurs between the last score of the first training session and the first score of the second training session, and reacquisition is the difference in the first and last scores of the second training session. A performance criterion level was defined for each task by testing a group of experienced laparoscopic surgeons (n = 10). Groups were compared using the nonparametric Wilcoxon signed rank test, with p psychomotor skills in individual NSTs and to compare them with a predefined performance criterion level. This study defines parameters that will be useful in repeated training sessions of NSTs in the preoperative phase of training and during retraining.

Cell and Tissue Engineering

CERN Document Server

2012-01-01

“Cell and Tissue Engineering” introduces the principles and new approaches in cell and tissue engineering. It includes both the fundamentals and the current trends in cell and tissue engineering, in a way useful both to a novice and an expert in the field. The book is composed of 13 chapters all of which are written by the leading experts. It is organized to gradually assemble an insight in cell and tissue function starting form a molecular nano-level, extending to a cellular micro-level and finishing at the tissue macro-level. In specific, biological, physiological, biophysical, biochemical, medical, and engineering aspects are covered from the standpoint of the development of functional substitutes of biological tissues for potential clinical use. Topics in the area of cell engineering include cell membrane biophysics, structure and function of the cytoskeleton, cell-extracellular matrix interactions, and mechanotransduction. In the area of tissue engineering the focus is on the in vitro cultivation of ...

Distance-mediated mentoring: A telecommunication-supported model for novice rural mathematics and science teachers

Science.gov (United States)

Luebeck, Jennifer Lyn

Rural educators face unique professional challenges and limitations. This study investigated the effectiveness of an innovative distance-mediated mentoring program for rural novice mathematics and science teachers. Four purposes were pursued: (1) characterize and document the nature and development of the mentor-novice relationship; (2) describe how discourse influenced the novice teachers' perceptions about mathematics and science teaching; (3) determine whether telecommunication effectively supported a distance-mediated mentoring relationship for novice rural teachers; and (4) investigate program effects on novice teachers' attitudes, concerns, and professional growth. A qualitative research design was implemented during academic years 1996-98. Primary data collection focused on nine rural novice teachers and their mentors and included three sets of interviews spanning three semesters, field observation of classrooms, schools, and communities, and analysis of electronic mail messages over a four-month period. Supporting data were collected during observation of workshops and training sessions, and through surveys administered to all program participants in early 1997 and 1998. Categories of mentor-novice communication were identified: curriculum and content, validation of teaching practice, classroom and school issues, moral support, and social talk. Impact on mathematics and science teaching was accomplished by: sharing materials and activities; planning units and projects; locating resources; classroom and student concerns; long-range curriculum design, and improvement of teaching practices. Professional growth (for both novices and mentors) occurred through individual contact with partners and interaction within the larger mentoring community in both face-to-face and on-line venues. Telecommunication was highly valued by successful users. Technical difficulty curtailed access for a significant number of teachers, but they maintained successful relationships

Mapping the plateau of novices in virtual reality simulation training of mastoidectomy

DEFF Research Database (Denmark)

A.W. Andersen, Steven; Konge, Lars; Mikkelsen, Peter Trier

2016-01-01

To explore why novices' performance plateau in directed, self-regulated virtual reality (VR) simulation training and how performance can be improved.......To explore why novices' performance plateau in directed, self-regulated virtual reality (VR) simulation training and how performance can be improved....

A Virtual Reality Training Curriculum for Laparoscopic Colorectal Surgery.

Science.gov (United States)

Beyer-Berjot, Laura; Berdah, Stéphane; Hashimoto, Daniel A; Darzi, Ara; Aggarwal, Rajesh

Training within a competency-based curriculum (CBC) outside the operating room enhances performance during real basic surgical procedures. This study aimed to design and validate a virtual reality CBC for an advanced laparoscopic procedure: sigmoid colectomy. This was a multicenter randomized study. Novice (surgeons who had performed 50) were enrolled. Validity evidence for the metrics given by the virtual reality simulator, the LAP Mentor, was based on the second attempt of each task in between groups. The tasks assessed were 3 modules of a laparoscopic sigmoid colectomy (medial dissection [MD], lateral dissection [LD], and anastomosis) and a full procedure (FP). Novice surgeons were randomized to 1 of 2 groups to perform 8 further attempts of all 3 modules or FP, for learning curve analysis. Two academic tertiary care centers-division of surgery of St. Mary's campus, Imperial College Healthcare NHS Trust, London and Nord Hospital, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Marseille, were involved. Novice surgeons were residents in digestive surgery at St. Mary's and Nord Hospitals. Intermediate and experienced surgeons were board-certified academic surgeons. A total of 20 novice surgeons, 7 intermediate surgeons, and 6 experienced surgeons were enrolled. Evidence for validity based on experience was identified in MD, LD, and FP for time (p = 0.005, p = 0.003, and p = 0.001, respectively), number of movements (p = 0.013, p = 0.005, and p = 0.001, respectively), and path length (p = 0.03, p = 0.017, and p = 0.001, respectively), and only for time (p = 0.03) and path length (p = 0.013) in the anastomosis module. Novice surgeons' performance significantly improved through repetition for time, movements, and path length in MD, LD, and FP. Experienced surgeons' benchmark criteria were defined for all construct metrics showing validity evidence. A CBC in laparoscopic colorectal surgery has been designed. Such training may reduce the learning

Novice Nurses' Experiences of Unpreparedness at the Beginning of the Work

Science.gov (United States)

Hezaveh, Mahbobeh Sajadi; Rafii, Forough; Seyedfatemi, Naiemeh

2014-01-01

Introduction: Unpreparedness of novice nurses during the process of transition to their professional role can has broad consequences for the nurse and health care system and leads to reduction of the quality of patient care. This study has been carried out with the aim of investigating the experiences of the unpreparedness of novice nurses. Method: This study was conducted qualitatively by using conventional content analysis. Participants were 21persons including 17 novice nurses, 2 supervisors, and 2 experienced nurses who were selected through purposeful sampling from four hospitals dependent on Tehran University of Medical Sciences. Findings: Participants' experiences were reflected in three main themes of "functional disability", "communicative problems", and "managerial challenges". Each of these dimensions consisted of several sub-categories. These areas had represented the inability to apply the learned knowledge in practice. Discussion: The sensitivity of health system, especially, educational mentors and nursing managers to create preparation in novice nurses by providing appropriate orientation programs at the beginning of work and the revision and amendment of nursing curriculum can solve this problem to some extent. PMID:24373282

Biomechanical differences between expert and novice workers in a manual material handling task.

Science.gov (United States)

Plamondon, Andre; Denis, Denys; Delisle, Alain; Lariviere, Christian; Salazar, Erik

2010-10-01

The objective was to verify whether the methods were safer and more efficient when used by expert handlers than by novice handlers. Altogether, 15 expert and 15 novice handlers were recruited. Their task was to transfer four boxes from a conveyor to a hand trolley. Different characteristics of the load and lifting heights were modified to achieve a larger variety of methods by the participants. The results show that the net moments at the L5/S1 joint were not significantly different (p > 0.05) for the two groups. However, compared with the novices, the experts bent their lumbar region less (experts 54° (SD 11°); novices 66° (SD 15°)) but bent their knees more (experts approx. 72° (SD approx. 30°); novices approx. 53° (SD approx. 33°), which brought them closer to the box. The handler's posture therefore seems to be a major aspect that should be paid specific attention, mainly when there is maximum back loading. STATEMENT OF RELEVANCE: The findings of this research will be useful for improving manual material handling training programmes. Most biomechanical research is based on novice workers and adding information about the approach used by expert handlers in performing their tasks will help provide new avenues for reducing the risk of injury caused by this demanding physical task.

Challenges and Induction Needs of Novice English as a Foreign Language Teachers in Saudi Arabia

Science.gov (United States)

Alhamad, Rufaida

2018-01-01

The first year of teaching poses massive challenges that lead to attrition among novice teachers. School communities often fail to provide adequate support to novice teachers to help them adapt to their new professional environments. In Saudi Arabia, attrition among novice teachers is a significant problem that hinders the development of the…

Comparing resident cataract surgery outcomes under novice versus experienced attending supervision

Directory of Open Access Journals (Sweden)

Puri S

2015-09-01

Full Text Available Sidharth Puri,1 Amanda E Kiely,2 Jiangxia Wang,3 Alonzo S Woodfield,4 Saras Ramanathan,5 Shameema Sikder21Johns Hopkins School of Medicine, Baltimore, MD, 2Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 3Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 4Kaiser Permanente South Sacramento Medical Center, Sacramento, 5San Francisco School of Medicine, University of California, San Francisco, CA, USAPurpose: To determine whether supervision by an attending new to surgical teaching or an experienced attending measurably influences intraoperative complications rates or outcomes in phacoemulsification performed by ophthalmology residents.Setting: Single tertiary hospital.Design: Retrospective cohort study. Methods: Resident-performed phacoemulsification cases supervised by one novice attending (N=189 and experienced attending (N=172 over 1 year were included. Data included: resident year, patient age, sex, preoperative risk factors (4+ dense/white/brunescent cataracts, Flomax, zonular dialysis, pseudoexfoliation, glaucoma risk, post-vitrectomy, intraoperative risk factors (Trypan blue, iris hooks, and intraoperative complications (capsule tears, vitreous loss, zonular dialysis, zonular dehiscence, burns, nuclear fragment loss, Descemet’s tear. Experienced attending data were compared against those of the novice attending.Results: Regarding preoperative risks, experienced attending cases more likely involved 4+ cataract (P=0.005, Flomax (P<0.001, or glaucoma risk (P=0.001. For intraoperative risks, novice attending cases more likely involved Trypan blue (P<0.001. Regarding complications, novice attending cases were associated with vitreous loss (P=0.002 and anterior capsule tears (P<0.001. When comparing total complications, the novice attending was more likely to have both increased number of cases with complications and total complications than the experienced attending. The novice

Training Impact on Novice and Experienced Research Coordinators.

Science.gov (United States)

Behar-Horenstein, Linda S; Potter, JoNell Efantis; Prikhidko, Alena; Swords, Stephanie; Sonstein, Stephen; Kolb, H Robert

2017-12-01

Competency-based training and professional development is critical to the clinical research enterprise. Understanding research coordinators' perspectives is important for establishing a common core curriculum. The purpose of this study was to describe participants' perspectives regarding the impact of online and classroom training sessions. 27 participants among three institutions, completed a two-day classroom training session. 10 novice and seven experienced research coordinators participated in focus group interviews. Grounded theory revealed similarities in novice and experienced coordinator themes including Identifying Preferences for Instruction and Changing Self Perceptions. Differences, seen in experienced participants, focused on personal change, in the theme of Re-Assessing Skills. Infrastructure and cultural issues were evident in their theme, Promoting Leadership and Advocacy. Novice participants recommended ways to improve training via their theme of Making Programmatic Improvements. Participants reported a clear preference for classroom learning. Training played an influential role in changing participants' self-perceptions by validating their experiences. The findings provided guidance for developing a standardized curriculum. Training must be carefully tailored to the needs of participants while considering audience needs based on work experience, how technology can be used and offering content that is most urgently needed.

Novice Nurses’ Perception of Working Night Shifts: A Qualitative Study

Directory of Open Access Journals (Sweden)

Mohsen Faseleh Jahromi

2013-08-01

Full Text Available Introduction: Nursing is always accompanied by shift working and nurses in Iran have to work night shifts in some stages of their professional life. Therefore, the present study aimed to describe the novice nurses’ perception of working night shifts. Methods: The present qualitative study was conducted on 20 novice nurses working in two university hospitals of Jahrom, Iran. The study data were collected through focus group interviews. All the interviews were recorded, transcribed, and analyzed using constant comparative analysis and qualitative content analysis. Results: The study findings revealed five major themes of value system, physical and psychological problems, social relationships, organizational problems, and appropriate opportunity. Conclusion: The study presented a deep understanding of the novice nurses’ perception of working night shifts, which can be used by the managers as a basis for organizing health and treatment systems.

Differences of Ballet Turns ("Pirouette") Performance between Experienced and Novice Ballet Dancers

Science.gov (United States)

Lin, Chia-Wei; Chen, Shing-Jye; Su, Fong-Chin; Wu, Hong-Wen; Lin, Cheng-Feng

2014-01-01

Purpose: This study investigated the different postural control strategies exhibited by experienced and novice dancers in ballet turns ("pirouettes"). Method: Thirteen novice and 13 experienced dancers performed ballet turns with dominant-leg support. The peak push force was measured in the double-leg support phase. The inclination…

Comparison of different sets of instruments for laparoendoscopic single-site surgery in a surgical simulator with novices.

Science.gov (United States)

Wang, Dong; Shi, Long-Qing; Wang, Jing-Min; Jiang, Xiao-Hua; Ji, Zhen-Ling

2016-04-01

Given the parallel entry of working instruments through a single incision in laparoendoscopic single-site surgery, loss of triangulation in the abdominal cavity and counteracting movements of the instruments are inevitable obstacles. Some specially designed devices have emerged to ameliorate these challenges. Twenty-four novice participants were randomized into four groups using assigned instruments, conventional straight instruments, single-curved instruments, double-curved instruments and articulating instruments, respectively, to perform two basic tasks (peg transferring and pattern cutting) 14 times in a modified simulator. A test of the tasks and a resection of the intestine segment of a rat were performed. The task scores and evaluation of intraoperative skills during the resection of the intestine segment were recorded. The instrument of modified National Aeronautics and Space Administration Task Load Index (NASA-TLX) was completed. The task scores of the groups using single-curved instruments and articulating instruments were better than the other two groups on the simulator tasks, consistent with the evaluation of intraoperative skills during the resection of intestine segment. As the proficiency with the instruments increased, the task scores improved, as demonstrated by the learning curve. The workload measured by the modified NASA-TLX tool demonstrated that the groups using articulating instruments and double-curved instruments had a heavier workload in most of the categories compared with the other two groups. Single-curved and articulating instruments are more effective than conventional straight and double-curved devices, and are favourable in laparoendoscopic single-site surgery for novice learners. © 2013 Royal Australasian College of Surgeons.

Ensuring Competency of Novice Laparoscopic Surgeons

DEFF Research Database (Denmark)

Thinggaard, Ebbe; Bjerrum, Flemming; Strandbygaard, Jeanett

2016-01-01

and the Zealand Region of Denmark. PARTICIPANTS: Participants were recruited among surgical trainees in their first year of specialty training from surgery, gynecology, and urology departments. A total of 40 participants were included and completed the trial. RESULTS: The different standard setting methods......OBJECTIVE: Simulation-based assessment tools have been developed to allow for proficiency-based simulator training in laparoscopy. However, few studies have examined the consequences of different standard setting methods or examined what level of proficiency is considered adequate for trainees....... The objectives of the present study were to explore the consequences of different standard setting methods and to examine the proficiency level that surgical trainees are expected to reach, before performing supervised surgery on patients. DESIGN: Study participants undertook the Training and Assessment of Basic...

Women surgeons in the new millennium.

Science.gov (United States)

Troppmann, Kathrin M; Palis, Bryan E; Goodnight, James E; Ho, Hung S; Troppmann, Christoph

2009-07-01

Women are increasingly entering the surgical profession. To assess professional and personal/family life situations, perceptions, and challenges for women vs men surgeons. National survey of American Board of Surgery-certified surgeons. A questionnaire was mailed to all women and men surgeons who were board certified in 1988, 1992, 1996, 2000, or 2004. Of 3507 surgeons, 895 (25.5%) responded. Among these, 178 (20.3%) were women and 698 (79.7%) were men. Most women and men surgeons would choose their profession again (women, 82.5%; men, 77.5%; P = .15). On multivariate analysis, men surgeons (odds ratio [OR], 2.5) and surgeons of a younger generation (certified in 2000 or 2004; OR, 1.3) were less likely to favor part-time work opportunities for surgeons. Most of the surgeons were married (75.6% of women vs 91.7% of men, P women surgeons (OR, 5.0) and surgeons of a younger generation (OR, 1.9) were less likely to have children. More women than men surgeons had their first child later in life, while already in surgical practice (62.4% vs 32.0%, P women surgeons vs 79.4% of men surgeons (P women surgeons than men surgeons thought that maternity leave was important (67.8% vs 30.8%, P work (86.5% vs 69.7%, P Women considering a surgical career should be aware that most women surgeons would choose their profession again. Strategies to maximize recruitment and retention of women surgeons should include serious consideration of alternative work schedules and optimization of maternity leave and child care opportunities.

Comparing Expert and Novice Driving Behavior in a Driving Simulator

Directory of Open Access Journals (Sweden)

Hiran B. Ekanayake

2014-02-01

Full Text Available This paper presents a study focused on comparing driving behavior of expert and novice drivers in a mid-range driving simulator with the intention of evaluating the validity of driving simulators for driver training. For the investigation, measurements of performance, psychophysiological measurements, and self-reported user experience under different conditions of driving tracks and driving sessions were analyzed. We calculated correlations between quantitative and qualitative measures to enhance the reliability of the findings. The experiment was conducted involving 14 experienced drivers and 17 novice drivers. The results indicate that driving behaviors of expert and novice drivers differ from each other in several ways but it heavily depends on the characteristics of the task. Moreover, our belief is that the analytical framework proposed in this paper can be used as a tool for selecting appropriate driving tasks as well as for evaluating driving performance in driving simulators.

Molecular, cellular, and tissue engineering

CERN Document Server

Bronzino, Joseph D

2015-01-01

Known as the bible of biomedical engineering, The Biomedical Engineering Handbook, Fourth Edition, sets the standard against which all other references of this nature are measured. As such, it has served as a major resource for both skilled professionals and novices to biomedical engineering. Molecular, Cellular, and Tissue Engineering, the fourth volume of the handbook, presents material from respected scientists with diverse backgrounds in molecular biology, transport phenomena, physiological modeling, tissue engineering, stem cells, drug delivery systems, artificial organs, and personalized medicine. More than three dozen specific topics are examined, including DNA vaccines, biomimetic systems, cardiovascular dynamics, biomaterial scaffolds, cell mechanobiology, synthetic biomaterials, pluripotent stem cells, hematopoietic stem cells, mesenchymal stem cells, nanobiomaterials for tissue engineering, biomedical imaging of engineered tissues, gene therapy, noninvasive targeted protein and peptide drug deliver...

Tracking Professional Development of Novice Teachers When Integrating Technology in Teaching Mathematics

Science.gov (United States)

Gurevich, Irina; Stein, Hana; Gorev, Dvora

2017-01-01

This research traced changes in choices of technological tools and attitudes toward technology use among novice mathematics teachers at three stages of their professional development: as pre-service teachers, a year later, and in their work as novice teachers. At each stage, the participants were required to evaluate the benefits of technology use…

Challenging Transitions and Crossing Borders: Preparing Novice Mathematics Teacher Educators to Support Novice K-12 Mathematics Teachers

Science.gov (United States)

Yow, Jan A.; Eli, Jennifer A.; Beisiegel, Mary; McCloskey, Andrea; Welder, Rachael M.

2016-01-01

Sixty-nine recently graduated doctoral students in mathematics education completed a survey to determine their perceptions of transitioning from a doctoral program into an academic position at an institution of higher education. Research literature for novice mathematics school teachers was also reviewed to document their experiences transitioning…

Framing Behaviours in Novice Interaction Designers

Science.gov (United States)

Lotz, Nicole; Sharp, Helen; Woodroffe, Mark; Blyth, Richard; Rajah, Dino; Ranganai, Turugare

2015-01-01

Framing design problems and solutions has been recognised in design studies as a central designerly activity. Some recent findings with expert designers relate framing practices to problem-solution co-evolution and analogy use, two further widely recognised design strategies. We wanted to understand if interaction design novices also use…

[The surgeon and deontology].

Science.gov (United States)

Sucila, Antanas

2002-01-01

The aim of study is to recall surgeons deontological principles and errors. The article demonstrates some specific deontological errors, performed by surgeon on patients and his colleagues; points out painful sequela of these errors as well. CONCLUSION. The surgeon should take in account deontological principles rigorously in routine daily practice.

Can self-reported BMI be used as a valid measure among novice runners

DEFF Research Database (Denmark)

Juul, Martin Serup; Nielsen, R.O.; Rasmussen, Sten

There is an increased risk of running related injuries (RRI) among novice runners with a Body Mass Index (BMI) above 25. Information about BMI can be collected through questionnaires, when studies investigate if there is an association between BMI and RRI among novice runners. But can self...... of RRI. Healthy novice runners between the age of 18 to 65 and without lower extremity injuries were able to participate in the study. During July and August 2011 the participants were included in the study based on an online questionnaire. 1532 persons completed the questionnaire, of these, 970 were...

Using Facebook to Support Novice Teachers

Science.gov (United States)

Staudt, Denise; St. Clair, Norman; Martinez, Elda E.

2013-01-01

Providing quality support for novice teachers as they enter the profession has been an ongoing concern of educator preparation programs. This article describes the efforts of one teacher preparation program in addressing this matter by utilizing Facebook[R] to provide sustained support and professional development for its beginning teachers. We…

Being a Mentor: Novice Teachers' Mentors' Conceptions of Mentoring Prior to Training

Science.gov (United States)

Schatz-Oppenheimer, Orna

2017-01-01

This study deals with novice teachers' mentors' conceptions of mentoring prior to their mentoring training. In Israel, all novice teachers have to be supported and assessed by a mentor during their first year of teaching. The aim of this study was to elicit from prospective mentors their own conception of professional mentoring, as a basis for…

Objective psychomotor skills assessment of experienced and novice flexible endoscopists with a virtual reality simulator.

Science.gov (United States)

Ritter, E Matt; McClusky, David A; Lederman, Andrew B; Gallagher, Anthony G; Smith, C Daniel

2003-11-01

The objective of this study was to determine whether the GI Mentor II virtual reality simulator can distinguish the psychomotor skills of intermediately experienced endoscopists from those of novices, and do so with a high level of consistency and reliability. A total of five intermediate and nine novice endoscopists were evaluated using the EndoBubble abstract psychomotor task. Each subject performed three repetitions of the task. Performance and error data were recorded for each trial. The intermediate group performed better than the novice group in each trial. The differences were significant in trial 1 for balloons popped (P=.001), completion time (P=.04), and errors (P=.03). Trial 2 showed significance only for balloons popped (P=.002). Trial 3 showed significance for balloons popped (P=.004) and errors (P=.008). The novice group showed significant improvement between trials 1 and 3 (P<0.05). No improvement was noted in the intermediate group. Measures of consistency and reliability were greater than 0.8 in both groups with the exception of novice completion time where test-retest reliability was 0.74. The GI Mentor II simulator can distinguish between novice and intermediate endoscopists. The simulator assesses skills with levels of consistency and reliability required for high-stakes assessment.

Learning and remembering strategies of novice and advanced jazz dancers for skill level appropriate dance routines.

Science.gov (United States)

Poon, P P; Rodgers, W M

2000-06-01

This study examined the influence of the challenge level of to-be-learned stimulus on learning strategies in novice and advanced dancers. In Study 1, skill-level appropriate dance routines were developed for novice and advanced jazz dancers. In Study 2, 8 novice and 9 advanced female jazz dancers attempted to learn and remember the two routines in mixed model factorial design, with one between-participants factor: skill level (novice or advanced) and two within-participants factors: routine (easy or difficult) and performance (immediate or delayed). Participants were interviewed regarding the strategies used to learn and remember the routines. Results indicated that advanced performers used atypical learning strategies for insufficiently challenging stimuli, which may reflect characteristics of the stimuli rather than the performer. The qualitative data indicate a clear preference of novice and advanced performers for spatial compatibility of stimuli and response.

Novice and experienced teachers’ views on professionalism

NARCIS (Netherlands)

Okas, Anne; van der Schaaf, Marieke; Krull, Edgar

2014-01-01

This article discusses teachers’ practical knowledge and beliefs of their profession based on reflective writings of twenty Estonian teachers.Ten novice and ten experienced teachers participated in the study. They put together their professional portfolios, which among other documents included

The effects of experience and attrition for novice high-school science and mathematics teachers.

Science.gov (United States)

Henry, Gary T; Fortner, C Kevin; Bastian, Kevin C

2012-03-02

Because of the current high proportion of novice high-school teachers, many students' mastery of science and mathematics depends on the effectiveness of early-career teachers. In this study, which used value-added models to analyze high-school teachers' effectiveness in raising test scores on 1.05 million end-of-course exams, we found that the effectiveness of high-school science and mathematics teachers increased substantially with experience but exhibited diminishing rates of return by their fourth year; that teachers of algebra 1, algebra 2, biology, and physical science who continued to teach for at least 5 years were more effective as novice teachers than those who left the profession earlier; and that novice teachers of physics, chemistry, physical science, geometry, and biology exhibited steeper growth in effectiveness than did novice non-science, technology, engineering, and mathematics teachers.

Rethinking Teacher Preparation: Conceptualizing Skills and Knowledge of Novice Teachers of Secondary Mathematics

Science.gov (United States)

Cummings, Margarita Borelli

2010-01-01

This dissertation examines the extent to which novice secondary mathematics teachers (licensed and currently teaching in Utah) perceive they are prepared to do the work of teaching secondary mathematics. It first examined if novice secondary mathematics teachers' perceptions of their knowledge and skills of doing their work fell into four…

Automated robot-assisted surgical skill evaluation: Predictive analytics approach.

Science.gov (United States)

Fard, Mahtab J; Ameri, Sattar; Darin Ellis, R; Chinnam, Ratna B; Pandya, Abhilash K; Klein, Michael D

2018-02-01

Surgical skill assessment has predominantly been a subjective task. Recently, technological advances such as robot-assisted surgery have created great opportunities for objective surgical evaluation. In this paper, we introduce a predictive framework for objective skill assessment based on movement trajectory data. Our aim is to build a classification framework to automatically evaluate the performance of surgeons with different levels of expertise. Eight global movement features are extracted from movement trajectory data captured by a da Vinci robot for surgeons with two levels of expertise - novice and expert. Three classification methods - k-nearest neighbours, logistic regression and support vector machines - are applied. The result shows that the proposed framework can classify surgeons' expertise as novice or expert with an accuracy of 82.3% for knot tying and 89.9% for a suturing task. This study demonstrates and evaluates the ability of machine learning methods to automatically classify expert and novice surgeons using global movement features. Copyright © 2017 John Wiley & Sons, Ltd.

The Surgeons' Leadership Inventory (SLI): a taxonomy and rating system for surgeons' intraoperative leadership skills.

Science.gov (United States)

Henrickson Parker, Sarah; Flin, Rhona; McKinley, Aileen; Yule, Steven

2013-06-01

Surgeons must demonstrate leadership to optimize performance and maximize patient safety in the operating room, but no behavior rating tool is available to measure leadership. Ten focus groups with members of the operating room team discussed surgeons' intraoperative leadership. Surgeons' leadership behaviors were extracted and used to finalize the Surgeons' Leadership Inventory (SLI), which was checked by surgeons (n = 6) for accuracy and face validity. The SLI was used to code video recordings (n = 5) of operations to test reliability. Eight elements of surgeons' leadership were included in the SLI: (1) maintaining standards, (2) managing resources, (3) making decisions, (4) directing, (5) training, (6) supporting others, (7) communicating, and (8) coping with pressure. Interrater reliability to code videos of surgeons' behaviors while operating using this tool was acceptable (κ = .70). The SLI is empirically grounded in focus group data and both the leadership and surgical literature. The interrater reliability of the system was acceptable. The inventory could be used for rating surgeons' leadership in the operating room for research or as a basis for postoperative feedback on performance. Copyright © 2013 Elsevier Inc. All rights reserved.

Perceptual impairment and psychomotor control in virtual laparoscopic surgery.

Science.gov (United States)

Wilson, Mark R; McGrath, John S; Vine, Samuel J; Brewer, James; Defriend, David; Masters, Richard S W

2011-07-01

It is recognised that one of the major difficulties in performing laparoscopic surgery is the translation of two-dimensional video image information to a three-dimensional working area. However, research has tended to ignore the gaze and eye-hand coordination strategies employed by laparoscopic surgeons as they attempt to overcome these perceptual constraints. This study sought to examine if measures related to tool movements, gaze strategy, and eye-hand coordination (the quiet eye) differentiate between experienced and novice operators performing a two-handed manoeuvres task on a virtual reality laparoscopic surgical simulator (LAP Mentor™). Twenty-five right-handed surgeons were categorised as being either experienced (having led more than 60 laparoscopic procedures) or novice (having performed fewer than 10 procedures) operators. The 10 experienced and 15 novice surgeons completed the "two-hand manoeuvres" task from the LAP Mentor basic skills learning environment while wearing a gaze registration system. Performance, movement, gaze, and eye-hand coordination parameters were recorded and compared between groups. The experienced surgeons completed the task significantly more quickly than the novices, used significantly fewer movements, and displayed shorter tool paths. Gaze analyses revealed that experienced surgeons spent significantly more time fixating the target locations than novices, who split their time between focusing on the targets and tracking the tools. A more detailed analysis of a difficult subcomponent of the task revealed that experienced operators used a significantly longer aiming fixation (the quiet eye period) to guide precision grasping movements and hence needed fewer grasp attempts. The findings of the study provide further support for the utility of examining strategic gaze behaviour and eye-hand coordination measures to help further our understanding of how experienced surgeons attempt to overcome the perceptual difficulties inherent in

Novice Teachers' Attention to Student Thinking

Science.gov (United States)

Levin, Daniel M.; Hammer, David; Coffey, Janet E.

2009-01-01

Stage-based views of teacher development hold that novice teachers are unable to attend to students' thinking until they have begun to identify themselves as teachers and mastered classroom routines, and so the first emphases in learning to teach should be on forming routines and identity. The authors challenge those views, as others have done,…

Comparing experts and novices in Martian surface feature change detection and identification

Science.gov (United States)

Wardlaw, Jessica; Sprinks, James; Houghton, Robert; Muller, Jan-Peter; Sidiropoulos, Panagiotis; Bamford, Steven; Marsh, Stuart

2018-02-01

Change detection in satellite images is a key concern of the Earth Observation field for environmental and climate change monitoring. Satellite images also provide important clues to both the past and present surface conditions of other planets, which cannot be validated on the ground. With the volume of satellite imagery continuing to grow, the inadequacy of computerised solutions to manage and process imagery to the required professional standard is of critical concern. Whilst studies find the crowd sourcing approach suitable for the counting of impact craters in single images, images of higher resolution contain a much wider range of features, and the performance of novices in identifying more complex features and detecting change, remains unknown. This paper presents a first step towards understanding whether novices can identify and annotate changes in different geomorphological features. A website was developed to enable visitors to flick between two images of the same location on Mars taken at different times and classify 1) if a surface feature changed and if so, 2) what feature had changed from a pre-defined list of six. Planetary scientists provided ;expert; data against which classifications made by novices could be compared when the project subsequently went public. Whilst no significant difference was found in images identified with surface changes by expert and novices, results exhibited differences in consensus within and between experts and novices when asked to classify the type of change. Experts demonstrated higher levels of agreement in classification of changes as dust devil tracks, slope streaks and impact craters than other features, whilst the consensus of novices was consistent across feature types; furthermore, the level of consensus amongst regardless of feature type. These trends are secondary to the low levels of consensus found, regardless of feature type or classifier expertise. These findings demand the attention of researchers who

A Novice-Expert Study of Modeling Skills and Knowledge Structures about Air Quality

Science.gov (United States)

Hsu, Ying-Shao; Lin, Li-Fen; Wu, Hsin-Kai; Lee, Dai-Ying; Hwang, Fu-Kwun

2012-01-01

This study compared modeling skills and knowledge structures of four groups as seen in their understanding of air quality. The four groups were: experts (atmospheric scientists), intermediates (upper-level graduate students in a different field), advanced novices (talented 11th and 12th graders), and novices (10th graders). It was found that when…

Mapping the plateau of novices in virtual reality simulation training of mastoidectomy

DEFF Research Database (Denmark)

Andersen, Steven A W; Konge, Lars; Mikkelsen, Peter Trier

2017-01-01

OBJECTIVES/HYPOTHESIS: To explore why novices' performance plateau in directed, self-regulated virtual reality (VR) simulation training and how performance can be improved. STUDY DESIGN: Prospective study. METHODS: Data on the performances of 40 novices who had completed repeated, directed, self......-regulated VR simulation training of mastoidectomy were included. Data were analyzed to identify key areas of difficulty as well as the procedures terminated without using all the time allowed. RESULTS: Novices had difficulty in avoiding drilling holes in the outer anatomical boundaries of the mastoidectomy...... and often did not make use of the allowed time, lacking knowledge on when to stop or how to excel. CONCLUSION: Directed, self-regulated VR simulation training of mastoidectomy needs a strong instructional design with specific process goals to support deliberate practice because cognitive effort is needed...

Novice facilitators and the use of scripts for managing facilitated modelling workshops

DEFF Research Database (Denmark)

Tavella, Elena; Papadopoulos, Thanos

2015-01-01

There is limited research on the use of scripts by novice facilitators (novices) in Facilitated Modelling (FM) workshops. To address this gap, this paper illustrates how novices—supported by scripts—switch between and combine facilitation skills and competencies to successfully manage FM workshops...... and achieve outcomes. This illustration is based on a micro-level analysis of a transcript from a Viable System Model workshop held in a food cooperative in Copenhagen, Denmark. Through our findings we identify two distinct script-supported FM behaviours and related script-supported facilitation practices...... that enable novices to (a) acquire skills and competencies; and (b) switch between and combine skills and competencies to successfully manage workshops and achieve outcomes. Our study links micro-level considerations to a meta-level framework that relates the script-supported FM behaviours and practices...

Concurrent Surgery and the Role of the Pediatric Attending Surgeon: Comparing Parents' and Surgeons' Expectations.

Science.gov (United States)

Choe, Jennie K; Ibarra, Christopher; Feinn, Richard S; Rodriguez-Davalos, Manuel I; Carter, Cordelia W

2018-06-01

The common practice of performing concurrent or overlapping operations has been intensely scrutinized by lay media and academic press to investigate its safety and cost-effectiveness. However, there is little information about its use within the pediatric population. Even less is known about parents' expectations about the surgeon's role on the day of operation and how they align with those of pediatric surgeons and surgical trainees, despite the potential for significant discrepancies in expectations to erode trust and damage the physician-family relationship. A 5-point Likert-style survey was designed to characterize expectations about the degree of involvement by pediatric attending surgeons throughout a surgical case (1 = strongly disagree, 3 = neutral, 5 = strongly agree). The survey was administered to parents of pediatric patients undergoing elective operations during a 3-month interval at a single academic institution. The survey was also administered to surgeons and surgical residents at the same institution. Multivariate multiplicity-adjusted t-tests were used to identify significant differences between responders. One hundred and ten parents and 84 pediatric surgeons and trainees completed the survey. Parents' responses to the survey ranged from 4.15 to 4.89, compared with 2.75 to 4.86 from surgeons. The differences achieved statistical significance (p children. There is a significant mismatch between parents' expectations and those of pediatric surgeons about the role of the surgeon on the day of operation, with parents consistently expecting more direct involvement by the attending surgeon. These discrepancies can have implications for both parent/patient satisfaction and medical education. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

A "Smart" Force-Limiting Instrument for Microsurgery: Laboratory and In Vivo Validation.

Directory of Open Access Journals (Sweden)

Hani J Marcus

Full Text Available Residents are required to learn a multitude of skills during their microsurgical training. One such skill is the judicious application of force when handling delicate tissue. An instrument has been developed that indicates to the surgeon when a force threshold has been exceeded by providing vibrotactile feedback. The objective of this study was to validate the use of this "smart" force-limiting instrument for microsurgery. A laboratory and an in vivo experiment were performed to evaluate the force-limiting instrument. In the laboratory experiment, twelve novice surgeons were randomly allocated to use either the force-limiting instrument or a standard instrument. Surgeons were then asked to perform microsurgical dissection in a model. In the in vivo experiment, an intermediate surgeon performed microsurgical dissection in a stepwise fashion, alternating every 30 seconds between use of the force-limiting instrument and a standard instrument. The primary outcomes were the forces exerted and the OSATS scores. In the laboratory experiment, the maximal forces exerted by novices using the force-limiting instrument were significantly less than using a standard instrument, and were comparable to intermediate and expert surgeons (0.637N versus 4.576N; p = 0.007. In the in vivo experiment, the maximal forces exerted with the force-limiting instrument were also significantly less than with a standard instrument (0.441N versus 0.742N; p 0.1. In conclusion, the development and use of this force-limiting instrument in a clinical setting may improve patient safety.

Dialando: tangible programming for the novice with scratch, processing and arduino

CSIR Research Space (South Africa)

Smith, Andrew C

2010-01-01

Full Text Available Programming for the Novice with Scratch, Processing and Arduino Andrew Cyrus Smith CSIR Meraka Institute, PO Box 395, Pretoria, 0001, South Africa acsmith @ csir.co.za Abstract This paper reports on a tangible programming system designed... the Arduino controlling circuitry which is connected to the laptop computer using a USB cable. 2. Our Approach Our research aims to provide the novice user a gentle introduction to the abstract programming abilities of the PC. In order to achieve...

Novice chimpanzees cooperate successfully in the presence of experts, but may have limited understanding of the task.

Science.gov (United States)

Suchak, Malini; Watzek, Julia; Quarles, Luke F; de Waal, Frans B M

2018-01-01

Despite many observations of cooperation in nature, laboratory studies often fail to find careful coordination between individuals who are solving a cooperative task. Further, individuals tested are often naïve to cooperative tasks and there has been little exploration of partnerships with mixed expertise. In the current study, we examined acquisition of a cooperative pulling task in a group with both expert (N = 4) and novice (N = 11) chimpanzees (Pan troglodytes). We used five measures of competence and understanding: (1) success at the task, (2) latency to succeed, (3) efficiency, (4) uncoordinated pulling, and (5) pulling when a partner was present versus absent. We found that novices showed evidence of trial and error learning and developed competence over time, whereas the behavior of experts did not change throughout the course of the study. In addition to looking at patterns over time, we compared the performance of novices in this mixed-expertise group to an earlier study of novices in a group of all-novices. Novices in the mixed-expertise group pulled the same overall amount but for shorter periods of time, leading to higher pulling rates than individuals in the all-novice group. Taken together, these results suggest that learning in the presence of experts led to rapid and frequent success, although not necessarily careful coordination.

Who should lead a trauma team: surgeon or non surgeon? A systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Shahab Hajibandeh

2017-05-01

Full Text Available Background: Presence of a trauma team leader (TTL in the trauma team is associated with positive patient outcomes in major trauma. The TTL is traditionally a surgeon who coordinates the resuscitation and ensures adherence to Advanced Trauma Life Support (ATLS guidelines. The necessity of routine surgical leadership in the resuscitative component of trauma care has been questioned by some authors. Therefore, it remains controversial who should lead the trauma team. We aimed to evaluate outcomes associated with surgeon versus non-surgeon TTLs in management of trauma patients. Methods: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA statement standards, we performed a systematic review. Electronic databases MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials (CENTRAL were searched to identify randomized and non-randomized studies investigating outcomes associated with surgeon versus non-surgeon TTL in management of trauma patients. The Newcastle-Ottawa scale was used to assess the methodological quality and risk of bias of the selected studies. Fixed-effect model was applied to calculate pooled outcome data. Results: Three retrospective cohort studies, enrolling 2,519 adult major trauma patients, were included. Our analysis showed that there was no difference in survival [odds ratio (OR: 0.82, 95% confidence interval (CI 0.61-1.10, P=0.19] and length of stay when trauma team was led by surgeon or non-surgeon TTLs; however, fewer injuries were missed when the trauma team was led by a surgeon (OR: 0.48, 95% CI 0.25-0.92, P=0.03. Conclusions: Despite constant debate, the comparative evidence about outcomes associated with surgeon and non-surgeon trauma team leader is insufficient. The best available evidence suggests that there is no significant difference in outcomes of surgeon or non-surgeon trauma team leaders. High quality randomized controlled trials are required to compare

Characterizing novice-expert differences in macrocognition: an exploratory study of cognitive work in the emergency department.

Science.gov (United States)

Schubert, Christiane C; Denmark, T Kent; Crandall, Beth; Grome, Anna; Pappas, James

2013-01-01

The objectives of this study are to elicit and document descriptions of emergency physician expertise, to characterize cognitive differences between novice and expert physicians, and to identify areas in which novices' skill and knowledge gaps are most pronounced. The nature of the differences between novices and experts needs to be explored to develop effective instructional modalities that accelerate the learning curve of inexperienced physicians who work in high-complexity environments. We interviewed novice emergency physicians (first-year residents) and attending physicians with significant expertise, working in an academic Level I trauma center in Southern California. With cognitive task analysis, we used task diagrams to capture nonroutine critical incidents that required the use of complex cognitive skills. Timelines were constructed to develop a detailed understanding of challenging incidents and the decisions involved as the incident unfolded, followed by progressive deepening to tease out situation-specific cues, knowledge, and information that experts and novices used. A thematic analysis of the interview transcripts was conducted to identify key categories. Using classification techniques for data reduction, we identified a smaller set of key themes, which composed the core findings of the study. Five interns and 6 attending physicians participated in the interviews. Novice physicians reported having difficulties representing the patient's story to attending physicians and other health care providers. Overrelying on objective data, novice physicians use linear thinking to move to diagnosis quickly and are likely to discount and explain away data that do not "fit" the frame. Experienced physicians draw on expertise to recognize cues and patterns while leaving room for altering or even changing their initial diagnosis. Whereas experts maintain high levels of spatial, temporal, and organizational systems awareness when overseeing treatment modalities of

Does early training improve driving skills of young novice French drivers?

Science.gov (United States)

Freydier, Chloé; Berthelon, Catherine; Bastien-Toniazzo, Mireille

2016-11-01

The aim of this research was to study drivers' performances and divided attention depending on their initial training. The performances of young novice drivers who received early training, traditionally trained drivers and more experienced drivers were compared during a dual task consisting of a simulated car-following task and a number' parity judgment task. It was expected that, due to their limited driving experience, the young novice drivers would have more difficulty in adequately distributing their attention between the two tasks. Poorer performances by novice drivers than experienced drivers were therefore expected. The results indicate that traditionally trained drivers had more difficulties in speed regulation and maintaining their position in the lane than drivers with early training and experienced drivers. Performance impairment linked to driving inexperience was also found in the secondary task. The results were interpreted regarding the attentional resources involved in driving with a secondary task and supported the positive effects of French early training. Copyright © 2016 Elsevier Ltd. All rights reserved.

Holistic processing of musical notation: Dissociating failures of selective attention in experts and novices.

Science.gov (United States)

Wong, Yetta Kwailing; Gauthier, Isabel

2010-12-01

Holistic processing (i.e., the tendency to process objects as wholes) is associated with face perception and also with expertise individuating novel objects. Surprisingly, recent work also reveals holistic effects in novice observers. It is unclear whether the same mechanisms support holistic effects in experts and in novices. In the present study, we measured holistic processing of music sequences using a selective attention task in participants who vary in music-reading expertise. We found that holistic effects were strategic in novices but were relatively automatic in experts. Correlational analyses revealed that individual holistic effects were predicted by both individual music-reading ability and neural responses for musical notation in the right fusiform face area (rFFA), but in opposite directions for experts and novices, suggesting that holistic effects in the two groups may be of different natures. To characterize expert perception, it is important not only to measure the tendency to process objects as wholes, but also to test whether this effect is dependent on task constraints.

Comparison of Complications and Surgical Outcomes of Adolescent Idiopathic Scoliosis Between Junior Attending Surgeons and Senior Attending Surgeons.

Science.gov (United States)

Qiao, Jun; Xiao, Lingyan; Xu, Leilei; Shi, Benlong; Qian, Bangping; Zhu, Zezhang; Qiu, Yong

2018-04-24

To our knowledge, few studies have compared complications and surgical outcomes of adolescent idiopathic scoliosis (AIS) between junior attending surgeons and senior attending surgeons. To compare surgical strategies, complications, and outcomes of posterior corrective surgery for AIS between junior attending surgeons and senior attending surgeons. According to experience level of operation surgeons, the patients were assigned to 2 groups. Group A was the "junior surgeon" group. Group B was the "senior surgeon" group. The following parameters were compared between the 2 groups: age, sex, diagnosis, hospital of record, surgeon experience level, type of instrumentation, type of screws, estimated blood loss, duration of surgery, length of fusion, correction techniques, main curve correction, and thoracic kyphosis correction. A total of 132 patients with AIS were included in group A, whereas 207 were in group B. The translational technique was used more often in group A (P Senior surgeons used more monoaxial screws than junior surgeons (P senior group (P senior group had significant better correction rates of severe main curve (>70°) and thoracic kyphosis than the junior group (P Senior attending surgeons outperformed junior surgeons in blood loss control, thoracic kyphosis correction, and correction of severe curves. Copyright © 2018 Elsevier Inc. All rights reserved.

The Nonwhite Woman Surgeon: A Rare Species.

Science.gov (United States)

Frohman, Heather A; Nguyen, Thu-Hoai C; Co, Franka; Rosemurgy, Alexander S; Ross, Sharona B

2015-01-01

As of 2012, 39% of medical student graduates were nonwhite, yet very few nonwhite women graduates chose to become surgeons. To better understand issues regarding nonwhite women in surgery, an online survey was sent to surgeons across the United States. Results are based on self-reported data. Mean data are reported. A total of 194 surgeons (42% women) completed the survey; only 12% of responders were nonwhite. Overall, 56% of nonwhite women felt they earned less than what men surgeons earn for equal work. Nonwhite women surgeons earned less than what men surgeons ($224,000 vs. 351,000, p women surgeons ($285,000, p = 0.02) earned. Overall, 96% of nonwhite surgeons believed that racial discrimination currently exists among surgeons. The few nonwhite women surgeons in the United States recognize that they are paid significantly less than what other surgeons are paid. Inequitable remuneration and a discriminatory work environment encountered by nonwhite women surgeons must be addressed. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Challenges and Induction Needs of Novice English as a Foreign Language Teachers in Saudi Arabia

Directory of Open Access Journals (Sweden)

Rufaida Alhamad

2018-01-01

Full Text Available The first year of teaching poses massive challenges that lead to attrition among novice teachers. School communities often fail to provide adequate support to novice teachers to help them adapt to their new professional environments. In Saudi Arabia, attrition among novice teachers is a significant problem that hinders the development of the educational system. This study was conducted to examine the challenges that Saudi Arabian EFL novice teachers face as they transit into their first teaching jobs, and to determine whether these teachers have adequate support or would benefit from a formal induction process.  Two kinds of data collection methods were used in this study, namely quantitative and qualitative. In this mixed methods study, 150 novice teachers were surveyed and 5 teachers were selected for semi-structured interviews. The quantitative analysis of the data was accomplished using descriptive and inferential statistics to answer the research questions. The qualitative analysis of the data was accomplished by interpreting the responses provided to the interview questions. The findings indicated that the challenges surrounding novice teachers hinder them in their development as new teachers. The most conspicuous challenges reported by the study participants were dealing with low English proficiency students and managing the negative attitudes of students toward learning English. This report also determined additional perceptible challenges: adoption of various teaching methods and the establishment of a student-centered approach, student behavior management, course planning, dealing with individual differences, and communication with parents.  This study showed that these teachers had left their pre-service training with a very limited knowledge and skills for dealing with the reality of teaching. Mentoring and observing veteran teachers were identified by novice teachers as the two most beneficial strategies for implementing a teacher

Predictors of Errors of Novice Java Programmers

Science.gov (United States)

Bringula, Rex P.; Manabat, Geecee Maybelline A.; Tolentino, Miguel Angelo A.; Torres, Edmon L.

2012-01-01

This descriptive study determined which of the sources of errors would predict the errors committed by novice Java programmers. Descriptive statistics revealed that the respondents perceived that they committed the identified eighteen errors infrequently. Thought error was perceived to be the main source of error during the laboratory programming…

The Influence of a Bout of Exertion on Novice Barefoot Running Dynamics

Directory of Open Access Journals (Sweden)

Rami Hashish, Sachithra D. Samarawickrame, Lucinda Baker, George J. Salem

2016-06-01

Full Text Available Barefoot, forefoot strike (FFS running has recently risen in popularity. Relative to shod, rear-foot strike (RFS running, employing a FFS is associated with heightened triceps surae muscle activation and ankle mechanical demand. Novice to this pattern, it is plausible that habitually shod RFS runners exhibit fatigue to the triceps surae when acutely transitioning to barefoot running, thereby limiting their ability to attenuate impact. Therefore, the purpose was to determine how habitually shod RFS runners respond to an exertion bout of barefoot running, operationally defined as a barefoot run 20% of mean daily running distance. Twenty-one RFS runners performed novice barefoot running, before and after exertion. Ankle peak torque, triceps surae EMG median frequency, foot-strike patterns, joint energy absorption, and loading rates were evaluated. Of the 21 runners, 6 maintained a RFS, 10 adopted a mid-foot strike (MFS, and 5 adopted a FFS during novice barefoot running. In-response to exertion, MFS and FFS runners demonstrated reductions in peak torque, median frequency, and ankle energy absorption, and an increase in loading rate. RFS runners demonstrated reductions in peak torque and loading rate. These results indicate that a short bout of running may elicit fatigue to novice barefoot runners, limiting their ability to attenuate impact.

Impact of gender, organized athletics, and video gaming on driving skills in novice drivers.

Science.gov (United States)

Wayne, Nancy L; Miller, Gregory A

2018-01-01

Given that novice drivers tend to be young, and teenagers and young adult drivers are involved in the greatest number of accidents, it is important that we understand what factors impact the driving skills of this population of drivers. The primary aim of the present study was to understand the impact of gender, organized athletics, and video gaming on driving skills of novice drivers under real-world driving conditions. Novice driving students having less than five hours driving experience previous to a normal driving lesson were evaluated on their self-confidence (self-reported) prior to the lesson and driving skill evaluated by their instructor during the course of the lesson. Information was collected about gender, age, whether or not the students were involved in organized athletics, and the extent of their video game playing. There was no impact of gender or extent of video game playing on driving skills. Females were significantly less self-confident with driving than males, but this did not translate to gender differences in driving skills. Being involved in organized athletics-either currently or in the past-significantly enhanced driving skills in both females and males. Finally, novice drivers' age was negatively correlated with driving skills. That is, younger novice drivers (especially males) had better driving skills than older novice drivers. This is counter to popular belief that young drivers lack technical driving skills because they have less experience behind the wheel. Based on the results of the current study, we hypothesize that the relatively high accident rate of younger drivers (especially male drivers) is most likely due to inattention to safety considerations rather than lack of technical driving ability.

Impact of gender, organized athletics, and video gaming on driving skills in novice drivers

Science.gov (United States)

Miller, Gregory A.

2018-01-01

Given that novice drivers tend to be young, and teenagers and young adult drivers are involved in the greatest number of accidents, it is important that we understand what factors impact the driving skills of this population of drivers. The primary aim of the present study was to understand the impact of gender, organized athletics, and video gaming on driving skills of novice drivers under real-world driving conditions. Novice driving students having less than five hours driving experience previous to a normal driving lesson were evaluated on their self-confidence (self-reported) prior to the lesson and driving skill evaluated by their instructor during the course of the lesson. Information was collected about gender, age, whether or not the students were involved in organized athletics, and the extent of their video game playing. There was no impact of gender or extent of video game playing on driving skills. Females were significantly less self-confident with driving than males, but this did not translate to gender differences in driving skills. Being involved in organized athletics—either currently or in the past—significantly enhanced driving skills in both females and males. Finally, novice drivers’ age was negatively correlated with driving skills. That is, younger novice drivers (especially males) had better driving skills than older novice drivers. This is counter to popular belief that young drivers lack technical driving skills because they have less experience behind the wheel. Based on the results of the current study, we hypothesize that the relatively high accident rate of younger drivers (especially male drivers) is most likely due to inattention to safety considerations rather than lack of technical driving ability. PMID:29364957

Significant Value Found in Mentoring Programs for Novice Tenure-Track Academic Librarians

OpenAIRE

Saori Wendy Herman, MLIS, AHIP

2016-01-01

A Review of: Goodsett, M., & Walsh, A. (2015). Building a strong foundation: Mentoring programs for novice tenure-track librarians in academic libraries. College & Research Libraries, 76(7), 914-933. http://dx.doi.org/10.5860/crl.76.7.914 Objective – To examine the effectiveness of mentoring programs for novice tenure-track academic librarians, and to identify critical elements that define a successful mentoring program in various academic library settings. Design – Survey questionn...

An examination of the perceived teaching competencies of novice alternatively licensed and traditionally licensed high school science teachers

Science.gov (United States)

Shea, Kathleen A.

In most states, there are two routes to teacher licensure; traditional and alternative. The alternative route provides an accelerated entry into the classroom, often without the individual engaging in education coursework or a practicum. No matter the route, teaching skills continue to be learned by novice teachers while in the classroom with the guidance of a school-based mentor. In this study, the perceptions of mentor teachers of traditionally and alternatively licensed high school science teachers were compared with respect to mentees' science teaching competency. Further, the study explored the novice teachers' self-perception of their teaching competency. A survey, consisting of 56 Likert-type questions, was completed by mentors (N = 79) and novice high school science teachers (N = 83) in six northeastern states. The results revealed a statistically significant difference in the perceptions of the mentors of traditionally and alternatively licensed novice high school science teachers in the areas of general pedagogical knowledge, pedagogical content knowledge and professional growth, with more favorable perceptions recorded by mentors of traditionally licensed science teachers. There were no differences in the perceptions of the mentors with respect to novice high school teachers' content knowledge. There was no statistical difference in the self-perceptions of competency of the novice teachers. While alternative routes to licensure in science may be a necessity, the results of this study indicate that the lack of professional preparation may need to be addressed at the school level through the agency of the mentor. This study indicates that mentors must be prepared to provide alternatively licensed novice teachers with different assistance to that given to traditionally licensed novice teachers. School districts are urged to develop mentoring programs designed to develop the teaching competency of all novice teachers regardless of the route that led them

Novice Teachers and Linguistics: Foregrounding the Functional

Science.gov (United States)

Chappell, Phil; Moore, Stephen

2012-01-01

This forum article describes a postgraduate certificate teaching English to speakers of other languages (TESOL) program with a strong linguistics orientation and argues that such a program provides novice language teachers with knowledge and skills superior to those of programs which focus more on methodology and practicum experience and less on…

Smartphones and the plastic surgeon.

Science.gov (United States)

Al-Hadithy, Nada; Ghosh, Sudip

2013-06-01

Surgical trainees are facing limited training opportunities since the introduction of the European Working Time Directive. Smartphone sales are increasing and have usurped computer sales for the first time. In this context, smartphones are an important portable reference and educational tool, already in the possession of the majority of surgeons in training. Technology in the palm of our hands has led to a revolution of accessible information for the plastic surgery trainee and surgeon. This article reviews the uses of smartphones and applications for plastic surgeons in education, telemedicine and global health. A comprehensive guide to existing and upcoming learning materials and clinical tools for the plastic surgeon is included. E-books, podcasts, educational videos, guidelines, work-based assessment tools and online logbooks are presented. In the limited resource setting of modern clinical practice, savvy plastic surgeons can select technological tools to democratise access to education and best clinical care. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

TESOL Teacher Education: Novice Teachers' Perceptions of Their Preparedness and Efficacy in the Classroom

Science.gov (United States)

Faez, Farahnaz; Valeo, Antonella

2012-01-01

This study examined the teacher education of novice teachers of English to speakers of other languages (ESOL). A survey and follow-up interviews were employed to investigate novice teachers' perceptions about four aspects of their teacher preparation: (a) degree of preparedness to teach after graduating from a teaching English to speakers of other…

Construct validity for eye-hand coordination skill on a virtual reality laparoscopic surgical simulator.

Science.gov (United States)

Yamaguchi, Shohei; Konishi, Kozo; Yasunaga, Takefumi; Yoshida, Daisuke; Kinjo, Nao; Kobayashi, Kiichiro; Ieiri, Satoshi; Okazaki, Ken; Nakashima, Hideaki; Tanoue, Kazuo; Maehara, Yoshihiko; Hashizume, Makoto

2007-12-01

This study was carried out to investigate whether eye-hand coordination skill on a virtual reality laparoscopic surgical simulator (the LAP Mentor) was able to differentiate among subjects with different laparoscopic experience and thus confirm its construct validity. A total of 31 surgeons, who were all right-handed, were divided into the following two groups according to their experience as an operator in laparoscopic surgery: experienced surgeons (more than 50 laparoscopic procedures) and novice surgeons (fewer than 10 laparoscopic procedures). The subjects were tested using the eye-hand coordination task of the LAP Mentor, and performance was compared between the two groups. Assessment of the laparoscopic skills was based on parameters measured by the simulator. The experienced surgeons completed the task significantly faster than the novice surgeons. The experienced surgeons also achieved a lower number of movements (NOM), better economy of movement (EOM) and faster average speed of the left instrument than the novice surgeons, whereas there were no significant differences between the two groups for the NOM, EOM and average speed of the right instrument. Eye-hand coordination skill of the nondominant hand, but not the dominant hand, measured using the LAP Mentor was able to differentiate between subjects with different laparoscopic experience. This study also provides evidence of construct validity for eye-hand coordination skill on the LAP Mentor.

Thomas Vicary, barber-surgeon.

Science.gov (United States)

Thomas, Duncan P

2006-05-01

An Act of Parliament in 1540 uniting the barbers and surgeons to form the Barber-Surgeons' Company represented an important foundation stone towards better surgery in England. Thomas Vicary, who played a pivotal role in promoting this union, was a leading surgeon in London in the middle of the 16th century. While Vicary made no direct contribution to surgical knowledge, he should be remembered primarily as one who contributed much towards the early organization and teaching of surgery and to the consequent benefits that flowed from this improvement.

Novice Career Changers Weather the Classroom Weather

Science.gov (United States)

Gifford, James; Snyder, Mary Grace; Cuddapah, Jennifer Locraft

2013-01-01

A close look at one professional's career change into teaching illustrates unique challenges and qualities, showing in stark relief what makes the induction smoother and the experience more successful. This article presents the story of a novice career changer teacher that illustrates their unique problems and dispositions, as well as…

String Formatting Considered Harmful for Novice Programmers

Science.gov (United States)

Hughes, Michael C.; Jadud, Matthew C.; Rodrigo, Ma. Mercedes T.

2010-01-01

In Java, "System.out.printf" and "String.format" consume a specialised kind of string commonly known as a format string. In our study of first-year students at the Ateneo de Manila University, we discovered that format strings present a substantial challenge for novice programmers. Focusing on their first laboratory we found…

Stress in surgeons.

Science.gov (United States)

Green, A; Duthie, H L; Young, H L; Peters, T J

1990-10-01

A sample of 1000 members of the Association of Surgeons of Great Britain and Ireland was circulated with a postal questionnaire relating to their occupational stressors, their type A coronary-prone behaviour and their mental health. Six hundred and seventy-two (67 per cent) useable forms were returned anonymously. The major individual stressors were: (1) the interference of the job with personal life, (2) general administration, and (3) the number of patients in clinics. Type A behaviour was similar to that of other professional groups. Surgeons showed mean scores significantly higher than the general population on two subscales of the mental health index (free-floating anxiety and hysterical anxiety). The findings for the few female surgeons (2 per cent) were similar to those in men but they did not exhibit raised free-floating anxiety levels.

Novice Counselors' Conceptualizations and Experiences of Therapeutic Relationships

Science.gov (United States)

Schwing, Alison E.; LaFollette, Julie R.; Steinfeldt, Jesse A.; Wong, Y. Joel

2011-01-01

This qualitative study investigated three novice counselors' experiences and characterizations of therapeutic relationships. Thematic analyses of interviews and diaries revealed six common themes: (a) the centrality of supervision and training experiences to navigating interpersonal experiences with clients; (b) anxiety about counselors' roles in…

Endoscopic Approach for Tissue Expansion for Different Cosmetic ...

African Journals Online (AJOL)

Background/Purpose: The use of tissue expanders in plastic and reconstruction surgery is now well established for large defects in adults & children. Tissue expansion is one of the reconstructive surgeon's alternatives in providing optimal tissue replacement when skin shortage is a major problem. Predesigned plan about ...

What Is a Pediatric Heart Surgeon?

Science.gov (United States)

... Text Size Email Print Share What is a Pediatric Heart Surgeon? Page Content Article Body If your ... require heart surgery. What Kind of Training Do Pediatric Heart Surgeons Have? Pediatric heart surgeons are medical ...

The Affective Experience of Novice Computer Programmers

Science.gov (United States)

Bosch, Nigel; D'Mello, Sidney

2017-01-01

Novice students (N = 99) participated in a lab study in which they learned the fundamentals of computer programming in Python using a self-paced computerized learning environment involving a 25-min scaffolded learning phase and a 10-min unscaffolded fadeout phase. Students provided affect judgments at approximately 100 points (every 15 s) over the…

Practice among Novice Change Agents in Schools

Science.gov (United States)

Blossing, Ulf

2016-01-01

The aim of the article is to understand practice as negotiation of meaning among novice and internal change agents in school organisations. The research question is as follows: What themes of participation and reification/management occur among the change agents? The study was qualitative in design using the social learning theory of community of…

Using Simulation to Support Novice Teachers' Classroom Management Skills: Comparing Traditional and Alternative Certification Groups

Science.gov (United States)

Pankowski, Jennifer; Walker, Joan T.

2016-01-01

Drawing from research on situated cognition and the development of expertise and simulations in professional education, we designed two simulation tasks that provided novice teachers with repeated opportunities to deliberately practice managing a classroom under no-fault conditions. The simulations immersed novices in two perennial classroom…

CBT competence in novice therapists improves anxiety outcomes.

Science.gov (United States)

Brown, Lily A; Craske, Michelle G; Glenn, Daniel E; Stein, Murray B; Sullivan, Greer; Sherbourne, Cathy; Bystritsky, Alexander; Welch, Stacy S; Campbell-Sills, Laura; Lang, Ariel; Roy-Byrne, Peter; Rose, Raphael D

2013-02-01

This study explores the relationships between therapist variables (cognitive behavioral therapy [CBT] competence, and CBT adherence) and clinical outcomes of computer-assisted CBT for anxiety disorders delivered by novice therapists in a primary care setting. Participants were recruited for a randomized controlled trial of evidence-based treatment, including computer-assisted CBT, versus treatment as usual. Therapists (anxiety clinical specialists; ACSs) were nonexpert clinicians, many of whom had no prior experience in delivering psychotherapy (and in particular, very little experience with CBT). Trained raters reviewed randomly selected treatment sessions from 176 participants and rated therapists on measures of CBT competence and CBT adherence. Patients were assessed at baseline and at 6-, 12-, and 18-month follow-ups on measures of anxiety, depression, and functioning, and an average Reliable Change Index was calculated as a composite measure of outcome. CBT competence and CBT adherence were entered as predictors of outcome, after controlling for baseline covariates. Higher CBT competence was associated with better clinical outcomes whereas CBT adherence was not. Also, CBT competence was inversely correlated with years of clinical experience and trended (not significantly, though) down as the study progressed. CBT adherence was inversely correlated with therapist tenure in the study. Therapist competence was related to improved clinical outcomes when CBT for anxiety disorders was delivered by novice clinicians with technology assistance. The results highlight the value of the initial training for novice therapists as well as booster training to limit declines in therapist adherence. © 2012 Wiley Periodicals, Inc.

Differences between novice and experienced caregivers in muscle activity and perceived exertion while repositioning bedridden patients.

Science.gov (United States)

Daikoku, Rie; Saito, Yayoi

2008-11-01

The aim of this study was to investigate the impact of caregiver knowledge and experience on muscle activity and perceived exertion while repositioning bedridden patients. Subjects were 40- to 65-year-old female caregivers divided into novice and experienced groups. Subjects from both groups performed home-care repositioning techniques on bedridden patients while muscle activity was recorded via electromyogram. Recordings were made from four muscles on the subjects' dominant side: the latissimus dorsi, the biceps brachii, the erector spinae, and the rectus femoris. The subjective burden involved in repositioning was also assessed using the rate of perceived exertion (RPE) and visual analog scales (VAS). Rectus femoris percentage of maximum voluntary contraction (%MVC) values were significantly lower than latissimus dorsi, erector spinae, and biceps brachii values in the novice group. %MVC values from the latissimus dorsi and biceps brachii were significantly higher among the novice group compared to the experienced group. RPE ratings from the novice group were significantly higher than those of the experienced group, and there was a non-significant trend for higher VAS values for the low back, arms, and legs in the novice group compared to the experienced group. Novice caregivers tended to change the patient's position by pulling with the upper limbs without using the lower limbs. In contrast, experienced caregivers exerted less energy by communicating with the patient and utilizing the patient's own movements. They used large, distributed muscle groups that effectively harnessed body mechanics and prevented excess exertion.

The effect of feedback on attitudes toward cellular phone use while driving: a comparison between novice and experienced drivers.

Science.gov (United States)

Wang, Ying; Zhang, Wei; Reimer, Bryan; Lavallière, Martin; Lesch, Mary F; Horrey, William J; Wu, Su

2010-10-01

To assess and compare the effectiveness of a simulation-based approach to change drivers' attitudes toward cellular phone use while driving for younger novice and older experienced drivers. Thirty young novice drivers were tested on a driving simulator in this study. Their performance in dealing with driving tasks was measured for a single task and dual tasks (driving while using a cellular phone) and compared to 30 older experienced drivers tested previously in another study. Half of the younger drivers received video-based feedback regarding their performance in the two conditions, with an emphasis on the contribution of dual-tasking to degraded performance. The other half did not receive any performance feedback. Drivers' perceptions and attitudes toward cellular phone use while driving were investigated by a questionnaire before, immediately after, and again one month following the simulation-based testing for both groups of drivers (feedback; no feedback). All drivers (including the novice and experienced) reported willingness to engage in driving and talking on a cellular phone in some situations. The simulated driving test showed that a secondary cellular phone task significantly degraded driving performance for both the novice and the experienced drivers. The feedback treatment group (both the novice and the experienced) showed significant attitude change toward cellular phone use while driving (toward being less favorable), whereas the control group had no attitude change. At the one-month follow-up, the benefit of feedback was sustained more so in the experienced driver group than the novice driver group, although both groups still benefited relative to the control conditions. Simulation-based feedback training is promising for short-term education in novice drivers but may be more effective in the long-term for drivers with higher levels of experience. Drivers with more experience appear to have a greater, more sustained benefit from the training than

A Mixed Methods Survey Research Study of Novice Special Education Teachers: Investigation of Reading Preparedness

Science.gov (United States)

Stratton, Mary P.

2017-01-01

Novice special education teachers have become an integral part of the public and private school systems throughout Pennsylvania. This mixed-methods research study explored the expertise and preparedness of current novice special education teachers. A combination of an electronic survey questionnaire and phone and face-to-face interviews were…

Preliminary Experience Using Eye-Tracking Technology to Differentiate Novice and Expert Image Interpretation for Ultrasound-Guided Regional Anesthesia.

Science.gov (United States)

Borg, Lindsay K; Harrison, T Kyle; Kou, Alex; Mariano, Edward R; Udani, Ankeet D; Kim, T Edward; Shum, Cynthia; Howard, Steven K

2018-02-01

Objective measures are needed to guide the novice's pathway to expertise. Within and outside medicine, eye tracking has been used for both training and assessment. We designed this study to test the hypothesis that eye tracking may differentiate novices from experts in static image interpretation for ultrasound (US)-guided regional anesthesia. We recruited novice anesthesiology residents and regional anesthesiology experts. Participants wore eye-tracking glasses, were shown 5 sonograms of US-guided regional anesthesia, and were asked a series of anatomy-based questions related to each image while their eye movements were recorded. The answer to each question was a location on the sonogram, defined as the area of interest (AOI). The primary outcome was the total gaze time in the AOI (seconds). Secondary outcomes were the total gaze time outside the AOI (seconds), total time to answer (seconds), and time to first fixation on the AOI (seconds). Five novices and 5 experts completed the study. Although the gaze time (mean ± SD) in the AOI was not different between groups (7 ± 4 seconds for novices and 7 ± 3 seconds for experts; P = .150), the gaze time outside the AOI was greater for novices (75 ± 18 versus 44 ± 4 seconds for experts; P = .005). The total time to answer and total time to first fixation in the AOI were both shorter for experts. Experts in US-guided regional anesthesia take less time to identify sonoanatomy and spend less unfocused time away from a target compared to novices. Eye tracking is a potentially useful tool to differentiate novices from experts in the domain of US image interpretation. © 2017 by the American Institute of Ultrasound in Medicine.

A new possibility in thoracoscopic virtual reality simulation training: development and testing of a novel virtual reality simulator for video-assisted thoracoscopic surgery lobectomy.

Science.gov (United States)

Jensen, Katrine; Bjerrum, Flemming; Hansen, Henrik Jessen; Petersen, René Horsleben; Pedersen, Jesper Holst; Konge, Lars

2015-10-01

The aims of this study were to develop virtual reality simulation software for video-assisted thoracic surgery (VATS) lobectomy, to explore the opinions of thoracic surgeons concerning the VATS lobectomy simulator and to test the validity of the simulator metrics. Experienced VATS surgeons worked with computer specialists to develop a VATS lobectomy software for a virtual reality simulator. Thoracic surgeons with different degrees of experience in VATS were enrolled at the 22nd meeting of the European Society of Thoracic Surgeons (ESTS) held in Copenhagen in June 2014. The surgeons were divided according to the number of performed VATS lobectomies: novices (0 VATS lobectomies), intermediates (1-49 VATS lobectomies) and experienced (>50 VATS lobectomies). The participants all performed a lobectomy of a right upper lobe on the simulator and answered a questionnaire regarding content validity. Metrics were compared between the three groups. We succeeded in developing the first version of a virtual reality VATS lobectomy simulator. A total of 103 thoracic surgeons completed the simulated lobectomy and were distributed as follows: novices n = 32, intermediates n = 45 and experienced n = 26. All groups rated the overall user realism of the VATS lobectomy scenario to a median of 5 on a scale 1-7, with 7 being the best score. The experienced surgeons found the graphics and movements realistic and rated the scenario high in terms of usefulness as a training tool for novice and intermediate experienced thoracic surgeons, but not very useful as a training tool for experienced surgeons. The metric scores were not statistically significant between groups. This is the first study to describe a commercially available virtual reality simulator for a VATS lobectomy. More than 100 thoracic surgeons found the simulator realistic, and hence it showed good content validity. However, none of the built-in simulator metrics could significantly distinguish between novice, intermediate

The Plastic Surgeon at Work and Play: Surgeon Health, Practice Stress, and Work-Home Balance.

Science.gov (United States)

Bentz, Michael L

2016-10-01

Plastic surgeon wellness encompasses physical and mental health, considered in the context of practice stress. In addition, the challenges of work-home balance can lead to substantial negative impact on the surgeon, family, staff, and patients. The data-driven impact of each of these three components with personal vignettes, both individually and collectively, is presented by Michael Bentz, MD as the 2016 presidential address of American Association of Plastic Surgeons.

Validity and reliability of global operative assessment of laparoscopic skills (GOALS) in novice trainees performing a laparoscopic cholecystectomy.

Science.gov (United States)

Kramp, Kelvin H; van Det, Marc J; Hoff, Christiaan; Lamme, Bas; Veeger, Nic J G M; Pierie, Jean-Pierre E N

2015-01-01

Global Operative Assessment of Laparoscopic Skills (GOALS) assessment has been designed to evaluate skills in laparoscopic surgery. A longitudinal blinded study of randomized video fragments was conducted to estimate the validity and reliability of GOALS in novice trainees. In total, 10 trainees each performed 6 consecutive laparoscopic cholecystectomies. Sixty procedures were recorded on video. Video fragments of (1) opening of the peritoneum; (2) dissection of Calot's triangle and achievement of critical view of safety; and (3) dissection of the gallbladder from the liver bed were blinded, randomized, and rated by 2 consultant surgeons using GOALS. Also, a grade was given for overall competence. The correlation of GOALS with live observation Objective Structured Assessment of Technical Skills (OSATS) scores was calculated. Construct validity was estimated using the Friedman 2-way analysis of variance by ranks and the Wilcoxon signed-rank test. The interrater reliability was calculated using the absolute and consistency agreement 2-way random-effects model intraclass correlation coefficient. A high correlation was found between mean GOALS score (r = 0.879, p = 0.021) and mean OSATS score. The GOALS score increased significantly across the 6 procedures (p = 0.002). The trainees performed significantly better on their sixth when compared with their first cholecystectomy (p = 0.004). The consistency agreement interrater reliability was 0.37 for the mean GOALS score (p = 0.002) and 0.55 for overall competence (p < 0.001) of the 3 video fragments. The validity observed in this randomized blinded longitudinal study supports the existing evidence that GOALS is a valid tool for assessment of novice trainees. A relatively low reliability was found in this study. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Developing business opportunities from concept to end point for craniofacial surgeons.

Science.gov (United States)

Brown, Spencer A

2012-01-01

Craniofacial surgeons repair a wide variety of soft and hard tissues that produce the clinical expertise to recognize the need for an improved device or novel regenerative stem cell or use of molecules that may dramatically change the way clinical care for improved patient outcomes. The business pathway to bring a concept to clinical care requires knowledge, mentoring, and a team of experts in business and patent law.

Do young novice drivers overestimate their driving skills?

NARCIS (Netherlands)

Craen, S. de Twisk, D.A.M. Hagenzieker, M.P. Elffers, H. & Brookhuis, K.A.

2007-01-01

In this study the authors argue that, in order to sufficiently adapt to task demands in traffic, drivers have to make an assessment of their own driving skills. There are indications that drivers in general, and novice drivers in particular, overestimate their driving skills. The objective of this

Mentoring relationships and the levels of role conflict and role ambiguity experienced by novice nursing faculty.

Science.gov (United States)

Specht, Jennifer A

2013-01-01

This study explored the effect of mentoring on the levels of role conflict and role ambiguity experienced by novice nursing faculty related to their transitions into academe using a descriptive, comparative design. It also measured the relationship between the quality of mentoring experiences of novice nursing faculty and their levels of role conflict and role ambiguity using a correlational design. P. Benner's (1984) novice to expert model was utilized as a framework for successful role transition. J. R. Rizzo, R. J. House, and S. I. Lirtzman's (1970) role conflict and role ambiguity scale was used to measure the levels of role conflict and role ambiguity experienced by novice nursing faculty. Results indicate that participants (n = 224) who were mentored have significantly lower levels of role conflict (M = 3.57) and role ambiguity (M = 3.02) than those who were not mentored (M = 4.62 and M = 3.90, respectively). Also significant, the higher the participants' reported levels of quality of mentoring experiences were, the lower their levels of role conflict and role ambiguity were. The results of this study indicate that mentoring eases the transition of novice nursing faculty from practice into academe by decreasing the degree of role ambiguity and role conflict that they experience. © 2013.

Lived Experiences of Novice Male Nurses in Taiwan.

Science.gov (United States)

Cheng, Mei-Li; Tseng, Ying-Hua; Hodges, Eric; Chou, Fan-Hao

2016-11-03

Nursing remains a female-dominated profession around the world. The masculinity and male identity of men who choose nursing careers is questioned by the general public in many countries. Few studies report the situation of novice male nurses at their first year. The purpose of this study was to explore the lived experience of novice male nurses when they first enter the workplace. A qualitative descriptive study was conducted using purposive and snowball sampling for recruitment. Fourteen participants, 21 to 25 years old, were recruited, all of whom had at least 5 months of work experience. On average, in-depth, face-to-face interviews lasted 1 hour, with more than one follow-up telephone interview per participant. The following six themes emerged from the transcribed verbatim data based on content analysis: choosing appropriate work departments based on personality and needs, facing the pressure and frustration of independent work, getting help, obtaining acceptance among female cliques, reflecting on the relationship between gender and profession, and concerns about dependents and financial needs. This study addresses masculinity issues and gender stereotyping. In addition, male nurses were very concerned about their career options and development and the likelihood of promotion. This research not only has implications for better understanding of novice male nurses' needs and the challenges in their social life but also makes suggestions for nursing practice to attract and keep more male nurses in the nursing profession. The results illustrate how culturally congruent nursing care can be achieved when we more concern male nurses' role pressure and address traditional gender sensitivity to promote male nurses' career development. © The Author(s) 2016.

Exploring physics concepts among novice teachers through CMAP tools

Science.gov (United States)

Suprapto, N.; Suliyanah; Prahani, B. K.; Jauhariyah, M. N. R.; Admoko, S.

2018-03-01

Concept maps are graphical tools for organising, elaborating and representing knowledge. Through Cmap tools software, it can be explored the understanding and the hierarchical structuring of physics concepts among novice teachers. The software helps physics teachers indicated a physics context, focus questions, parking lots, cross-links, branching, hierarchy, and propositions. By using an exploratory quantitative study, a total 13-concept maps with different physics topics created by novice physics teachers were analysed. The main differences of scoring between lecturer and peer-teachers’ scoring were also illustrated. The study offered some implications, especially for physics educators to determine the hierarchical structure of the physics concepts, to construct a physics focus question, and to see how a concept in one domain of knowledge represented on the map is related to a concept in another domain shown on the map.

Evaluating The Impact Of Novice Students Sketches On Their Mental Imagery

Directory of Open Access Journals (Sweden)

F. Helmi

2015-08-01

Full Text Available Reinterpretation is one of the activities that occur in visualization the role of reinterpretation is restructuring half form idea and it can be performed with applying sketch as a useful tool and creation development evaluation communication and sharing of ideas can be facilitated by sketching. Reinterpretation basically is the outcome of the lateral thinking process. Investigating of the reinterpretation of some designers indicate that externalizing a design may not be the solitary approach of designing visually and for expert architects sketching is not a crucial action in the early stages of conceptual designing. Moreover experts could progress in design by thinking only. However novice students have problem in reinterpreting patterns in their mental image whether tools such as sketch could help in the better performance of the reinterpretation process. This paper raises a fundamental question that if the sketch of novice students can support their mental imagery in order to answer this question this paper uses documentary method to investigate the previous studies in this field. Finally in accordance to the weakness of novices sketches this study concluded that their sketches could not support their mental imagery.

Expert-novice differences in cognitive and execution skills during tennis competition.

Science.gov (United States)

Del Villar, Fernando; García González, Luis; Iglesias, Damián; Perla Moreno, M; Cervelló, Eduardo M

2007-04-01

This study deals with decision and execution behavior of tennis players during competition. The study is based on the expert-novice paradigm and aims to identify differences between both groups in the decision-making and execution variables in serve and shot actions in tennis. Six expert players (elite Spanish tennis players) and six novice players (grade school tennis players) took part in this study. To carry out this study, the observation protocol defined by McPherson and Thomas in 1989, in which control, decision-making and execution variables were included, was used, where it was applied to the performance of the tennis player in a real match situation. In the analysis, significant differences between experts and novices in decision-making and execution variables are found wherein it can be observed that experts display a greater ability to make the appropriate decisions, selecting the most tactical responses to put pressure on the opponent. Expert tennis players were also able to carry out forceful executions to their opponent with greater efficiency, making the opponent's response to a large extent more difficult. These findings are in accordance with those of McPherson and colleagues.

Burnout and career satisfaction among American surgeons.

Science.gov (United States)

Shanafelt, Tait D; Balch, Charles M; Bechamps, Gerald J; Russell, Thomas; Dyrbye, Lotte; Satele, Daniel; Collicott, Paul; Novotny, Paul J; Sloan, Jeff; Freischlag, Julie A

2009-09-01

To determine the incidence of burnout among American surgeons and evaluate personal and professional characteristics associated with surgeon burnout. : Burnout is a syndrome of emotional exhaustion and depersonalization that leads to decreased effectiveness at work. A limited amount of information exists about the relationship between specific demographic and practice characteristics with burnout among American surgeons. Members of the American College of Surgeons (ACS) were sent an anonymous, cross-sectional survey in June 2008. The survey evaluated demographic variables, practice characteristics, career satisfaction, burnout, and quality of life (QOL). Burnout and QOL were measured using validated instruments. Of the approximately 24,922 surgeons sampled, 7905 (32%) returned surveys. Responders had been in practice 18 years, worked 60 hours per week, and were on call 2 nights/wk (median values). Overall, 40% of responding surgeons were burned out, 30% screened positive for symptoms of depression, and 28% had a mental QOL score >1/2 standard deviation below the population norm. Factors independently associated with burnout included younger age, having children, area of specialization, number of nights on call per week, hours worked per week, and having compensation determined entirely based on billing. Only 36% of surgeons felt their work schedule left enough time for personal/family life and only 51% would recommend their children pursue a career as a physician/surgeon. Burnout is common among American surgeons and is the single greatest predictor of surgeons' satisfaction with career and specialty choice. Additional research is needed to identify individual, organizational, and societal interventions that preserve and promote the mental health of American surgeons.

Validation of a novel basic virtual reality simulator, the LAP-X, for training basic laparoscopic skills.

Science.gov (United States)

Kawaguchi, Koji; Egi, Hiroyuki; Hattori, Minoru; Sawada, Hiroyuki; Suzuki, Takahisa; Ohdan, Hideki

2014-10-01

Virtual reality surgical simulators are becoming popular as a means of providing trainees with an opportunity to practice laparoscopic skills. The Lap-X (Epona Medical, Rotterdam, the Netherlands) is a novel VR simulator for training basic skills in laparoscopic surgery. The objective of this study was to validate the LAP-X laparoscopic virtual reality simulator by assessing the face and construct validity in order to determine whether the simulator is adequate for basic skills training. The face and content validity were evaluated using a structured questionnaire. To assess the construct validity, the participants, nine expert surgeons (median age: 40 (32-45)) (>100 laparoscopic procedures) and 11 novices performed three basic laparoscopic tasks using the Lap-X. The participants reported a high level of content validity. No significant differences were found between the expert surgeons and the novices (Ps > 0.246). The performance of the expert surgeons on the three tasks was significantly better than that of the novices in all parameters (Ps training device.

Low-Cost Intra-Articular Distraction Technique Using Kirschner Wires and a Toothed Lamina Spreader.

Science.gov (United States)

Shymon, Stephen Joseph; Harris, Thomas Gregory

We describe a low-cost (instrument cost) technique for joint distraction using 2 Kirschner wires and a toothed lamina spreader in lieu of a Hintermann distractor. The described technique allows for temporary intra-articular distraction and visualization and preservation of the articular surface with extra-articular instrumentation. The technique can also allow for closed reduction and percutaneous treatment in cases of soft tissue compromise. Additionally, the technique uses common orthopedic surgical instruments, leading to a minimal learning curve for novice surgeons. We have found this distraction technique to be most effective for intra-articular preparation of hindfoot and midfoot arthrodeses and for navicular fracture reduction. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

The effects of perceived organisational support and span of control on the organisational commitment of novice leaders.

Science.gov (United States)

Havaei, Farinaz; Dahinten, V Susan; MacPhee, Maura

2015-04-01

The purpose of this study was to examine the main and interaction effects of perceived organisational support, span of control and leadership rank on novice nurse leaders' organisational commitment. As nurse leaders' organisational commitment is eroded at times of healthcare restructuring, it is important to study factors associated with organisational commitment. Cross-sectional data from 69 novice nurse leaders, collected via mailed surveys at two time points, were analysed using hierarchical regression. The findings supported our hypotheses about the positive effect of perceived organisational support, the positive effect of leadership rank and the negative effect of span of control on novice nurse leaders' organisational commitment. In addition, perceived organisational support was shown to moderate the negative effect of span of control on novice nurse leaders' organisational commitment at time 2. Organisational strategies aimed at supporting nurse leaders, and attention to span of control, are required to enhance the organisational commitment of novice nurse leaders. Nurse leaders with a wide span of control, in particular those with little leadership experience, need to adopt leadership strategies that maximise their effectiveness, such as organising smaller work groups or teams within their wide span of control. © 2013 John Wiley & Sons Ltd.

Heuristic Evaluation for Novice Programming Systems

OpenAIRE

Kölling, Michael; McKay, Fraser

2016-01-01

The past few years has seen a proliferation of novice programming tools. The availability of a large number of systems has made it difficult for many users to choose among them. Even for education researchers, comparing the relative quality of these tools, or judging their respective suitability for a given context, is hard in many instances. For designers of such systems, assessing the respective quality of competing design decisions can be equally difficult.\\ud Heuristic evaluation provides...

The surgeon's perspective: promoting and discouraging factors for choosing a career in surgery as perceived by surgeons.

Science.gov (United States)

Seelandt, Julia C; Kaderli, Reto M; Tschan, Franziska; Businger, Adrian P

2014-01-01

The aim of this study was to identify the factors perceived by surgeons that promote surgery as an attractive or unattractive career choice for today's graduates. In addition, it examined whether the perspectives of surgeons in different professional situations converges. The content of work, contextual work conditions, and calling to this job are discussed in the context of choosing surgery as a career. Eight hundred sixty-nine surgeons were asked to answer open-ended questions regarding the factors that promote surgery as an attractive or unattractive career choice for today's graduates. Four hundred ninety-two surgeons participated, and 1,525 statements were analyzed using Mayring's content-analyses method. Chi-square tests were used to analyze the differences among hierarchical positions. With respect to the factors that promote surgery as a profession, 40.8% (209/492) of the surgeons stated that surgery is a calling, 29.1% (149/492) of the surgeons provided at least one argument related to the positive task characteristics, and 12.9% (66/492) of the surgeons provided statements related to the positive contextual factors. With respect to the factors that discourage surgery as a profession, 45.7% (234/492) of the surgeons provided at least one argument related to the discouraging work characteristics, and 67.6% (346/492) of the surgeons provided problematic contextual characteristics. This study emphasizes the importance of the calling to surgery as an important factor for choosing surgery as a career. However, the extensive workload, training, and poor work-family balance have been identified as factors that discourage graduates from choosing surgery as a career. The identified positive factors could be used to attract and maintain graduates in surgical disciplines.

21 CFR 878.4460 - Surgeon's glove.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Surgeon's glove. 878.4460 Section 878.4460 Food... DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4460 Surgeon's glove. (a) Identification. A surgeon's glove is a device made of natural or synthetic rubber intended to be worn by...

Assessment and Recognition of Non-Formal and Informal Learning: A Lithuanian Case of Novice Consultants' Experience

Science.gov (United States)

Burkšaitiene, Nijole

2015-01-01

This article reports the results of the investigation into institutional support provided to adults by 12 novice consultants on assessment and recognition of their non-formal and informal learning in four institutions of higher education (HEIs) in Lithuania. Using the general systems perspective and perception theory, novice consultants'…

Novice to expert practice via postprofessional athletic training education: a grounded theory.

Science.gov (United States)

Neibert, Peter J

2009-01-01

To discover the theoretic constructs that confirm, disconfirm, or extend the principles and their applications appropriate for National Athletic Trainers' Association (NATA)-accredited postprofessional athletic training education programs. Interviews at the 2003 NATA Annual Meeting & Clinical Symposia. Qualitative study using grounded theory procedures. Thirteen interviews were conducted with postprofessional graduates. Participants were purposefully selected based on theoretic sampling and availability. The transcribed interviews were analyzed using open coding, axial coding, and selective coding procedures. Member checks, reflective journaling, and triangulation were used to ensure trustworthiness. The participants' comments confirmed and extended the current principles of postprofessional athletic training education programs and offered additional suggestions for more effective practical applications. The emergence of this central category of novice to expert practice is a paramount finding. The tightly woven fabric of the 10 processes, when interlaced with one another, provides a strong tapestry supporting novice to expert practice via postprofessional athletic training education. The emergence of this theoretic position pushes postprofessional graduate athletic training education forward to the future for further investigation into the theoretic constructs of novice to expert practice.

Choosing a Surgeon: An Exploratory Study of Factors Influencing Selection of a Gender Affirmation Surgeon.

Science.gov (United States)

Ettner, Randi; Ettner, Frederic; White, Tonya

2016-01-01

Purpose: Selecting a healthcare provider is often a complicated process. Many factors appear to govern the decision as to how to select the provider in the patient-provider relationship. While the possibility of changing primary care physicians or specialists exists, decisions regarding surgeons are immutable once surgery has been performed. This study is an attempt to assess the importance attached to various factors involved in selecting a surgeon to perform gender affirmation surgery (GAS). It was hypothesized that owing to the intimate nature of the surgery, the expense typically involved, the emotional meaning attached to the surgery, and other variables, decisions regarding choice of surgeon for this procedure would involve factors other than those that inform more typical healthcare provider selection or surgeon selection for other plastic/reconstructive procedures. Methods: Questionnaires were distributed to individuals who had undergone GAS and individuals who had undergone elective plastic surgery to assess decision-making. Results: The results generally confirm previous findings regarding how patients select providers. Conclusion: Choosing a surgeon to perform gender-affirming surgery is a challenging process, but patients are quite rational in their decision-making. Unlike prior studies, we did not find a preference for gender-concordant surgeons, even though the surgery involves the genital area. Providing strategies and resources for surgical selection can improve patient satisfaction.

The Different Inhibition of Return (IOR Effects of Emergency Managerial Experts and Novices: An Event-Related Potentials Study

Directory of Open Access Journals (Sweden)

Rong Cao

2017-05-01

Full Text Available Inhibition of return (IOR is an important effect of attention. However, the IOR of emergency managerial experts is unknown. By employing emergency and natural scene pictures in expert-novice paradigm, the present study explored the neural activity underlying the IOR effects for emergency managerial experts and novices. In behavioral results, there were no differences of IOR effects between novices and emergency managerial experts, while the event-related potentials (ERPs results were different between novices and experts. In Experiment 1 (novice group, ERPs results showed no any IOR was robust at both stimulus-onset asynchrony (SOA of 200 ms and 400 ms. In Experiment 2 (expert group, ERPs results showed an enhanced N2 at SOA of 200 ms and attenuated P3 at cued location in the right parietal lobe and adjacent brain regions than uncued location at SOA of 200 ms. The findings of the two experiments showed that, relative to the novices, IOR for the emergency managerial experts was robust, and dominated in the right parietal lobe and adjacent brain regions, suggesting more flexible attentional processing and higher visual search efficiency of the emergency managerial experts. The findings indicate that the P3, possible N2, over the right parietal lobe and adjacent brain regions are the biological indicators for IOR elicited by post-cued emergency pictures for emergency managerial experts.

Plagiarism: Misconduct Awareness on Novice Research within the ...

African Journals Online (AJOL)

More often than not, there exists some form of infringement relating to the use of other authors' work. This is particularly so in instances in which novice authors make use of the information available within the cyber-digital environment. The article explains the meaning of plagiarism and describes the many manifestations ...

Surgeons' vision rewarded.

Science.gov (United States)

Baillie, Jonathan

2010-08-01

Surgeons and clinical staff, theatre circulation and scrub personnel, and anaesthetists, as well as the estates and facilities team at Kent's Maidstone Hospital, have worked with specialist supplier of integrated audio, video, and instrumentation systems for the operating room, Olympus Medical, to develop what is claimed is among the UK's most advanced operating theatres yet built for laparoscopic and endoscopic surgery. HEJ editor Jonathan Baillie discussed the project with Amir Nisar, the surgeon who championed efforts to get the facility built, and Olympus Medical national sales manager, systems integration, James Watts.

The objective assessment of experts' and novices' suturing skills using an image analysis program.

Science.gov (United States)

Frischknecht, Adam C; Kasten, Steven J; Hamstra, Stanley J; Perkins, Noel C; Gillespie, R Brent; Armstrong, Thomas J; Minter, Rebecca M

2013-02-01

To objectively assess suturing performance using an image analysis program and to provide validity evidence for this assessment method by comparing experts' and novices' performance. In 2009, the authors used an image analysis program to extract objective variables from digital images of suturing end products obtained during a previous study involving third-year medical students (novices) and surgical faculty and residents (experts). Variables included number of stitches, stitch length, total bite size, travel, stitch orientation, total bite-size-to-travel ratio, and symmetry across the incision ratio. The authors compared all variables between groups to detect significant differences and two variables (total bite-size-to-travel ratio and symmetry across the incision ratio) to ideal values. Five experts and 15 novices participated. Experts' and novices' performances differed significantly (P 0.8) for total bite size (P = .009, d = 1.5), travel (P = .045, d = 1.1), total bite-size-to-travel ratio (P algorithm can extract variables from digital images of a running suture and rapidly provide quantitative summative assessment feedback. The significant differences found between groups confirm that this system can discriminate between skill levels. This image analysis program represents a viable training tool for objectively assessing trainees' suturing, a foundational skill for many medical specialties.

Opportunities in Total Knee Arthroplasty: Worldwide Surgeons' Perspective.

Science.gov (United States)

Dunbar, Michael; Newman, Jared M; Khlopas, Anton; Chughtai, Morad; Martinez, Nick; Bhowmik-Stoker, Manoshi; Mont, Michael A

2017-07-25

This study surveyed a group of US and international orthopaedic surgeons to prioritize areas of improvement in primary total knee arthroplasty (TKA). Specifically, we assessed surgeon responses regarding the top five areas of TKA needing improvement; which were stratified by: a) US surgeons, b) international surgeons, c) US surgeons' implant-brand-loyalty, and d) surgeons' years of experience and case volume. Four hundred and eighteen surgeons who were board-certified, in practice for at least two years, spent 60% of their time in clinical practice, and performed a minimum of 25 lower extremity joint arthroplasties per year were surveyed. They chose the top five areas (among 17) needing improvement for TKA. Results were stratified by surgeons' location (US and international), implant-brand-loyalty, years of experience, and case volume. Functional outcomes was the top identified area for improvement (US 63% and international 71%), followed by brand loyalty (Company I 68%, other brand 59%, and multi-brand/no loyalty 66%), years of experience (early-career 64%, mid-career 63%, and late-career 75%) and case volume (low-volume 69%, mid-volume 60%, and high-volume 71%). Following this was costs for US surgeons (47%) and implant survivorship for international surgeons (57%). While costs were the next highest area for specific Company-loyal surgeons (57%), implant survivorship was the next highest area for the other two cohorts. Implant survivorship was the second most important area of improvement regardless of years of experience and for low- and mid-volume surgeons. Surgeons identified functional outcomes as the most important area needing improvement. Cost of implants was more important for American as compared to international surgeons.

The surgeon's perspective: promoting and discouraging factors for choosing a career in surgery as perceived by surgeons.

Directory of Open Access Journals (Sweden)

Julia C Seelandt

Full Text Available BACKGROUND: The aim of this study was to identify the factors perceived by surgeons that promote surgery as an attractive or unattractive career choice for today's graduates. In addition, it examined whether the perspectives of surgeons in different professional situations converges. The content of work, contextual work conditions, and calling to this job are discussed in the context of choosing surgery as a career. METHODS: Eight hundred sixty-nine surgeons were asked to answer open-ended questions regarding the factors that promote surgery as an attractive or unattractive career choice for today's graduates. Four hundred ninety-two surgeons participated, and 1,525 statements were analyzed using Mayring's content-analyses method. Chi-square tests were used to analyze the differences among hierarchical positions. RESULTS: With respect to the factors that promote surgery as a profession, 40.8% (209/492 of the surgeons stated that surgery is a calling, 29.1% (149/492 of the surgeons provided at least one argument related to the positive task characteristics, and 12.9% (66/492 of the surgeons provided statements related to the positive contextual factors. With respect to the factors that discourage surgery as a profession, 45.7% (234/492 of the surgeons provided at least one argument related to the discouraging work characteristics, and 67.6% (346/492 of the surgeons provided problematic contextual characteristics. CONCLUSION: This study emphasizes the importance of the calling to surgery as an important factor for choosing surgery as a career. However, the extensive workload, training, and poor work-family balance have been identified as factors that discourage graduates from choosing surgery as a career. The identified positive factors could be used to attract and maintain graduates in surgical disciplines.

Business knowledge in surgeons.

Science.gov (United States)

Satiani, Bhagwan

2004-07-01

Surgeons and residents in training receive little, if any, formal education in the economic side of clinical practice during medical school or residency. As medical professionals face shrinking reimbursement, loss of control over health care decisions, and limited resources, surgical specialties must reevaluate the need to teach their members business survival skills. Before designing business related-teaching modules, educators must know the exact gaps in knowledge that exist among surgeons. This article reports a survey of 133 surgeons in the Midwest who were asked to rate their knowledge base in 11 business topics relevant to the practice of medicine. The survey showed that the average surgeon perceives himself or herself to be poorly equipped to understand basic financial accounting principles, financial markets, economics of health care, tools for evaluating purchases, marketing, budgets, antitrust and fraud and abuse regulations, and risk and return on investments. Armed with this data, teaching faculty, health care systems, and medical specialty societies should design business education seminars to better position surgical specialists and trainees to communicate with insurers, hospital administrators, health care organizations, and their own personal financial advisors.

What Is a Foot and Ankle Surgeon?

Science.gov (United States)

... A A | Print | Share What is a Foot & Ankle Surgeon? Foot and ankle surgeons are the surgical ... every age. What education has a foot and ankle surgeon received? After completing undergraduate education, the foot ...

Normative values of eccentric hip abduction strength in novice runners

DEFF Research Database (Denmark)

Ramskov, D; Pedersen, M B; Kastrup, K

2014-01-01

normative values of maximal eccentric hip abduction strength in novice runners. METHODS: Novice healthy runners (n = 831) were recruited through advertisements at a hospital and a university. Maximal eccentric hip abduction strength was measured with a hand-held dynamometer. The demographic variables...... was found, p values were identified using a regression equation adjusting for age and gender. Based on this, the equation to calculate normative values for relative eccentric hip abduction strength became: (1.600 + (age * -0.005) + (gender (1 = male / 0 = female) * 0.215) ± 1 or 2 * 0......PURPOSE: Low eccentric strength of the hip abductors, might increase the risk of patellofemoral pain syndrome and iliotibial band syndrome in runners. No normative values for maximal eccentric hip abduction strength have been established. Therefore the purpose of this study was to establish...

Face, content, and construct validity of the EndoViS training system for objective assessment of psychomotor skills of laparoscopic surgeons.

Science.gov (United States)

Escamirosa, Fernando Pérez; Flores, Ricardo Manuel Ordorica; García, Ignacio Oropesa; Vidal, Cristian Rubén Zalles; Martínez, Arturo Minor

2015-11-01

The aim of this study is to present face, content, and constructs validity of the endoscopic orthogonal video system (EndoViS) training system and determines its efficiency as a training and objective assessment tool of the surgeons' psychomotor skills. Thirty-five surgeons and medical students participated in this study: 11 medical students, 19 residents, and 5 experts. All participants performed four basic skill tasks using conventional laparoscopic instruments and EndoViS training system. Subsequently, participants filled out a questionnaire regarding the design, realism, overall functionality, and its capabilities to train hand-eye coordination and depth perception, rated on a 5-point Likert scale. Motion data of the instruments were obtained by means of two webcams built into a laparoscopic physical trainer. To identify the surgical instruments in the images, colored markers were placed in each instrument. Thirteen motion-related metrics were used to assess laparoscopic performance of the participants. Statistical analysis of performance was made between novice, intermediate, and expert groups. Internal consistency of all metrics was analyzed with Cronbach's α test. Overall scores about features of the EndoViS system were positives. Participants agreed with the usefulness of tasks and the training capacities of EndoViS system (score >4). Results presented significant differences in the execution of three skill tasks performed by participants. Seven metrics showed construct validity for assessment of performance with high consistency levels. EndoViS training system has been successfully validated. Results showed that EndoViS was able to differentiate between participants of varying laparoscopic experience. This simulator is a useful and effective tool to objectively assess laparoscopic psychomotor skills of the surgeons.

Exploring the experiences of novice clinical instructors in physical therapy clinical education: a phenomenological study.

Science.gov (United States)

Greenfield, B H; Bridges, P H; Phillips, T A; Drill, A N; Gaydosik, C D; Krishnan, A; Yandziak, H J

2014-12-01

To explore the perceptions of novice physical therapy clinical instructors (CIs) about their interactions and teaching behaviours with physical therapy students. A phenomenological approach using semi-structured interviews and a focus group. Six novice physical therapy CIs (less than two years as a CI and supervised fewer than three students) were recruited purposefully from a large metropolitan area in the USA. All participants were credentialed by the American Physical Therapy Association as CIs. Transcripts of interview data and focus group data were analysed using interpretative analysis for themes and subthemes. Participants viewed the transition of students from the classroom to the clinic as their primary role, using strategies of 'providing a way in', 'fostering critical thinking', 'finding a balance', 'overcoming barriers' and 'letting go'. While novice CIs showed skill in fostering student reflection and providing orientation, they struggled with student autonomy and balancing the competing obligations of patient care and clinical instruction. They expressed issues related to anxiety and lack of confidence. In the future, novice CIs could benefit from training and support in these areas. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Scaffolding Writing Using Feedback in Students' Graphic Organizers--Novice Writers' Relevance of Ideas and Cognitive Loads

Science.gov (United States)

Lee, Chien Ching; Tan, Seng Chee

2010-01-01

This paper aims to find out two outcomes of feedback in the novice writers' graphic organizers, which are the novice writers' ability to align their ideas to their writing goal, and their perceived germane, metacognitive, extraneous and intrinsic cognitive loads when generating and revising ideas based on the feedback. Data was gathered from the…

Study of the 5E Instructional Model to Improve the Instructional Design Process of Novice Teachers

Science.gov (United States)

Hu, Jiuhua; Gao, Chong; Liu, Yang

2017-01-01

This study investigated the effects of 5E instructional model on the teaching processes of novice teachers. First, we conducted a teaching design training project based on the 5E model for 40 novice teachers, and compared pre-texts of the teachers' teaching process from before the training with post-texts obtained immediately following the…

No effect of a graded training program on the number of running-related injuries in novice runners

NARCIS (Netherlands)

Buist, Ida; Bredeweg, Steef W.; van Mechelen, Willem; Lemmink, Koen A. P. M.; Pepping, Gert-Jan; Diercks, Ron L.

Background: Although running has positive effects on health and fitness, the incidence of a running-related injury (RRI) is high. Research on prevention of RRI is scarce; to date, no studies have involved novice runners. Hypothesis: A graded training program for novice runners will lead to a

Face, content and construct validity of a virtual reality simulator for robotic surgery (SEP Robot).

Science.gov (United States)

Gavazzi, Andrea; Bahsoun, Ali N; Van Haute, Wim; Ahmed, Kamran; Elhage, Oussama; Jaye, Peter; Khan, M Shamim; Dasgupta, Prokar

2011-03-01

This study aims to establish face, content and construct validation of the SEP Robot (SimSurgery, Oslo, Norway) in order to determine its value as a training tool. The tasks used in the validation of this simulator were arrow manipulation and performing a surgeon's knot. Thirty participants (18 novices, 12 experts) completed the procedures. The simulator was able to differentiate between experts and novices in several respects. The novice group required more time to complete the tasks than the expert group, especially suturing. During the surgeon's knot exercise, experts significantly outperformed novices in maximum tightening stretch, instruments dropped, maximum winding stretch and tool collisions in addition to total task time. A trend was found towards the use of less force by the more experienced participants. The SEP robotic simulator has demonstrated face, content and construct validity as a virtual reality simulator for robotic surgery. With steady increase in adoption of robotic surgery world-wide, this simulator may prove to be a valuable adjunct to clinical mentorship.

An In Situ Study of Analogical Reasoning in Novice and Experienced Design Engineers

DEFF Research Database (Denmark)

Ahmed, Saeema; Christensen, B T

2009-01-01

This paper describes a study to understand the use of analogies by design engineers with different levels of experience in an adaptive design domain. Protocol analyses of 12 design engineers have been analyzed to understand the functions and reasoning of the analogies. The protocols are real......-world data from the aerospace industry. The findings indicate a significant difference in both the use of analogies by novices and experienced designers and the reasoning from the analogies. Novices were found to predominantly transfer information related to the geometric properties without explicit...

Beginning Python from novice to professional

CERN Document Server

Hetland, Magnus Lie

2005-01-01

""Beginning Python: From Novice to Professional"" is the most comprehensive book on the Python ever written. Based on ""Practical Python,"" this newly revised book is both an introduction and practical reference for a swath of Python-related programming topics, including addressing language internals, database integration, network programming, and web services. Advanced topics, such as extending Python and packaging/distributing Python applications, are also covered. Ten different projects illustrate the concepts introduced in the book. You will learn how to create a P2P file-sharing applicati

Using a Complexity-Based Perspective to Better Understand the Relationships among Mentoring, School Conflicts, and Novice Retention

Science.gov (United States)

Waterman, Sheryn Elaine Spencer

2011-01-01

In this study I used complexity-thinking, ecologically-based sustainable capacity-building, narrative methodology, and pragmatism to explore the relationships among mentoring, conflict, and novice retention. In order to explore these relationships, I constructed stories from my interviews with six mentor-novice dyads in a southeastern 9-12 high…

Pedagogy, Empowerment and Discipline: Comparative Perspectives of Novice Teachers in England and Turkey Reflecting on "the Other"

Science.gov (United States)

Busher, Hugh; Lawson, Tony; Wilkins, Chris; Acun, Ismail

2011-01-01

This article discusses the views of Turkish and British novice teachers on pedagogy and pedagogical relationships with school students when confronted with the pedagogical practices of the "Other" in particular policy contexts. Experiences of those practices were gained by novice teachers during an exchange visit for British and Turkish…

Dietary tendencies as predictors of marathon time in novice marathoners.

Science.gov (United States)

Wilson, Patrick B; Ingraham, Stacy J; Lundstrom, Chris; Rhodes, Gregory

2013-04-01

The effects of dietary factors such as carbohydrate (CHO) on endurance-running performance have been extensively studied under laboratory-based and simulated field conditions. Evidence from "real-life" events, however, is poorly characterized. The purpose of this observational study was to examine the associations between prerace and in-race nutrition tendencies and performance in a sample of novice marathoners. Forty-six college students (36 women and 10 men) age 21.3 ± 3.3 yr recorded diet for 3 d before, the morning of, and during a 26.2-mile marathon. Anthropometric, physiological, and performance measurements were assessed before the marathon so the associations between diet and marathon time could be included as part of a stepwise-regression model. Mean marathon time was 266 ± 42 min. A pre-marathon 2-mile time trial explained 73% of the variability in marathon time (adjusted R2 = .73, p marathon time, explaining an additional 4% of the variability in marathon time (adjusted R2 = .77, p = .006). Other factors such as age, body-mass index, gender, day-before + morning-of energy, and in-race CHO were not significant independent predictors of marathon time. In this sample of primarily novice marathoners, DBMC intake was associated with faster marathon time, independent of other known predictors. These results suggest that novice and recreational marathoners should consider consuming a moderate to high amount of CHO in the 24-36 hr before a marathon.

Solving Accounting Problems: Differences between Accounting Experts and Novices.

Science.gov (United States)

Marshall, P. Douglas

2002-01-01

Performance of 90 accounting experts (faculty and practitioners) and 60 novices (senior accounting majors) was compared. Experts applied more accounting principles to solving problems. There were no differences in types of principles applied and no correlation between (1) principles applied and number of breadth comments or (2) importance placed…

Performing Systematic Literature Reviews with Novices: An Iterative Approach

Science.gov (United States)

Lavallée, Mathieu; Robillard, Pierre-N.; Mirsalari, Reza

2014-01-01

Reviewers performing systematic literature reviews require understanding of the review process and of the knowledge domain. This paper presents an iterative approach for conducting systematic literature reviews that addresses the problems faced by reviewers who are novices in one or both levels of understanding. This approach is derived from…

Rural Rides in Queensland: Travels with Novice Teaching Principals

Science.gov (United States)

Clarke, Simon; Stevens, Elizabeth; Wildy, Helen

2006-01-01

This article is concerned with the nature of novice teaching principals' interactions in Queensland rural communities. Stories selected from case accounts are used to provide insights into the teaching principals' interrelationship with the community. The article concludes with a discussion of some implications for practice suggested by these…

Retention of Mohs surgeons in academic dermatology.

Science.gov (United States)

Zhang, Shali; Mina, Mary Alice; Brown, Marc D; Zwald, Fiona O

2015-08-01

Retention of academic Mohs surgeons is important for the growth of this specialty and teaching of residents and students. To examine factors that influence retention of Mohs surgeons in academics and to better understand reasons for their departure. A survey was electronically distributed to academic Mohs surgeons in the American College of Mohs Surgery, asking them to rate the importance of several variables on their decision to remain in academia. Private practice Mohs surgeons who had left academics were also surveyed. Two hundred thirty-six dermatologic surgeons completed the survey. Twenty-nine percent work full time in academics, and approximately 7% work part time. The top reasons for practicing in the academic setting are intellectual stimulation, teaching opportunities, and collaboration with other university physicians and researchers. Seventy-one percent of respondents reported they would stay in academics, 7% indicated they would not, and 22% were unsure. Unfair compensation, inadequate support staff, poor leadership, increased bureaucracy, and decreased autonomy were top reasons that may compel a Mohs surgeon to leave. Opportunities for intellectual stimulation, collaboration, and teaching remain the main draw for academic Mohs surgeons. A supportive environment, strong leadership, and establishing fair compensation are imperative in ensuring their stay.

Quantifying Novice and Expert Differences in Visual Diagnostic Reasoning in Veterinary Pathology Using Eye-Tracking Technology.

Science.gov (United States)

Warren, Amy L; Donnon, Tyrone L; Wagg, Catherine R; Priest, Heather; Fernandez, Nicole J

2018-01-18

Visual diagnostic reasoning is the cognitive process by which pathologists reach a diagnosis based on visual stimuli (cytologic, histopathologic, or gross imagery). Currently, there is little to no literature examining visual reasoning in veterinary pathology. The objective of the study was to use eye tracking to establish baseline quantitative and qualitative differences between the visual reasoning processes of novice and expert veterinary pathologists viewing cytology specimens. Novice and expert participants were each shown 10 cytology images and asked to formulate a diagnosis while wearing eye-tracking equipment (10 slides) and while concurrently verbalizing their thought processes using the think-aloud protocol (5 slides). Compared to novices, experts demonstrated significantly higher diagnostic accuracy (preasoning and script-inductive knowledge structures with system 2 (analytic) reasoning to verify their diagnosis.

Effects of leg dominance on performance of ballet turns (pirouettes) by experienced and novice dancers.

Science.gov (United States)

Lin, Chia-Wei; Su, Fong-Chin; Wu, Hong-Wen; Lin, Cheng-Feng

2013-01-01

Turns (pirouettes) are an important movement in ballet and may be affected by "lateral bias". This study investigated physiological differences exhibited by experienced and novice dancers, respectively, when performing pirouette with dominant and non-dominant leg supports, respectively. Thirteen novice and 13 experienced dancers performed turns on dominant or non-dominant legs. The maximum ankle plantarflexion, knee extension and hip extension were measured during the single-leg support phase. The inclination angle of rotation axis is the angle between instantaneous rotation axis and global vertical axis in the early single-leg support phase. Both groups exhibited a greater hip extension, knee extension, and ankle plantarflexion when performing a turn on the non-dominant leg. For experienced dancers, the inclination angle of rotation axis during the pre-swing phase was generally smaller for dominant leg support than non-dominant leg. However, no significant difference was found in inclination angle of rotation axis of novice dancers. For experienced dancers, an improved performance is obtained when using the dominant leg for support. By contrast, for novice dancers, the performance is independent of choice of support leg. The significant lateral bias in experienced dancers indicates the possible influence of training. That is, repetitive rehearsal on the preferred leg strengthens the impact of side dominance in experienced dancers.

Solving the surgeon ergonomic crisis with surgical exosuit.

Science.gov (United States)

Liu, Shanglei; Hemming, Daniel; Luo, Ran B; Reynolds, Jessica; Delong, Jonathan C; Sandler, Bryan J; Jacobsen, Garth R; Horgan, Santiago

2018-01-01

The widespread adoption of laparoscopic surgery has put new physical demands on the surgeon leading to increased musculoskeletal disorders and injuries. Shoulder, back, and neck pains are among the most common complaints experienced by laparoscopic surgeons. Here, we evaluate the feasibility and efficacy of a non-intrusive progressive arm support exosuit worn by surgeons under the sterile gown to reduce pain and fatigue during surgery. This is a prospective randomized crossover study approved by the Internal Review Board (IRB). The study involves three phases of testing. In each phase, general surgery residents or attendings were randomized to wearing the surgical exosuit at the beginning or at the crossover point. The first phase tests for surgeon manual dexterity wearing the device using the Minnesota Dexterity test, the Purdue Pegboard test, and the Fundamentals of Laparoscopic Surgery (FLS) modules. The second phase tests the effect of the device on shoulder pain and fatigue while operating the laparoscopic camera. The third phase rates surgeon experience in the operating room between case-matched operating days. Twenty subjects were recruited for this study. Surgeons had the similar dexterity scores and FLS times whether or not they wore the exosuit (p value ranges 0.15-0.84). All exosuit surgeons completed 15 min of holding laparoscopic camera compared to three non-exosuit surgeons (p Exosuit surgeons experienced significantly less fatigue at all time periods and arm pain (3.11 vs 5.88, p = 0.019) at 10 min. Surgeons wearing the exosuit during an operation experienced significant decrease in shoulder pain and 85% of surgeons reported some form of pain reduction at the end of the operative day. The progressive arm support exosuit can be a minimally intrusive device that laparoscopic surgeons wear to reduce pain and fatigue of surgery without significantly interfering with operative skills or manual dexterity.

Surgeon Participation in Early Accountable Care Organizations.

Science.gov (United States)

Resnick, Matthew J; Graves, Amy J; Buntin, Melinda B; Richards, Michael R; Penson, David F

2018-03-01

We aimed to characterize the landscape of surgeon participation in early accountable care organizations (ACOs) and to identify specialty-, organization-, and market-specific factors associated with ACO participation. Despite rapid deployment of alternative payment models (APMs), little is known about the prevalence of surgeon participation, and key drivers behind surgeon participation in APMs. Using data from SK&A, a research firm, we evaluated the near universe of US practices to characterize ACO participation among 125,425 US surgeons in 2015. We fit multivariable logistic regression models to characterize key drivers of ACO participation, and more specifically, the interaction between ACO affiliation and organizational structure. Of 125,425 US surgeons, 27,956 (22.3%) participated in at least 1 ACO program in 2015. We observed heterogeneity in participation by subspecialty, with trauma and transplant reporting the highest rate of ACO enrollment (36% for both) and plastic surgeons reporting the lowest (12.9%) followed by ophthalmology (16.0%) and hand (18.6%). Surgeons in group practices and integrated systems were more likely to participate relative to those practicing independently (aOR 1.57, 95% CI 1.50, 1.64; aOR 4.87, 95% CI 4.68, 5.07, respectively). We observed a statistically significant interaction (P organization. Model-derived predicted probabilities revealed that, within each specialty, surgeons in integrated health systems had the highest predicted probabilities of ACO and those practicing independently generally had the lowest. We observed considerable variation in ACO enrollment among US surgeons, mediated at least in part by differences in practice organization. These data underscore the need for development of frameworks to characterize the strategic advantages and disadvantages associated with APM participation.

Using Social Media and Professional Learning Communities as Tools for Novice Teacher Collegiality and Improved Self-Efficacy

Science.gov (United States)

Bostick, Bradley

2013-01-01

Teacher attrition and the migration between schools and districts can have a negative impact on quality of education and teacher performance. Novice teachers leave the profession because they are overwhelmed by the workload and responsibilities of the job. In a previous action research cycle, I found that novice teachers' perceptions of…

Surgeon Reliability for the Assessment of Lumbar Spinal Stenosis on MRI: The Impact of Surgeon Experience.

Science.gov (United States)

Marawar, Satyajit V; Madom, Ian A; Palumbo, Mark; Tallarico, Richard A; Ordway, Nathaniel R; Metkar, Umesh; Wang, Dongliang; Green, Adam; Lavelle, William F

2017-01-01

Treating surgeon's visual assessment of axial MRI images to ascertain the degree of stenosis has a critical impact on surgical decision-making. The purpose of this study was to prospectively analyze the impact of surgeon experience on inter-observer and intra-observer reliability of assessing severity of spinal stenosis on MRIs by spine surgeons directly involved in surgical decision-making. Seven fellowship trained spine surgeons reviewed MRI studies of 30 symptomatic patients with lumbar stenosis and graded the stenosis in the central canal, the lateral recess and the foramen at T12-L1 to L5-S1 as none, mild, moderate or severe. No specific instructions were provided to what constituted mild, moderate, or severe stenosis. Two surgeons were "senior" (>fifteen years of practice experience); two were "intermediate" (>four years of practice experience), and three "junior" (< one year of practice experience). The concordance correlation coefficient (CCC) was calculated to assess inter-observer reliability. Seven MRI studies were duplicated and randomly re-read to evaluate inter-observer reliability. Surgeon experience was found to be a strong predictor of inter-observer reliability. Senior inter-observer reliability was significantly higher assessing central(p<0.001), foraminal p=0.005 and lateral p=0.001 than "junior" group.Senior group also showed significantly higher inter-observer reliability that intermediate group assessing foraminal stenosis (p=0.036). In intra-observer reliability the results were contrary to that found in inter-observer reliability. Inter-observer reliability of assessing stenosis on MRIs increases with surgeon experience. Lower intra-observer reliability values among the senior group, although not clearly explained, may be due to the small number of MRIs evaluated and quality of MRI images.Level of evidence: Level 3.

Surgeons in Difficulty: An Exploration of Differences in Assistance-Seeking Behaviors between Male and Female Surgeons.

Science.gov (United States)

Sanfey, Hilary; Fromson, John; Mellinger, John; Rakinic, Jan; Williams, Michael; Williams, Betsy

2015-08-01

Physician burnout is associated with diminished ability to practice with requisite skill and safety. Physicians are often reluctant to seek help for an impaired colleague or for impairment that affects their own ability to practice. To better support surgeons in difficulty, we explored sex differences in assistance-seeking behaviors under stress. Surgeons in 3 national societies completed an IRB-approved anonymous multiple-choice and free-text response survey. Responses were explored with the general linear model using item-specific continuous and categorical methods. Two hundred and twelve surgeons (n = 79 [37.3%] male, n = 133 [63%] female) responded. Although men and women worked similar hours (p > 0.05), women worked more clinical (p work-life balance, as identified by aggregate variables related to emotional/decisional partnership, non-work-related chore support, and personal fulfillment (F = 15.29; df 3/16; p < 0.01), but change jobs less frequently (F = 4.23; df 1/201; p < 0.05). Males are more likely to seek help from colleagues (chi-square 107.5; p < 0.01) or friends (chi-square 123.8; p < 0.01) and women are more likely to seek support from professional counselors (chi-square 146.8; p < 0.01). Almost one-third of surgeons would ignore behaviors that adversely impact well being and could result in potential personal or patient safety. The differences between the assistance-seeking and reporting behaviors of male and female surgeons in distress could have implications for identification and treatment of this population. These findings can be used to develop educational activities to teach surgeons how to effectively handle these challenging situations. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Exploring the Evolving Professional Identity of Novice School Counselors

Science.gov (United States)

Bamgbose, Olamojiba Omolara

2017-01-01

The study employed a grounded theory approach to explore the evolving professional identity of novice school counselors. Participants, who are currently employed as school counselors at the elementary, middle, or high school level with 1-4 years' experience, were career changers from other helping professions and graduates from an intensive school…

Supporting Novice Special Education Teachers through Quality Professional Development

Science.gov (United States)

Tate, Mary E.

2013-01-01

The special education teaching environment is a teaching environment with unique duties that often challenge novice special education teachers. The purpose of this qualitative case study was to gain clarity of the work environment of special education teachers to uncover professional development practices that would work to support them. Research…

Systematic Literature Review Protocol: Teaching Novices Programming Using Robots

Science.gov (United States)

Major, Louis

2010-01-01

Teaching computer programming to novices is a difficult task due to the complex nature of the subject, as negative stereotypes are associated with programming and because introductory programming courses often fail to encourage student understanding. This Protocol outlines the plan that is to be followed in order to investigate the effectiveness…

The Metamorphosis of Industrial Designers from Novices to Experts

Science.gov (United States)

Wong, Ju-Joan; Chen, Po-Yu; Chen, Chun-Di

2016-01-01

Professional training for designers is crucial in the field of design studies. The characteristics of novices versus those of expert designers have been identified in the literature; however, studies exploring the issue of professional training processes in the actual workplace are not well developed. Our study addresses the topic by using…

Novice Teachers' Case Dilemmas: Surprising Perspectives Related to Diversity.

Science.gov (United States)

Mastrilli, Thomas; Sardo-Brown, Deborah; Hinson, Stephanie

This study described novice teachers' case dilemmas, analyzing them for assumptions made by teachers about teaching and learning as well as for solutions to the dilemmas. Twenty-one of the thirty-six dilemmas emphasized either minority students, students of low socioeconomic status, or students from single-parent households. Among the issues…

Educating the surgeon-scientist: A qualitative study evaluating challenges and barriers toward becoming an academically successful surgeon.

Science.gov (United States)

Kodadek, Lisa M; Kapadia, Muneera R; Changoor, Navin R; Dunn, Kelli Bullard; Are, Chandrakanth; Greenberg, Jacob A; Minter, Rebecca M; Pawlik, Timothy M; Haider, Adil H

2016-12-01

The advancement of surgical science relies on educating new generations of surgeon-scientists. Career development awards (K Awards) from the National Institutes of Health, often considered a marker of early academic success, are one way physician-scientists may foster skills through a mentored research experience. This study aimed to develop a conceptual framework to understand institutional support and other factors leading to a K Award. A national, qualitative study was conducted with academic surgeons. Participants included 15 K Awardees and 12 surgery department Chairs. Purposive sampling ensured a diverse range of experiences. Semistructured, in-depth telephone interviews were conducted. Interviews were audio recorded and transcribed verbatim, and 2 reviewers analyzed the transcripts using Grounded Theory methodology. Participants described individual and institutional factors contributing to success. K Awardees cited personal factors such as perseverance and team leadership skills. Chairs described the K Awardee as an institutional "investment" requiring protected time for research, financial support, and mentorship. Both K Awardees and Chairs identified a number of challenges unique to the surgeon-scientist, including financial strains and competing clinical demands. Institutional support for surgeons pursuing K Awards is a complex investment with significant initial costs to the department. Chairs act as stewards of institutional resources and support those surgeon-scientists most likely to be successful. Although the K Award pathway is one way to develop surgeon-scientists, financial burdens and challenges may limit its usefulness. These findings, however, may better prepare young surgeons to develop career plans and identify new mechanisms for academic productivity. Copyright © 2016 Elsevier Inc. All rights reserved.

Burnout in the Plastic Surgeon: Implications and Interventions.

Science.gov (United States)

Prendergast, Christina; Ketteler, Erika; Evans, Gregory

2017-03-01

A career as a plastic surgeon is both rewarding and challenging. The road to becoming a surgeon is a long arduous endeavor and can bring significant challenges not only to the surgeon but their family. A study by the American College of Surgeons (ACS) suggested that over 40% of surgeons experience burnout and a recent survey of American Society of Plastic Surgeons (ASPS) showed that more than one-fourth of plastic surgeons have signs of professional burnout. Burnout is a state of physical and mental exhaustion. The three main components of burnout are emotional exhaustion, depersonalization, and reduced personal accomplishment. Exhaustion occurs as a result of emotional demands. Depersonalization refers to a cynical, negative or a detached response to patient care. The reduced accomplishment refers to a belief that one can no longer work effectively. There has been a recent explosion in the literature characterizing burnout within the surgical profession. Reports of burnout, burnout victims, and burnout syndrome are filling the medical literature, books, blogs, and social media across all different specialties. Burnout in a plastic surgeon has negative and potentially fatal repercussions to the surgeon, their family, their patients, their staff, colleagues, coworkers, and their organization. To date, there are a limited number of publications addressing burnout in the plastic surgery community. The goals of this paper are to review the symptoms of burnout, its effect on plastic surgeons, and discuss potential solutions for burnout prevention and physician wellness.

Improving Novice Radiology Trainees' Perception Using Fine Art.

Science.gov (United States)

Goodman, Thomas Rob; Kelleher, Michael

2017-10-01

To determine if fine art perception training improved performance in novice radiology trainees. On the first day of their residency, 15 radiology residents underwent a basic radiology perception test in which they were shown 15 different radiographs that each had a significant abnormality. This was followed by a focused session of interpretation training at a local art gallery where art experts taught the trainees how to thoroughly analyze a painting. After this fine art session, the residents were once again shown 15 different radiographs and asked, in the same manner as before, to identify the location of the abnormality. The results of both radiograph assessments were then compared. The 15 residents correctly identified the areas of abnormality on 35 of 225 cases pre-art training with a mean score of 2.33 and a SD of 1.4. After art training, the figure for correctly identifying the area of abnormality rose to 94 of 225 cases with a mean score of 6.27 and a SD of 1.79 (P art gallery may be a novel, effective transitional starting point for novice radiology trainees. Copyright © 2017. Published by Elsevier Inc.

Impact of Different Surgeons on Dental Implant Failure.

Science.gov (United States)

Chrcanovic, Bruno Ramos; Kisch, Jenö; Albrektsson, Tomas; Wennerberg, Ann

To assess the influence of several factors on the prevalence of dental implant failure, with special consideration of the placement of implants by different dental surgeons. This retrospective study is based on 2,670 patients who received 10,096 implants at one specialist clinic. Only the data of patients and implants treated by surgeons who had inserted a minimum of 200 implants at the clinic were included. Kaplan-Meier curves were stratified with respect to the individual surgeon. A generalized estimating equation (GEE) method was used to account for the fact that repeated observations (several implants) were placed in a single patient. The factors bone quantity, bone quality, implant location, implant surface, and implant system were analyzed with descriptive statistics separately for each individual surgeon. A total of 10 surgeons were eligible. The differences between the survival curves of each individual were statistically significant. The multivariate GEE model showed the following variables to be statistically significant: surgeon, bruxism, intake of antidepressants, location, implant length, and implant system. The surgeon with the highest absolute number of failures was also the one who inserted the most implants in sites of poor bone and used turned implants in most cases, whereas the surgeon with the lowest absolute number of failures used mainly modern implants. Separate survival analyses of turned and modern implants stratified for the individual surgeon showed statistically significant differences in cumulative survival. Different levels of failure incidence could be observed between the surgeons, occasionally reaching significant levels. Although a direct causal relationship could not be ascertained, the results of the present study suggest that the surgeons' technique, skills, and/or judgment may negatively influence implant survival rates.

Expert and Novice Approaches to Using Graphs: Evidence from Eye-Track Experiments

Science.gov (United States)

Wirth, K. R.; Lindgren, J. M.

2015-12-01

Professionals and students in geology use an array of graphs to study the earth, but relatively little detail is known about how users interact with these graphs. Comprehension of graphical information in the earth sciences is further complicated by the common use of non-traditional formats (e.g., inverted axes, logarithmic scales, normalized plots, ternary diagrams). Many educators consider graph-reading skills an important outcome of general education science curricula, so it is critical that we understand both the development of graph-reading skills and the instructional practices that are most efficacious. Eye-tracking instruments provide quantitative information about eye movements and offer important insights into the development of expertise in graph use. We measured the graph reading skills and eye movements of novices (students with a variety of majors and educational attainment) and experts (faculty and staff from a variety of disciplines) while observing traditional and non-traditional graph formats. Individuals in the expert group consistently demonstrated significantly greater accuracy in responding to questions (e.g., retrieval, interpretation, prediction) about graphs. Among novices, only the number of college math and science courses correlated with response accuracy. Interestingly, novices and experts exhibited similar eye-tracks when they first encountered a new graph; they typically scanned through the title, x and y-axes, and data regions in the first 5-15 seconds. However, experts are readily distinguished from novices by a greater number of eye movements (20-35%) between the data and other graph elements (e.g., title, x-axis, y-axis) both during and after the initial orientation phase. We attribute the greater eye movements between the different graph elements an outcome of the generally better-developed self-regulation skills (goal-setting, monitoring, self-evaluation) that likely characterize individuals in our expert group.

Danish surgeons' views on minimally invasive surgery

DEFF Research Database (Denmark)

Edwards, Hellen; Jørgensen, Lars Nannestad

2014-01-01

BACKGROUND AND AIM: Advancements in minimally invasive surgery have led to increases in popularity of single-incision laparoscopic surgery (SILS) and natural orifice translumenal surgery (NOTES(®); American Society for Gastrointestinal Endoscopy [Oak Brook, IL] and Society of American...... Gastrointestinal and Endoscopic Surgeons [Los Angeles, CA]) due to their postulated benefits of better cosmesis, less pain, and quicker recovery. This questionnaire-based study investigated Danish surgeons' attitudes toward these new procedures. SUBJECTS AND METHODS: A 26-item questionnaire was developed...... and distributed electronically via e-mail to a total of 1253 members of The Danish Society of Surgeons and The Danish Society of Young Surgeons. RESULTS: In total, 352 (approximately 30%) surgeons completed the questionnaire, 54.4% were over 50 years of age, and 76.6% were men. When choosing surgery, the most...

Kant and the cosmetic surgeon.

Science.gov (United States)

Carey, J S

1989-07-01

Philosophers know that modern philosophy owes a great debt to the intellectual contributions of the 18th century philosopher Immanuel Kant. This essay attempts to show how cosmetic surgeons, and all surgeons at that, could learn much from his work. Not only did Kant write about the structure of human reasoning and how it relates to appearances but he also wrote about the nature of duties and other obligations. His work has strongly influenced medical ethics. In a more particular way, Kant wrote the most important work on aesthetics. His theory still influences how philosophers understand the meaning of the beautiful and how it pertains to the human figure. This essay presents an exercise in trying to apply Kantian philosophy to aesthetic plastic surgery. Its intention is to show cosmetic surgeons some of the implicit and explicit philosophical principles and potential arguments undergirding their potential surgical evaluations. It is meant to challenge the surgeon to reconsider how decisions are made using philosophical reasoning instead of some of the more usual justifications based on psychology or sociology.

Surgeon General's Family Health History Initiative

Science.gov (United States)

... Source Code The Surgeon General's Family Health History Initiative To help focus attention on the importance of ... health campaign, called the Surgeon General's Family History Initiative, to encourage all American families to learn more ...

Speeding by young novice drivers: What can personal characteristics and psychosocial theory add to our understanding?

Science.gov (United States)

Scott-Parker, Bridie; Hyde, Melissa K; Watson, Barry; King, Mark J

2013-01-01

Young novice drivers continue to be overrepresented in fatalities and injuries arising from crashes even with the introduction of countermeasures such as graduated driver licensing (GDL). Enhancing countermeasures requires a better understanding of the variables influencing risky driving. One of the most common risky behaviours performed by drivers of all ages is speeding, which is particularly risky for young novice drivers who, due to their driving inexperience, have difficulty in identifying and responding appropriately to road hazards. Psychosocial theory can improve our understanding of contributors to speeding, thereby informing countermeasure development and evaluation. This paper reports an application of Akers' social learning theory (SLT), augmented by Gerrard and Gibbons' prototype/willingness model (PWM), in addition to personal characteristics of age, gender, car ownership, and psychological traits/states of anxiety, depression, sensation seeking propensity and reward sensitivity, to examine the influences on self-reported speeding of young novice drivers with a Provisional (intermediate) licence in Queensland, Australia. Young drivers (n=378) recruited in 2010 for longitudinal research completed two surveys containing the Behaviour of Young Novice Drivers Scale, and reported their attitudes and behaviours as pre-Licence/Learner (Survey 1) and Provisional (Survey 2) drivers and their sociodemographic characteristics. An Akers' measurement model was created. Hierarchical multiple regressions revealed that (1) personal characteristics (PC) explained 20.3%; (2) the combination of PC and SLT explained 41.1%; (3) the combination of PC, SLT and PWM explained 53.7% of variance in self-reported speeding. Whilst there appeared to be considerable shared variance, the significant predictors in the final model included gender, car ownership, reward sensitivity, depression, personal attitudes, and Learner speeding. These results highlight the capacity for

Facilitating programming comprehension for novice learners with multimedia approach: A preliminary investigation

Science.gov (United States)

Annamalai, Subashini; Salam, Sobihatun Nur Abdul

2017-10-01

This research paper presents the preliminary investigation on the use of an interactive multimedia courseware named MAFPro, to facilitate C Programming lessons for novice learners. The courseware utilizes the elements of multimedia that focus on enhancing learners' programming comprehension. Among the aspects that were examined were the students' programming comprehension and their perceived motivation of MAFPro. This study was carried out in a survey design method with the participation of 30 undergraduates who are novice learners. The data analysis indicates that the multimedia courseware, MAFPro that has been used in the C programming classroom has a significant difference on the undergraduates' programming comprehension. The students also perceived MAFPro as motivating and engaging.

Novice supervisee's experiences of what is good and bad psychotherapy supervision

DEFF Research Database (Denmark)

Jacobsen, Claus Haugaard; Pedersen, Lene Tanggaard

2007-01-01

This paper presents a qualitative study of novice supervisee’s experiences of good and bad supervisory experiences and on how this change as the supervisees gain more experience. Novice psychotherapists rate supervision as the most important element in their acquisition of professional skills...... was conducted as a series of semi structured qualitative research interviews with 7 student therapist 2 month after their first clinical experience in a university clinic setting. The subjects were re-interviewed when they had almost a year of clinical experience and supervision. The interviews were...... thematically focusing on the experience of specific good and bad supervisory experiences. Also included were the importance of peers in the supervision group and the organisational setting of the supervision. After analysing each individuals experience all individual experiences were examined until patterns...

Mindfulness for Novice Pediatric Nurses: Smartphone Application Versus Traditional Intervention.

Science.gov (United States)

Morrison Wylde, Chelsey; Mahrer, Nicole E; Meyer, Rika M L; Gold, Jeffrey I

The current study compares the effects of a traditionally delivered mindfulness (TDM) intervention to a smartphone delivered mindfulness (SDM) intervention, Headspace, an audio-guided mindfulness meditation program, in a group of novice nurses. Novice nurses participating in a pediatric nurse residency program were asked to participate in either a TDM or SDM intervention. Participants (N=95) completed self-administered pencil and paper questionnaires measuring mindfulness skills, and risk and protective factors at the start of their residency and three months after entering the program. Nurses in the SDM group reported significantly more "acting with awareness" and marginally more "non-reactivity to inner experience" skills compared to the TDM group. The smartphone intervention group also showed marginally more compassion satisfaction and marginally less burnout. Additionally, nurses in the SDM group had lower risk for compassion fatigue compared to the TDM group, but only when the nurses had sub-clinical posttraumatic symptoms at the start of the residency training program. Smartphone delivered mindfulness interventions may provide more benefits for novice nurses than traditionally delivered mindfulness interventions. However, the smart-phone intervention may be better indicated for nurses without existing symptoms of posttraumatic stress. Mindfulness interventions delivered through smartphone applications show promise in equipping nurses with important coping skills to manage stress. Because of the accessibility of smartphone applications, more nurses can benefit from the intervention as compared to a therapist delivered intervention. However, nurses with existing stress symptoms may require alternate interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

Accuracy of intuition in clinical decision-making among novice clinicians.

Science.gov (United States)

Price, Amanda; Zulkosky, Kristen; White, Krista; Pretz, Jean

2017-05-01

To assess the reliance on intuitive and analytical approaches during clinical decision-making among novice clinicians and whether that reliance is associated with accurate decision-making. Nurse educators and managers tend to emphasize analysis over intuition during clinical decision-making though nurses typically report some reliance on intuition in their practice. We hypothesized that under certain conditions, reliance on intuition would support accurate decision-making, even among novices. This study utilized an experimental design with clinical complication (familiar vs. novel) and decision phase (cue acquisition, diagnosis and action) as within-subjects' factors, and simulation role (observer, family, auxiliary nurse and primary nurse) as between-subjects' factor. We examined clinical decision-making accuracy among final semester pre-licensure nursing students in a simulation experience. Students recorded their reasoning about emerging clinical complications with their patient during two distinct points in the simulation; one point involved a familiar complication and the other a relatively novel complication. All data were collected during Spring 2015. Although most participants relied more heavily on analysis than on intuition, use of intuition during the familiar complication was associated with more accurate decision-making, particularly in guiding attention to relevant cues. With the novel complication, use of intuition appeared to hamper decision-making, particularly for those in an observer role. Novice clinicians should be supported by educators and nurse managers to note when their intuitions are likely to be valid. Our findings emphasize the integrated nature of intuition and analysis in clinical decision-making. © 2016 John Wiley & Sons Ltd.

Occupational Stress and Burnout among Surgeons in Fiji.

Science.gov (United States)

Patel, Rajeev; Huggard, Peter; van Toledo, Annik

2017-01-01

This study examined the levels of occupational stress and burnout among surgeons in Fiji. A document set comprising a cover letter; a consent form; a sociodemographic and supplementary information questionnaire; the Maslach Burnout Inventory (MBI); the 12-item General Health Questionnaire (GHQ-12); the Alcohol Use Disorders Identification Test (AUDIT); and the Professional Quality of Life (ProQOL) questionnaires were provided to surgeons from three public divisional hospitals in Fiji. Thirty-six of 43 (83.7%) invited surgeons participated in the study. According to their MBI scores, surgeons suffered from low (10, 27.8%), moderate (23, 63.9%), and high (3, 8.3%) levels of burnout. Comparatively, 23 (63.9%) demonstrated moderate burnout according to their ProQOL scores. Substantial psychiatric morbidity was observed in 16 (44.0%) surgeons per their GHQ-12 scores. Consumption of alcohol was noted in 29 (80.6%) surgeons, and 12 (33.4%) had AUDIT scores characterizing their alcohol use in excess of low-risk guidelines or as harmful or hazardous drinking. Surgeons of Fijian nationality showed higher MBI emotional exhaustion and depersonalization scores compared with surgeons of other nationalities. Surgeons with an awareness of the availability of counseling services at their hospitals showed low AUDIT and ProQOL burnout scores. Smokers, alcohol drinkers, and kava drinkers showed higher AUDIT scores. This study highlights a level of occupational stress and burnout among surgeons in Fiji and a lack of awareness of their mental and physical well-being. The authors recommend that occupational stress and burnout intervention strategies be put in place in hospitals in Fiji.

Predictors of running-related injuries in novice runners enrolled in a systematic training program: a prospective cohort study.

Science.gov (United States)

Buist, Ida; Bredeweg, Steef W; Lemmink, Koen A P M; van Mechelen, Willem; Diercks, Ron L

2010-02-01

The popularity of running is still growing. As participation increases, running-related injuries also increase. Until now, little is known about the predictors for injuries in novice runners. Predictors for running-related injuries (RRIs) will differ between male and female novice runners. Cohort study; Level of evidence, 2. Participants were 532 novice runners (226 men, 306 women) preparing for a recreational 4-mile (6.7-km) running event. After completing a baseline questionnaire and undergoing an orthopaedic examination, they were followed during the training period of 13 weeks. An RRI was defined as any self-reported running-related musculoskeletal pain of the lower extremity or back causing a restriction of running for at least 1 week. Twenty-one percent of the novice runners had at least one RRI during follow-up. The multivariate adjusted Cox regression model for male participants showed that body mass index (BMI) (hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.05-1.26), previous injury in the past year (HR, 2.7; 95% CI, 1.36-5.55), and previous participation in sports without axial load (HR, 2.05; 95% CI, 1.03-4.11) were associated with RRI. In female participants, only navicular drop (HR, 0.85; 95% CI, 0.75-0.97) remained a significant predictor for RRI in the multivariate Cox regression modeling. Type A behavior and range of motion (ROM) of the hip and ankle did not affect risk. Male and female novice runners have different risk profiles. Higher BMI, previous injury, and previous sports participation without axial loading are important predictors for RRI in male participants. Further research is needed to detect more predictors for female novice runners.

The Future Medical Science and Colorectal Surgeons.

Science.gov (United States)

Kim, Young Jin

2017-12-01

Future medical technology breakthroughs will build from the incredible progress made in computers, biotechnology, and nanotechnology and from the information learned from the human genome. With such technology and information, computer-aided diagnoses, organ replacement, gene therapy, personalized drugs, and even age reversal will become possible. True 3-dimensional system technology will enable surgeons to envision key clinical features and will help them in planning complex surgery. Surgeons will enter surgical instructions in a virtual space from a remote medical center, order a medical robot to perform the operation, and review the operation in real time on a monitor. Surgeons will be better than artificial intelligence or automated robots when surgeons (or we) love patients and ask questions for a better future. The purpose of this paper is looking at the future medical science and the changes of colorectal surgeons.

Regressive Imagery in Creative Problem-Solving: Comparing Verbal Protocols of Expert and Novice Visual Artists and Computer Programmers

Science.gov (United States)

Kozbelt, Aaron; Dexter, Scott; Dolese, Melissa; Meredith, Daniel; Ostrofsky, Justin

2015-01-01

We applied computer-based text analyses of regressive imagery to verbal protocols of individuals engaged in creative problem-solving in two domains: visual art (23 experts, 23 novices) and computer programming (14 experts, 14 novices). Percentages of words involving primary process and secondary process thought, plus emotion-related words, were…

Using motion capture to assess colonoscopy experience level

DEFF Research Database (Denmark)

Svendsen, Morten Bo Søndergaard; Preisler, Louise; Hillingsø, Jens Georg

2014-01-01

AIM: To study technical skills of colonoscopists using a Microsoft Kinect™ for motion analysis to develop a tool to guide colonoscopy education. RESULTS: Ten experienced endoscopists (gastroenterologists, n = 2; colorectal surgeons, n = 8) and 11 novices participated in the study. A Microsoft......) vs 12% for novice endoscopists (SD 9)], the level of the right hand below the sighting line (z-axis) (25 cm for experienced endoscopists vs 36 cm for novice endoscopists, P level of the left hand below the z-axis (6 cm for experienced endoscopists vs 15 cm for novice endoscopists, P...... experienced and novice endoscopists and to provide non-biased feedback. Whether it is possible to use this tool to train novices in a clinical setting requires further study....

Expert vs. novice differences in the detection of relevant information during a chess game: evidence from eye movements.

Science.gov (United States)

Sheridan, Heather; Reingold, Eyal M

2014-01-01

The present study explored the ability of expert and novice chess players to rapidly distinguish between regions of a chessboard that were relevant to the best move on the board, and regions of the board that were irrelevant. Accordingly, we monitored the eye movements of expert and novice chess players, while they selected white's best move for a variety of chess problems. To manipulate relevancy, we constructed two different versions of each chess problem in the experiment, and we counterbalanced these versions across participants. These two versions of each problem were identical except that a single piece was changed from a bishop to a knight. This subtle change reversed the relevancy map of the board, such that regions that were relevant in one version of the board were now irrelevant (and vice versa). Using this paradigm, we demonstrated that both the experts and novices spent more time fixating the relevant relative to the irrelevant regions of the board. However, the experts were faster at detecting relevant information than the novices, as shown by the finding that experts (but not novices) were able to distinguish between relevant and irrelevant information during the early part of the trial. These findings further demonstrate the domain-related perceptual processing advantage of chess experts, using an experimental paradigm that allowed us to manipulate relevancy under tightly controlled conditions.

Expert versus novice differences in the detection of relevant information during a chess game: Evidence from eye movements

Directory of Open Access Journals (Sweden)

Heather eSheridan

2014-08-01

Full Text Available The present study explored the ability of expert and novice chess players to rapidly distinguish between regions of a chessboard that were relevant to the best move on the board, and regions of the board that were irrelevant. Accordingly, we monitored the eye movements of expert and novice chess players, while they selected white’s best move for a variety of chess problems. To manipulate relevancy, we constructed two different versions of each chess problem in the experiment, and we counterbalanced these versions across participants. These two versions of each problem were identical except that a single piece was changed from a bishop to a knight. This subtle change reversed the relevancy map of the board, such that regions that were relevant in one version of the board were now irrelevant (and vice versa. Using this paradigm, we demonstrated that both the experts and novices spent more time fixating the relevant relative to the irrelevant regions of the board. However, the experts were faster at detecting relevant information than the novices, as shown by the finding that experts (but not novices were able to distinguish between relevant and irrelevant information during the early part of the trial. These findings further demonstrate the domain-related perceptual processing advantage of chess experts, using an experimental paradigm that allowed us to manipulate relevancy under tightly controlled conditions.

Mentorship as Experienced by Women Surgeons in Japan.

Science.gov (United States)

Yorozuya, Kyoko; Kawase, Kazumi; Akashi-Tanaka, Sadako; Kanbayashi, Chizuko; Nomura, Sachiyo; Tomizawa, Yasuko

2016-01-01

Women have accounted for over 30% of new medical students since 1995 in Japan. Establishing support systems for women surgeons to continue their work is a major issue in Japan. Mentorship can be one of the most effective means to help women surgeons to continue their work. The purpose of this study was to clarify the current status of mentorship among Japanese women surgeons and to discuss the role of mentors for women surgeons. Invitation letters were sent to all female members of the Japan Association of Women Surgeons in April 2011. An 84-item questionnaire survey was sent to those who agreed to participate in this study via the internet. Fifty-five surgeons participated in this study, a response rate of 48.7%. Sixty-seven percent of respondents found it difficult to continue in their job; 85% thought mentorship was necessary for women surgeons to progress in their careers; and 84% reported that they already had a mentor. Respondents thought that a mentor helped them to advance their clinical career, to stay in their job, and to provide moral support. However, mentors appeared to be less useful in helping them to advance their research career, to network, to increase their status, and to achieve a work-life balance. This study revealed areas where mentors appeared to be less helpful to women surgeons. The survey gave an indication of how to help improve and develop the career and personal life of women surgeons in Japan.

Novice in Secondary School--The Coin Has Two Sides

Science.gov (United States)

Ulvik, Marit; Smith, Kari; Helleve, Ingrid

2009-01-01

The aim of this study is to gain an insight into novice teachers' diverse experiences. The study is conducted among nine beginning teachers in upper secondary school in Norway, and the research instrument was semi structured interviews. The main findings indicate that there are two sides of the coin of being a new teacher, positive as well as less…

Perceptions of Linguistically Responsive Teaching in Teacher Candidates/Novice Teachers

Science.gov (United States)

Tandon, Madhavi; Viesca, Kara Mitchell; Hueston, Colin; Milbourn, Tamara

2017-01-01

This qualitative study examined data from 36 teacher candidates and novice teachers to explore their perceptions and understandings of linguistic responsiveness. The findings illustrate the challenge of demonstrating linguistically responsive teaching practices in the early and initial stages of entering the teaching profession, and more research…

Using simulation to improve the cognitive and psychomotor skills of novice students in advanced laparoscopic surgery: a meta-analysis.

Science.gov (United States)

Al-Kadi, Azzam S; Donnon, Tyrone

2013-01-01

Advances in simulation technologies have enhanced the ability to introduce the teaching and learning of laparoscopic surgical skills to novice students. In this meta-analysis, a total of 18 randomized controlled studies were identified that specifically looked at training novices in comparison with a control group as it pertains to knowledge retention, time to completion and suturing and knotting skills. The combined random-effect sizes (ESs) showed that novice students who trained on laparoscopic simulators have considerably developed better laparoscopic suturing and knot tying skills (d = 1.96, p < 0.01), conducted fewer errors (d = 2.13, p < 0.01), retained more knowledge (d = 1.57, p < 0.01) than their respective control groups, and were significantly faster on time to completion (d = 1.98, p < 0.01). As illustrated in corresponding Forest plots, the majority of the primary study outcomes included in this meta-analysis show statistically significant support (p < 0.05) for the use of laparoscopic simulators for novice student training on both knowledge and advanced surgical skill development (28 of 35 outcomes, 80%). The findings of this meta-analysis support strongly the use of simulators for teaching laparoscopic surgery skills to novice students in surgical residency programs.

Civil Surgeon Info

Data.gov (United States)

Department of Homeland Security — USCIS designates certain doctors (also known as civil surgeons) to perform the medical exam required for most Green Card applicants. This data set represents the...

Effects of a work-based critical reflection program for novice nurses.

Science.gov (United States)

Kim, Yeon Hee; Min, Ja; Kim, Soon Hee; Shin, Sujin

2018-02-27

Critical reflection is effective in improving students' communication abilities and confidence. The aim of this study was to evaluate the effectiveness of a work-based critical reflection program to enhance novice nurses' clinical critical-thinking abilities, communication competency, and job performance. The present study used a quasi-experimental design. From October 2014 to August 2015, we collected data from 44 novice nurses working in an advanced general hospital in S city in Korea. Nurses in the experimental group participated in a critical reflection program for six months. Outcome variables were clinical critical-thinking skills, communication abilities, and job performance. A non-parametric Mann-Whitney U-test and a Wilcoxon rank sum test were selected to evaluate differences in mean ranks and to assess the null hypothesis that the medians were equal across the groups. The results showed that the clinical critical-thinking skills of those in the experimental group improved significantly (p = 0.003). The differences in mean ranks of communication ability between two groups was significantly statistically different (p = 0.028). Job performance improved significantly in both the experimental group and the control group, so there was no statistical difference (p = 0.294). We therefore suggest that a critical reflection program be considered an essential tool for improving critical thinking and communication abilities among novice nurses who need to adapt to the clinical environment as quickly as possible. Further, we suggest conducting research into critical reflection programs among larger and more diverse samples.

Surgeon-patient communication during awake procedures.

Science.gov (United States)

Smith, Claire S; Guyton, Kristina; Pariser, Joseph J; Siegler, Mark; Schindler, Nancy; Langerman, Alexander

2017-06-01

Surgeons are increasingly performing procedures on awake patients. Communication during such procedures is complex and underexplored in the literature. Surgeons were recruited from the faculty of 2 hospitals to participate in an interview regarding their approaches to communication during awake procedures. Three researchers used the constant comparative method to transcribe, code, and review interviews until saturation was reached. Twenty-three surgeons described the advantages and disadvantages of awake procedures, their communication with the awake patient, their interactions with staff and with trainees, the environment of awake procedures, and how communication in this context is taught and learned. Surgeons recognized communication during awake procedures as important and reported varied strategies for ensuring patient comfort in this context. However, they also acknowledged challenges with multiparty communication during awake procedures, especially in balancing commitments to teaching with their duty to comfort the patient. Copyright © 2016 Elsevier Inc. All rights reserved.

The Internet and the paediatric surgeon.

Science.gov (United States)

Srinivas, M; Inumpudi, A; Mitra, D K

1998-12-01

The Internet, which has truly united the world, is an extensive network of inter-linked computers storing immense bytes of information that can be accessed by anyone, transcending all barriers. The paediatric surgery Internet consists of exponentially growing material that deals with information specifically for paediatric surgeons and patients of the paediatric age group. We reviewed the methods available to take advantage of this network to enable busy paediatric surgeons to accrue the benefits easily and efficiently rather than be lost in the information ocean by surfing individually. By getting connected to the Internet, the paediatric surgeon gains enormous information that can be useful for patient care. The Internet has revolutionised scientific publications by virtue of its fast and accurate transmission of manuscripts. Paediatric surgeons can send manuscripts by this channel and also access journals, obviating the inherent lag period of communication by post.

Projecting surgeon supply using a dynamic model.

Science.gov (United States)

Fraher, Erin P; Knapton, Andy; Sheldon, George F; Meyer, Anthony; Ricketts, Thomas C

2013-05-01

To develop a projection model to forecast the head count and full-time equivalent supply of surgeons by age, sex, and specialty in the United States from 2009 to 2028. The search for the optimal number and specialty mix of surgeons to care for the United States population has taken on increased urgency under health care reform. Expanded insurance coverage and an aging population will increase demand for surgical and other medical services. Accurate forecasts of surgical service capacity are crucial to inform the federal government, training institutions, professional associations, and others charged with improving access to health care. The study uses a dynamic stock and flow model that simulates future changes in numbers and specialty type by factoring in changes in surgeon demographics and policy factors. : Forecasts show that overall surgeon supply will decrease 18% during the period form 2009 to 2028 with declines in all specialties except colorectal, pediatric, neurological surgery, and vascular surgery. Model simulations suggest that none of the proposed changes to increase graduate medical education currently under consideration will be sufficient to offset declines. The length of time it takes to train surgeons, the anticipated decrease in hours worked by surgeons in younger generations, and the potential decreases in graduate medical education funding suggest that there may be an insufficient surgeon workforce to meet population needs. Existing maldistribution patterns are likely to be exacerbated, leading to delayed or lost access to time-sensitive surgical procedures, particularly in rural areas.

The first year of practice: an investigation of the professional learning and development of promising novice physical therapists.

Science.gov (United States)

Black, Lisa L; Jensen, Gail M; Mostrom, Elizabeth; Perkins, Jan; Ritzline, Pamela D; Hayward, Lorna; Blackmer, Betsy

2010-12-01

The goal in studying expertise is not merely to describe ways in which experts excel but also to understand how experts develop in order to better facilitate the development of novices. The study of novice progression helps us to understand what successful versus unsuccessful learning looks like. This understanding is critical, as autonomous practice places increased demands for advanced clinical judgments and the ability to assume professional responsibilities. The purpose of this study was to explore the experiences, learning, and development of promising novice therapists throughout their first year of practice in the United States. A longitudinal, multiple-site qualitative case study method was used for within-case and across-case analysis. A purposive sample of 11 promising new graduates from 4 physical therapist education programs participated. Investigators followed the graduates throughout their first year of practice. Data sources included: (1) semistructured interviews conducted at baseline and every 3 months thereafter for 1 year, (2) reflective journals completed at regular intervals, and (3) review of academic and clinical education records and résumés. Four themes emerged: (1) the clinical environment influenced the novice physical therapists' performance, (2) participants learned through experience and social interaction and learning was primarily directed toward self, (3) growing confidence was directly related to developing communication skills, and (4) therapists were engaged in professional identity formation and role transitions. The findings suggest there are common experiences and themes that emerge as novice physical therapists develop. Although research has been conducted on expertise in physical therapy, few longitudinal investigations have explored the development of therapists across transitions from graduate to novice to expert practitioner. This study explored and described the learning and development of graduates during their first

Risk of ionising radiation to trainee orthopaedic surgeons.

Science.gov (United States)

Khan, Ishrat A; Kamalasekaran, Senthil; Fazal, M Ali

2012-02-01

We undertook this study to determine the amount of scattered radiation received by the primary surgeon, assistant and patient during dynamic hip screw fixation for proximal femoral fractures. Data was collected from fifty patients. Five registrars were included as operating surgeon and four senior house officers as assistant surgeon. Radiation was monitored by thermo luminescent dosimeters placed on the surgeon and assistant. The approximate distance of surgeon and assistant from the operative site was measured. A dosimeter on the unaffected hip of patients measured the radiation to the patient. The results show that the surgeon's dominant hand receives the highest dose of radiation and radiation exposure is dependent on the experience of the operator. Our study concludes that exposure to radiation during this procedure is well below the toxic levels; however greater awareness is needed for harmful effects of exposure to long term low dose radiation.

Among Musculoskeletal Surgeons, Job Dissatisfaction Is Associated With Burnout.

Science.gov (United States)

van Wulfften Palthe, Olivier D R; Neuhaus, Valentin; Janssen, Stein J; Guitton, Thierry G; Ring, David

2016-08-01

Burnout is common in professions such as medicine in which employees have frequent and often stressful interpersonal interactions where empathy and emotional control are important. Burnout can lead to decreased effectiveness at work, negative health outcomes, and less job satisfaction. A relationship between burnout and job satisfaction is established for several types of physicians but is less studied among surgeons who treat musculoskeletal conditions. We asked: (1) For surgeons treating musculoskeletal conditions, what risk factors are associated with worse job dissatisfaction? (2) What risk factors are associated with burnout symptoms? Two hundred ten (52% of all active members of the Science of Variation Group [SOVG]) surgeons who treat musculoskeletal conditions (94% orthopaedic surgeons and 6% trauma surgeons; in Europe, general trauma surgeons do most of the fracture surgery) completed the Global Job Satisfaction instrument, Shirom-Malamed Burnout Measure, and provided practice and surgeon characteristics. Most surgeons were male (193 surgeons, 92%) and most were academically employed (186 surgeons, 89%). Factors independently associated with job satisfaction and burnout were identified with multivariable analysis. Greater symptoms of burnout (β, -7.13; standard error [SE], 0.75; 95% CI, -8.60 to -5.66; p job satisfaction. Having children (β, -0.45; SE, 0.0.21; 95% CI, -0.85 to -0.043; p = 0.030; adjusted R(2), 0.046) was the only factor independently associated with fewer symptoms of burnout. Among an active research group of largely academic surgeons treating musculoskeletal conditions, most are satisfied with their job. Efforts to limit burnout and job satisfaction by optimizing engagement in and deriving meaning from the work are effective in other settings and merit attention among surgeons. Level II, prognostic study.

The lesser spotted pregnant surgeon.

Science.gov (United States)

Hamilton, L C

2017-10-19

With more women entering surgical training, it will become more commonplace to encounter pregnant surgeons. This paper discusses the evidence for work-related risk factors as well as outlining the rights of a pregnant doctor. There are, in fact, very few real risks to pregnancy encountered as a surgeon, with the main risks involving standing or sitting for long periods and fatigue, which can be managed with support from the department. It is important for women in surgery to know that it is possible to continue their training while pregnant so they do not feel pressured into changing to a less demanding specialty or even leaving medicine entirely. It is also important for other professionals to understand the risks and choices faced by pregnant surgeons so that they can better support them in the workplace.

A Model for Teaching Experiential Counseling Interventions to Novice Counselors.

Science.gov (United States)

Cummings, Anne L.

1992-01-01

Describes model for teaching experiential interventions to novice counselors. Includes two experiential interventions that are focus for new model: two-chair approach based on Gestalt therapy principles and resolution of problematic reaction points. Cognitive, affective, and behavioral concepts of model are related to transfer of learning with the…

How Do Novice Art Teachers Define and Implement Meaningful Curriculum?

Science.gov (United States)

Bain, Christina; Newton, Connie; Kuster, Deborah; Milbrandt, Melody

2010-01-01

Four researchers collaborated on this qualitative case study that examined 11 first-year novice art teachers' understanding and implementation of meaningful curriculum. Participants were selected through a criterion method sampling strategy; the subjects were employed in rural, urban, and suburban public school districts. In order to conduct a…

The Development of Novice Teachers' Culturally Responsive Classroom Management Practice

Science.gov (United States)

Patish, Yelena

2016-01-01

While extensive research has been conducted on classroom management little research exists on culturally responsive classroom management. The primary purpose of this qualitative study was to examine how four novice teachers developed their culturally responsive management practice (CRCM) to better meet the needs of their students. My analysis was…

Current trends in chaperone use by plastic and reconstructive surgeons.

Science.gov (United States)

Choudry, Umar; Barta, Ruth J; Kim, Nicholas

2013-06-01

There is a paucity of literature regarding the use of chaperones by surgeons when examining patients. Use of a chaperone not only makes the patient comfortable but also potentially protects the surgeon from perceived misconduct. This is especially true for plastic surgeons who examine sensitive areas commonly. The purpose of this study was to determine the current trends in chaperone use by plastic surgeons when examining patients. A 23-question online survey was sent to all members of the American Society of Plastic Surgeons. Data collected online were analyzed using Student t test and Pearson χ test. A P use by plastic surgeons during all examinations of patients was 30%. This rate increased up to 60% while examining sensitive areas. Male surgeons reported a higher frequency of chaperone use than female surgeons (P use compared to reconstructive surgeons (P = 0.001). Similarly, surgeons who had been in practice for more than 20 years reported a higher rate of chaperone use compared to surgeons in practice for less than 20 years (P = 0.032). Sixty-one (7.6%; 56 male and 5 female) surgeons reported being accused of inappropriate behavior by patients, of whom 49 (80%) did not have a chaperone present. There was no significant difference among male and female surgeons in rates of being accused of inappropriate behavior (7.9% vs 4.2%, P = 0.19). There was a higher rate of chaperone use by male plastic surgeons, surgeons with more than 20 years experience, and cosmetic surgeons. Despite the difference in chaperone use between the sexes, both had similar rates of being accused of inappropriate behavior during examinations by patients, and although these incidents were quite low, most had no chaperone present during those examinations.

Surgeons' musculoskeletal pain in minimally invasive surgery

DEFF Research Database (Denmark)

Dalager, Tina; Søgaard, Karen; Bech (Katrine Tholstrup Pedersen), Katrine Tholstrup

in surgeons performing MIS is high and derives mainly from static postures. Positioning of monitor, adjustment of table height and instrument design also contribute substantially. Robotic assisted laparoscopy seems less physically demanding for the surgeon compared with conventional laparoscopy. However, some...... put the patients at a higher risk of complications, and on the longer term there is an increasing risk for the surgeon to develop chronic musculoskeletal pain that will disable him/her to perform his/her job. Therefore, surgeons’ musculoskeletal health is of vital importance and must be considered...... alongside patient safety. The present literature study supports the need for a randomized controlled trial evaluating the effect of an individually designed training program for surgeons performing MIS....

Decellularized Tissue and Cell-Derived Extracellular Matrices as Scaffolds for Orthopaedic Tissue Engineering

Science.gov (United States)

Cheng, Christina W.; Solorio, Loran D.; Alsberg, Eben

2014-01-01

The reconstruction of musculoskeletal defects is a constant challenge for orthopaedic surgeons. Musculoskeletal injuries such as fractures, chondral lesions, infections and tumor debulking can often lead to large tissue voids requiring reconstruction with tissue grafts. Autografts are currently the gold standard in orthopaedic tissue reconstruction; however, there is a limit to the amount of tissue that can be harvested before compromising the donor site. Tissue engineering strategies using allogeneic or xenogeneic decellularized bone, cartilage, skeletal muscle, tendon and ligament have emerged as promising potential alternative treatment. The extracellular matrix provides a natural scaffold for cell attachment, proliferation and differentiation. Decellularization of in vitro cell-derived matrices can also enable the generation of autologous constructs from tissue specific cells or progenitor cells. Although decellularized bone tissue is widely used clinically in orthopaedic applications, the exciting potential of decellularized cartilage, skeletal muscle, tendon and ligament cell-derived matrices has only recently begun to be explored for ultimate translation to the orthopaedic clinic. PMID:24417915

Median sternotomy - gold standard incision for cardiac surgeons

Directory of Open Access Journals (Sweden)

Radu Matache

2016-05-01

Full Text Available Sternotomy is the gold standard incision for cardiac surgeons but it is also used in thoracic surgery especially for mediastinal, tracheal and main stem bronchus surgery. The surgical technique is well established and identification of the correct anatomic landmarks, midline tissue preparation, osteotomy and bleeding control are important steps of the procedure. Correct sternal closure is vital for avoiding short- and long-term morbidity and mortality. The two sternal halves have to be well approximated to facilitate healing of the bone and to avoid instability, which is a risk factor for wound infection. New suture materials and techniques would be expected to be developed to further improve the patients evolution, in respect to both immediate postoperative period and long-term morbidity and mortality

Perspectives of South African general surgeons regarding their ...

African Journals Online (AJOL)

Objectives. To canvass the perceptions of SA general surgeons regarding certain aspects of their training. Methods. An electronic postal survey was conducted. All general surgeons on the Association of Surgeons of South Africa database were requested to complete a structured questionnaire. Four Likert scale items were ...

Assessing the Impact of Surgeon Experience on Urinary Continence Recovery After Robot-Assisted Radical Prostatectomy: Results of Four High-Volume Surgeons.

Science.gov (United States)

Fossati, Nicola; Di Trapani, Ettore; Gandaglia, Giorgio; Dell'Oglio, Paolo; Umari, Paolo; Buffi, Nicolò Maria; Guazzoni, Giorgio; Mottrie, Alexander; Gaboardi, Franco; Montorsi, Francesco; Briganti, Alberto; Suardi, Nazareno

2017-09-01

To test the impact of surgeon experience on urinary continence (UC) recovery after robot-assisted radical prostatectomy (RARP). The study included 1477 consecutive patients treated with RARP by four surgeons between 2006 and 2014. UC recovery was defined as being completely dry over a 24-hour period at follow-up. Surgeon experience was coded as the total number of RARP performed by the surgeon before the patient's operation. Multivariable analysis tested the association between surgeon experience and UC recovery. Covariates consisted of patient age, Charlson comorbidity index, preoperative International Index of Erectile Function-Erectile Function domain (IIEF-EF), nerve-sparing surgery (none vs unilateral vs bilateral), and preoperative risk groups (low- vs intermediate- vs high risk). The number of cases performed by each surgeon was 541, 413, 411, and 112, respectively. Median follow-up was 24 months (inter-quartile range: 18, 40). The UC recovery rate at 1 year after surgery was 82%. At multivariable analyses, surgeon experience represented an independent predictor of UC recovery (hazard ratio: 1.02, p < 0.001). The surgical learning curve was similar among surgeons, moving linearly from ∼60% of UC rate at the initial cases to almost 90% after more than 400 procedures. In patients undergoing RARP, surgeon experience is a significant predictor of UC recovery. The surgical learning curve of UC recovery does not reach a plateau even after more than 100 cases, suggesting a continuous improvement of the surgical technique. These findings deserve attention for patient counseling and future comparative studies evaluating functional outcomes after RARP.

Short-Term Absenteeism and Health Care Utilization Due to Lower Extremity Injuries Among Novice Runners: A Prospective Cohort Study.

Science.gov (United States)

Smits, Dirk-Wouter; Huisstede, Bionka; Verhagen, Evert; van der Worp, Henk; Kluitenberg, Bas; van Middelkoop, Marienke; Hartgens, Fred; Backx, Frank

2016-11-01

To describe absenteeism and health care utilization (HCU) within 6 weeks after occurrence of running-related injuries (RRIs) among novice runners and to explore differences relating to injury and personal characteristics. Prospective cohort study. Primary care. One thousand six hundred ninety-six novice runners (18-65 years) participating in a 6-week running program ("Start-to-Run"). Injury characteristics were assessed by weekly training logs and personal characteristics by a baseline questionnaire. Data on absenteeism and HCU were collected using questionnaires at 2 and 6 weeks after the RRI occurred. A total of 185 novice runners (11%) reported an RRI during the 6-week program. Of these injured novice runners, 78% reported absence from sports, whereas only 4% reported absence from work. Fifty-one percent of the injured novice runners visited a health care professional, mostly physical therapists (PTs) rather than physicians. Absenteeism was more common among women than men and was also more common with acute RRIs than gradual-onset RRIs. As regards HCU, both the variety of professionals visited and the number of PT visits were higher among runners with muscle-tendon injuries in the ankle/foot region than among those with other RRIs. Among novice runners sustaining an RRI during a 6-week running program, over three quarters reported short-term absence from sports, whereas absence from work was very limited, and over half used professional health care. Both absence and HCU are associated with injury characteristics. In future running promotion programs (eg in Start-to-Run programs), specific attention should be paid to acute injuries and to muscle-tendon injuries in the ankle/foot region.

Being a surgeon--the myth and the reality: a meta-synthesis of surgeons' perspectives about factors affecting their practice and well-being.

Science.gov (United States)

Orri, Massimiliano; Farges, Olivier; Clavien, Pierre-Alain; Barkun, Jeffrey; Revah-Lévy, Anne

2014-11-01

Synthesize the findings from individual qualitative studies about surgeons' account of their practice. Social and contextual factors of practice influence doctors' well-being and therapeutic relationships. Little is known about surgery, but it is generally assumed that surgeons are not affected by them. We searched international publications (2000-2012) to identify relevant qualitative research exploring how surgeons talk about their practice. Meta-ethnography (a systematic analysis of qualitative literature that compensates for the potential lack of generalizability of the primary studies and provides new insight by their conjoint interpretation) was used to identify key themes and synthesize them. We identified 51 articles (>1000 surgeons) from different specialties and countries. Two main themes emerged. (i) The patient-surgeon relationship, described surgeons' characterizations of their relationships with patients. We identified factors influencing surgical decision making, communication, and personal involvement in the process of care; these were surgeon-related, patient-related, and contextual. (ii) Group relations and culture described perceived issues related to surgical culture (image and education, teamwork, rules, and guidelines); it highlighted the influence of a social dimension on surgical practice. In both themes, we uncovered an emotional dimension of surgeons' practice. Surgeons' emphasis on technical aspects, individuality, and performance seems to impede a modern patient-centered approach to care and to act as a barrier to well-being. Our findings suggest that taking into account the relational and emotional dimensions of surgical practice (both with patients and within the institution) might improve surgical innovation, surgeons' well-being, and the attractiveness of this specialty.

Simplifying the writing process for the novice writer.

Science.gov (United States)

Redmond, Mary Connie

2002-10-01

Nurses take responsibility for reading information to update their professional knowledge and to meet relicensure requirements. However, nurses are less enthusiastic about writing for professional publication. This article explores the reluctance of nurses to write, the reasons why writing for publication is important to the nursing profession, the importance of mentoring to potential writers, and basic information about simplifying the writing process for novice writers. Copyright 2002 by American Society of PeriAnesthesia Nurses.

Relationship between automation trust and operator performance for the novice and expert in spacecraft rendezvous and docking (RVD).

Science.gov (United States)

Niu, Jianwei; Geng, He; Zhang, Yijing; Du, Xiaoping

2018-09-01

Operator trust in automation is a crucial factor influencing its use and operational performance. However, the relationship between automation trust and performance remains poorly understood and requires further investigation. The objective of this paper is to explore the difference in trust and performance on automation-aided spacecraft rendezvous and docking (RVD) between the novice and the expert and to investigate the relationship between automation trust and performance as well. We employed a two-factor mixed design, with training skill (novice and expert) and automation mode (manual RVD and automation aided RVD) serving as the two factors. Twenty participants, 10 novices and 10 experts, were recruited to conduct six RVD tasks for two automation levels. After the tasks, operator performance was recorded by the desktop hand-held docking training equipment. Operator trust was also measured by a 12-items questionnaire at the beginning and end of each trial. As a result, automation narrowed the performance gap significantly between the novice and the expert, and the automation trust showed a marginally significant difference between the novice and the expert. Furthermore, the result demonstrated that the attitude angle control error of the expert was related to the total trust score, whereas other automation performance indicators were not related to the total score of trust. However, automation performance was related to the dimensions of trust, such as entrust, harmful, and dependable. Copyright © 2018 Elsevier Ltd. All rights reserved.

Taking on Critical Literacy: The Journey of Newcomers and Novices.

Science.gov (United States)

Lewison, Mitzi; Flint, Amy Seely; Van Sluys, Katie

2002-01-01

Describes a portion of the authors' work with a group of elementary teachers during the first eight months of an ongoing study investigating critical literacy in classrooms. Examines the understandings and classroom practices of two groups of teachers: newcomers and novices. Provides insights into the concerns teachers have when they begin…

Extending the Classroom: Digital Micro-Narratives for Novice Language Learners

Science.gov (United States)

Kronenberg, Felix A.

2014-01-01

Digital Storytelling offers many advantages for language learning, especially within a project-based framework. In this article, the use of Digital Micro-Narratives is proposed as particularly useful for second language learners at the novice level. As a sub-genre of Digital Storytelling, Digital Micro-Narratives focus more on frequently updated…

The Evolution of the Personal Networks of Novice Librarian Researchers

Science.gov (United States)

Kennedy, Marie R.; Kennedy, David P.; Brancolini, Kristine R.

2017-01-01

This article describes for the first time the composition and structure of the personal networks of novice librarian researchers. We used social network analysis to observe if participating in the Institute for Research Design in Librarianship (IRDL) affected the development of the librarians' personal networks and how the networks changed over…

The safe use of surgical energy devices by surgeons may be overestimated.

Science.gov (United States)

Ha, Ally; Richards, Carly; Criman, Erik; Piaggione, Jillian; Yheulon, Christopher; Lim, Robert

2018-03-01

Surgical energy injuries are an underappreciated phenomenon. Improper use of surgical energy or poor attention to patient safety can result in operating room fires, tissue injuries, and interferences with other electronic devices, while rare complications can be devastatingly severe. Despite this, there is no current standard requirement for educating surgeons on the safe use of energy-based devices or evaluation of electrosurgery (ES) education in residency training, credentialing, or practice. The study aimed to assess the current baseline knowledge of surgeons and surgical trainees with regards to ES across varying experiences at a tertiary level care center. Surgeons and surgical trainees from seven surgical specialties (General Surgery, Cardiothoracic Surgery, Vascular Surgery, Obstetrics/Gynecology, Orthopedic Surgery, Urology, and Otorhinolaryngology) at a tertiary level care hospital were tested. Testing included an evaluation regarding their background training and experiences with ES-related adverse events and a 15 multiple-choice-question exam testing critical knowledge of ES. A total of 134 surveys were sent out with 72 responses (53.7%). The mean quiz score was 51.5 ± 15.5% (passing score was 80%). Of staff surgeons, 33/65 (50.8%) completed the survey with mean and median scores of 54.9 and 53.3%, respectively (range 33.3-86.7%). Of surgical trainees, 39/69 (56.5%) completed the survey with mean and median scores of 48.6 and 46.7%, respectively (range 13.3-80.0%). There were no statistically significant differences based on training status (p = 0.08), previous training (p = 0.24), number of cases (p = 0.06), or specialty (p = 0.689). Surgeons and surgical trainees both have a significant knowledge gap in the safe and effective use of surgical energy devices, regardless of surgical specialty and despite what they feel was adequate training. The knowledge gap is not improved with experience. A formal surgical energy education program

The impact of injury definition on injury surveillance in novice runners

NARCIS (Netherlands)

Kluitenberg, Bas; van Middelkoop, Marienke; Verhagen, Evert; Hartgens, Fred; Huisstede, Bionka; Diercks, Ron; van der Worp, Henk

Objectives: Despite several consensus statements, different injury definitions are used in the literature. This study aimed to identify the impact of different injury definitions on the nature and incidence of complaints captured during a short-term running program for novice runners. Design:

The impact of injury definition on injury surveillance in novice runners

NARCIS (Netherlands)

Kluitenberg, Bas; van Middelkoop, Marienke; Verhagen, Evert; Hartgens, Fred; Huisstede, Bionka; Diercks, Ron; van der Worp, Henk

2016-01-01

Objectives: Despite several consensus statements, different injury definitions are used in the literature. This study aimed to identify the impact of different injury definitions on the nature and incidence of complaints captured during a short-term running program for novice runners. Design:

Lifelong Learning for the Hand Surgeon.

Science.gov (United States)

Adkinson, Joshua M; Chung, Kevin C

2015-09-01

Hand surgeons are faced with the impossible task of mastering a rapidly expanding pool of knowledge and surgical techniques. Dedication to lifelong learning is, therefore, an essential component of delivering the best, most up-to-date care for patients. Board certification, participation in continuing medical education and maintenance of certification activities, and attendance at national meetings are essential mechanisms by which hand surgeons may foster the acquisition of essential knowledge and clinical skills, This article highlights the history, current status, and emerging needs in continuing medical education for the hand surgeon. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

HISTORICAL NOTE JOHN HUNTER (SURGEON) John Hunter FRS ...

African Journals Online (AJOL)

JOHN HUNTER (SURGEON). John Hunter FRS (13 February 1728-16 October 1793) was a Scottish surgeon, one of the most distinguished scientists and surgeons of his day. He was an early advocate of careful observation and scientific method in medicine. He was the husband of Anne Hunter, a teacher, friend and ...

Young transplant surgeons and NIH funding.

Science.gov (United States)

Englesbe, M J; Sung, R S; Segev, D L

2011-02-01

Transplant surgeons have historically been instrumental in advancing the science of transplantation. However, research in the current environment inevitably requires external funding, and the classic career development pathway for a junior investigator is the NIH K award. We matched transplant surgeons who completed fellowships between 1998 and 2004 with the NIH funding database, and also queried them regarding research effort and attitudes. Of 373 surgeons who completed a fellowship, only 6 (1.8%) received a K award; of these, 3 subsequently obtained R-level funding. An additional 5 individuals received an R-level grant within their first 5 years as faculty without a K award, 3 of whom had received a prior ASTS-sponsored award. Survey respondents reported extensive research experience during their training (78.8% spent median 24 months), a high proportion of graduate research degrees (36%), and a strong desire for more research time (78%). However, they reported clinical burdens and lack of mentorship as their primary perceived barriers to successful research careers. The very low rate of NIH funding for young transplant surgeons, combined with survey results that indicate their desire to participate in research, suggest institutional barriers to access that may warrant attention by the ASTS and the transplant surgery community. ©2010 The Authors Journal compilation©2010 The American Society of Transplantation and the American Society of Transplant Surgeons.

Canadian cardiac surgeons' perspectives on biomedical innovation.

Science.gov (United States)

Snyman, Gretchen; Tucker, Joseph E L; Cimini, Massimo; Narine, Kishan; Fedak, Paul W M

2012-01-01

Barriers to successful innovation can be identified and potentially addressed by exploring the perspectives of key stakeholders in the innovation process. Cardiac surgeons in Canada were surveyed for personal perspectives on biomedical innovation. Quantitative data was obtained by questionnaire and qualitative data via interviews with selected survey participants. Surgeons were asked to self-identify into 1 of 3 categories: "innovator," "early adopter," or "late adopter," and data were compared between groups. Most surgeons viewed innovation favourably and this effect was consistent irrespective of perceived level of innovativeness. Key barriers to the innovation pathway were identified: (1) support from colleagues and institutions; (2) Canada's health system; (3) sufficient investment capital; and (4) the culture of innovation within the local environment. Knowledge of the innovation process was perceived differently based on self-reported innovativeness. The majority of surgeons did not perceive themselves as having the necessary knowledge and skills to effectively translate innovative ideas to clinical practice. In general, responses indicate support for implementation of leadership and training programs focusing on the innovation process in an effort to prepare surgeons and enhance their ability to successfully innovate and translate new therapies. The perspectives of cardiac surgeons provide an intriguing portal into the challenges and opportunities for healthcare innovation in Canada. Copyright © 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Workplace Learning: Differential Learning Needs of Novice and More Experienced Workers.

Science.gov (United States)

Cornford, Ian R.; Beven, Fred A.

1999-01-01

A literature review identified differing learning needs of new and more experienced workers. Novices need to learn over extended time periods with deliberate practice and feedback. Experienced workers need to develop existing knowledge and skills. Different approaches to training and supervision are needed. (SK)

Usability Issues in the Design of Novice Programming Systems,

Science.gov (United States)

1996-08-01

lists this as a design principle for novice programming environments. In traditional compiled languages, beginners are also confused by the need to...programming task external knowledge that might interfere with correct under- standing of the language. Most beginner programming errors can be...language for text editing, but [Curtis 1988] found that a textual pseudocode and graphical flowcharts were both bet- ter than natural language in program

Specialization and the Current Practices of General Surgeons

Science.gov (United States)

Decker, Marquita R; Dodgion, Christopher M; Kwok, Alvin C; Hu, Yue-Yung; Havlena, Jeff A; Jiang, Wei; Lipsitz, Stuart R; Kent, K Craig; Greenberg, Caprice C

2014-01-01

Background The impact of specialization on the practice of general surgery has not been characterized. Our goal was to assess general surgeons’ operative practices to inform surgical education and workforce planning. Study Design We examined the practices of general surgeons identified in the 2008 State Inpatient and Ambulatory Surgery Databases of the Healthcare Cost and Utilization Project (HCUP) for three US states. Operations were identified using ICD-9 and CPT codes linked to encrypted physician identifiers. For each surgeon, total operative volume and the percentage of practice comprised of their most common operation were calculated. Correlation was measured between general surgeons’ case volume and the number of other specialists in a health service area. Results There were 1,075 general surgeons who performed 240,510 operations in 2008. The mean operative volume for each surgeon was 224 annual procedures. General surgeons performed an average of 23 different types of operations. For the majority of general surgeons, their most common procedure comprised no more than 30% of total practice. The most common operations, ranked by the frequency that they appeared as general surgeons’ top procedure, included: cholecystectomy, colonoscopy, endoscopy, and skin excision. The proportion of general surgery practice comprised of endoscopic procedures inversely correlated with the number of gastroenterologists in the health service area (Rho = - 0.50, p = 0.005). Conclusions Despite trends toward specialization, the current practices of general surgeons remain heterogeneous. This indicates a continued demand for broad-based surgical education to allow future surgeons to tailor their practices to their environment. PMID:24210145

Artificial muscles for a novel simulator in minimally invasive spine surgery.

Science.gov (United States)

Hollensteiner, Marianne; Fuerst, David; Schrempf, Andreas

2014-01-01

Vertebroplasty and kyphoplasty are commonly used minimally invasive methods to treat vertebral compression fractures. Novice surgeons gather surgical skills in different ways, mainly by "learning by doing" or training on models, specimens or simulators. Currently, a new training modality, an augmented reality simulator for minimally invasive spine surgeries, is going to be developed. An important step in investigating this simulator is the accurate establishment of artificial tissues. Especially vertebrae and muscles, reproducing a comparable haptical feedback during tool insertion, are necessary. Two artificial tissues were developed to imitate natural muscle tissue. The axial insertion force was used as validation parameter. It appropriates the mechanical properties of artificial and natural muscles. Validation was performed on insertion measurement data from fifteen artificial muscle tissues compared to human muscles measurement data. Based on the resulting forces during needle insertion into human muscles, a suitable material composition for manufacturing artificial muscles was found.

Teaching Physics Novices at University: A Case for Stronger Scaffolding

Science.gov (United States)

Lindstrom, Christine; Sharma, Manjula D.

2011-01-01

In 2006 a new type of tutorial, called Map Meeting, was successfully trialled with novice first year physics students at the University of Sydney, Australia. Subsequently, in first semester 2007 a large-scale experiment was carried out with 262 students who were allocated either to the strongly scaffolding Map Meetings or to the less scaffolding…

Solo-Surgeon Retroauricular Approach Endoscopic Thyroidectomy.

Science.gov (United States)

Lee, Doh Young; Baek, Seung-Kuk; Jung, Kwang-Yoon

2017-01-01

This study aimed to evaluate the feasibility and efficacy of solo-surgeon retroauricular thyroidectomy. For solo-surgery, we used an Endoeye Flex Laparo-Thoraco Videoscope (Olympus America, Inc.). A Vitom Karl Storz holding system (Karl Storz GmbH & Co.) composed of several bars connected by a ball-joint system was used for fixation of endoscope. A snake retractor and a brain-spoon retractor were used on the sternocleidomastoid. Endoscopic thyroidectomy using the solo-surgeon technique was performed in 10 patients having papillary thyroid carcinoma. The mean patient age was 36.0 ± 11.1 years, and all patients were female. There were no postoperative complications such as vocal cord paralysis and hematoma. When compared with the operating times and volume of drainage of a control group of 100 patients who underwent surgery through the conventional retroauricular approach between May 2013 and December 2015, the operating times and volume of drainage were not significantly different (P = .781 and .541, respectively). Solo-surgeon retroauricular thyroidectomy is safe and feasible when performed by a surgeon competent in endoscopic thyroidectomy.

Facial soft-tissue fillers conference: assessing the state of the science.

Science.gov (United States)

Rohrich, Rod J; Hanke, C William; Busso, Mariano; Carruthers, Alastair; Carruthers, Jean; Fagien, Steven; Fitzgerald, Rebecca; Glogau, Richard; Greenberger, Phyllis E; Lorenc, Z Paul; Marmur, Ellen S; Monheit, Gary D; Pusic, Andrea; Rubin, Mark G; Rzany, Berthold; Sclafani, Anthony; Taylor, Susan; Weinkle, Susan; McGuire, Michael F; Pariser, David M; Casas, Laurie A; Collishaw, Karen J; Dailey, Roger A; Duffy, Stephen C; Edgar, Elizabeth Jan; Greenan, Barbara L; Haenlein, Kelly; Henrichs, Ronald A; Hume, Keith M; Lum, Flora; Nielsen, David R; Poulsen, Lisle; Shoaf, Lori; Schoaf, Lori; Seward, William; Begolka, Wendy Smith; Stanton, Robert G; Svedman, Katherine J; Thomas, J Regan; Sykes, Jonathan M; Wargo, Carol; Weiss, Robert A

2011-04-01

: The American Society of Plastic Surgeons and the American Academy of Dermatology, with the support of other sister societies, conducted the Facial Soft-Tissue Fillers: Assessing the State of the Science conference in December of 2009. The American Society of Plastic Surgeons and the American Academy of Dermatology established a panel of leading experts in the field of soft-tissue fillers-from researchers to clinicians-and other stakeholders for the conference to examine and discuss issues of patient safety, efficacy, and effectiveness in relation to the approved and off-label use of soft-tissue fillers, and other factors, including the training and level of experience of individuals administering fillers. This report represents the systematic literature review that examines comprehensively the available evidence and gaps in the evidence related to soft-tissue fillers, to inform and support the work of the state-of-the-science conference panel. This evidence-based medicine review will serve as the foundation for future evidence-based medicine reports in this growing field.

Free temporal fascia flap to cover soft tissue defects of the foot: a case report

Directory of Open Access Journals (Sweden)

Schreiber, Martin

2015-01-01

Full Text Available Severe soft tissue defects as a result of lye contamination remain a huge challenge in the interdisciplinary approach of trauma surgeons and plastic surgeons. Free tissue transfer is a suitable surgical option for successful reconstruction of form and function of defects in the distal parts of the lower extremities. We report the successful two-stage reconstruction of a full thickness lye contamination at the dorsum of the foot with a free temporoparietal fascia flap covered with a split-thickness skin graft from the thigh. The described method is a suitable operative alternative to anterolateral thigh flaps or other thin fascia flaps regarding flap harvest and donor site morbidity and should be considered in the portfolio of the plastic surgeon.

Patient Attitudes Toward Orthopedic Surgeon Ownership of Related Ancillary Businesses.

Science.gov (United States)

Yi, Paul H; Cross, Michael B; Johnson, Staci R; Rasinski, Kenneth A; Nunley, Ryan M; Della Valle, Craig J

2016-08-01

Physician ownership of businesses related to orthopedic surgery, such as surgery centers, has been criticized as potentially leading to misuse of health care resources. The purpose of this study was to determine patients' attitudes toward surgeon ownership of orthopedic-related businesses. We surveyed 280 consecutive patients at 2 centers regarding their attitudes toward surgeon ownership of orthopedic-related businesses using an anonymous questionnaire. Three surgeon ownership scenarios were presented: (1) owning a surgery center, (2) physical therapy (PT), and (3) imaging facilities (eg, Magnetic Resonance Imaging scanner). Two hundred fourteen patients (76%) completed the questionnaire. The majority agreed that it is ethical for a surgeon to own a surgery center (73%), PT practice (77%), or imaging facility (77%). Most (>67%) indicated that their surgeon owning such a business would have no effect on the trust they have in their surgeon. Although >70% agreed that a surgeon in all 3 scenarios would make the same treatment decisions, many agreed that such surgeons might perform more surgery (47%), refer more patients to PT (61%), or order more imaging (58%). Patients favored surgeon autonomy, however, believing that surgeons should be allowed to own such businesses (78%). Eighty-five percent agreed that patients should be informed if their surgeon owns an orthopedic-related business. Although patients express concern over and desire disclosure of surgeon ownership of orthopedic-related businesses, the majority believes that it is an ethical practice and feel comfortable receiving care at such a facility. Copyright © 2016 Elsevier Inc. All rights reserved.

Knowledge and opinions on oncoplastic surgery among breast and plastic surgeons

DEFF Research Database (Denmark)

Carstensen, Lena Felicia; Rose, Michael; Bentzon, Niels

2015-01-01

surgeons and 22 plastic surgeons; the response rate was 67%. All breast surgery units had an established cooperation with plastic surgeons. Most breast surgeons used unilateral displacement techniques; plastic surgeons also included breast reduction techniques and replacement with local flaps. Almost all...... of implementation of OPS in Denmark. METHODS: An electronic questionnaire was sent to breast and plastic surgeons performing breast cancer treatment. The questionnaire included demographics, education, experience with operative procedures and opinions on OPS. RESULTS: The questionnaire was sent to 50 breast...... symmetrisation procedures were performed by plastic surgeons. Breast surgeons had sought more specific education, both international observerships and specific courses. In both groups of surgeons, the majority expressed that both tumour removal and reconstruction should be performed by doctors of their own...

Do Surgeons Treat Their Patients Like They Would Treat Themselves?

NARCIS (Netherlands)

Janssen, Stein J.; Teunis, Teun; Guitton, Thierry G.; Ring, David; Spoor, Andy B.; Chauhan, Aakash; Shafritz, Adam B.; Wasterlain, Amy; Terrono, Andrew L.; Neviaser, Andrew S.; Schmidt, Andrew; Nelson, Andy; Miller, Anna N.; Kristan, Anze; Apard, Thomas; Berner, Arne; Ilyas, Asif; Jubel, Axel; Jost, Bernhard; Babis, George; Watkins, Barry; Kreis, Barbara; Nolan, Betsy M.; Crist, Brett D.; Cross, Brian J.; Wills, Brian P. D.; Barreto, Camilo Jose Romero; Ekholm, Carl; Swigart, Carrie; Spath, Catherine; Zalavras, Charalampos; Cassidy, Charles; Garnavos, Christos; Moreno-Serrano, Constanza L.; Rodner, Craig; Klostermann, Cyrus; Osei, Daniel A.; Rikli, Daniel A.; Haverkamp, Daniel; Polatsch, Daniel; Drosdowech, Darren; Edelstein, David M.; Eygendaal, Denise; Verbeek, Diederik O. F.; Doornberg, Job N.; van den Bekerom, Michel P. J.; Schep, Niels; Kloen, Peter; Haverlag, Robert; Schepers, Tim

2015-01-01

There is substantial unexplained geographical and surgeon-to-surgeon variation in rates of surgery. One would expect surgeons to treat patients and themselves similarly based on best evidence and accounting for patient preferences. (1) Are surgeons more likely to recommend surgery when choosing for

Characterizing and fostering charity care in the surgeon workforce.

Science.gov (United States)

Wright, D Brad; Scarborough, John E

2011-07-01

We sought to determine which demographic and practice characteristics are associated with both a surgeon's willingness to provide any charity care as well as the amount of charity care provided. Although it is known that surgeons tend to provide a greater amount of charity care than other physicians, no studies have attempted to look within the surgeon population to identify which factors lead some surgeons to provide more charity care than others. Using 4 rounds of data from the Community Tracking Study, we employ a 2-part multivariate regression model with fixed effects. A greater amount of charity care is provided by surgeons who are male, practice owners, employed in academic medical centers, or earn a greater proportion of their revenue from Medicaid. Surgeons who work in a group HMO are significantly less likely to provide any charity care. Personal resources (eg, time and money) had a minimal association with charity care provision. Surgeons whose characteristics are associated with a greater propensity for charity care provision as suggested by this study, should be considered as a potential source for building the volunteer workforce.

Virtual airway simulation to improve dexterity among novices performing fibreoptic intubation.

Science.gov (United States)

De Oliveira, G S; Glassenberg, R; Chang, R; Fitzgerald, P; McCarthy, R J

2013-10-01

We developed a virtual reality software application (iLarynx) using built-in accelerometer properties of the iPhone(®) or iPad(®) (Apple Inc., Cupertino, CA, USA) that mimics hand movements for the performance of fibreoptic skills. Twenty novice medical students were randomly assigned to virtual airway training with the iLarynx software or no additional training. Eight out of the 10 subjects in the standard training group had at least one failed (> 120 s) attempt compared with two out of the 10 participants in the iLarynx group (p = 0.01). There were a total of 24 failed attempts in the standard training group and four in the iLarynx group (p < 0.005). Cusum analysis demonstrated continued group improvement in the iLarynx, but not in the standard training group. Virtual airway simulation using freely available software on a smartphone/tablet device improves dexterity among novices performing upper airway endoscopy. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

The Role of Moral Reasoning and Order Effects on Ethical Decision Making Ability: Novice vs. Experienced Accounting Students

DEFF Research Database (Denmark)

Pillalamarri, Sudarshan Kumar; Holm, Claus

that novice accounting students cannot differentiate between these two types of reasoning, but would exhibit order effects while making ethical decisions. One hundred forty graduate accounting students from universities in Denmark respond to an audit-specific DIT instrument, measuring prescriptive...... investigates the order effects of presentation of dilemmas on ethical decision making ability of novice and experienced accounting students. Rest (1979, 1983, 1991) categorizes moral reasoning into prescriptive reasoning i.e. consideration of what should ideally be done to resolve a particular ethical dilemma...... and deliberative reasoning i.e. consideration of what would actually be done in resolving ethical dilemmas. Because of lack of work experience, novice accounting students often do not face scenarios where there is a difference between their prescriptive and deliberative reasoning. This study hypothesizes...

Hand dominance in orthopaedic surgeons.

LENUS (Irish Health Repository)

Lui, Darren F

2012-08-01

Handedness is perhaps the most studied human asymmetry. Laterality is the preference shown for one side and it has been studied in many aspects of medicine. Studies have shown that some orthopaedic procedures had poorer outcomes and identified laterality as a contributing factor. We developed a questionnaire to assess laterality in orthopaedic surgery and compared this to an established scoring system. Sixty-two orthopaedic surgeons surveyed with the validated Waterloo Handedness Questionnaire (WHQ) were compared with the self developed Orthopaedic Handedness Questionnaire (OHQ). Fifty-eight were found to be right hand dominant (RHD) and 4 left hand dominant (LHD). In RHD surgeons, the average WHQ score was 44.9% and OHQ 15%. For LHD surgeons the WHQ score was 30.2% and OHQ 9.4%. This represents a significant amount of time using the non dominant hand but does not necessarily determine satisfactory or successful dexterity transferable to the operating room. Training may be required for the non dominant side.

The volume of fluid injected into the tissue expander and the tissue expansion

Directory of Open Access Journals (Sweden)

Mahmood Omranifard

2014-01-01

Full Text Available Background: Replacement of the lost tissue is the major concerns of the plastic surgeons. Expanded area should be coherent with the surrounding tissue. Tissue expansion technique is the reforming methods the skin tissue scarcities. Several methods for tissue expansion are available; including usage of silicon balloon and injecting fluid into the tissue expander. Materials and Methods: In a clinical trial study, 35 patients, with burn scars, in the face, skull and neck area were studied. We provided a tissue expander device with capacities of 125, 250 and 350cc. Fluid was injected inside the device, 3 consecutive weeks with 1-week interval. After 3 months the device was set out and the tissue expansion was measured using a transparent board and the results were analyzed. Multiple regression was done by SPSS 20 to analyze the data. Results: Regression model showed Skin expansion was positively correlated with the volume of the injected fluid. For each centimeter square of skin expansion, about 6-8 ml of fluid must be injected. Conclusion: Correction of skin defects resulting from burning scar is possible using tissue expanders. The tissue expansion is correlated with the amount of the injected fluid.

ATTENTION MAINTENANCE IN NOVICE DRIVERS: ASSESSMENT AND TRAINING

OpenAIRE

Pradhan, Anuj; Masserang, Kathleen M.; Divekar, Gautam; Reagan, Ian; Thomas, F. Dennis; Blomberg, Richard; Pollatsek, Alexander; Fisher, Donald

2009-01-01

All programs assessing attention maintenance inside the vehicle have required eye trackers and either a driving simulator or a specially equipped field vehicle. Ideally, one would like a way to assess attention maintenance that could be implemented on a desktop PC. Additionally, one would like to have a program that could be used to train novice drivers to maintain their attention more safely on the forward roadway. An experiment was run (a) to determine whether a program FOCAL (Focused Conce...

Adverse reactions to injectable soft tissue fillers

DEFF Research Database (Denmark)

Requena, Luis; Requena, Celia; Christensen, Lise

2011-01-01

In recent years, injections with filler agents are often used for wrinkle-treatment and soft tissue augmentation by dermatologists and plastic surgeons. Unfortunately, the ideal filler has not yet been discovered and all of them may induce adverse reactions. Quickly biodegradable or resorbable ag...

A leadership development program for surgeons: First-year participant evaluation.

Science.gov (United States)

Pradarelli, Jason C; Jaffe, Gregory A; Lemak, Christy Harris; Mulholland, Michael W; Dimick, Justin B

2016-08-01

In a dynamic health care system, strong leadership has never been more important for surgeons. Little is known about how to design and conduct effectively a leadership program specifically for surgeons. We sought to evaluate critically a Leadership Development Program for practicing surgeons by exploring how the program's strengths and weaknesses affected the surgeons' development as physician-leaders. At a large academic institution, we conducted semistructured interviews with 21 surgical faculty members who applied voluntarily, were selected, and completed a newly created Leadership Development Program in December 2012. Interview transcripts underwent qualitative descriptive analysis with thematic coding based on grounded theory. Themes were extracted regarding surgeons' evaluations of the program on their development as physician-leaders. After completing the program, surgeons reported personal improvements in the following 4 areas: self-empowerment to lead, self-awareness, team-building skills, and knowledge in business and leadership. Surgeons felt "more confident about stepping up as a leader" and more aware of "how others view me and my interactions." They described a stronger grasp on "giving feedback" as well as a better understanding of "business/organizational issues." Overall, surgeon-participants reported positive impacts of the program on their day-to-day work activities and general career perspective as well as on their long-term career development plans. Surgeons also recommended areas where the program could potentially be improved. These interviews detailed self-reported improvements in leadership knowledge and capabilities for practicing surgeons who completed a Leadership Development Program. A curriculum designed specifically for surgeons may enable future programs to equip surgeons better for important leadership roles in a complex health care environment. Copyright © 2016 Elsevier Inc. All rights reserved.

Perioperative antibiotics in the setting of microvascular free tissue transfer: current practices

NARCIS (Netherlands)

Reiffel, Alyssa J.; Kamdar, Mehul R.; Kadouch, Daniel J. M.; Rohde, Christine H.; Spector, Jason A.

2010-01-01

Microvascular free tissue transfer is a ubiquitous and routine method of restoring anatomic defects. There is a paucity of data regarding the role of perioperative antibiotics in free tissue transfer. We designed a survey to explore usage patterns among microvascular surgeons and thereby define a

The Effect of Mentor Intervention Style in Novice Entrepreneur Mentoring Relationships

Science.gov (United States)

St-Jean, Etienne; Audet, Josee

2013-01-01

In this study, we aimed to determine whether mentor intervention styles influence benefits gained by novice entrepreneurs through their mentoring relationship. An empirical study conducted with 360 mentees who had received mentoring services shows that an intervention style which combines a maieutic approach with mentor involvement produced the…

An online review of plastic surgeons in southern California.

Science.gov (United States)

Lewis, Priya; Kobayashi, Emily; Gupta, Subhas

2015-05-01

It has become commonplace for patients to access online reviews of physicians when making choices about health care, just as any consumer would in today's computer-dependent world. Previous studies have shown that online reviews of physicians are generally positive. However, 1 negative review has the potential to adversely affect business and reputations. To characterize the online presence of plastic surgeons in Southern California as portrayed by physician rating websites (PRWs). An extensive online database of board-certified plastic surgeons was used to generate a list of surgeons within a 50-mile radius of Pomona, CA. Ratings from the PRWs HealthGrades.com, Vitals.com, and UCompareHealthcare.com were cataloged by number of reviews and ratings. Two hundred sixty-three surgeons were evaluated with the most-represented cities being Beverly Hills (N=47), Los Angeles (N=31), and Newport Beach (N=27). Ninety-seven percent of the surgeons were rated on at least 1 of the 3 PRWs chosen. In general, surgeons were rated highly, with a mean rating of 85%, SD, 14% (Ponline ratings ranged from 0 to 222 per surgeon. The median number of total reviews was 25 and the mean rating for those surgeons above and below the median were equivocal, at 86% and 85%, respectively (P=0.284). In this study, we found that plastic surgeons in Southern California have an online presence that can be influenced by their patients; they should be aware of this and conscious of their online reputations. Overall, the ratings were high, regardless of the number of reviews.

A novice's process of object-oriented programming

DEFF Research Database (Denmark)

Caspersen, Michael Edelgaard; Kölling, Michael

2006-01-01

Exposing students to the process of programming is merely implied but not explicitly addressed in texts on programming which appear to deal with 'program' as a noun rather than as a verb.We present a set of principles and techniques as well as an informal but systematic process of decomposing...... a programming problem. Two examples are used to demonstrate the application of process and techniques.The process is a carefully down-scaled version of a full and rich software engineering process particularly suited for novices learning object-oriented programming. In using it, we hope to achieve two things...

The GRONORUN study: is a graded training program for novice runners effective in preventing running related injuries? Design of a Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Pepping Gert-Jan

2007-03-01

Full Text Available Abstract Background Running is a popular form of recreational exercise. Beside the positive effects of running on health and fitness, the risk of a running related injury has to be considered. The incidence of injuries in runners is high and varies from 30–79%. However, few intervention studies on prevention of running related injuries have been performed and none of these studies involved novice runners. Methods GRONORUN (Groningen Novice Running is a two armed randomized controlled trial, comparing the effects of two different training programs for novice runners on the incidence of running related injuries. Participants are novice runners, who want to train for a four mile running event. The control group will train according a standard 8 week training program. The intervention group will use a more gradual, 13 week training program which is based on "the ten percent training rule". During the thirteen week follow up participants register information on running and RRI's in an internet based running log. The primary outcome measure is RRI. An injury is defined as a musculoskeletal ailment of the lower extremity or back, causing a restriction of running for at least one week. Discussion The GRONORUN trial is the first randomized controlled trial to study a preventive intervention in novice runners. Many different training programs for novice runners are offered, but none are evidence based.

Surgeon-performed ultrasonography

DEFF Research Database (Denmark)

Todsen, Tobias

2017-01-01

Surgeons are increasingly using ultrasonography (US) in their clinical management of patients. However, US is a very user-dependent imaging modality and proper skills of the US operator are needed to ensure quality in patient care. This thesis explores the validity evidence for assessment...

Naturalistic Assessment of Novice Teenage Crash Experience

Science.gov (United States)

Lee, Suzanne E.; Simons-Morton, Bruce G.; Klauer, Sheila E.; Ouimet, Marie Claude; Dingus, Thomas A.

2011-01-01

teenage drivers.. Discussion The findings are the first comparing crash and near-crash rates among novice teenage drivers with those of adults using the same vehicle over the same period of time. The finding of highly elevated crash rates of novice teenagers during the first six months of licensure are consistent with and confirm the archival crash data showing high crash risk for novice teenagers. The NTDS convenience sample of teenage drivers was similar to the U.S. teenage driver population in terms of exposure and crash experience. The dataset is expected be a valuable resource for future in-depth analyses of crash risk, exposure to risky driving conditions, and comparisons of teenage and adult driving performance in various driving situations. PMID:21545880

Musculoskeletal pain among surgeons performing minimally invasive surgery

DEFF Research Database (Denmark)

Dalager, Tina; Søgaard, Karen; Bech, Katrine Tholstrup

2017-01-01

BACKGROUND: Musculoskeletal pain is the most common occupational disease in Europe. Surgeons with awkward and static working postures are no exception. Robotic-assisted laparoscopy has been postulated to be superior to conventional laparoscopy regarding the ergonomic strain for surgeons. In this ......BACKGROUND: Musculoskeletal pain is the most common occupational disease in Europe. Surgeons with awkward and static working postures are no exception. Robotic-assisted laparoscopy has been postulated to be superior to conventional laparoscopy regarding the ergonomic strain for surgeons......, and comparative data on surgeons' physical workload with robotic-assisted laparoscopy and conventional laparoscopy. Studies only describing a single surgical modality were excluded. We applied the checklist, STrengthening the Reporting of OBservational studies in Epidemiology (STROBE), to assess the quality...... fulfilled the criteria of STROBE, with an average score of 13 (range 10-16) out of 18. DISCUSSION: Results, mainly self-reported measures, suggest that robotic-assisted laparoscopy is less strenuous compared with conventional laparoscopy. However, results are limited by the large methodological...

Musculoskeletal Pain in Gynecologic Surgeons

Science.gov (United States)

Adams, Sonia R.; Hacker, Michele R.; McKinney, Jessica L.; Elkadry, Eman A.; Rosenblatt, Peter L.

2013-01-01

Objective To describe the prevalence of musculoskeletal pain and symptoms in gynecologic surgeons. Design Prospective cross-sectional survey study (Canadian Task Force classification II-2). Setting Virtual. All study participants were contacted and participated via electronic means. Participants Gynecologic surgeons. Interventions An anonymous, web-based survey was distributed to gynecologic surgeons via electronic newsletters and direct E-mail. Measurements and Main Results There were 495 respondents with complete data. When respondents were queried about their musculoskeletal symptoms in the past 12 months, they reported a high prevalence of lower back (75.6%) and neck (72.9%) pain and a slightly lower prevalence of shoulder (66.6%), upper back (61.6%), and wrist/hand (60.9%) pain. Many respondents believed that performing surgery caused or worsened the pain, ranging from 76.3% to 82.7% in these five anatomic regions. Women are at an approximately twofold risk of pain, with adjusted odds ratios (OR) of 1.88 (95% confidence interval [CI], 1.1–3.2; p 5 .02) in the lower back region, OR 2.6 (95% CI, 1.4–4.8; p 5 .002) in the upper back, and OR 2.9 (95% CI, 1.8–4.6; p 5 .001) in the wrist/hand region. Conclusion Musculoskeletal symptoms are highly prevalent among gynecologic surgeons. Female sex is associated with approximately twofold risk of reported pain in commonly assessed anatomic regions. Journal of Minimally Invasive Gynecology (2013) 20, 656-660 PMID:23796512

Society of Thoracic Surgeons

Science.gov (United States)

... Apply for Membership Membership Directory Pay Your Dues Industry Mailing List License & eBlast Communications Programs Advertise on ... Hotel Discount Copyright © 2017 The Society of Thoracic Surgeons. ...

Imaging of bone tumors for the musculoskeletal oncologic surgeon.

Science.gov (United States)

Errani, C; Kreshak, J; Ruggieri, P; Alberghini, M; Picci, P; Vanel, D

2013-12-01

The appropriate diagnosis and treatment of bone tumors requires close collaboration between different medical specialists. Imaging plays a key role throughout the process. Radiographic detection of a bone tumor is usually not challenging. Accurate diagnosis is often possible from physical examination, history, and standard radiographs. The location of the lesion in the bone and the skeleton, its size and margins, the presence and type of periosteal reaction, and any mineralization all help determine diagnosis. Other imaging modalities contribute to the formation of a diagnosis but are more critical for staging, evaluation of response to treatment, surgical planning, and follow-up.When necessary, biopsy is often radioguided, and should be performed in consultation with the surgeon performing the definitive operative procedure. CT is optimal for characterization of the bone involvement and for evaluation of pulmonary metastases. MRI is highly accurate in determining the intraosseous extent of tumor and for assessing soft tissue, joint, and vascular involvement. FDG-PET imaging is becoming increasingly useful for the staging of tumors, assessing response to neoadjuvant treatment, and detecting relapses.Refinement of these and other imaging modalities and the development of new technologies such as image fusion for computer-navigated bone tumor surgery will help surgeons produce a detailed and reliable preoperative plan, especially in challenging sites such as the pelvis and spine. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

[Close teamwork between pathologist and surgeon can improve results in colorectal cancer treatment].

Science.gov (United States)

West, Nicholas P; Quirke, Philip; Hagemann-Madsen, Rikke Hjarnø

2011-04-04

Colorectal cancer is common in the Western world and is a leading cause of cancer related mortality. The introduction of multidisciplinary teams and focus on quality control has led to improved outcomes in which pathologists play a central role through feedback to surgeons, radiologists, and oncologists. This review focuses on the importance of pathological examination of the resection specimen and subsequent feedback to the surgical team regarding quality. Specific markers of oncological quality including grading the plane of surgery, tissue morphometry and lymph node yields are discussed.

3D Bioprinting of Cartilage for Orthopedic Surgeons: Reading between the Lines.

Science.gov (United States)

Di Bella, Claudia; Fosang, Amanda; Donati, Davide M; Wallace, Gordon G; Choong, Peter F M

2015-01-01

Chondral and osteochondral lesions represent one of the most challenging and frustrating scenarios for the orthopedic surgeon and for the patient. The lack of therapeutic strategies capable to reconstitute the function and structure of hyaline cartilage and to halt the progression toward osteoarthritis has brought clinicians and scientists together, to investigate the potential role of tissue engineering as a viable alternative to current treatment modalities. In particular, the role of bioprinting is emerging as an innovative technology that allows for the creation of organized 3D tissue constructs via a "layer-by-layer" deposition process. This process also has the capability to combine cells and biomaterials in an ordered and predetermined way. Here, we review the recent advances in cartilage bioprinting and we identify the current challenges and the directions for future developments in cartilage regeneration.

3D-BIOPRINTING OF CARTILAGE FOR ORTHOPAEDIC SURGEONS.READING BETWEEN THE LINES

Directory of Open Access Journals (Sweden)

Claudia eDi Bella

2015-08-01

Full Text Available Chondral and Osteochondral lesions represent one of the most challenging and frustrating scenarios for the orthopaedic surgeon and for the patient. The lack of therapeutic strategies capable to reconstitute the function and structure of hyaline cartilage and to halt the progression towards osteoarthritis has brought clinicians and scientists together, to investigate the potential role of tissue engineering as a viable alternative to current treatment modalities. In particular, the role of bioprinting is emerging as an innovative technology that allows for the creation of organized 3D tissue constructs via a layer-by-layer deposition process. This process also has the capability to combine cells and biomaterials in an ordered and predetermined way. Here we review the recent advances in cartilage bioprinting and we identify the current challenges and the directions for future developments in cartilage regeneration.

The Novice User and CD-ROM Database Services. ERIC Digest.

Science.gov (United States)

Schamber, Linda

This digest answers the following questions that beginning or novice users may have about CD-ROM (a compact disk with read-only memory) database services: (1) What is CD-ROM? (2) What databases are available? (3) Is CD-ROM difficult to use? (4) How much does CD-ROM cost? and (5) What is the future of CD-ROM? (15 references) (MES)

A Modular Laparoscopic Training Program for Pediatric Surgeons

Science.gov (United States)

Wasa, Masafumi; Takiguchi, Shuji; Taniguchi, Eiji; Soh, Hideki; Ohashi, Shuichi; Okada, Akira

2003-01-01

Objectives: A structured endoscopic training program for pediatric surgeons has not yet been established. This study was conducted to develop a modular training program (MTP) for pediatric surgeons and to evaluate its effectiveness for surgeons with and without previous experience in laparoscopic surgery. Methods: Nine pediatric surgeons participated in the study. They were divided into 2 groups: group A (n=4), surgeons who had experienced more than 10 cases of laparoscopic surgery prior to MTP; group B (n=5), those who had experienced fewer than 10 cases. They participated in a standardized MTP workshop, which consisted of 2 “see-through” and 3 “laparoscopic” tasks. Each participant's psychomotor skills were evaluated objectively before and after MTP with a computer-generated virtual simulator and were evaluated for precision, efficiency, and speed. Results: In participants, speed was significantly enhanced after MTP. In group A, no differences were observed after MTP, whereas significant improvements were noted in efficiency and speed after MTP in group B. Before MTP, efficiency was significantly higher in group A than in group B; however, no difference remained between the 2 groups after MTP. Conclusions: MTP is effective for nonlaparoscopic pediatric surgeons to become familiar with basic endoscopic skills. PMID:12722996

Tissue engineered vascular grafts: Origins, development, and current strategies for clinical application.

Science.gov (United States)

Benrashid, Ehsan; McCoy, Christopher C; Youngwirth, Linda M; Kim, Jina; Manson, Roberto J; Otto, James C; Lawson, Jeffrey H

2016-04-15

Since the development of a dependable and durable synthetic non-autogenous vascular conduit in the mid-twentieth century, the field of vascular surgery has experienced tremendous growth. Concomitant with this growth, development in the field of bioengineering and the development of different tissue engineering techniques have expanded the armamentarium of the surgeon for treating a variety of complex cardiovascular diseases. The recent development of completely tissue engineered vascular conduits that can be implanted for clinical application is a particularly exciting development in this field. With the rapid advances in the field of tissue engineering, the great hope of the surgeon remains that this conduit will function like a true blood vessel with an intact endothelial layer, with the ability to respond to endogenous vasoactive compounds. Eventually, these engineered tissues may have the potential to supplant older organic but not truly biologic technologies, which are used currently. Copyright © 2015 Elsevier Inc. All rights reserved.

Exploring novice nurses' needs regarding their work-related health: a qualitative study

NARCIS (Netherlands)

Ketelaar, Sarah M.; Nieuwenhuijsen, Karen; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

2015-01-01

To investigate Dutch novice nurses' experiences and needs regarding occupational health support to prevent work-related health problems and to keep them well-functioning. A qualitative interview study was conducted with six nursing students and eight newly qualified nurses. The interviews covered

Supporting Secondary Novices' Efforts to Implement Student- and Discourse-Centred Pedagogical Practices

Science.gov (United States)

Lewis, Gary

2012-01-01

Novice secondary mathematics teachers attempting teaching consonant with NCTM (1991) Professional Standards for Teaching Mathematics experience stresses related to those attempts. Foremost among those stresses are challenges while orchestrating student-centred, whole-class discussions. Such discussions can create uncertainty and stress as novices…

How surgeons make decisions when the evidence is inconclusive

NARCIS (Netherlands)

Hageman, Michiel G. J. S.; Guitton, Thierry G.; Ring, David; Osterman, A. Lee; Spoor, A. B.; van der Zwan, A. L.; Shrivastava, Abhay; Wahegaonkar, Abhijeet L.; Aida, E. Garcia G.; Aita, M. A.; Castillo, Alberto Pérez; Marcus, Alexander; Ladd, Amy; Terrono, Andrew L.; Gutow, Andrew P.; Schmidt, Andrew; Wang, Angela A.; Eschler, Anica; Miller, Anna N.; Wikerøy, Annette K. B.; Barquet, Antonio; Armstrong, April D.; van Vugt, Arie B.; Bedi, Asheesh; Shyam, Ashok K.; Mazzocca, Augustus D.; Jubel, Axel; Babst, Reto H.; Nolan, Betsy M.; Arciero, Bob; Bremer, Vanden; Bamberger, Brent; Peterson, Bret C.; Crist, Brett D.; Cross, Brian J.; Badman, Brian L.; Henley, C. Noel; Ekholm, Carl; Swigart, Carrie; Manke, Chad; Zalavras, Charalampos; Goldfarb, Charles A.; Cassidy, Charles; Cornell, Charles; Getz, Charles L.; Metzger, Charles; Wilson, Chris; Heiss, Christian; Perrotto, Christian J.; Wall, Christopher J.; Walsh, Christopher J.; Garnavos, Christos; Jiang, Chunyan; Lomita, Craig; Torosian, Craig M.; Rikli, Daniel A.; Whelan, Daniel B.; Wascher, Daniel C.; Hernandez, Daniel; Polatsch, Daniel; Beingessner, Daphne; Drosdowech, Darren; Tate, David E.; Hak, David; Rowland, David J.; Kalainov, David M.; Nelson, David; Weiss, David; McKee, Desirae M.; van Deurzen, D. F. G.; Endrizzi, Donald; Erol, Konul; Overbeck, Joachim P.; Baer, Wolfgang; Schwab, Eckart; Maza, Edgardo Ramos; Harvey, Edward; Rodriguez, Edward K.; Preloggler, Elisabeth; Schemitsch, Emil H.; Shin, Eon K.; Hofmeister, Eric P.; Kaplan, Thomas D.; Beeres, F. J. P.; Suarez, Fabio; Fernandes, C. H.; Cayón, Fidel Ernesto Cayón; Dolatowski, Filip Celestyn; Martin, Fischmeister; Sierra, Francisco Javier Aguilar; Lopez-Gonzalez, Francisco; Walter, Frank; Seibert, Franz Josef; Baumgaertel, Fred; Frihagen, Frede; Fuchs, P. C.; Huemer, Georg M.; Kontakis, George; Athwal, George S.; Dyer, George S. M.; Thomas, George; Kohut, Georges; Williams, Gerald; Hernandez, German Ricardo; Caro, Gladys Cecilia Zambrano; Garrigues, Grant; Merrell, Greg; DeSilva, Gregory; Della Rocca, Gregory J.; Regazzi, Gustavo; de Azevedo, Gustavo Borges Laurindo; Ruggiero, Gustavo Mantovani; Helling, H. J.; MccUtchan, Hal; Goost, Hans; Kreder, Hans J.; Hasenboehler, Paula M.; Routman, Howard D.; van der Heide, Huub; Kleinlugtenbelt, I.; McGraw, Iain; Harris, Ian; Ibrahim, Ibrahim Mohammad; Lin, Ines C.; Iossifidis, A.; Andrew, J.; Trenholm, I.; Goslings, J. Carel; Wiater, J. Michael; Choueka, Jack; Ahn, Jaimo; Kellam, James; Biert, Jan; Pomerance, Jay; Johnson, Jeff W.; Greenberg, Jeffrey A.; Yao, Jeffrey; Watson, Jeffry T.; Giuffre, Jennifer L.; Hall, Jeremy; Park, Jin-Young; Fischer, Jochen; Murachovsky, Joel; Howlett, John; McAuliffe, John; Evans, John P.; Taras, John; Braman, Jonathan; Hobby, Jonathan L.; Rosenfeld, Jonathan; Boretto, Jorge; Orbay, Jorge; Rubio, Jorge; Ortiz, Jose A.; Abboud, Joseph; Conflitti, Joseph M.; Vroemen, Joseph P. A. M.; Adams, Julie; Clarke, J. V.; Kabir, K.; Chivers, Karel; Prommersberger, Karl-Josef; Segalman, Keith; Lee, Kendrick; Eng, Kevin; Chhor, Kimberlly S.; Ponsen, K. J.; Jeray, Kyle; Marsh, L.; Poelhekke, L. M. S. J.; Mica, Ladislav; Borris, Lars C.; Halperin, Lawrence; Weiss, Lawrence; Benson, Leon; Elmans, Leon; de Mendonca, Leonardo Alves; Rocha, Leonardo; Katolik, Leonid; Lattanza, Lisa; Taitsman, Lisa; Guenter, Lob; Catalano, Louis; Buendia, Luis Antonio; Austin, Luke S.; Palmer, M. Jason; de Vries, M. R.; Bronkhorst, Maarten W. G. A.; Abdel-Ghany, Mahmoud I.; van de Sande, M. A. J.; Swiontkowski, Marc; Rizzo, Marco; Lehnhardt, Marcus; Pirpiris, Marinis; Baratz, Mark; Lazarus, Mark D.; Boyer, Martin; Richardson, Martin; Kastelec, Matej; Mormino, Matt; Budge, Matthew D.; Turina, Matthias; Wood, Megan M.; Baskies, Michael; Baumgaertner, Michael; Behrman, Michael; Hausman, Michael; Jones, Michael; LeCroy, Michael; Moskal, Michael; Nancollas, Michael; Prayson, Michael; Grafe, Michael W.; Kessler, Michael W.; van den Bekerom, Michel P. J.; Mckee, Mike; Merchant, Milind; Tyllianakis, Minos; Felipe, Naquira Escobar Luis; Chen, Neal C.; Saran, Neil; Wilson, Neil; Shortt, Nicholas L.; Schep, Niels; Rossiter, Nigel; Lasanianos, N. G.; Kanakaris, Nikolaos; Weiss, Noah D.; Harvey, Norah M.; van Eerten, P. V.; Melvanki, Parag; McCulloch, Patrick T.; Martineau, Paul A.; Appleton, Paul; Guidera, Paul; Levin, Paul; Giannoudis, Peter; Evans, Peter J.; Jebson, Peter; Kloen, Peter; Krause, Peter; Brink, Peter R. G.; Peters, J. H.; Blazar, Philip; Streubel, Philipp N.; Inna, Prashanth; Prashanth, S.; Solanki, Punita V.; Wang, Qiugen; Quell, M.; Benafield, R. Bryan; Haverlag, R.; Peters, R. W.; Varma, Rajat; Nyszkiewicz, Ralf; Costanzo, Ralph M.; de Bedout, Ramon; Ranade, Ashish S.; Smith, Raymond Malcolm; Abrams, Reid; Fricker, Renato M.; Omid, Reza; Barth, Richard; Buckley, Richard; Jenkinson, Richard; GIlbert, Richard S.; Page, Richard S.; Wallensten, Richard; Zura, Robert D.; Feibel, Robert J.; Gray, Robert R. L.; Tashijan, Robert; Wagenmakers, Robert; Pesantez, Rodrigo; van Riet, Roger; Norlin, Rolf; Pfeifer, Roman; Liem, Ronald; Kulick, Roy G.; Poolman, Rudolf W.; Shatford, Russell; Klinefelter, Ryan; Calfee, Ryan P.; Moghtaderi, Sam; Sodha, Samir; Sprujt, Sander; Kakar, Sanjeev; Kaplan, Saul; Duncan, Scott; Kluge, Sebastian; Rodriguez-Elizalde, Sebastian; Checchia, Sergio L.; Rowinski, Sergio; Dodds, Seth; Hurwit, Shep; Sprengel, K.; van der Stappen, W. A. H.; Kronlage, Steve; Belded, Steven; Morgan, Steven J.; Rhemrev, Steven J.; Hilliard, Stuart; Gosens, Taco; Sasaki, Takashi; Taleb, C.; Pritsch, Tamir; Tosounidis, Theodoros; Wyrick, Theresa; DeCoster, Thomas; Dienstknecht, Thomas; Stackhouse, Thomas G.; Hughes, Thomas; Wright, Thomas; Ly, Thuan V.; Havenhill, Timothy G.; Omara, Timothy; Siff, Todd; McLaurin, Toni M.; Wanich, Tony; Rueger, Johannes M.; Vallim, Frederico C. M.; Sabesan, Vani J.; Nikolaou, Vasileios S.; Knoll, Victoria D.; Telang, Vidyadhar; Iyer, Vishwanath M.; Jokhi, Vispi; Batson, W. Arnnold; Willems, W. Jaap; Smith, Wade R.; Belangero, William Dias; Wolkenfelt, J.; Weil, Yoram

2013-01-01

To address the factors that surgeons use to decide between 2 options for treatment when the evidence is inconclusive. We tested the null hypothesis that the factors surgeons use do not vary by training, demographics, and practice. A total of 337 surgeons rated the importance of 7 factors when

Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe : a 1-year prospective cohort study

NARCIS (Netherlands)

Nielsen, Rasmus Oestergaard; Buist, Ida; Parner, Erik Thorlund; Nohr, Ellen Aagaard; Sorensen, Henrik; Lind, Martin; Rasmussen, Sten

Objective To investigate if running distance to first running-related injury varies between foot postures in novice runners wearing neutral shoes. Design A 1-year epidemiological observational prospective cohort study. Setting Denmark. Participants A total of 927 novice runners equivalent to 1854

Working night shifts affects surgeons' biological rhythm

DEFF Research Database (Denmark)

Amirian, Ilda; Andersen, Lærke T; Rosenberg, Jacob

2015-01-01

BACKGROUND: Chronic sleep deprivation combined with work during the night is known to affect performance and compromise residents' own safety. The aim of this study was to examine markers of circadian rhythm and the sleep-wake cycle in surgeons working night shifts. METHODS: Surgeons were monitor...

Cardiac Surgeons after Vacation: Refreshed or Rusty?

Science.gov (United States)

Welk, Blayne; Winick-Ng, Jennifer; McClure, Andrew; Dubois, Luc; Nagpal, Dave

2017-10-01

Many surgeons describe feeling a bit out of practice when they return from a vacation. There have been no studies assessing the impact of surgeon vacation on patient outcomes. We used administrative data from the province of Ontario to identify patients who underwent a coronary artery bypass grafting. Using a propensity score, we matched patients who underwent their procedure immediately after their surgeon returned from vacation of at least 7 days (n = 1,161) to patients who were not operated immediately before or after a vacation period (n = 2,138). There was no significant difference in patient mortality (odds ratio: 1.23, p = 0.52), length of operation (relative risk [RR]: 1.00 p = 0.58), or intensive care unit/ hospital stay (RR: 0.97 p = 0.66/RR: 0.98 p = 0.54, respectively). There was not a significant change in risk of death, operative length, or hospital stay after a surgeon vacation.

Income, productivity, and satisfaction of breast surgeons.

Science.gov (United States)

Bendorf, David C; Helmer, Stephen D; Osland, Jacqueline S; Tenofsky, Patty L

2010-03-01

The purpose of this study was to assess how the practice patterns of breast surgeons affect their income and job satisfaction. A 19-question survey regarding practice patterns and income and job satisfaction was mailed to all active US members of the American Society of Breast Surgeons. There were 772 responses. An increasing percentage of breast care was associated with lower incomes (P=.0001) and similar income satisfaction (P=.4517) but higher job satisfaction (P=.0001). The increasing proportion of breast care was also associated with fewer hours worked per week (P=.0001). Although incomes were lower in surgeons with a higher proportion of their practice in breast care, income satisfaction was not affected. Although cause and effect relationships between income and breast surgery are difficult to establish, several trends do emerge. Most significantly, we found that dedicated breast surgeons have higher job satisfaction ratings and similar income satisfaction despite lower incomes. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Surgeons' Perspectives on Premium Implants in Total Joint Arthroplasty.

Science.gov (United States)

Wasterlain, Amy S; Bello, Ricardo J; Vigdorchik, Jonathan; Schwarzkopf, Ran; Long, William J

2017-09-01

Declining total joint arthroplasty reimbursement and rising implant prices have led many hospitals to restrict access to newer, more expensive total joint arthroplasty implants. The authors sought to understand arthroplasty surgeons' perspectives on implants regarding innovation, product launch, costs, and cost-containment strategies including surgeon gain-sharing and patient cost-sharing. Members of the International Congress for Joint Reconstruction were surveyed regarding attitudes about implant technology and costs. Descriptive and univariate analyses were performed. A total of 126 surgeons responded from all 5 regions of the United States. Although 76.9% believed new products advance technology in orthopedics, most (66.7%) supported informing patients that new implants lack long-term clinical data and restricting new implants to a small number of investigators prior to widespread market launch. The survey revealed that 66.7% would forgo gain-sharing incentives in exchange for more freedom to choose implants. Further, 76.9% believed that patients should be allowed to pay incremental costs for "premium" implants. Surgeons who believed that premium products advance orthopedic technology were more willing to forgo gain-sharing (P=.040). Surgeons with higher surgical volume (P=.007), those who believed implant companies should be allowed to charge more for new technology (Pnew implants with patients. Many surgeons support alternative payment models permitting surgeons and patients to retain implant selection autonomy. Most respondents prioritized patient beneficence and surgeon autonomy above personal financial gain. [Orthopedics. 2017; 40(5):e825-e830.]. Copyright 2017, SLACK Incorporated.

Exploring novice nurses' needs regarding their work-related health: a qualitative study.

Science.gov (United States)

Ketelaar, Sarah M; Nieuwenhuijsen, Karen; Frings-Dresen, Monique H W; Sluiter, Judith K

2015-10-01

To investigate Dutch novice nurses' experiences and needs regarding occupational health support to prevent work-related health problems and to keep them well-functioning. A qualitative interview study was conducted with six nursing students and eight newly qualified nurses. The interviews covered three topics: experiences with the link between work and health, received occupational health support, and occupational health support needs. Data were analysed using a grounded theory approach. Participants reported experiences with work-related health problems early in their career and described experiences with how health problems lead to suboptimal work functioning. Occupational health support needs included knowledge and psychosocial support during nursing education, e.g. through paying attention to dealing with shift work, or career counselling. Also, they reported a need for knowledge and psychosocial support at the start of their clinical placement or new job in the hospital, e.g. information from occupational health services or having a mentor. Furthermore, they reported that occupational health support requires a more general place at work through offering knowledge, e.g. tailored advice on proper lifting position; psychosocial support, e.g. positive team atmosphere; and physical support, e.g. suitable preventive measures. Occupational health support for novice nurses is important, since they already experience work-related health problems and suboptimal work functioning due to health problems early in their career and while still in training to be a nurse. Novice nurses should be given more knowledge and support to help them stay healthy and well-functioning in their work. This is a joint responsibility of nurse educators, the employer and occupational health services.

The effect of virtual endoscopy simulator training on novices: a systematic review.

Directory of Open Access Journals (Sweden)

Weiguang Qiao

Full Text Available BACKGROUND: Advances in virtual endoscopy simulators have paralleled an interest in medical simulation for gastrointestinal endoscopy training. OBJECTIVE: The primary objective was to determine whether the virtual endoscopy simulator training could improve the performance of novices. DESIGN: A systematic review. SETTING: Randomized controlled trials (RCTs that compared virtual endoscopy simulator training with bedside teaching or any other intervention for novices were collected. PATIENTS: Novice endoscopists. INTERVENTIONS: The PRISMA statement was followed during the course of the research. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and ScienceDirect were searched (up to July 2013. Data extraction and assessment were independently performed. MAIN OUTCOME MEASUREMENTS: Independent procedure completion, total procedure time and required assistance. RESULTS: Fifteen studies (n = 354 were eligible for inclusion: 9 studies designed for colonoscopy training, 6 for gastroscopy training. For gastroscopy training, procedure completed independently was reported in 87.7% of participants in simulator training group compared to 70.0% of participants in control group (1 study; 22 participants; RR 1.25; 95% CI 1.13-1.39; P<0.0001. For colonoscopy training, procedure completed independently was reported in 89.3% of participants in simulator training group compared to 88.9% of participants in control group (7 study; 163 participants; RR 1.10; 95% CI 0.88-1.37; P = 0.41; I(2 = 85%. LIMITATIONS: The included studies are quite in-homogeneous with respect to training schedule and procedure. CONCLUSIONS: Virtual endoscopy simulator training might be effective for gastroscopy, but so far no data is available to support this for colonoscopy.

[Management abilities of the head surgeon: essential for survival!].

Science.gov (United States)

Jähne, J

2012-04-01

Due to increased economic challenges in the management of hospitals head surgeons do not only need excellent surgical expertise but also significant management qualities. The personality of head surgeons should include authenticity, sincerity, fairness and the ability to cooperate. Visionary leadership, strategic thinking and strategic management of the personnel are further prerequisites for success. Besides good abilities in communication head surgeons need knowledge of the operating figures for interpretation. To keep up with the own capabilities time and self-management is essential. A survival as head surgeon is likely if these qualities and abilities exist.

Practitioner of Cooperative Learning as Part of Novice Teachers' Professional Identity

Science.gov (United States)

Astuti, Puji

2016-01-01

This paper identifies challenges that English as a foreign language (EFL) novice teachers in Indonesia may face in developing a professional identity, which, in this paper, refers to becoming a practitioner of cooperative learning. Cooperative learning is a mandated teaching method both in the 2006 and 2013 Indonesian curriculum, and is under the…

Controlled Autonomy: Novice Principals' Schema for District Control and School Autonomy

Science.gov (United States)

Weiner, Jennie M.; Woulfin, Sarah L.

2017-01-01

Purpose: The purpose of this paper is to gain insights into how a group of novice principals, all in schools that deployed principles of autonomy as mechanisms for improvement, conceptualized what the authors label "controlled autonomy"--a condition in which school leaders are expected to both make site-based decisions and be accountable…

Evaluating the Effectiveness Roles of Variables in the Novice Programmers Learning

Science.gov (United States)

Shi, Nianfeng; Cui, Wen; Zhang, Ping; Sun, Ximing

2018-01-01

This research applies the roles of variables to the novice programmers in the C language programming. The results are evaluated using the Structure of Observed Learning Outcomes (SOLO) taxonomy. The participants were divided into an experimental group and a control group. The students from the control group learned programming in the traditional…

Novice Nurses' Experiences With Palliative and End-of-Life Communication.

Science.gov (United States)

Hendricks-Ferguson, Verna L; Sawin, Kathleen J; Montgomery, Kitty; Dupree, Claretta; Phillips-Salimi, Celeste R; Carr, Barb; Haase, Joan E

2015-01-01

Health care providers recognize that delivery of effective communication with family members of children with life-threatening illnesses is essential to palliative and end-of-life care (PC/EOL). Parents value the presence of nurses during PC/EOL of their dying child. It is vital that nurses, regardless of their years of work experience, are competent and feel comfortable engaging family members of dying children in PC/EOL discussions. This qualitative-descriptive study used focus groups to explore the PC/EOL communication perspectives of 14 novice pediatric oncology nurses (eg, with less than 1 year of experience). Audio-taped focus group discussions were reviewed to develop the following 6 theme categories: (a) Sacred Trust to Care for the Child and Family, (b) An Elephant in the Room, (c) Struggling with Emotional Unknowns, (d) Kaleidoscope of Death: Patterns and Complexity, (e) Training Wheels for Connectedness: Critical Mentors during PC/EOL of Children, and (f) Being Present with an Open Heart: Ways to Maintain Hope and Minimize Emotional Distress. To date, this is the first study to focus on PC/EOL communication perspectives of novice pediatric oncology nurses. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

The X-factor : A longitudinal study of calibration in young novice drivers

NARCIS (Netherlands)

De Craen, S.

2010-01-01

It is often assumed that young novice drivers overestimate their driving skills and underestimate the risks in traffic; and therefore insufficiently adapt their driving behaviour (e.g. speed or headway) to the specific situation. This balancing of skills and task demands has been called calibration.

Practice patterns and job satisfaction in fellowship-trained endocrine surgeons.

Science.gov (United States)

Tsinberg, Michael; Duh, Quan-Yang; Cisco, Robin M; Gosnell, Jessica E; Scholten, Anouk; Clark, Orlo H; Shen, Wen T

2012-12-01

Debates about the difficult job market for young endocrine surgeons are ongoing. This study aimed to analyze the practice patterns and work-related satisfaction levels of recently trained endocrine surgeons. An anonymous survey was utilized. Participants were divided into 3 groups: "Young" (5 years). Fifty-six of 78 surgeons (72%) responded to the survey. Time in practice ranged from 1 to 9 years (mean, 3.9 ± 0.28). Forty-five (80%) described their practice as academic. Participants performed 244.1 ± 17.8 operations within the last year; 75.4 ± 3.3% were endocrine cases. More surgeons in the "young" group have academic practices (92%) and joined established endocrine surgery groups (54%) versus older surgeons (67% and 42%; P = .05). Of surgeons in the "young" group, 4% started their own practice versus 33% in the "older" group (P = .04). Level of satisfaction with financial compensation (3.2 on a 4-point scale versus 2.9) and lifestyle (3.6 vs 3.1) was also higher in the younger group (P = .009). Despite widespread speculation about scarcity of academic jobs after fellowship, recently trained endocrine surgeons are more likely to practice in academic settings and join established endocrine surgery practices when compared with older surgeons. Overall satisfaction level is higher among recently trained surgeons. Copyright © 2012 Mosby, Inc. All rights reserved.

Sustained attention in skilled and novice martial arts athletes: a study of event-related potentials and current sources.

Science.gov (United States)

Sanchez-Lopez, Javier; Silva-Pereyra, Juan; Fernandez, Thalia

2016-01-01

Background. Research on sports has revealed that behavioral responses and event-related brain potentials (ERP) are better in expert than in novice athletes for sport-related tasks. Focused attention is essential for optimal athletic performance across different sports but mainly in combat disciplines. During combat, long periods of focused attention (i.e., sustained attention) are required for a good performance. Few investigations have reported effects of expertise on brain electrical activity and its neural generators during sport-unrelated attention tasks. The aim of the present study was to assess the effect of expertise (i.e., skilled and novice martial arts athletes) analyzing the ERP during a sustained attention task (Continuous Performance Task; CPT) and the cortical three-dimensional distribution of current density, using the sLORETA technique. Methods. CPT consisted in an oddball-type paradigm presentation of five stimuli (different pointing arrows) where only one of them (an arrow pointing up right) required a motor response (i.e., target). CPT was administered to skilled and novice martial arts athletes while EEG were recorded. Amplitude ERP data from target and non-target stimuli were compared between groups. Subsequently, current source analysis for each ERP component was performed on each subject. sLORETA images were compared by condition and group using Statistical Non-Parametric Mapping analysis. Results. Skilled athletes showed significant amplitude differences between target and non-target conditions in early ERP components (P100 and P200) as opposed to the novice group; however, skilled athletes showed no significant effect of condition in N200 but novices did show a significant effect. Current source analysis showed greater differences in activations in skilled compared with novice athletes between conditions in the frontal (mainly in the Superior Frontal Gyrus and Medial Frontal Gyrus) and limbic (mainly in the Anterior Cingulate Gyrus) lobes

Shark attack-related injuries: Epidemiology and implications for plastic surgeons.

Science.gov (United States)

Ricci, Joseph A; Vargas, Christina R; Singhal, Dhruv; Lee, Bernard T

2016-01-01

The increased media attention to shark attacks has led to a heightened fear and public awareness. Although few sharks are considered dangerous, attacks on humans can result in large soft tissue defects necessitating the intervention of reconstructive surgeons. This study aims to evaluate and describe the characteristics of shark-related injuries in order to improve treatment. The Global Shark Accident File, maintained by the Shark Research Institute (Princeton, NJ, USA), is a compilation of all known worldwide shark attacks. Database records since the 1900s were reviewed to identify differences between fatal and nonfatal attacks, including: geography, injury pattern, shark species, and victim activity. Since the 1900s, there have been 5034 reported shark attacks, of which 1205 (22.7%) were fatal. Although the incidence of attacks per decade has increased, the percentage of fatalities has decreased. Characteristics of fatal attacks included swimming (p = 0.001), boating (p = 0.001), three or more bite sites (p = 0.03), limb loss (p = 0.001), or tiger shark attack (p = 0.002). The most common attacks were bites to the legs (41.8%) or arms (18.4%), with limb loss occurring in 7% of attacks. Geographically, the majority of attacks occurred in North America (36.7%) and Australia (26.5%). Most attacks in the USA occurred in Florida (49.1%) and California (13.6%). Although rare, shark attacks result in devastating injuries to patients. As these injuries often involve multiple sites and limb loss, this creates a significant challenge for reconstructive surgeons. Proper identification of the characteristics of the attack can aid in providing optimal care for those affected. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Report from the Committee for Improving the Work Environment of Japanese Surgeons: survey on effects of the fee revision for medical services provided by surgeons.

Science.gov (United States)

Hanazaki, Kazuhiro; Tominaga, Ryuji; Nio, Masaki; Iwanaka, Tadashi; Okoshi, Kae; Kaneko, Koichi; Nagano, Hiroaki; Nishida, Takahiro; Nishida, Hiroshi; Hoshino, Ken; Maehara, Tadaaki; Masuda, Munetaka; Matsufuji, Hiroshi; Yanaga, Katsuhiko; Tabayashi, Koichi; Satomi, Susumu; Kokudo, Norihiro

2013-11-01

The aim of this study was to achieve improvements in the work environment of Japanese surgeons and shortage of surgeons. Questionnaires were distributed to selected Japanese surgical Society (JSS) members. Retrospective analysis was conducted comparing the current 2011 survey with previous 2007 survey. To examine the influence of 2010 revision of the fee for medical services performed by surgeons, we distributed a second questionnaire to directors of hospitals and administrators of clerks belonging to official institutes in JSS. Collective data were analyzed retrospectively. The main potential causes for the shortage of surgeons in Japan were long hours (72.8 %), excessive emergency surgeries (69.4 %), and high risk of lawsuit (67.7 %). Mean weekly working hours of surgeons in national or public university hospitals and private university hospitals were 96.2 and 85.6, respectively. Approximately 70 % of surgeons were forced to do hardworking tasks, possibly leading to death from overwork. Of note, approximately 25 % of surgeons had over time of more than 100 h a week, coinciding to the number of hours that might lead to death from fatigue, described in the Japanese labor law. Although the total medical service fee in hospitals, especially in large-scale hospitals with more than 500 beds, increased markedly after 2010 revision of the fee for medical services performed by surgeons, few hospitals gave perquisites and/or incentives to surgeons. To prevent and avoid collapse of the surgical specialty in Japan, an improvement in the work environment of surgeons by initiation of the JSS would be required as soon as possible.

Approaching time is important for assessment of endoscopic surgical skills.

Science.gov (United States)

Tokunaga, Masakazu; Egi, Hiroyuki; Hattori, Minoru; Yoshimitsu, Masanori; Sumitani, Daisuke; Kawahara, Tomohiro; Okajima, Masazumi; Ohdan, Hideki

2012-05-01

This study aimed to verify whether the approaching time (the time taken to reach the target point from another point, a short distance apart, during point-to-point movement in endoscopic surgery), assessed using the Hiroshima University Endoscopic Surgical Assessment Device (HUESAD), could distinguish the skill level of surgeons. Expert surgeons (who had performed more than 50 endoscopic surgeries) and novice surgeons (who had no experience in performing endoscopic surgery) were tested using the HUESAD. The approaching time, total time, and intermediate time (total time--approaching time) were measured and analyzed using the trajectory of the tip of the instrument. The approaching time and total time were significantly shorter in the expert group than in the novice group (p time did not significantly differ between the groups (p > 0.05). The approaching time, which is a component of the total time, is very mportant in the measurement of the total time to assess endoscopic surgical skills. Further, the approaching time was useful for skill assessment by the HUESAD for evaluating the skill of surgeons performing endoscopic surgery.

Meta-Analysis of Surgeon Burnout Syndrome and Specialty Differences.

Science.gov (United States)

Bartholomew, Alex J; Houk, Anna K; Pulcrano, Marisa; Shara, Nawar M; Kwagyan, John; Jackson, Patrick G; Sosin, Michael

2018-02-27

Surgeon burnout compromises the quality of life of physicians and the delivery of care to patients. Burnout rates and interpretation of the Maslach Burnout Inventory (MBI) complicates the interpretation of surgeon burnout. The purpose of this study is to apply a standardized interpretation of severe surgeon burnout termed, "burnout syndrome" to analyze inherent variation within surgical specialties. A systematic literature search was performed using MEDLINE, PsycINFO, and EMBASE to identify studies reporting MBI data by surgical specialty. Data extraction was performed to isolate surgeon specific data. A meta-analysis was performed. A total of 16 cross-sectional studies were included in this meta-analysis, totaling 3581 subjects. A random effects model approximated burnout syndrome at 3.0% (95% CI: 2.0%-5.0%; I 2 = 78.1%). Subscale analysis of emotional exhaustion, depersonalization, and personal accomplishment indicated subscale burnout in 30.0% (CI: 25.0%-36.0%; I 2 = 93.2%), 34.0% (CI: 25.0%-43.0%; I 2 = 96.9%), and 25.0% (CI: 18.0%-32.0%; I 2 = 96.5%) of surgeons, respectively. Significant differences (p burnout termed "burnout syndrome," although surgeon burnout may occur in up to 34% of surgeons, characterized by high burnout in 1 of 3 subscales. Surgical specialties have significantly different rates of burnout subscales. Future burnout studies should target the specialty-specific level to understand inherent differences in an effort to better understand methods of improving surgeon burnout. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The role of visual and direct force feedback in robotics-assisted mitral valve annuloplasty.

Science.gov (United States)

Currie, Maria E; Talasaz, Ali; Rayman, Reiza; Chu, Michael W A; Kiaii, Bob; Peters, Terry; Trejos, Ana Luisa; Patel, Rajni

2017-09-01

The objective of this work was to determine the effect of both direct force feedback and visual force feedback on the amount of force applied to mitral valve tissue during ex vivo robotics-assisted mitral valve annuloplasty. A force feedback-enabled master-slave surgical system was developed to provide both visual and direct force feedback during robotics-assisted cardiac surgery. This system measured the amount of force applied by novice and expert surgeons to cardiac tissue during ex vivo mitral valve annuloplasty repair. The addition of visual (2.16 ± 1.67), direct (1.62 ± 0.86), or both visual and direct force feedback (2.15 ± 1.08) resulted in lower mean maximum force applied to mitral valve tissue while suturing compared with no force feedback (3.34 ± 1.93 N; P forces on cardiac tissue during robotics-assisted mitral valve annuloplasty suturing, force feedback may be required. Copyright © 2016 John Wiley & Sons, Ltd.

The Surgeon and Advocacy

African Journals Online (AJOL)

and how the hospital administration handles and resolves ... regard to having systems that improve patient care. Surgeons have been ... implementation of the Surgical safety checklist (9). ... aviation industry, has helped to streamline patient.

Parent involvement in novice teen driving: a review of the literature.

Science.gov (United States)

Simons-Morton, B; Ouimet, M C

2006-06-01

Motor vehicle crashes remain elevated among novice teen drivers for at least several years after licensure. Licensing policies and driver education are the two primary countermeasures employed to decrease young driver crash risks. Graduated driver licensing policies have proved to be effective in reducing crash rates where evaluated. Driver education is an essential part of teaching teens the rules of the road and operating a vehicle, but requires few hours of professional driver training, relying mainly on parents to provide most of the supervised practice driving teens obtain before independent driving licensure. The few studies that have been conducted to increase parent supervised practice driving have not shown positive results. Moreover, it is unclear that increases in practice would improve independent driving safety. Recent research has shown that parent management of the early independent driving experience of novice teens improves safety outcomes, and other research has shown that it is possible to increase parent management practices. This paper provides a review of the literature on parent involvement in supervised practice and independent driving, and efforts to increase parental management.

The cardiovascular responses of male subjects to kung fu techniques. Expert/novice paradigm.

Science.gov (United States)

Jones, M A; Unnithan, V B

1998-12-01

The primary aim was to assess cardiovascular responses of expert and novice subjects to kung fu techniques. It was hypothesised that experienced subjects would demonstrate improved economy of movement during the techniques, evidenced by reduced exercise intensity. a comparative design was established utilising two groups; experienced (group E), and novice (group N). the experimentation took place under laboratory conditions, but was designed to maximise external validity. the only preselection variables were regular attendance at training and experience. Nine experienced males (group E, exp 9.5 +/- 5.2 yrs) and nine novice males (group N, exp 1.2 +/- 0.1 yrs) participated. The only exclusion guidelines were contraindications to participate within a maximal test, no subjects were excluded upon this basis. N/A. each subject participated in three kung fu protocols (forms, kicking and punching). Each protocol, randomly allocated, consisted of ten work (30 sec) and ten rest periods (30 sec). MEASURES taken during the protocols were heart rate (HR) and oxygen consumption (VO2). These were expressed as a percentage of maximal values to reflect exercise intensity. During both the form protocol and punching protocol group E were found to be working at a significantly (p kung fu techniques differ depending upon experience level. It is difficult to directly relate this to improved economy since work output could not be accurately quantified. It was also found that kung fu protocols elicited exercise intensity into the cardiovascular training zone.

Surgeon-reported conflict with intensivists about postoperative goals of care.

Science.gov (United States)

Paul Olson, Terrah J; Brasel, Karen J; Redmann, Andrew J; Alexander, G Caleb; Schwarze, Margaret L

2013-01-01

To examine surgeons' experiences of conflict with intensivists and nurses about goals of care for their postoperative patients. Cross-sectional incentivized US mail-based survey. Private and academic surgical practices. A total of 2100 vascular, neurologic, and cardiothoracic surgeons. Surgeon-reported rates of conflict with intensivists and nurses about goals of care for patients with poor postsurgical outcomes. The adjusted response rate was 55.6%. Forty-three percent of surgeons reported sometimes or always experiencing conflict about postoperative goals of care with intensivists, and 43% reported conflict with nurses. Younger surgeons reported higher rates of conflict than older surgeons with both intensivists (57% vs 32%; P = .001) and nurses (48% vs 33%; P = .001). Surgeons practicing in closed intensive care units reported more frequent conflict than those practicing in open intensive care units (60% vs 41%; P = .005). On multivariate analysis, the odds of reporting conflict with intensivists were 2.5 times higher for surgeons with fewer years of experience compared with their older colleagues (odds ratio, 2.5; 95% CI, 1.6-3.8) and 70% higher for reporting conflict with nurses (odds ratio, 1.7; 95% CI, 1.1-2.6). The odds of reporting conflict with intensivists about goals of postoperative care were 40% lower for surgeons who primarily managed their intensive care unit patients than for those who worked in a closed unit (odds ratio, 0.60; 95% CI, 0.40-0.96). Surgeons regularly experience conflict with critical care clinicians about goals of care for patients with poor postoperative outcomes. Higher rates of conflict are associated with less experience and working in a closed intensive care unit.

Running injuries in novice runners enrolled in different training interventions: a pilot randomized controlled trial.

Science.gov (United States)

Baltich, J; Emery, C A; Whittaker, J L; Nigg, B M

2017-11-01

The purpose of this trial was to evaluate injury risk in novice runners participating in different strength training interventions. This was a pilot randomized controlled trial. Novice runners (n = 129, 18-60 years old, running experience) were block randomized to one of three groups: a "resistance" strength training group, a "functional" strength training group, or a stretching "control" group. The primary outcome was running related injury. The number of participants with complaints and the injury rate (IR = no. injuries/1000 running hours) were quantified for each intervention group. For the first 8 weeks, participants were instructed to complete their training intervention three to five times a week. The remaining 4 months was a maintenance period. NCT01900262. A total of 52 of the 129 (40%) novice runners experienced at least one running related injury: 21 in the functional strength training program, 16 in the resistance strength training program and 15 in the control stretching program. Injury rates did not differ between study groups [IR = 32.9 (95% CI 20.8, 49.3) in the functional group, IR = 31.6 (95% CI 18.4, 50.5) in the resistance group, and IR = 26.7 (95% CI 15.2, 43.2)] in the control group. Although this was a pilot assessment, home-based strength training did not appear to alter injury rates compared to stretching. Future studies should consider methods to minimize participant drop out to allow for the assessment of injury risk. Injury risk in novice runners based on this pilot study will inform the development of future larger studies investigating the impact of injury prevention interventions. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Effect of Surgeon Empathy and Emotional Intelligence on Patient Satisfaction

Science.gov (United States)

Weng, Hui-Ching; Steed, James F.; Yu, Shang-Won; Liu, Yi-Ten; Hsu, Chia-Chang; Yu, Tsan-Jung; Chen, Wency

2011-01-01

We investigated the associations of surgeons' emotional intelligence and surgeons' empathy with patient-surgeon relationships, patient perceptions of their health, and patient satisfaction before and after surgical procedures. We used multi-source approaches to survey 50 surgeons and their 549 outpatients during initial and follow-up visits.…

Comprehensive feedback on trainee surgeons' non-technical skills

DEFF Research Database (Denmark)

Spanager, Lene; Dieckmann, Peter; Beier-Holgersen, Randi

2015-01-01

OBJECTIVE: This study aimed to explore the content of conversations, feedback style, and perceived usefulness of feedback to trainee surgeons when conversations were stimulated by a tool for assessing surgeons' non-technical skills. METHODS: Trainee surgeons and their supervisors used the Non...... qualitatively analyzed for content and feedback style. Usefulness was investigated using a scale from 1 to 5 and written comments were qualitatively analyzed. RESULTS: Six trainees and six supervisors participated in eight feedback conversations. Eighty questionnaires (response rate 83 percent) were collected...

The nature of surgeon human capital depreciation.

Science.gov (United States)

Hockenberry, Jason M; Helmchen, Lorens A

2014-09-01

To test how practice interruptions affect worker productivity, we estimate how temporal breaks affect surgeons' performance of coronary artery bypass grafting (CABG). Examining 188 surgeons who performed 56,315 CABG surgeries in Pennsylvania between 2006 and 2010, we find that a surgeon's additional day away from the operating room raised patients' inpatient mortality by up to 0.067 percentage points (2.4% relative effect) but reduced total hospitalization costs by up to 0.59 percentage points. Among emergent patients treated by high-volume providers, where temporal distance is most plausibly exogenous, an additional day away raised mortality risk by 0.398 percentage points (11.4% relative effect) but reduced cost by up to 1.4 percentage points. This is consistent with the hypothesis that as temporal distance increases, surgeons are less likely to recognize and address life-threatening complications. Our estimates imply additional intraprocedural treatment intensity has a cost per life-year preserved of $7871-18,500, well within conventional cost-effectiveness cutoffs. Copyright © 2014 Elsevier B.V. All rights reserved.

New, Novice or Nervous? The "Quick" Guide to the "No-Quick-Fix"

Science.gov (United States)

Teaching History, 2016

2016-01-01

"Teaching History" presents "New, Novice or Nervous (NNN)" for those new to the published writings of history teachers. Each problem newcomers wrestle with is one other teachers have wrestled with too. Quick fixes do not exist. But in others' writing, there is something better: "conversations in which other history…

Validation of SINERGIA as training tool: a randomized study to test the transfer of acquired basic psychomotor skills to LapMentor.

Science.gov (United States)

Moyano-Cuevas, J L; Sánchez-Margallo, F M; Sánchez-Peralta, L F; Pagador, J B; Enciso, S; Sánchez-González, P; Gómez-Aguilera, E J; Usón-Gargallo, J

2011-11-01

Laparoscopic surgery is commonly used in many surgical procedures but requires a learning process to develop the necessary skills. Virtual reality simulators play an essential role within the training curricula. This paper aims to determine whether training in SINERGIA VR simulator allows novice surgeons to improve their basic psychomotor laparoscopic skills. Forty-two people participated in this study, including 28 unexperience medical students and 14 expert surgeons who developed previously more than 100 laparoscopic procedures. Medical students made a pre-training test in LapMentor II; then, they trained in SINERGIA and they finally accomplished a post-training test in LapMentor II. Experts just made one trial in LapMentor II. A statistical analysis was carried out and results of pre- and post-training tests of novices were compared with Wilcoxon signed-rank test. Pre- and post-training tests of novices were also compared with results of experts with Mann-Whitney U test. Most metrics provided by LapMentor II and included in this study show significant differences when comparing pre- and post-training tests of novices. Analysis of pre-training test of novices and experts results show significant differences in all analyzed metrics for all studied tasks. On the other hand, LapMentor was not able to distinguish between experts and novices after training in SINERGIA for any metric in the camera manipulation task and for some metrics of the other tasks. Training in SINERGIA VR simulator allows improvement of basic psychomotor laparoscpic skills and transferring them to another virtual simulator. Therefore, it could be used in laparoscopic surgery training programs.

Ergonomics in the operating room: protecting the surgeon.

Science.gov (United States)

Rosenblatt, Peter L; McKinney, Jessica; Adams, Sonia R

2013-01-01

To review elements of an ergonomic operating room environment and describe common ergonomic errors in surgeon posture during laparoscopic and robotic surgery. Descriptive video based on clinical experience and a review of the literature (Canadian Task Force classification III). Community teaching hospital affiliated with a major teaching hospital. Gynecologic surgeons. Demonstration of surgical ergonomic principles and common errors in surgical ergonomics by a physical therapist and surgeon. The physical nature of surgery necessitates awareness of ergonomic principles. The literature has identified ergonomic awareness to be grossly lacking among practicing surgeons, and video has not been documented as a teaching tool for this population. Taking this into account, we created a video that demonstrates proper positioning of monitors and equipment, and incorrect and correct ergonomic positions during surgery. Also presented are 3 common ergonomic errors in surgeon posture: forward head position, improper shoulder elevation, and pelvic girdle asymmetry. Postural reset and motion strategies are demonstrated to help the surgeon learn techniques to counterbalance the sustained and awkward positions common during surgery that lead to muscle fatigue, pain, and degenerative changes. Correct ergonomics is a learned and practiced behavior. We believe that video is a useful way to facilitate improvement in ergonomic behaviors. We suggest that consideration of operating room setup, proper posture, and practice of postural resets are necessary components for a longer, healthier, and pain-free surgical career. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

ERP to chess stimuli reveal expert-novice differences in the amplitudes of N2 and P3 components.

Science.gov (United States)

Wright, Michael J; Gobet, Fernand; Chassy, Philippe; Ramchandani, Payal Nanik

2013-10-01

ERP experiments were conducted to analyze the underlying neural events when chess players make simple judgments of a board position. Fourteen expert players and 14 age-matched novices viewed, for each of four tasks, 128 unique positions on a mini (4 × 4) chess board each presented for 0.5 s. The tasks were to respond: (a) if white king was in check, (b) if black knight was present, (c) if white king was not in check, and (d) if no black knight was present. Experts showed an enhanced N2 with check targets and a larger P3 with knight targets, relative to novices. Expert-novice differences in posterior N2 began as early as 240 ms on check-related searches. Results were consistent with the view that prolonged N2 components reflect matching of current perceptual input to memory, and thus are sensitive to experts' superior pattern recognition and memory retrieval of chunks. Copyright © 2013 Society for Psychophysiological Research.

Preparedness for physiotherapy in private practice: Novices identify key factors in an interpretive description study.

Science.gov (United States)

Atkinson, Robyn; McElroy, Theresa

2016-04-01

Physiotherapists in Australia deliver services to a diverse range of clients, across many settings, however little research exists examining graduate preparedness for practice, even in the populous field of private practice. To explore novice physiotherapist perspectives on preparedness for work in private practice. The qualitative approach of interpretive description was used to guide in-depth interviews with 8 novice physiotherapists from 3 universities working in 5 private practices in Melbourne. All interviews were digitally recorded, transcribed verbatim and analyzed thematically. Four main themes influencing graduate preparedness for work in private practice were identified: 1) non-curricular experiences (e.g. sports training) 2) elective curricular: practicum experiences; 3) curricular: attainment of skills specific to private practice; and 4) the private practice setting: supportive colleagues. This combination of non-curricular, curricular, and practice setting factors offered the necessary scaffolding for the graduates to report feeling prepared for work in private practice. Non-curricular activities, radiological instruction, clinical placements, building supportive colleague relations and professional development in private practice are recommended as potential means of building preparedness in novice therapists. Findings have implications for physiotherapy students, educators and private practice clinics looking to recruit new graduates. Copyright © 2015 Elsevier Ltd. All rights reserved.

Problem-solving strategies in psychiatry: differences between experts and novices in diagnostic accuracy and reasoning.

Science.gov (United States)

Gabriel, Adel; Violato, Claudio

2013-01-01

The purpose of this study was to examine and compare diagnostic success and its relationship with the diagnostic reasoning process between novices and experts in psychiatry. Nine volunteers, comprising five expert psychiatrists and four clinical clerks, completed a think-aloud protocol while attempting to make a DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) diagnosis of a selected case with both Axis I and Axis III diagnoses. Expert psychiatrists made significantly more successful diagnoses for both the primary psychiatric and medical diagnoses than clinical clerks. Expert psychiatrists also gave fewer differential options. Analyzing the think-aloud protocols, expert psychiatrists were much more organized, made fewer mistakes, and utilized significantly less time to access their knowledge than clinical clerks. Both novices and experts seemed to use the hypothetic-deductive and scheme-inductive approaches to diagnosis. However, experts utilized hypothetic-deductive approaches significantly more often than novices. The hypothetic-deductive diagnostic strategy was utilized more than the scheme-inductive approach by both expert psychiatrists and clinical clerks. However, a specific relationship between diagnostic reasoning and diagnostic success could not be identified in this small pilot study. The author recommends a larger study that would include a detailed analysis of the think-aloud protocols.

Society of Laparoendoscopic Surgeons

Science.gov (United States)

... the Minimally Invasive Surgery and Therapy World. Nezhat’s History of Endoscopy In 2005 pioneering surgeon Dr. Camran Nezhat was awarded a fellowship by The American College of Obstetrics and Gynecology to research and write this important ...

The NLstart2run study: Training-related factors associated with running-related injuries in novice runners.

Science.gov (United States)

Kluitenberg, Bas; van der Worp, Henk; Huisstede, Bionka M A; Hartgens, Fred; Diercks, Ron; Verhagen, Evert; van Middelkoop, Marienke

2016-08-01

The incidence of running-related injuries is high. Some risk factors for injury were identified in novice runners, however, not much is known about the effect of training factors on injury risk. Therefore, the purpose of this study was to examine the associations between training factors and running-related injuries in novice runners, taking the time varying nature of these training-related factors into account. Prospective cohort study. 1696 participants completed weekly diaries on running exposure and injuries during a 6-week running program for novice runners. Total running volume (min), frequency and mean intensity (Rate of Perceived Exertion) were calculated for the seven days prior to each training session. The association of these time-varying variables with injury was determined in an extended Cox regression analysis. The results of the multivariable analysis showed that running with a higher intensity in the previous week was associated with a higher injury risk. Running frequency was not significantly associated with injury, however a trend towards running three times per week being more hazardous than two times could be observed. Finally, lower running volume was associated with a higher risk of sustaining an injury. These results suggest that running more than 60min at a lower intensity is least injurious. This finding is contrary to our expectations and is presumably the result of other factors. Therefore, the findings should not be used plainly as a guideline for novices. More research is needed to establish the person-specific training patterns that are associated with injury. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Ethical challenges in surgery as narrated by practicing surgeons

Directory of Open Access Journals (Sweden)

Nordam Ann

2005-02-01

Full Text Available Abstract Background The aim of this study was to explore the ethical challenges in surgery from the surgeons' point of view and their experience of being in ethically difficult situations. Methods Five male and five female surgeons at a university hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of nurses and physicians about being in such situations. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation. Results No differences in ethical reasoning between male and female surgeons were found. They reasoned in both action and relational ethical perspectives. Surgeons focused on their relationships with patients and colleagues and their moral self in descriptions of the ethical challenges in their work. Dialogue and personal involvement were important in their relationships with patients. The surgeons emphasized the importance of open dialogue, professional recognition, and an inclusive and accepting environment between colleagues. Conclusion The surgeons are personally challenged by the existential realities of human life in their relationships with patients. They realized that ethical challenges are an inherent part of performing surgery and of life itself, and say that they have to learn to "live with" these challenges in a way that is confirmed both socially and by their inner moral self. This means accepting their personal and professional limitations, being uncertain, being fallible, and being humble. Living with the ethical challenges of surgery seems to contribute to the surgeons' confidence and vulnerability in their professional identity.

Novice Music Teachers Learning to Improvise in an Improvisation Professional Development Workshop

Science.gov (United States)

Filsinger, Mark H.

2013-01-01

With the intent of improving music improvisation pedagogy, the purpose of this research was to examine experiences of six novice music teachers and a professional development facilitator in an eight-week Improvisation Professional Development Workshop (IPDW). The research questions were: 1. How do teachers learn to improvise within the context of…

Exploring Novice and Experienced Teachers' Perceptions of Motivational Constructs with Adolescent Students

Science.gov (United States)

Wiesman, Jeff

2016-01-01

The purpose of this study was to compare novice and experienced teachers' perceptions of student motivation at the high school level and to determine if the teachers were likely to incorporate research-based techniques. Survey data were collected on the following motivational constructs: intrinsic and extrinsic motivation; performance, mastery,…

Against All Odds: Problem-Solving Strategies and Behavioural Characteristics of Novice Students

Science.gov (United States)

Chang, Pei-Fen; Lin, Miao-Chen

2015-01-01

This study investigates problem-solving difficulties of novices in a classroom setting, using a German instructional tool, the Fischertechnik kit of approximately 400 parts. In order to analyse the students' thinking processes as they solved the problems, verbal protocol analysis (VPA) was used to record the students'' thinking processes and…

High Bar Swing Performance in Novice Adults: Effects of Practice and Talent

Science.gov (United States)

Busquets, Albert; Marina, Michel; Irurtia, Alfredo; Ranz, Daniel; Angulo-Barroso, Rosa M.

2011-01-01

An individual's a priori talent can affect movement performance during learning. Also, task requirements and motor-perceptual factors are critical to the learning process. This study describes changes in high bar swing performance after a 2-month practice period. Twenty-five novice participants were divided by a priori talent level…

Toward late career transitioning: a proposal for academic surgeons.

Science.gov (United States)

Richards, Robin; McLeod, Robin; Latter, David; Keshavjee, Shaf; Rotstein, Ori; Fehlings, Michael G; Ahmed, Najma; Nathens, Avery; Rutka, James

2017-09-01

In the absence of a defined retirement age, academic surgeons need to develop plans for transition as they approach the end of their academic surgical careers. The development of a plan for late career transition represents an opportunity for departments of surgery across Canada to initiate a constructive process in cooperation with the key stakeholders in the hospital or institution. The goal of the process is to develop an individual plan for each faculty member that is agreeable to the academic surgeon; informs the surgical leadership; and allows the late career surgeon, the hospital, the division and the department to make plans for the future. In this commentary, the literature on the science of aging is reviewed as it pertains to surgeons, and guidelines for late career transition planning are shared. It is hoped that these guidelines will be of some value to academic programs and surgeons across the country as late career transition models are developed and adopted.

Virtual-reality simulation to assess performance in hip fracture surgery

DEFF Research Database (Denmark)

Pedersen, Poul; Palm, Henrik; Ringsted, Charlotte

2014-01-01

BACKGROUND AND PURPOSE: Internal fixation of hip fractures is a common and important procedure that orthopedic surgeons must master early in their career. Virtual-reality training could improve initial skills, and a simulation-based test would make it possible to ensure basic competency of junior...... experienced surgeon failing the test. INTERPRETATION: The simulation-based test was reliable and valid in our setting, and the pass/fail standard could discriminate between novices and experienced surgeons. Potentially, training and testing of future junior surgeons on a virtual-reality simulator could ensure...

Disclosure of Individual Surgeon's Performance Rates During Informed Consent

Science.gov (United States)

Burger, Ingrid; Schill, Kathryn; Goodman, Steven

2007-01-01

Objective: The purpose of the paper is to examine the ethical arguments for and against disclosing surgeon-specific performance rates to patients during informed consent, and to examine the challenges that generating and using performance rates entail. Methods: Ethical, legal, and statistical theory is explored to approach the question of whether, when, and how surgeons should disclosure their personal performance rates to patients. The main ethical question addressed is what type of information surgeons owe their patients during informed consent. This question comprises 3 related, ethically relevant considerations that are explored in detail: 1) Does surgeon-specific performance information enhance patient decision-making? 2) Do patients want this type of information? 3) How do the potential benefits of disclosure balance against the risks? Results: Calculating individual performance measures requires tradeoffs and involves inherent uncertainty. There is a lack of evidence regarding whether patients want this information, whether it facilitates their decision-making for surgery, and how it is best communicated to them. Disclosure of personal performance rates during informed consent has the potential benefits of enhancing patient autonomy, improving patient decision-making, and improving quality of care. The major risks of disclosure include inaccurate and misleading performance rates, avoidance of high-risk cases, unjust damage to surgeon's reputations, and jeopardized patient trust. Conclusion: At this time, we think that, for most conditions, surgical procedures, and outcomes, the accuracy of surgeon- and patient-specific performance rates is illusory, obviating the ethical obligation to communicate them as part of the informed consent process. Nonetheless, the surgical profession has the duty to develop information systems that allow for performance to be evaluated to a high degree of accuracy. In the meantime, patients should be informed of the quantity of

Description of Mexican Cleft Surgeons' Experience With Foreign Surgical Volunteer Missions in Mexico.

Science.gov (United States)

Schoenbrunner, Anna R; Kelley, Kristen D; Buckstaff, Taylor; McIntyre, Joyce K; Sigler, Alicia; Gosman, Amanda A

2018-05-01

Mexican cleft surgeons provide multidisciplinary comprehensive cleft lip and palate care to children in Mexico. Many Mexican cleft surgeons have extensive experience with foreign, visiting surgeons. The purpose of this study was to characterize Mexican cleft surgeons' domestic and volunteer practice and to learn more about Mexican cleft surgeons' experience with visiting surgeons. A cross-sectional validated e-mail survey tool was sent to Mexican cleft surgeons through 2 Mexican plastic surgery societies and the Asociación Mexicana de Labio y Paladar Hendido y Anomalías Craneofaciales, the national cleft palate society that includes plastic and maxillofacial surgeons who specialize in cleft surgery. We utilized validated survey methodology, including neutral fact-based questions and repeated e-mails to survey nonresponders to maximize validity of statistical data; response rate was 30.6% (n = 81). Mexican cleft surgeons performed, on average, 37.7 primary palate repairs per year with an overall complication rate of 2.5%; 34.6% (n = 28) of respondents had direct experience with patients operated on by visiting surgeons; 53.6% of these respondents performed corrective surgery because of complications from visiting surgeons. Respondents rated 48% of the functional outcomes of visiting surgeons as "acceptable," whereas 43% rated aesthetic outcomes of visiting surgeons as "poor"; 73.3% of respondents were never paid for the corrective surgeries they performed. Thirty-three percent of Mexican cleft surgeons believe that there is a role for educational collaboration with visiting surgeons. Mexican cleft surgeons have a high volume of primary cleft palate repairs in their domestic practice with good outcomes. Visiting surgeons may play an important role in Mexican cleft care through educational collaborations that complement the strengths of Mexican cleft surgeons.

THE IMPACT OF MODERATE AND HIGH INTENSITY TOTAL BODY FATIGUE ON PASSING ACCURACY IN EXPERT AND NOVICE BASKETBALL PLAYERS

Directory of Open Access Journals (Sweden)

Mark Lyons

2006-06-01

Full Text Available Despite the acknowledged importance of fatigue on performance in sport, ecologically sound studies investigating fatigue and its effects on sport-specific skills are surprisingly rare. The aim of this study was to investigate the effect of moderate and high intensity total body fatigue on passing accuracy in expert and novice basketball players. Ten novice basketball players (age: 23.30 ± 1.05 yrs and ten expert basketball players (age: 22.50 ± 0.41 yrs volunteered to participate in the study. Both groups performed the modified AAHPERD Basketball Passing Test under three different testing conditions: rest, moderate intensity and high intensity total body fatigue. Fatigue intensity was established using a percentage of the maximal number of squat thrusts performed by the participant in one minute. ANOVA with repeated measures revealed a significant (F 2,36 = 5.252, p = 0.01 level of fatigue by level of skill interaction. On examination of the mean scores it is clear that following high intensity total body fatigue there is a significant detriment in the passing performance of both novice and expert basketball players when compared to their resting scores. Fundamentally however, the detrimental impact of fatigue on passing performance is not as steep in the expert players compared to the novice players. The results suggest that expert or skilled players are better able to cope with both moderate and high intensity fatigue conditions and maintain a higher level of performance when compared to novice players. The findings of this research therefore, suggest the need for trainers and conditioning coaches in basketball to include moderate, but particularly high intensity exercise into their skills sessions. This specific training may enable players at all levels of the game to better cope with the demands of the game on court and maintain a higher standard of play

Successful linking of the Society of Thoracic Surgeons Database to Social Security data to examine the accuracy of Society of Thoracic Surgeons mortality data.

Science.gov (United States)

Jacobs, Jeffrey P; O'Brien, Sean M; Shahian, David M; Edwards, Fred H; Badhwar, Vinay; Dokholyan, Rachel S; Sanchez, Juan A; Morales, David L; Prager, Richard L; Wright, Cameron D; Puskas, John D; Gammie, James S; Haan, Constance K; George, Kristopher M; Sheng, Shubin; Peterson, Eric D; Shewan, Cynthia M; Han, Jane M; Bongiorno, Phillip A; Yohe, Courtney; Williams, William G; Mayer, John E; Grover, Frederick L

2013-04-01

The Society of Thoracic Surgeons Adult Cardiac Surgery Database has been linked to the Social Security Death Master File to verify "life status" and evaluate long-term surgical outcomes. The objective of this study is explore practical applications of the linkage of the Society of Thoracic Surgeons Adult Cardiac Surgery Database to Social Securtiy Death Master File, including the use of the Social Securtiy Death Master File to examine the accuracy of the Society of Thoracic Surgeons 30-day mortality data. On January 1, 2008, the Society of Thoracic Surgeons Adult Cardiac Surgery Database began collecting Social Security numbers in its new version 2.61. This study includes all Society of Thoracic Surgeons Adult Cardiac Surgery Database records for operations with nonmissing Social Security numbers between January 1, 2008, and December 31, 2010, inclusive. To match records between the Society of Thoracic Surgeons Adult Cardiac Surgery Database and the Social Security Death Master File, we used a combined probabilistic and deterministic matching rule with reported high sensitivity and nearly perfect specificity. Between January 1, 2008, and December 31, 2010, the Society of Thoracic Surgeons Adult Cardiac Surgery Database collected data for 870,406 operations. Social Security numbers were available for 541,953 operations and unavailable for 328,453 operations. According to the Society of Thoracic Surgeons Adult Cardiac Surgery Database, the 30-day mortality rate was 17,757/541,953 = 3.3%. Linkage to the Social Security Death Master File identified 16,565 cases of suspected 30-day deaths (3.1%). Of these, 14,983 were recorded as 30-day deaths in the Society of Thoracic Surgeons database (relative sensitivity = 90.4%). Relative sensitivity was 98.8% (12,863/13,014) for suspected 30-day deaths occurring before discharge and 59.7% (2120/3551) for suspected 30-day deaths occurring after discharge. Linkage to the Social Security Death Master File confirms the accuracy of

Influence of median surgeon operative duration on adverse outcomes in bariatric surgery.

Science.gov (United States)

Reames, Bradley N; Bacal, Daniel; Krell, Robert W; Birkmeyer, John D; Birkmeyer, Nancy J O; Finks, Jonathan F

2015-01-01

Evidence suggests that prolonged operative time adversely affects surgical outcomes. However, whether faster surgeons have better outcomes is unclear, as a surgeon׳s speed could reflect skill and efficiency, but may alternatively reflect haste. This study evaluates whether median surgeon operative time is associated with adverse surgical outcomes after laparoscopic Roux-en-Y gastric bypass. We performed a retrospective cohort study using statewide clinical registry data from the years 2006 to 2012. Surgeons were ranked by their median operative time and grouped into terciles. Multivariable logistic regression with robust standard errors was used to evaluate the influence of median surgeon operative time on 30-day surgical outcomes, adjusting for patient and surgeon characteristics, trainee involvement, concurrent procedures, and the complex interaction between these variables. A total of 16,344 patients underwent surgery during the study period. Compared to surgeons in the fastest tercile, slow surgeons required 53 additional minutes to complete a gastric bypass procedure (median [interquartile range] 139 [133-150] versus 86 [69-91], Ppatient characteristic only, slow surgeons had significantly higher adjusted rates of any complication, prolonged length of stay, emergency department visits or readmissions, and venous thromboembolism (VTE). After further adjustment for surgeon characteristics, resident involvement, and the interaction between these variables, slow surgeons had higher rates of any complication (10.5% versus 7.1%, P=.039), prolonged length of stay (14.0% versus 4.4%, P=.002), and VTE (0.39% versus .22%, P<.001). Median surgeon operative duration is independently associated with adjusted rates of certain adverse outcomes after laparoscopic Roux-en-Y gastric bypass. Improving surgeon efficiency while operating may reduce operative time and improve the safety of bariatric surgery. Copyright © 2015 American Society for Bariatric Surgery. Published by

Reliability of Maximal Strength Testing in Novice Weightlifters

Science.gov (United States)

Loehr, James A.; Lee, Stuart M. C.; Feiveson, Alan H.; Ploutz-Snyder, Lori L.

2009-01-01

The one repetition maximum (1RM) is a criterion measure of muscle strength. However, the reliability of 1RM testing in novice subjects has received little attention. Understanding this information is crucial to accurately interpret changes in muscle strength. To evaluate the test-retest reliability of a squat (SQ), heel raise (HR), and deadlift (DL) 1RM in novice subjects. Twenty healthy males (31 plus or minus 5 y, 179.1 plus or minus 6.1 cm, 81.4 plus or minus 10.6 kg) with no weight training experience in the previous six months participated in four 1RM testing sessions, with each session separated by 5-7 days. SQ and HR 1RM were conducted using a smith machine; DL 1RM was assessed using free weights. Session 1 was considered a familiarization and was not included in the statistical analyses. Repeated measures analysis of variance with Tukey fs post-hoc tests were used to detect between-session differences in 1RM (p.0.05). Test-retest reliability was evaluated by intraclass correlation coefficients (ICC). During Session 2, the SQ and DL 1RM (SQ: 90.2 }4.3, DL: 75.9 }3.3 kg) were less than Session 3 (SQ: 95.3 }4.1, DL: 81.5 plus or minus 3.5 kg) and Session 4 (SQ: 96.6 }4.0, DL: 82.4 }3.9 kg), but there were no differences between Session 3 and Session 4. HR 1RM measured during Session 2 (150.1 }3.7 kg) and Session 3 (152.5 }3.9 kg) were not different from one another, but both were less than Session 4 (157.5 }3.8 kg). The reliability (ICC) of 1RM measures for Sessions 2-4 were 0.88, 0.83, and 0.87, for SQ, HR, and DL, respectively. When considering only Sessions 3 and 4, the reliability was 0.93, 0.91, and 0.86 for SQ, HR, and DL, respectively. One familiarization session and 2 test sessions (for SQ and DL) were required to obtain excellent reliability (ICC greater than or equal to 0.90) in 1RM values with novice subjects. We were unable to attain this level of reliability following 3 HR testing sessions therefore additional sessions may be required to obtain an

Surgeons' Leadership Styles and Team Behavior in the Operating Room.

Science.gov (United States)

Hu, Yue-Yung; Parker, Sarah Henrickson; Lipsitz, Stuart R; Arriaga, Alexander F; Peyre, Sarah E; Corso, Katherine A; Roth, Emilie M; Yule, Steven J; Greenberg, Caprice C

2016-01-01

The importance of leadership is recognized in surgery, but the specific impact of leadership style on team behavior is not well understood. In other industries, leadership is a well-characterized construct. One dominant theory proposes that transactional (task-focused) leaders achieve minimum standards and transformational (team-oriented) leaders inspire performance beyond expectations. We videorecorded 5 surgeons performing complex operations. Each surgeon was scored on the Multifactor Leadership Questionnaire, a validated method for scoring transformational and transactional leadership style, by an organizational psychologist and a surgeon researcher. Independent coders assessed surgeons' leadership behaviors according to the Surgical Leadership Inventory and team behaviors (information sharing, cooperative, and voice behaviors). All coders were blinded. Leadership style (Multifactor Leadership Questionnaire) was correlated with surgeon behavior (Surgical Leadership Inventory) and team behavior using Poisson regression, controlling for time and the total number of behaviors, respectively. All surgeons scored similarly on transactional leadership (range 2.38 to 2.69), but varied more widely on transformational leadership (range 1.98 to 3.60). Each 1-point increase in transformational score corresponded to 3 times more information-sharing behaviors (p leadership and its impact on team performance in the operating room. As in other fields, our data suggest that transformational leadership is associated with improved team behavior. Surgeon leadership development, therefore, has the potential to improve the efficiency and safety of operative care. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Effects of Internal and External Focus of Attention on Novices' Rehearsal Evaluations

Science.gov (United States)

Silvey, Brian A.; Montemayor, Mark

2014-01-01

The purpose of this study was to investigate the effects of internal and external focus of attention on novices' rehearsal evaluations. Thirty-two undergraduate instrumental music education students led bands in a series of three 6-minute rehearsals on their assigned excerpt. Prior to these rehearsals, participants were led in score study and…

Practice Patterns and Job Satisfaction of Mohs Surgeons.

Science.gov (United States)

Kohli, Nita; Golda, Nicholas

2018-01-01

There is a paucity of data on Mohs surgery workforce patterns. To identify if gender differences exist in practice patterns of Mohs surgeons, factors that influence these differences, and factors influencing job satisfaction among Mohs surgeons. An electronic survey was distributed to dermatology organizations targeting members of the American College of Mohs Surgery (ACMS), from October 2015 to April 2016. Two hundred twenty-seven ACMS members responded; 37% were women. Twenty-five percent of women and 19% of men work part time. Thirty-seven percent of women practice in academia versus 22% of men. Forty-three percent of women and 23% of men identified children as a factor affecting their ability to work full time. Gender comparisons for current job satisfaction show 57% of men and 35% of women being very satisfied. Supervision/feedback/recognition adds to satisfaction at a higher rate for women (53%) than for men (29%). For both genders combined, work content, patient base, and autonomy had the highest average job satisfaction ratings. Gender differences exist in practice patterns and job satisfaction of Mohs surgeons. This study demonstrates factors that could influence job satisfaction among female Mohs surgeons-knowledge that is important to individuals who lead, mentor, or supervise female Mohs surgeons.

Designing a leadership development program for surgeons.

Science.gov (United States)

Jaffe, Gregory A; Pradarelli, Jason C; Lemak, Christy Harris; Mulholland, Michael W; Dimick, Justin B

2016-01-01

Although numerous leadership development programs (LDPs) exist in health care, no programs have been specifically designed to meet the needs of surgeons. This study aimed to elicit practicing surgeons' motivations and desired goals for leadership training to design an evidence-based LDP in surgery. At a large academic health center, we conducted semistructured interviews with 24 surgical faculty members who voluntarily applied and were selected for participation in a newly created LDP. Transcriptions of the interviews were analyzed using analyst triangulation and thematic coding to extract major themes regarding surgeons' motivations and perceived needs for leadership knowledge and skills. Themes from interview responses were then used to design the program curriculum specifically to meet the leadership needs of surgical faculty. Three major themes emerged regarding surgeons' motivations for seeking leadership training: (1) Recognizing key gaps in their formal preparation for leadership roles; (2) Exhibiting an appetite for personal self-improvement; and (3) Seeking leadership guidance for career advancement. Participants' interviews revealed four specific domains of knowledge and skills that they indicated as desired takeaways from a LDP: (1) leadership and communication; (2) team building; (3) business acumen/finance; and (4) greater understanding of the health care context. Interviews with surgical faculty members identified gaps in prior leadership training and demonstrated concrete motivations and specific goals for participating in a formal leadership program. A LDP that is specifically tailored to address the needs of surgical faculty may benefit surgeons at a personal and institutional level. Copyright © 2016 Elsevier Inc. All rights reserved.

Patient perceptions of surgeon-industry relations in a military setting.

Science.gov (United States)

Ortiz, Dionisio; Jenne, Joel

2014-12-01

Investigations into the financial relationships between orthopedic surgeons and device manufacturers have recently been investigated. Despite these investigations, the public appears to maintain trust and confidence that their surgeons are acting in patients' best interest. However, patient perceptions of these relationships have not been investigated in a military treatment setting. We surveyed patients' perception of the surgeon-industry relationship in a single military treatment facility. From March 2012 to March 2013, we surveyed 282 preoperative and postoperative spine and arthroplasty patients in a single military treatment facility. Patients were eligible if they were adult TRICARE beneficiaries being followed in one of those clinics and within the age requirements. Most patients were aware of private industry involvement in the manufacture of orthopedic implants (77%). Most patients thought that it was beneficial for surgeons to serve in an advisory role to device companies (81%) and most (65%) felt that the relationship was appropriate and beneficial for patient care. A minority (29%) felt their surgeon should receive payment for this role. Most patients in the military setting had a positive view of the relationship that their surgeons had with industry, which is reflective of data obtained in the civilian literature. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

An fMRI study of differences in brain activity among elite, expert, and novice archers at the moment of optimal aiming.

Science.gov (United States)

Kim, Woojong; Chang, Yongmin; Kim, Jingu; Seo, Jeehye; Ryu, Kwangmin; Lee, Eunkyung; Woo, Minjung; Janelle, Christopher M

2014-12-01

We investigated brain activity in elite, expert, and novice archers during a simulated archery aiming task to determine whether neural correlates of performance differ by skill level. Success in shooting sports depends on complex mental routines just before the shot, when the brain prepares to execute the movement. During functional magnetic resonance imaging, 40 elite, expert, or novice archers aimed at a simulated 70-meter-distant target and pushed a button when they mentally released the bowstring. At the moment of optimal aiming, the elite and expert archers relied primarily on a dorsal pathway, with greatest activity in the occipital lobe, temporoparietal lobe, and dorsolateral pre-motor cortex. The elites showed activity in the supplementary motor area, temporoparietal area, and cerebellar dentate, while the experts showed activity only in the superior frontal area. The novices showed concurrent activity in not only the dorsolateral pre-motor cortex but also the ventral pathways linked to the ventrolateral pre-motor cortex. The novices exhibited broad activity in the superior frontal area, inferior frontal area, ventral prefrontal cortex, primary motor cortex, superior parietal lobule, and primary somatosensory cortex. The more localized neural activity of elite and expert archers than novices permits greater efficiency in the complex processes subserved by these regions. The elite group's high activity in the cerebellar dentate indicates that the cerebellum is involved in automating simultaneous movements by integrating the sensorimotor memory enabled by greater expertise in self-paced aiming tasks. A companion article comments on and generalizes our findings.

"They Have to Adapt to Learn": Surgeons' Perspectives on the Role of Procedural Variation in Surgical Education.

Science.gov (United States)

Apramian, Tavis; Cristancho, Sayra; Watling, Chris; Ott, Michael; Lingard, Lorelei

2016-01-01

Clinical research increasingly acknowledges the existence of significant procedural variation in surgical practice. This study explored surgeons' perspectives regarding the influence of intersurgeon procedural variation on the teaching and learning of surgical residents. This qualitative study used a grounded theory-based analysis of observational and interview data. Observational data were collected in 3 tertiary care teaching hospitals in Ontario, Canada. Semistructured interviews explored potential procedural variations arising during the observations and prompts from an iteratively refined guide. Ongoing data analysis refined the theoretical framework and informed data collection strategies, as prescribed by the iterative nature of grounded theory research. Our sample included 99 hours of observation across 45 cases with 14 surgeons. Semistructured, audio-recorded interviews (n = 14) occurred immediately following observational periods. Surgeons endorsed the use of intersurgeon procedural variations to teach residents about adapting to the complexity of surgical practice and the norms of surgical culture. Surgeons suggested that residents' efforts to identify thresholds of principle and preference are crucial to professional development. Principles that emerged from the study included the following: (1) knowing what comes next, (2) choosing the right plane, (3) handling tissue appropriately, (4) recognizing the abnormal, and (5) making safe progress. Surgeons suggested that learning to follow these principles while maintaining key aspects of surgical culture, like autonomy and individuality, are important social processes in surgical education. Acknowledging intersurgeon variation has important implications for curriculum development and workplace-based assessment in surgical education. Adapting to intersurgeon procedural variations may foster versatility in surgical residents. However, the existence of procedural variations and their active use in surgeons

A Content Analysis Concerning the Studies on Challenges Faced by Novice Teachers

Science.gov (United States)

Kozikoglu, Ishak

2017-01-01

The purpose of this research is to analyze the studies concerning challenges faced by novice teachers in terms of various aspects and compare challenges according to location of the studies conducted in Turkey and abroad. A total of 30 research studies were included in detailed analysis. This is a descriptive study based on qualitative research…

Librarian as Advisor: Information Search Process of Undecided Students and Novice Researchers

Science.gov (United States)

Wiley, Claire; Williams, Judy

2015-01-01

Faculty librarians who advise undecided students have found the experiences of novice researcher and advisee comparable: Both groups seek to solve a problem or answer a question by finding new information to add to their current understanding and knowledge base. As a result, librarians familiar with needs and stages of the research process may…

Preparing Novice Principals in Australia and Turkey: How Similar Are Their Needs?

Science.gov (United States)

Wildy, Helen; Clarke, Simon; Styles, Irene; Beycioglu, Kadir

2010-01-01

Part of a 13-nation, cross-cultural study of the extent to which principals perceive their pre-appointment experiences had prepared them for the job, the International Study of Principal Preparation (ISPP), this paper compares the responses of novice principals in Turkey and Western Australia. Using a survey based on data from case studies of…

[Improving the surgeon's image: introduction].

Science.gov (United States)

Tajima, Tomoo

2004-05-01

The number of medical students who aspire to become surgeons has been decreasing in recent years. With a vicious spiral in the decreasing number and the growing deterioration of surgeons' working conditions, there is fear of deterioration of surgical care and subsequent disintegration of overall health care in Japan. The purpose of this issue is to devise a strategy for improving surgeons' image and their working conditions to attract future medical students. However, we cannot expect a quick cure for the problem of the decreasing number of applicants for surgery since this issue is deeply related to many fundamental problems in the health care system in Japan. The challenge for surgical educators in coming years will be to solve the problem of chronic sleep deprivation and overwork of surgery residents and to develop an efficient program to meet the critical educational needs of surgical residents. To solve this problem it is necessary to ensure well-motivated surgical residents and to develop an integrated research program. No discussion of these issues would be complete without attention to the allocation of scarce medical resources, especially in relation to financial incentives for young surgeons. The authors, who are conscientious representatives of this society, would like to highlight these critical problems and issues that are particularly relevant to our modern surgical practice, and it is our sincere hope that all members of this society fully recognize these critical issues in the Japanese health care system to take leadership in improving the system. With the demonstration of withholding unnecessary medical conducts we may be able to initiate a renewal of the system and eventually to fulfill our dreams of Japan becoming a nation that can attract many patients from all over the world. Furthermore, verification of discipline with quality control and effective surgical treatment is needed to avoid criticism by other disciplines for being a self

Development of PCK for Novice and Experienced University Physics Instructors: A Case Study

Science.gov (United States)

Jang, Syh-Jong; Tsai, Meng-Fang; Chen, Ho-Yuan

2013-01-01

The current study assessed and compared university students' perceptions' of a novice and an experienced physics instructor's Pedagogical Content Knowledge (PCK). Two college physics instructors and 116 students voluntarily participated in this study. The research model comprised three workshops, mid-term and final evaluations and instructor…

Social Class (In)Visibility and the Professional Experiences of Middle-Class Novice Teachers

Science.gov (United States)

Hall, David; Jones, Lisa

2013-01-01

This article focuses upon the classed and early professional experiences of middle-class novice teachers in England experiencing and contemplating working in schools serving socio-economically disadvantaged communities. Through an examination of the visibility and invisibility of social class in education set within an increasingly unequal and…

Listening to music primes space: pianists, but not novices, simulate heard actions.

Science.gov (United States)

Taylor, J Eric T; Witt, Jessica K

2015-03-01

Musicians sometimes report twitching in their fingers or hands while listening to music. This anecdote could be indicative of a tendency for auditory-motor co-representation in musicians. Here, we describe two studies showing that pianists (Experiment 1), but not novices (Experiment 2) automatically generate spatial representations that correspond to learned musical actions while listening to music. Participants made one-handed movements to the left or right from a central location in response to visual stimuli while listening to task-irrelevant auditory stimuli, which were scales played on a piano. These task-irrelevant scales were either ascending (compatible with rightward movements) or descending (compatible with leftward movements). Pianists were faster to respond when the scale direction was compatible with the direction of response movement, whereas novices' movements were unaffected by the scale. These results are in agreement with existing research on action-effect coupling in musicians, which draw heavily on common coding theory. In addition, these results show how intricate auditory stimuli (ascending or descending scales) evoke coarse, domain-general spatial representations.

[Problems in career planning for novice medical technologists in Japanese national hospitals].

Science.gov (United States)

Ogasawara, Shu; Tsutaya, Shoji; Akimoto, Hiroyuki; Kojima, Keiya; Yabaka, Hiroyuki

2012-12-01

Skills and knowledge regarding many different types of test are required for medical technologists (MTs) to provide accurate information to help doctors and other medical specialists. In order to become an efficient MT, specialized training programs are required. Certification in specialized areas of clinical laboratory sciences or a doctoral degree in medical sciences may help MTs to realize career advancement, a higher earning potential, and expand the options in their career. However, most young MTs in national university hospitals are employed as part-time workers on a three-year contract, which is too short to obtain certifications or a doctoral degree. We have to leave the hospital without expanding our future. We need to take control of our own development in order to enhance our employability within the period. As teaching and training hospitals, national university hospitals in Japan are facing a difficult dilemma in nurturing MTs. I hope, as a novice medical technologist, that at least university hospitals in Japan create an appropriate workplace environment for novice MTs.

Work-life balance of female versus male surgeons in Hong Kong based on findings of a questionnaire designed by a Japanese surgeon.

Science.gov (United States)

Kwong, Ava; Chau, Wai Wang; Kawase, K

2014-01-01

We evaluated the attitudes of female and male surgeons in Hong Kong to work, personal life, and work-life balance, through a questionnaire survey. We sent an online questionnaire survey designed by a female Japanese surgeon to 142 female surgeons practicing in Hong Kong, while its customized version was sent to 953 of their male counterparts. "Home life" and "Work" were the first and second priorities for both the women and the men. More of the female surgeons reported that they could not find enough time to participate in community activities (p = 0.038) or rest (p = 0.024). Both reported moderate satisfaction at work (p = 0.114) and in their life outside work (p = 0.346), as well as equality at home (p = 0.548) and at work (p = 0.177). Of the men, 89 % agreed with the necessity for granting paternity leave and reported that they would like to work part-time during the child-rearing years (p = 0.013). The number of female surgeons involved in key roles is increasing in parallel with the increasing number of female medical students. The introduction of paternity leave for male surgeons is an important concern. The issues of work-life balance may need to be addressed to attract more talent into an important specialty in Hong Kong and this is likely to apply to other parts of Asia as well.

Workload assessment of surgeons: correlation between NASA TLX and blinks.

Science.gov (United States)

Zheng, Bin; Jiang, Xianta; Tien, Geoffrey; Meneghetti, Adam; Panton, O Neely M; Atkins, M Stella

2012-10-01

Blinks are known as an indicator of visual attention and mental stress. In this study, surgeons' mental workload was evaluated utilizing a paper assessment instrument (National Aeronautics and Space Administration Task Load Index, NASA TLX) and by examining their eye blinks. Correlation between these two assessments was reported. Surgeons' eye motions were video-recorded using a head-mounted eye-tracker while the surgeons performed a laparoscopic procedure on a virtual reality trainer. Blink frequency and duration were computed using computer vision technology. The level of workload experienced during the procedure was reported by surgeons using the NASA TLX. A total of 42 valid videos were recorded from 23 surgeons. After blinks were computed, videos were divided into two groups based on the blink frequency: infrequent group (≤ 6 blinks/min) and frequent group (more than 6 blinks/min). Surgical performance (measured by task time and trajectories of tool tips) was not significantly different between these two groups, but NASA TLX scores were significantly different. Surgeons who blinked infrequently reported a higher level of frustration (46 vs. 34, P = 0.047) and higher overall level of workload (57 vs. 47, P = 0.045) than those who blinked more frequently. The correlation coefficients (Pearson test) between NASA TLX and the blink frequency and duration were -0.17 and 0.446. Reduction of blink frequency and shorter blink duration matched the increasing level of mental workload reported by surgeons. The value of using eye-tracking technology for assessment of surgeon mental workload was shown.

Surgeons' Emotional Experience of Their Everyday Practice - A Qualitative Study.

Directory of Open Access Journals (Sweden)

Massimiliano Orri

Full Text Available Physicians' emotions affect both patient care and personal well-being. Surgeons appear at particularly high risk, as evidenced by the high rate of burnout and the alarming consequences in both their personal lives and professional behavior. The aim of this qualitative study is to explore the emotional experiences of surgeons and their impact on their surgical practice.27 purposively selected liver and pancreatic surgeons from 10 teaching hospitals (23 men, 4 women participated. Inclusion took place until data saturation was reached. Data were collected through individual interviews and thematically analyzed independently by 3 researchers (a psychologist, a psychiatrist, and a surgeon. 7 themes emerged from the analysis, categorized in 3 main or superordinate themes, which described surgeons' emotional experience before, during, and after surgery. Burdensome emotions are present throughout all 3 periods (and invade life outside the hospital-surgeons' own emotions, their perception of patients' emotions, and their entwinement. The interviewees described the range of emotional situations they face (with patients, families, colleagues, the influence of the institutional framework (time pressure and fatigue, cultural pressure to satisfy the ideal image of a surgeon, as well as the emotions they feel (including especially anxiety, fear, distress, guilt, and accountability.Emotions are ubiquitous in surgeons' experience, and their exposure to stress is chronic rather than acute. Considering emotions only in terms of their relations to operative errors (as previous studies have done is limiting. Although complications are quite rare events, the concern for possible complications is an oppressive experience, regardless of whether or not they actually occur.

Surgeon-nurse anesthetist collaboration advanced surgery between 1889 and 1950.

Science.gov (United States)

Koch, Bruce Evan

2015-03-01

To meet the need for qualified anesthetists, American surgeons recruited nurses to practice anesthesia during the Civil War and in the latter half of the 19th century. The success of this decision led them to collaborate with nurses more formally at the Mayo Clinic in Minnesota. During the 1890s, Alice Magaw refined the safe administration of ether. Florence Henderson continued her work improving the safety of ether administration during the first decade of the 20th century. Safe anesthesia enabled the Mayo surgeons to turn the St. Mary's Hospital into a surgical powerhouse. The prominent surgeon George Crile collaborated with Agatha Hodgins at the Lakeside Hospital in Cleveland to introduce nitrous oxide/oxygen anesthesia. Nitrous oxide/oxygen caused less cardiovascular depression than ether and thus saved the lives of countless trauma victims during World War I. Crile devised "anoci-association," an outgrowth of nitrous oxide/oxygen anesthesia. Hodgins' use of anoci-association made Crile's thyroid operations safer. Pioneering East Coast surgeons followed the lead of the surgeons at Mayo. William Halsted worked closely with Margaret Boise, and Harvey Cushing worked closely with Gertrude Gerard. As medicine became more complex, collaboration between surgeons and nurse anesthetists became routine and necessary. Teams of surgeons and nurse anesthetists advanced thoracic, cardiovascular, and pediatric surgery. The team of Evarts Graham and Helen Lamb performed the world's first pneumonectomy. Surgeon-nurse anesthetist collaboration seems to have been a uniquely American phenomenon. This collaboration facilitated both the "Golden Age of Surgery" and the profession we know today as nurse anesthesia.

Instructional Support for Novice Law Students: Reducing Search Processes and Explaining Concepts in Cases

NARCIS (Netherlands)

Nievelstein, Fleurie; Van Gog, Tamara; Van Dijck, Gijs; Boshuizen, Els

2010-01-01

Nievelstein, F., Van Gog, T., Van Dijck, C., & Boshuizen, H. P. A. (2011). Instructional support for novice law students: Reducing search processes and explaining concepts in cases. Applied Cognitive Psychology, 25(3), 408-413. doi:10.1002/acp.1707

Implant vendors and hospitals: competing influences over product choice by orthopedic surgeons.

Science.gov (United States)

Burns, Lawton R; Housman, Michael G; Booth, Robert E; Koenig, Aaron

2009-01-01

Vendors of hip and knee implants court orthopedic surgeons to adopt their products. Hospitals, which have to pay for these products, now court the same surgeons to help reduce the number of vendors and contain implant costs. This study measures the surgeon's perceived alignment of interests with both vendors and hospitals and gauges surgeons' exposure and receptivity to hospital cost-containment efforts. We surveyed all practicing orthopedists performing 12 or more implant procedures annually in Pennsylvania. The survey identified the surgeon's preferred vendor, tenure with that vendor, use of the vendor during residency training, receipt of financial payments from the vendor, alignment of interests with both vendor and hospital stakeholders, and exposure and receptivity to hospital cost-containment efforts. Surgeons have long-standing relationships with implant vendors, but only a small proportion receive financial payments. Surgeons align most closely with the vendor's sales representative and least closely with the hospital's purchasing manager. Paradoxically, surgeons support hospital efforts to limit the number of vendors but report that their own choice of vendor is not constrained. The major drivers of surgeons' alignment and stance toward cost containment are their tenure with and receipt of financial payments from the vendor. Hospitals face a competitive disadvantage in capturing the attention of orthopedists, compared with implant vendors. The vendors' advantage stems from historical, financial, and service benefits offered to surgeons. Hospital executives now seek to offer comparable benefits to surgeons.

Surveyed opinion of American trauma surgeons in management of colon injuries.

Science.gov (United States)

Eshraghi, N; Mullins, R J; Mayberry, J C; Brand, D M; Crass, R A; Trunkey, D D

1998-01-01

Primary repair or resection and anastomosis of colon wounds have been advocated in many recent studies, but the proportion of trauma surgeons accepting these recommendations is unknown. To determine the current preferences of American trauma surgeons for colon injury management. Four hundred forty-nine members of the American Association for the Surgery of Trauma were surveyed regarding their preferred management of eight types of colon wounds among three options: diverting colostomy (DC), primary repair (PR), or resection and anastomosis (RA). The influence of selected patient factors and surgeons' characteristics on the choice of management was also surveyed. Seventy-three percent of surgeons completed the survey. Ninety-eight percent chose PR for at least one type of injury. Thirty percent never selected DC. High-velocity gunshot wound was the only injury for which the majority (54%) would perform DC. More than 55% of the surgeons favored RA when the isolated colon injury was a contusion with possible devascularization, laceration greater than 50% of the diameter, or transection. Surgeons who managed five or fewer colon wounds per year chose DC more frequently (p colon wounds per year. The prevailing opinion of trauma surgeons favors primary repair or resection of colon injuries, including anastomosis of unprepared bowel. Surgeons who manage fewer colon wounds prefer colostomy more frequently.

ORIGINAL ARTICLES Surgeons and HIV: South African attitudes

African Journals Online (AJOL)

2009-02-01

Feb 1, 2009 ... Local policies and those from developed countries may not .... National Health Act 61 of 2003, such information (surgeon HIV ... specialist surgeon trainees established that 91% did not think .... 2008 Report on the Global AIDS ... Schulman KA, McDonald RC, Lynn LA, Frank I, Christakis NA, Schwartz JS.

Comparison of precision and speed in laparoscopic and robot-assisted surgical task performance.

Science.gov (United States)

Zihni, Ahmed; Gerull, William D; Cavallo, Jaime A; Ge, Tianjia; Ray, Shuddhadeb; Chiu, Jason; Brunt, L Michael; Awad, Michael M

2018-03-01

Robotic platforms have the potential advantage of providing additional dexterity and precision to surgeons while performing complex laparoscopic tasks, especially for those in training. Few quantitative evaluations of surgical task performance comparing laparoscopic and robotic platforms among surgeons of varying experience levels have been done. We compared measures of quality and efficiency of Fundamentals of Laparoscopic Surgery task performance on these platforms in novices and experienced laparoscopic and robotic surgeons. Fourteen novices, 12 expert laparoscopic surgeons (>100 laparoscopic procedures performed, no robotics experience), and five expert robotic surgeons (>25 robotic procedures performed) performed three Fundamentals of Laparoscopic Surgery tasks on both laparoscopic and robotic platforms: peg transfer (PT), pattern cutting (PC), and intracorporeal suturing. All tasks were repeated three times by each subject on each platform in a randomized order. Mean completion times and mean errors per trial (EPT) were calculated for each task on both platforms. Results were compared using Student's t-test (P task performance was slower on the robotic platform compared with laparoscopy. In comparisons of expert laparoscopists performing tasks on the laparoscopic platform and expert robotic surgeons performing tasks on the robotic platform, expert robotic surgeons demonstrated fewer errors during the PC task (P = 0.009). Robotic assistance provided a reduction in errors at all experience levels for some laparoscopic tasks, but no benefit in the speed of task performance. Robotic assistance may provide some benefit in precision of surgical task performance. Copyright © 2017 Elsevier Inc. All rights reserved.

Differences in kinetic variables between injured and noninjured novice runners : A prospective cohort study

NARCIS (Netherlands)

Bredeweg, Steef W.; Kluitenberg, Bas; Bessem, Bram; Buist, Ida

Objectives: This prospective study examined differences in kinetic variables between injured and noninjured novice female and male runners and their potential contribution to RRIs. Design: A prospective cohort study. Methods: At baseline vertical ground reaction forces were assessed with an

Surgeons' Leadership Styles and Team Behavior in the Operating Room

Science.gov (United States)

Hu, Yue-Yung; Parker, Sarah Henrickson; Lipsitz, Stuart R; Arriaga, Alexander F; Peyre, Sarah E; Corso, Katherine A; Roth, Emilie M; Yule, Steven J; Greenberg, Caprice C

2016-01-01

Background The importance of leadership is recognized in surgery, but the specific impact of leadership style on team behavior is not well understood. In other industries, leadership is a well-characterized construct. One dominant theory proposes that transactional (task-focused) leaders achieve minimum standards, whereas transformational (team-oriented) leaders inspire performance beyond expectations. Study Design We video-recorded 5 surgeons performing complex operations. Each surgeon was scored on the Multifactor Leadership Questionnaire, a validated method for scoring transformational and transactional leadership style, by an organizational psychologist and a surgeon-researcher. Independent coders assessed surgeons' leadership behaviors according to the Surgical Leadership Inventory and team behaviors (information-sharing, cooperative, and voice behaviors). All coders were blinded. Leadership style (MLQ) was correlated with surgeon behavior (SLI) and team behavior using Poisson regression, controlling for time and the total number of behaviors, respectively. Results All surgeons scored similarly on transactional leadership (2.38-2.69), but varied more widely on transformational leadership (1.98-3.60). Each 1-point increase in transformational score corresponded to 3× more information-sharing behaviors (psupportive behaviors (pleadership and its impact on team performance in the OR. As in other fields, our data suggest that transformational leadership is associated with improved team behavior. Surgeon leadership development therefore has the potential to improve the efficiency and safety of operative care. PMID:26481409

Indian novice nurses' perceptions of their role in caring for women who have experienced intimate partner violence.

Science.gov (United States)

Gandhi, Sailaxmi; Poreddi, Vijayalakshmi; Nikhil, Reddy Ss; Palaniappan, Marimuthu; Math, Suresh Bada

2018-05-24

intimate partner violence (IPV) is a significant health problem and a gross violation of the human rights of women. Nurses play an important role in providing support for these women. There is limited research on nurses' understanding and perceptions of their role in caring for women with IPV issues in India. to assess novice nurses' perceptions of self-efficacy, educational preparedness and their role in this area. this was a cross-sectional descriptive survey carried out among a convenience sample of novice nurses (n=83) at a tertiary care centre using self-reported questionnaires. a majority of the subjects were confident and had adequate knowledge in dealing with women who have experienced IPV. A significantly positive relationship was found between educational preparedness and self-efficacy and attitudes towards nurses' roles in caring for these women. novice nurses were confident and held positive attitudes towards women who experienced IPV. Yet their self-efficacy in caring for these patients could be improved through continuing education and there is an urgent need to integrate comprehensive training on IPV to improve clinical competencies, including how to refer women for further support.

An Investigation into Novice English Teachers’ Beliefs about Method and Post-method Pedagogy in Turkish EFL Context

Directory of Open Access Journals (Sweden)

Mustafa Tekin

2013-04-01

Full Text Available This study which has a qualitative research design, reports on the views and beliefs of eleven novice English as a foreign language (EFL teachers about the English language teaching (ELT methods for the purpose of examining their knowledge about and attitudes towards popular methods and post-method as well as towards current discussions in ELT and the effects of them on their reported classroom practices. In this respect, the novice teachers were interviewed by means of the video conferencing feature of the Windows Live Messenger (currently SKYPE about their views and beliefs related to method vs. post-method discussions as well as their current teaching practices. The results revealed a discrepancy between the participants’ views and their classroom practices. In fact, the majority of the participants reported a negative change in their attitudes towards teaching after they started teaching. The majority of the eleven participants were totally unaware of the postmethod discussions. In the final section of the paper, the reasons for these findings are discussed in detail, and further suggestions are made in an attempt to find solutions to some of the problems reported by the participant novice teachers

Productivity change of surgeons in an academic year.

Science.gov (United States)

Nakata, Yoshinori; Watanabe, Yuichi; Otake, Hiroshi; Nakamura, Toshihito; Oiso, Giichiro; Sawa, Tomohiro

2015-01-01

The goal of this study was to calculate total factor productivity of surgeons in an academic year and to evaluate the effect of surgical trainees on their productivity. We analyzed all the surgical procedures performed from April 1 through September 30, 2013 in the Teikyo University Hospital. The nonradial and nonoriented Malmquist model under the variable returns-to-scale assumptions was employed. A decision-making unit is defined as a surgeon with the highest academic rank in the surgery. Inputs were defined as the number of physicians who assisted in surgery, and the time of surgical operation from skin incision to skin closure. The output was defined as the surgical fee for each surgery. April is the beginning month of a new academic year in Japan, and we divided the study period into April to June and July to September 2013. We computed each surgeon's Malmquist index, efficiency change, and technical change. We analyzed 2789 surgical procedures that were performed by 105 surgeons. The Malmquist index of all surgeons was significantly greater than 1 (p = 0.0033). The technical change was significantly greater than 1 (p productive in the beginning months of a new academic year. The main factor of this productivity loss is considered to be surgical training. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The Glass Houses of Attending Surgeons: An Assessment of Unprofessional Behavior on Facebook Among Practicing Surgeons.

Science.gov (United States)

Langenfeld, Sean J; Sudbeck, Craig; Luers, Thomas; Adamson, Peter; Cook, Gates; Schenarts, Paul J

2015-01-01

Our recent publication demonstrated that unprofessional behavior on Facebook is common among surgical residents. In the formulation of standards and curricula to address this issue, it is important that surgical faculty lead by example. Our current study refocuses on the Facebook profiles of faculty surgeons involved in the education of general surgery residents. The American College of Surgeons (ACS) web site was used to identify general surgery residencies located in the Midwest. Departmental web sites were then searched to identify teaching faculty for the general surgery residency. Facebook was then searched to determine which faculty had profiles available for viewing by the general public. Profiles were then placed in 1 of the 3 following categories: professional, potentially unprofessional, or clearly unprofessional. A chi-square test was used to determine significance. In all, 57 residency programs were identified on the ACS web site, 100% of which provided an institutional web site listing the surgical faculty. A total of 758 general surgery faculty were identified (133 women and 625 men), of which 195 (25.7%) had identifiable Facebook accounts. In all, 165 faculty (84.6%) had no unprofessional content, 20 (10.3%) had potentially unprofessional content, and 10 (5.1%) had clearly unprofessional content. Inter-rater reliability was good (88.9% agreement, κ = 0.784). Clearly unprofessional behavior was found only in male surgeons. For male surgeons, clearly unprofessional behavior was more common among those in practice for less than 5 years (p = 0.031). Alcohol and politics were the most commonly found variables in the potentially unprofessional group. Inappropriate language and sexually suggestive material were the most commonly found variables in the clearly unprofessional group. Unprofessional behavior on Facebook is less common among surgical faculty compared with surgical residents. However, the rates remain unacceptably high, especially among men and

Interweaving Teaching and Emotional Support for Novice Special Educators in Alternative Certification Programs

Science.gov (United States)

Ricci, Leila Ansari; Zetlin, Andrea G.

2013-01-01

As the shortage of special education teachers has led to increasing numbers of teacher candidates enrolled in alternative certification programs, there is a need to provide systematic mentoring and coaching. The relationship between support providers and novice teachers enrolled in an alternative certification program in a diverse, urban…

Conceptions of Teaching Science Held by Novice Teachers in an Alternative Certification Program

Science.gov (United States)

Koballa, Thomas R.; Glynn, Shawn M.; Upson, Leslie

2005-01-01

Case studies to investigate the conceptions of teaching science held by three novice teachers participating in an alternative secondary science teacher certification program were conducted, along with the relationships between their conceptions of science teaching and their science teaching practice. Data used to build the cases included the…

Induction and Mentoring of Novice Teachers: A Scheme for the United Arab Emirates

Science.gov (United States)

Ibrahim, Ali S.

2012-01-01

Induction and mentoring of novice teachers have gained considerable worldwide attention. However, in the United Arab Emirates, graduates from teacher education programmes are recruited as teachers without being provided with any formal school-based support. They suffer from stress, overload, and low self-esteem and a high percentage leave…

An Exploration of Self-Efficacy among Novice Nursing Faculty in Formal Mentoring Relationships

Science.gov (United States)

Greenwood, Lisa Marie

2017-01-01

This qualitative study explored the lived experiences of novice nursing faculty members at one Midwestern Technical college, who were in formal mentoring relationships with seasoned nursing faculty members. A total of nine faculty members participated in a single, sixty minute, semi-structured interview exploring the lived experiences of being…

A novel prototype 3/5 laparoscopic needle driver: A validation study with conventional laparoscopic needle driver.

Science.gov (United States)

Ganpule, Arvind P; Deshmukh, Chaitanya S; Joshi, Tanmay

2018-01-01

The challenges in laparoscopic suturing include need to expertise to suture. Laparoscopic needle holder is a" key" instrument to accomplish this arduous task. The objective of this new invention was to develop a laparoscopic needle holder which would be adapted to avoid any wobble (with a shaft diameter same as a 5mm port), ensure accurate and dexterous suturing not just in adult patients but pediatric patients alike (with a short shaft diameter) and finally ensure seamless throw of knots with a narrow tip configuration. We did an initial evaluation to evaluate the validity of the prototype needle holder and its impact on laparoscopic suturing skills by experienced laparoscopic surgeons and novice laparoscopic Surgeons. Both the groups of surgeons performed two tasks. The first task was to grasp the needle and position it in an angle deemed ideal for suturing. The second task was to pass suture through two fixed points and make a single square knot. At the end of the tasks each participant was asked to complete a 5- point Likert's scale questionnaire (8 items; 4 items of handling and 4 items of suturing) rating each needle holder. In expert group, the mean time to complete task 1 was shorter with prototype 3/5 laparoscopic needle holder (11.8 sec Vs 20.8 sec). The mean time to complete task 2 was also shorter with prototype 3/5 laparoscopic needle holder (103.2 sec Vs 153.2 sec). In novice group, mean time to complete both the task was shorter with prototype 3/5 laparoscopic needle holder. The expert laparoscopic surgeons as well as novice laparoscopic surgeons performed laparoscopic suturing faster and with more ease while using the prototype 3/5 laparoscopic needle holder.

Best Practices During Hip Arthroscopy: Aggregate Recommendations of High-Volume Surgeons.

Science.gov (United States)

Gupta, Asheesh; Suarez-Ahedo, Carlos; Redmond, John M; Gerhardt, Michael B; Hanypsiak, Bryan; Stake, Christine E; Finch, Nathan A; Domb, Benjamin G

2015-09-01

To survey surgeons who perform a high volume of hip arthroscopy procedures regarding their operative technique, type of procedure, and postoperative management. We conducted a cross-sectional survey of 27 high-volume orthopaedic surgeons specializing in hip arthroscopy to report their preferences and practices related to their operative practice and postoperative rehabilitation protocol. All participants completed the survey in person in an anonymous fashion during a meeting of the American Hip Institute. All surgeons perform hip arthroscopy with the patient in the supine position, accessing the central compartment of the hip initially, using intraoperative fluoroscopy. All surgeons perform labral repair (100%), with the majority performing labral reconstructions (77.8%) and gluteus medius repairs (81.5%). There is variability in the type of anchors used during labral repair. Most surgeons perform capsular closure in most cases (88.9%), inject either intra-articular cortisone or platelet-rich plasma at the conclusion of the procedure (59%), and prescribe a postoperative hip brace for some or all patients (59%). There is considerable variability in rehabilitation protocols. All surgeons routinely prescribe postoperative heterotopic ossification prophylaxis to their patients, with most surgeons (88.9%) prescribing a nonsteroidal anti-inflammatory medication for 3 weeks. Forty percent of the respondents use the modified Harris Hip Score as the most important outcome measure. Consistent practices such as use of intraoperative fluoroscopy, heterotopic ossification prophylaxis, and labral repair skills were identified by surveying 27 hip arthroscopy surgeons at high-volume centers. Most of the surgeons performed routine capsular closure unless underlying conditions precluded capsular release or plication. The survey identified higher variability between surgeons regarding postoperative rehabilitation protocols and use of intra-articular pharmacologic injections at the

High occupational stress and low career satisfaction of Korean surgeons.

Science.gov (United States)

Kang, Sang Hee; Boo, Yoon Jung; Lee, Ji Sung; Han, Hyung Joon; Jung, Cheol Woong; Kim, Chong Suk

2015-02-01

Surgery is a demanding and stressful field in Korea. Occupational stress can adversely affect the quality of care, decrease job satisfaction, and potentially increase medical errors. The aim of this study was to investigate the occupational stress and career satisfaction of Korean surgeons. We have conducted an electronic survey of 621 Korean surgeons for the occupational stress. Sixty-five questions were used to assess practical and personal characteristics and occupational stress using the Korean occupational stress scale (KOSS). The mean KOSS score was 49.31, which was higher than the average of Korean occupational stress (45.86) or that of other specialized professions (46.03). Young age, female gender, long working hours, and frequent night duties were significantly related to the higher KOSS score. Having spouse, having hobby and regular exercise decreased the KOSS score. Multiple linear regression analysis showed that long working hours and regular exercise were the independent factors associated with the KOSS score. Less than 50% of surgeons answered that they would become a surgeon again. Most surgeons (82.5%) did not want to recommend their child follow their career. Korean Surgeons have high occupational stress and low level of career satisfaction.

Can Surgeon Demographic Factors Predict Postoperative Complication Rates After Elective Spinal Fusion?

Science.gov (United States)

Chun, Danielle S; Cook, Ralph W; Weiner, Joseph A; Schallmo, Michael S; Barth, Kathryn A; Singh, Sameer K; Freshman, Ryan D; Patel, Alpesh A; Hsu, Wellington K

2018-03-01

Retrospective cohort. Determine whether surgeon demographic factors influence postoperative complication rates after elective spine fusion procedures. Surgeon demographic factors have been shown to impact decision making in the management of degenerative disease of the lumbar spine. Complication rates are frequently reported outcome measurements used to evaluate surgical treatments, quality-of-care, and determine health care reimbursements. However, there are few studies investigating the association between surgeon demographic factors and complication outcomes after elective spine fusions. A database of US spine surgeons with corresponding postoperative complications data after elective spine fusions was compiled utilizing public data provided by the Centers for Medicare and Medicaid Services (2011-2013) and ProPublica Surgeon Scorecard (2009-2013). Demographic data for each surgeon was collected and consisted of: surgical specialty (orthopedic vs. neurosurgery), years in practice, practice setting (private vs. academic), type of medical degree (MD vs. DO), medical school location (United States vs. foreign), sex, and geographic region of practice. General linear mixed models using a Beta distribution with a logit link and pairwise comparison with post hoc Tukey-Kramer were used to assess the relationship between surgeon demographics and complication rates. 2110 US-practicing spine surgeons who performed spine fusions on 125,787 Medicare patients from 2011 to 2013 met inclusion criteria for this study. None of the surgeon demographic factors analyzed were found to significantly affect overall complication rates in lumbar (posterior approach) or cervical spine fusion. Publicly available complication rates for individual spine surgeons are being utilized by hospital systems and patients to assess aptitude and gauge expectations. The increasing demand for transparency will likely lead to emphasis of these statistics to improve outcomes. We conclude that none of the

Ultrasound of the acute abdomen performed by surgeons in training

DEFF Research Database (Denmark)

Eiberg, J.P.; Grantcharov, T.P.; Eriksen, J.R.

2008-01-01

, specificity and kappa-agreement of the surgeon performed ultrasound examination was 1.00 (0.77-1.00), 0.96 (0.79-0.99), 0.94 (0.3-1.00) and 0.40 (0.12-0.77), 0.97 (0.83-0.99), 0.44 (0.00-0.96); respectively. Visualization of the common bile duct was poor having 73% non-diagnostic surgeon-performed ultrasound...... perform valid abdominal ultrasound examinations of patients referred with acute abdominal pain. METHODS: Patients referred with acute abdominal pain had an ultrasound examination by a surgeon in training as well as by an experienced consultant radiologist whose results served as the gold standard. All...... participating surgeons were without any pre-existing ultrasound experience and received one hour of introduction to abdominal ultrasound. RESULTS: Thirty patients underwent 40 surgeon performed and 30 radiologist performed ultrasound examinations. Regarding gallstone and cholecholecystitis the sensitivity...

Lowering the Barriers to Programming: A Survey of Programming Environments and Languages for Novice Programmers

National Research Council Canada - National Science Library

Kelleher, Caitlin; Pausch, Randy

2003-01-01

.... The systems are organized by their primary goal, either to teach programming or to use programming to empower their users, and then by the authors' approach to making learning to program easier for novice programmers...

Tapping into past design experiences : Knowledge sharing and creation during novice-expert design consultations

NARCIS (Netherlands)

Deken, F.; Kleinsmann, M.S.; Aurisicchio, M.; Lauche, K.; Bracewell, R.

2011-01-01

Designing is a knowledge-intensive activity. For novice design engineers, an important means of acquiring knowledge is to consult experienced colleagues. We observed novice–expert consultations as part of three engineering projects in a large aerospace company. Seven meetings were analysed in detail

Acquisition of flexible cystoscopy skills on a virtual reality simulator by experts and novices

NARCIS (Netherlands)

Schout, Barbara M. A.; Muijtjens, Arno M. M.; Hendrikx, Ad J. M.; Ananias, Hildo J. K.; Dolmans, Valerie E. M. G.; Scherpbier, Albert J. J. A.; Bemelmans, Bart L. H.

OBJECTIVE To assess the construct validity of the URO MentorTM (Simbionix Corp., Cleveland, OH, USA) virtual reality training model for several variables of skills training in cysto-urethroscopy, addressing two research questions: (i) Does training on the URO Mentor significantly improve novices'

Surgeon distress as calibrated by hours worked and nights on call.

Science.gov (United States)

Balch, Charles M; Shanafelt, Tait D; Dyrbye, Lotte; Sloan, Jeffrey A; Russell, Thomas R; Bechamps, Gerald J; Freischlag, Julie A

2010-11-01

The relationships of working hours and nights on call per week with various parameters of distress among practicing surgeons have not been previously examined in detail. More than 7,900 members of the American College of Surgeons responded to an anonymous, cross-sectional survey. The survey included self-assessment of their practice setting, a validated depression screening tool, and standardized assessments of burnout and quality of life. There was a clear gradient between hours and burnout, with the prevalence of burnout ranging from 30% for surgeons working hours/week, 44% for 60 to 80 hours/week, and 50% for those working >80 hours/week (p hours and nights on call (both p worked >80 hours/week reported a higher rate of medical errors compared with those who worked hours/week (10.7% versus 6.9%; p work and home conflicts were higher among surgeons who worked longer hours or had ≥2 nights on call. A significantly higher proportion of surgeons who worked >80 hours/week or had >2 nights on call/week would not become a surgeon again (p hours worked and nights on call per week appear to have a substantial impact on surgeons, both professionally and personally. These factors are strongly related to burnout, depression, career satisfaction, and work and home conflicts. Copyright © 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Body dysmorphia, self-mutilation and the reconstructive surgeon.

Science.gov (United States)

Chan, James Kwok-Kwan; Jones, Sophie M; Heywood, Anthony J

2011-01-01

Body dysmorphic disorder (BDD) is a disabling preoccupation with a slight or an imagined defect in appearance. It is recognised in some patients who present to the plastic surgeon requesting multiple cosmetic procedures. Very rarely, BDD patients may wish for amputation of a healthy limb and may even mutilate themselves deliberately in order to necessitate amputation. These patients pose a diagnostic challenge as BDD is uncommon and they are often uncooperative whilst appearing mentally sound. Furthermore, they raise difficult ethical and legal issues for the surgeon. Although there is some guidance for the management of BDD patients seeking elective amputation, there is currently none for the management of those who present in the emergency setting. Illustrated by the case of a man who, having failed to find a complicit surgeon, attempted self-amputation of the hand, we review the relevant ethical, legal and management issues with advice by the British Medical Association and General Medical Council. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Internal and External Imagery Effects on Tennis Skills Among Novices.

Science.gov (United States)

Dana, Amir; Gozalzadeh, Elmira

2017-10-01

The purpose of this study was to determine the effects of internal and external visual imagery perspectives on performance accuracy of open and closed tennis skills (i.e., serve, forehand, and backhand) among novices. Thirty-six young male novices, aged 15-18 years, from a summer tennis program participated. Following initial skill acquisition (12 sessions), baseline assessments of imagery ability and imagery perspective preference were used to assign participants to one of three groups: internal imagery ( n = 12), external imagery ( n = 12), or a no-imagery (mental math exercise) control group ( n = 12). The experimental interventions of 15 minutes of mental imagery (internal or external) or mental math exercises followed by 15 minutes of physical practice were held three times a week for six weeks. The performance accuracy of the groups on the serve, forehand, and backhand strokes was measured at pre- and post-test using videotaping. Results showed significant increases in the performance accuracy of all three tennis strokes in all three groups, but serve accuracy in the internal imagery group and forehand accuracy in the external imagery group showed greater improvements, while backhand accuracy was similarly improved in all three groups. These findings highlight differential efficacy of internal and external visual imagery for performance improvement on complex sport skills in early stage motor learning.

Radiosterilization of Tissues Preserved for Clinical Purposes: Effect on Tissue Antigenicity

International Nuclear Information System (INIS)

Ostrowski, K.; Kossowska, B.; Moskalewski, S.; Komender, A.; Kurnatowski, W.

1967-01-01

The first part of the paper contains practical considerations on the radiosterilization of preserved human bone, human and calf cartilage, cow’s fascia and aponeurosis, based on material from the Tissue Bank which produces about 2500 transplants yearly. The method of preservation and packing of each type of tissue is mentioned briefly. The preserved tissues are irradiated in a cobalt bomb or in a nuclear reactor. The conditions of irradiation and the control of sterility are described. The advantages and disadvantages of radiosterilization are discussed on the basis of the authors’ own experience and clinical reports of surgeons using radiosterilized tissues in practice. In the second part of the paper, experimental studies on the influence of freezing, lyophilization and radiosterilization on tissue antigenicity are reported. The regional lymph node reacts to an antigenic stimulus by an increased production of large, pyroninophylic cells, so-called ''blast'' cells. The rabbits used as recipients received grafts of allogeneic cancellous bone, fresh or subjected to different experimental procedures. Smears from lymph node cell suspension were prepared and the percentage of blast cells was estimated. On the basis of the lymph node response, it appears that freezing and lyophilization, as well as radiosterilization, may abolish the antigenicity of cancellous bone. The practical implication of these results for methods of preservation of tissues for clinical purposes is discussed. (author)

The paediatric surgeon and his working conditions in Francophone sub-Saharan Africa

Directory of Open Access Journals (Sweden)

K Gnassingbé

2011-01-01

Full Text Available Background: This study described the current conditions of work of paediatric surgeons in Francophone sub-Saharan Africa (FSSA and set the debate at the level of the humanist thinking in medicine. Patients and Methods: This was a multicentre study from 1 st May to 30 th October 2008. The African Society of paediatric surgeons′ directory was used to identify paediatric surgeons in the Francophone′s countries in Sub Saharan Africa. The parameters studied were number of surgeons per country, means of training, working conditions, remunerations, needs for continuous training and the research. Results: A total of 41 paediatric surgeons (68.33% responded. The average number of paediatric surgeons per country was 5. The means of training included government scholarships among 7 paediatric surgeons (17.07%, scholarship from a non-governmental organisations in 14 (34.15% and self-sponsorships in 20 (48.78%. The average salary was 450 Euros (€ (range: 120-1 400 Euros. Most of the paediatric surgeons (68.29% had internet services for continuous update courses and research. Thirty six paediatric surgeons (87.80% had no subscription to specialised scientific journals. Conclusion: The paediatric surgeon in FSSA faces many problems related to his working and living conditions that may have a negative impact on their competences.

Projections of Demand for Cardiovascular Surgery and Supply of Surgeons.

Science.gov (United States)

Lee, Jung Jeung; Park, Nam Hee; Lee, Kun Sei; Chee, Hyun Keun; Sim, Sung Bo; Kim, Myo Jeong; Choi, Ji Suk; Kim, Myunghwa; Park, Choon Seon

2016-12-01

While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040-an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309-an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time, effort, and resources; therefore, by analyzing the various factors

Thinking Like Researchers: Action Research and Its Impact on Novice Teachers' Thinking

Science.gov (United States)

Davis, Janine; Clayton, Courtney; Broome, John

2018-01-01

This project investigated the effects of novice teachers' responses to an action research project conducting during the student-teaching semester. This study drew on a framework that considered the participants' process of research, practice of teaching, and identity as a researcher and utilized a qualitative, multiple case-study approach with an…

Discrepancies in the female pelvic medicine and reconstructive surgeon workforce.

Science.gov (United States)

Muffly, Tyler M; Weterings, Robbie; Barber, Mathew D; Steinberg, Adam C

2015-01-01

It is unclear whether the current distribution of surgeons practicing female pelvic medicine and reconstructive surgery in the United States is adequate to meet the needs of a growing and aging population. We assessed the geographic distribution of female pelvic surgeons as represented by members of the American Urogynecologic Society (AUGS) throughout the United States at the county, state, and American Congress of Obstetricians and Gynecologists district levels. County-level data from the AUGS, American Congress of Obstetricians and Gynecologists, and the United States Census were analyzed in this observational study. State and national patterns of female pelvic surgeon density were mapped graphically using ArcGIS software and 2010 US Census demographic data. In 2013, the 1058 AUGS practicing physicians represented 0.13% of the total physician workforce. There were 6.7 AUGS members available for every 1 million women and 20 AUGS members for every 1 million postreproductive-aged women in the United States. The density of female pelvic surgeons was highest in metropolitan areas. Overall, 88% of the counties in the United States lacked female pelvic surgeons. Nationwide, there was a mean of 1 AUGS member for every 31 practicing general obstetrician-gynecologists. These findings have implications for training, recruiting, and retaining female pelvic surgeons. The uneven distribution of female pelvic surgeons throughout the United States is likely to worsen as graduating female pelvic medicine and reconstructive surgery fellows continue to cluster in urban areas.

Current Concepts in Tissue Engineering: Skin and Wound.

Science.gov (United States)

Tenenhaus, Mayer; Rennekampff, Hans-Oliver

2016-09-01

Pure regenerative healing with little to no donor morbidity remains an elusive goal for both surgeon and patient. The ability to engineer and promote the development of like tissue holds so much promise, and efforts in this direction are slowly but steadily advancing. Products selected and reviewed reflect historical precedence and importance and focus on current clinically available products in use. Emerging technologies we anticipate will further expand our therapeutic options are introduced. The topic of tissue engineering is incredibly broad in scope, and as such the authors have focused their review on that of constructs specifically designed for skin and wound healing. A review of pertinent and current clinically related literature is included. Products such as biosynthetics, biologics, cellular promoting factors, and commercially available matrices can be routinely found in most modern health care centers. Although to date no complete regenerative or direct identical soft-tissue replacement exists, currently available commercial components have proven beneficial in augmenting and improving some types of wound healing scenarios. Cost, directed specificity, biocompatibility, and bioburden tolerance are just some of the impending challenges to adoption. Quality of life and in fact the ability to sustain life is dependent on our most complex and remarkable organ, skin. Although pure regenerative healing and engineered soft-tissue constructs elude us, surgeons and health care providers are slowly gaining comfort and experience with concepts and strategies to improve the healing of wounds.

The effect of surgeon experience on outcomes of surgery for adolescent idiopathic scoliosis.

Science.gov (United States)

Cahill, Patrick J; Pahys, Joshua M; Asghar, Jahangir; Yaszay, Burt; Marks, Michelle C; Bastrom, Tracey P; Lonner, Baron S; Shah, Suken A; Shufflebarger, Harry L; Newton, Peter O; Betz, Randal R; Samdani, Amer F

2014-08-20

Single-surgeon series investigating the learning curve involved in surgery for spinal deformity may be confounded by changes in technology and techniques. Our objective with this multicenter, prospective study was to present a cross-sectional analysis of the impact of surgeon experience on surgery for adolescent idiopathic scoliosis. All posterior-only surgical procedures for adolescent idiopathic scoliosis performed in the 2007 to 2008 academic year, with a minimum of two years of patient follow-up, were included. Two groups were created on the basis of surgeon experience: a young surgeons' group, which included patients of surgeons with less than five years of experience, and an experienced surgeons' group, which included patients of surgeons with five or more years of experience. Nine surgeons (four young and five experienced) operated on a total of one hundred and sixty-five patients with adolescent idiopathic scoliosis. The surgeons' experience ranged from less than one year to thirty-six years in practice. The two groups had similar preoperative curve-magnitude measurements, SRS-22 (Scoliosis Research Society-22) scores, and distribution by Lenke curve type. There were significant operative and postoperative differences. The young surgeons fused an average of 1.2 levels more than the experienced surgeons (p = 0.045). The mean intraoperative estimated blood loss (EBL) of the young surgeons' group was more than twice that of the experienced surgeons' group (2042 mL compared with 1013 mL; p self-image (p = 0.008), and function (p adolescent idiopathic scoliosis were significantly and positively correlated with surgeon experience. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Disparities between resident and attending surgeon perceptions of intraoperative teaching.

Science.gov (United States)

Butvidas, Lynn D; Anderson, Cheryl I; Balogh, Daniel; Basson, Marc D

2011-03-01

This study aimed to assess attending surgeon and resident recall of good and poor intraoperative teaching experiences and how often these experiences occur at present. By web-based survey, we asked US surgeons and residents to describe their best and worst intraoperative teaching experiences during training and how often 26 common intraoperative teaching behaviors occur in their current environment. A total of 346 residents and 196 surgeons responded (51 programs; 26 states). Surgeons and residents consistently identified trainee autonomy, teacher confidence, and communication as positive, while recalling negatively contemptuous, arrogant, accusatory, or uncommunicative teachers. Residents described intraoperative teaching behaviors by faculty as substantially less frequent than faculty self-reports. Neither sex nor seniority explained these results, although women reported communicative behaviors more frequently than men. Although veteran surgeons and current trainees agree on what constitutes effective and ineffective teaching in the operating room, they disagree on how often these behaviors occur, leaving substantial room for improvement. Published by Elsevier Inc.

Idiopathic Soft Tissue Calcification in an Extremity: A Case Report

Directory of Open Access Journals (Sweden)

Dinesh Dhar

2013-03-01

Full Text Available We report a case of a-15-days-old infant presenting with firm palpable thickening of the left leg soft tissues along with induration. Radiographs of the leg revealed generalized calcification of soft tissues. No obvious underlying cause could be identified for tissue calcification and hence termed as Idiopathic calcinois cutis. There are reports of this condition in Pediatric and Dermatology literature, but very few reports in orthopedic literature. The aim of this report is to highlight the pathogenesis, course and review of literature of this relatively uncommon condition which can easily be mistaken by Orthopedic or General Surgeons for infective bony of soft tissue infection.

Knowledge and opinions on oncoplastic surgery among breast and plastic surgeons

DEFF Research Database (Denmark)

Carstensen, Lena; Rose, Michael; Bentzon, Niels

2015-01-01

symmetrisation procedures were performed by plastic surgeons. Breast surgeons had sought more specific education, both international observerships and specific courses. In both groups of surgeons, the majority expressed that both tumour removal and reconstruction should be performed by doctors of their own...... of implementation of OPS in Denmark. METHODS: An electronic questionnaire was sent to breast and plastic surgeons performing breast cancer treatment. The questionnaire included demographics, education, experience with operative procedures and opinions on OPS. RESULTS: The questionnaire was sent to 50 breast...

Replication of elite music performance enhancement following alpha/theta neurofeedback and application to novice performance and improvisation with SMR benefits.

Science.gov (United States)

Gruzelier, J H; Holmes, P; Hirst, L; Bulpin, K; Rahman, S; van Run, C; Leach, J

2014-01-01

Alpha/theta (A/T) and sensory-motor rhythm (SMR) neurofeedback were compared in university instrumentalists who were novice singers with regard to prepared and improvised instrumental and vocal performance in three music domains: creativity/musicality, technique and communication/presentation. Only A/T training enhanced advanced playing seen in all three domains by expert assessors and validated by correlations with learning indices, strongest with Creativity/Musicality as shown by Egner and Gruzelier (2003). Here A/T gains extended to novice performance - prepared vocal, improvised vocal and instrumental - and were recognised by a lay audience who judged the prepared folk songs. SMR learning correlated positively with Technical Competence and Communication in novice performance, in keeping with SMR neurofeedback's known impact on lower-order processes such as attention, working memory and psychomotor skills. The importance of validation through learning indices was emphasised in the interpretation of neurofeedback outcome. Copyright © 2013 Elsevier B.V. All rights reserved.

Novice Supervisors' Practices and Dilemmatic Space in Supervision of Student Research Projects

Science.gov (United States)

Vereijken, Mayke W. C.; van der Rijst, Roeland M.; van Driel, Jan H.; Dekker, Friedo W.

2018-01-01

Growing interest in student research projects in higher education has led to an emphasis on research supervision. We focus in this study on novice supervisors' approaches to research supervision as they explore their practices and experience difficulties supervising medical-students. Teacher noticing was used as a sensitising concept and relations…

The novice birthing: theorising first-time mothers' experiences of birth at home and in hospital in Australia.

Science.gov (United States)

Dahlen, Hannah G; Barclay, Lesley M; Homer, Caroline S E

2010-02-01

to explore first-time mothers' experiences of birth at home and in hospital in Australia. a grounded theory methodology was used. Data were generated from in-depth interviews with women in their own homes. Sydney, Australia. 19 women were interviewed. Seven women who gave in a public hospital and seven women who gave birth for the first time at home were interviewed and their experiences were contrasted with two mothers who gave birth for the first time in a birth centre, one mother who gave birth for the first time in a private hospital and two women who had given birth more than once. three categories emerged from the analysis: preparing for birth, the novice birthing and processing the birth. These women shared a common core experience of seeing that they gave birth as 'novices'. The basic social process running through their experience of birth, regardless of birth setting, was that, as novices, they were all 'reacting to the unknown'. The mediating factors that influenced the birth experiences of these first-time mothers were preparation, choice and control, information and communication, and support. The quality of midwifery care both facilitated and hindered these needs, contributing to the women's perceptions of being 'honoured'. The women who gave birth at home seemed to have more positive birth experiences. identifying the novice status of first-time mothers and understanding the way in which they experience birth better explains previous research that reports unrealistic expectations and fear that may be associated with first-time birthing. It demonstrates how midwives can contribute to positive birth experiences by being aware that first-time mothers, irrespective of birth setting, are essentially reacting to the unknown as they negotiate the experience of birth. Copyright 2008 Elsevier Ltd. All rights reserved.

Emergent management of postpartum hemorrhage for the general and acute care surgeon

Directory of Open Access Journals (Sweden)

Blankenship Charles L

2009-11-01

Full Text Available Abstract Background Postpartum hemorrhage is one of the rare occasions when a general or acute care surgeon may be emergently called to labor and delivery, a situation in which time is limited and the stakes high. Unfortunately, there is generally a paucity of exposure and information available to surgeons regarding this topic: obstetric training is rarely found in contemporary surgical residency curricula and is omitted nearly completely from general and acute care surgery literature and continuing medical education. Methods The purpose of this manuscript is to serve as a topic specific review for surgeons and to present a surgeon oriented management algorithm. Medline and Ovid databases were utilized in a comprehensive literature review regarding the management of postpartum hemorrhage and a management algorithm for surgeons developed based upon a collaborative panel of general, acute care, trauma and obstetrical surgeons' review of the literature and expert opinion. Results A stepwise approach for surgeons of the medical and surgical interventions utilized to manage and treat postpartum hemorrhage is presented and organized into a basic algorithm. Conclusion The manuscript should promote and facilitate a more educated, systematic and effective surgeon response and participation in the management of postpartum hemorrhage.

A narrative study of novice elementary teachers' perceptions of science instruction

Science.gov (United States)

Harrell, Roberta

It is hoped that, once implemented, the Next Generation Science Standards (NGSS) will engage students more deeply in science learning and build science knowledge sequentially beginning in Kindergarten (NRC, 2013). Early instruction is encouraged but must be delivered by qualified elementary teachers who have both the science content knowledge and the necessary instructional skills to teach science effectively to young children (Ejiwale, 2012, Spencer, Vogel, 2009, Walker, 2011). The purpose of this research study is to gain insight into novice elementary teachers' perceptions of science instruction. This research suggests that infusion of constructivist teaching in the elementary classroom is beneficial to the teacher's instruction of science concepts to elementary students. Constructivism is theory that learning is centered on the learner constructing new ideas or concepts built upon their current/past knowledge (Bruner, 1966). Based on this theory, it is recommended that the instructor should try to encourage students to discover principles independently; essentially the instructor presents the problem and lets students go (Good & Brophy, 2004). Discovery learning, hands-on, experimental, collaborative, and project-based learning are all approaches that use constructivist principles. The NGSS are based on constructivist principles. This narrative study provides insight into novice elementary teachers' perceptions of science instruction considered through the lens of Constructivist Theory (Bruner, 1960).

Spinal fMRI of Interoceptive Attention/Awareness in Experts and Novices

Directory of Open Access Journals (Sweden)

Keyvan Kashkouli Nejad

2014-01-01

Full Text Available Many disciplines/traditions that promote interoceptive (inner sensation of body parts attention/awareness (IAA train practitioners to both attend to and be aware of interoceptive sensory experiences in body parts. The effect of such practices has been investigated in previous imaging studies but limited to cerebral neural activity. Here, for the first time, we studied the impact of these practices on the spinal neural activity of experts and novices. We also attempted to clarify the effect of constant and deep breathing, a paradigm utilized in concentration practices to avoid mind wandering, on IAA-related spinal neural activity. Subjects performed IAA tasks with and without a deep and constant breathing pattern in two sessions. Results showed that neural activity in the spinal segment innervating the attended-to body area increased in experts (P=0.04 when they performed IAA and that this increase was significantly larger for experts versus novices in each of the sessions (P=0.024. The significant effects of IAA and expertise on spinal neural activity are consistent with and elaborate on previous reports showing similar effects on cerebral neural activity. As the spinal cord directly innervates body parts, the results might indicate that IAA has an instantaneous (possibly beneficial effect on the physical body after extended training.

Testing Basic Competency in Knee Arthroscopy Using a Virtual Reality Simulator

DEFF Research Database (Denmark)

Jacobsen, Mads Emil; Andersen, Morten Jon; Hansen, Claus Ol

2015-01-01

was set at a total z-score of 15.5 points, resulting in two of the novices passing the test and a single experienced surgeon failing the test. CONCLUSIONS: By combining four procedures on a virtual reality arthroscopy simulator, it was possible to create a valid, reliable, and feasible test of basic......BACKGROUND: Diagnostic knee arthroscopy is a common procedure that orthopaedic residents are expected to learn early in their training. Arthroscopy requires a different skill set from traditional open surgery, and many orthopaedic residents feel less prepared for arthroscopic procedures. Virtual...... reality simulation training and testing provide an opportunity to ensure basic competency before proceeding to supervised procedures in patients. METHODS: Twenty-six physicians (thirteen novices and thirteen experienced arthroscopic surgeons) were voluntarily recruited to perform a test consisting of five...

Soft tissue twisting injuries of the knee

International Nuclear Information System (INIS)

Magee, T.; Shapiro, M.

2001-01-01

Twisting injuries occur as a result of differential motion of different tissue types in injuries with some rotational force. These injuries are well described in brain injuries but, to our knowledge, have not been described in the musculoskeletal literature. We correlated the clinical examination and MR findings of 20 patients with twisting injuries of the soft tissues around the knee. Design and patients: We prospectively followed the clinical courses of 20 patients with knee injuries who had clinical histories and MR findings to suggest twisting injuries of the subcutaneous tissues. Patients with associated internal derangement of the knee (i.e., meniscal tears, ligamentous or bone injuries) were excluded from this study. MR findings to suggest twisting injuries included linear areas of abnormal dark signal on T1-weighted sequences and abnormal bright signal on T2-weighted or short tau inversion recovery (STIR) sequences and/or signal to suggest hemorrhage within the subcutaneous tissues. These MR criteria were adapted from those established for indirect musculotendinous junction injuries. Results: All 20 patients presented with considerable pain that suggested internal derangement on physical examination by the referring orthopedic surgeons. All presented with injuries associated with rotational force. The patients were placed on a course of protected weight-bearing of the affected extremity for 4 weeks. All patients had pain relief by clinical examination after this period of protected weight-bearing. Twisting injuries of the soft tissues can result in considerable pain that can be confused with internal derangement of the knee on physical examination. Soft tissue twisting injuries need to be recognized on MR examinations as they may be the cause of the patient's pain despite no MR evidence of internal derangement of the knee. The demonstration of soft tissue twisting injuries in a patient with severe knee pain but no documented internal derangement on MR

A Worldwide Survey on Peyronie's Disease Surgical Practice Patterns Among Surgeons.

Science.gov (United States)

Chung, Eric; Wang, Run; Ralph, David; Levine, Laurence; Brock, Gerald

2018-04-01

Despite published guidelines on Peyronie's disease (PD), there are limited data on actual surgical practice among surgeons. To evaluate the surgical practice patterns in PD among surgeons from different continents and members of various sexual medicine societies. An anonymous survey on various pre-, intra-, and postoperative aspects of PD surgical care was distributed in printed format during International Society of Sexual Medicine meetings and as an online survey to International Society of Sexual Medicine members. 390 surgeons responded to the survey, with great variations in pre-, intra-, and postoperative strategies in PD surgical care. Most surgeons performed fewer than 10 penile plications and 10 graft surgeries per year. Modified Nesbit plication was the preferred option by most surgeons. Surgeons who received fellowship training were more likely to perform autologous than allograft surgery (odds ratio = 1.79, 95% CI = 1.13-2.82, P = .01). The use of penile color duplex ultrasound was inconsistently performed, with higher-volume surgeons (ie, >20 cases operated a year) more likely to use this diagnostic modality (odds ratio = 70.18, 95% CI = 20.99-234.6, P worldwide survey study has the potential to assist in the formation of a new practice guideline and serve as the basis for future prospective multinational studies. This is one of the largest surveys on PD practice and, to our knowledge, the only survey conducted across various sexual medicine societies, with the inclusion of many high-volume and experienced PD surgeons. This also is the 1st study to comprehensively evaluate many key aspects in surgical practice patterns for PD. However, the categorization on the questionnaire used in this survey was not designed to allow for direct comparison given the possibility of some surgeons with dual society memberships, reporting biases, large CIs in outcomes, different patient demographics, and cultural acceptance. There is great variation in surgical

[How much business management does a surgeon need?].

Science.gov (United States)

Bork, U; Koch, M; Büchler, M W; Weitz, J

2010-08-01

The present day healthcare system in Germany is rapidly changing, even more so after the introduction of diagnosis-related groups. The basic requirements for every surgeon remain manual skills, a profound clinical knowledge and the ability for clinical decision-making even in difficult situations. However, these key elements of surgical education no longer fulfill the requirements for today's leaders in surgery. New requirements, consisting of administrative duties, strategic decision-making and department management are too complex to be made only intuitively. Nowadays surgeons also need a profound education in management skills and knowledge of economic mechanisms in order to run an efficient, profitable, patient-oriented surgical department. Every surgeon who aims at obtaining a leadership position should acquire the necessary knowledge and skills.

Patient Satisfaction and its Relation to Perceived Visit Duration With a Hand Surgeon.

Science.gov (United States)

Parrish, Raymond C; Menendez, Mariano E; Mudgal, Chaitanya S; Jupiter, Jesse B; Chen, Neal C; Ring, David

2016-02-01

To determine whether patient perception of time spent with a hand surgeon relates to patient satisfaction after a single new-patient office visit. Prior to each visit, 112 consecutive new patients predicted how much time they expected to spend with the surgeon. Following the visit, patients were asked to estimate the time spent with the surgeon, indicate whether the surgeon appeared rushed, and rate their overall satisfaction with the surgeon. Wait time and actual visit duration were measured. Patients also completed a sociodemographic survey, the Consultation and Relational Empathy Measure, the Newest Vital Sign Health Literacy test, and 3 Patient-Reported Outcomes Measurement Information System-based questionnaires: Upper Extremity Function, Pain Interference, and Depression. Multivariable logistic and linear regression models were used to determine predictors of patient satisfaction, patient-perceived surgeon rush, and high previsit expectations of visit duration. Patient satisfaction was not associated with perceived visit duration but did correlate strongly with patient-rated surgeon empathy and symptoms of depression. Neither visit duration nor previsit expectations of visit length were determinants of patient-perceived surgeon rush. Only surgeon empathy was associated. Less-educated patients anticipated needing more time with the surgeon. Patient satisfaction with the surgeon and with the time spent during the office visit was primarily linked to surgeon empathy rather than to visit duration or previsit expectation of visit length. Efforts to make hand surgery office visits more patient-centered should focus on improving dialogue quality, and not necessarily on making visits longer. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Dissecting Attending Surgeons' Operating Room Guidance: Factors That Affect Guidance Decision Making.

Science.gov (United States)

Chen, Xiaodong Phoenix; Williams, Reed G; Smink, Douglas S

2015-01-01

The amount of guidance provided by the attending surgeon in the operating room (OR) is a key element in developing residents' autonomy. The purpose of this study is to explore factors that affect attending surgeons' decision making regarding OR guidance provided to the resident. We used video-stimulated recall interviews (VSRI) throughout this 2-phase study. In Phase 1, 3 attending surgeons were invited to review separately 30 to 45 minute video segments of their prerecorded surgical operations to explore factors that influenced their OR guidance decision making. In Phase 2, 3 attending surgeons were observed and documented in the OR (4 operations, 341min). Each operating surgeon reviewed their videotaped surgical performance within 5 days of the operation to reflect on factors that affected their decision making during the targeted guidance events. All VSRI were recorded. Thematic analysis and manual coding were used to synthesize and analyze data from VSRI transcripts, OR observation documents, and field notes. A total of 255 minutes of VSRI involving 6 surgeons and 7 surgical operations from 5 different procedures were conducted. A total of 13 guidance decision-making influence factors from 4 categories were identified (Cohen's κ = 0.674): Setting (case schedule and patient morbidity), content (procedure attributes and case progress), resident (current competency level, trustworthiness, self-confidence, and personal traits), and attending surgeon (level of experience, level of comfort, preferred surgical technique, OR training philosophy, and responsibility as surgeon). A total of 5 factors (case schedule, patient morbidity, procedure attributes, resident current competency level, and trustworthiness) influenced attending surgeons' pre-OR guidance plans. "OR training philosophy" and "responsibility as surgeon" were anchor factors that affected attending surgeons' OR guidance decision-making patterns. Surgeons' OR guidance decision making is a dynamic process

Comparing industry compensation of cardiothoracic surgeons and interventional cardiologists.

Science.gov (United States)

Parreco, Joshua; Donath, Elie; Kozol, Robert; Faber, Cristiano

2017-02-01

The purpose of this study was to compare payment trends between cardiothoracic surgeons and interventional cardiologists using the Open Payments website made available for the public by the Center for Medicare and Medicaid Services. Data were extracted from the second release of the Open Payments database, which includes payments made between August 1, 2013 and December 31, 2014. Total payments to individual physicians were aggregated based on specialty, region of the country, and payment type. The Gini index was calculated for each specialty to measure income disparity. A Gini index of 1 indicates all the payments went to one individual, whereas a Gini index of 0 indicates all individuals received equal payments. During the study period of interest, data were made available for 3587 (80%) cardiothoracic surgeons compared with 2957 (99%) interventional cardiologists. Mean total payments to cardiothoracic surgeons were $7770 (standard deviation, $52,608) compared with a mean of $15,221 (standard deviation, $98,828) for interventional cardiologists. The median total payments to cardiothoracic surgeons was $1050 (interquartile range, $233-$3612) compared with $1851 (interquartile range, $607-$5462) for interventional cardiologists. The overall Gini index was 0.932, whereas the Gini index was 0.862 for interventional cardiologists and 0.860 for cardiothoracic surgeons. The vast majority of interventional cardiologists and cardiothoracic surgeons received payments from drug and device manufacturers. The mean total payments to interventional cardiologists were higher than any other specialty. However, like cardiothoracic surgery, they were among the most equitably distributed compared with other specialties. Copyright © 2016 Elsevier Inc. All rights reserved.

Surgeon specialization and use of sentinel lymph node biopsy for breast cancer

Science.gov (United States)

Yen, Tina W.F.; Laud, Purushuttom W.; Sparapani, Rodney A.; Nattinger, Ann B.

2014-01-01

IMPORTANCE Sentinel lymph node biopsy (SLNB) is the standard of care for axillary staging in clinically node-negative breast cancer patients. It is not known whether SLNB rates differ by surgeon expertise. If surgeons with less breast cancer expertise are less likely to offer SLNB to clinically node-negative patients, this practice pattern could lead to unnecessary axillary lymph node dissections (ALND) and lymphedema. OBJECTIVE To explore potential measures of surgical expertise (including a novel objective specialization measure – percentage of a surgeon’s operations devoted to breast cancer determined from claims) on the use of SLNB for invasive breast cancer. DESIGN Population-based prospective cohort study. Patient, tumor, treatment and surgeon characteristics were examined. SETTING California, Florida, Illinois PARTICIPANTS Elderly (65+ years) women identified from Medicare claims as having had incident invasive breast cancer surgery in 2003. MAIN OUTCOME MEASURES Type of axillary surgery performed. RESULTS Of the 1,703 women treated by 863 different surgeons, 56% underwent an initial SLNB, 37% initial ALND and 6% no axillary surgery. The median annual surgeon Medicare volume of breast cancer cases was 6 (range: 1.5–57); the median surgeon percentage of breast cancer cases was 4.6% (range: 0.7%–100%). After multivariable adjustment of patient and surgeon factors, women operated on by surgeons with higher volumes and percentages of breast cancer cases had a higher likelihood of undergoing SLNB. Specifically, women were most likely to undergo SLNB if operated on by high volume surgeons (regardless of percentage) or by lower volume surgeons with a high percentage of cases devoted to breast cancer. In addition, membership in the American Society of Breast Surgeons (OR 1.98, CI 1.51–2.60) and Society of Surgical Oncology (OR 1.59, CI 1.09–2.30) were independent predictors of women undergoing an initial SLNB. CONCLUSIONS AND RELEVANCE Patients treated

Diffusion of laparoscopic cholecystectomy among general surgeons in the United States.

Science.gov (United States)

Escarce, J J; Bloom, B S; Hillman, A L; Shea, J A; Schwartz, J S

1995-03-01

Introduced in 1989, laparoscopic cholecystectomy has rapidly become the treatment of choice for symptomatic gallstones. This study describes the diffusion of laparoscopic cholecystectomy among general surgeons; assesses the importance of various reasons for surgeons adopting the procedure; and examine the influence of surgeon, practice, and health care market characteristics on the timing of adoption. The data were obtained from a survey of a national sample of surgeons. Most surgeons (81%) adopted laparoscopic cholecystectomy by early 1992. More than three fourths of adopters identified the desire to keep up with the state-of-the-art and improved patient outcomes as very or extremely important reasons for adoption. Results of proportional hazards regression analysis indicate that individual surgeons' adoption behavior generally was consistent with expected utility maximization in an uncertain new technological environment. Of particular interest, fee-for-service payment and more competitive practice settings and markets were associated with earlier adoption. These findings suggest that the "technological imperative" and surgeons' perception of the relative clinical and financial advantages of laparoscopic cholecystectomy were important reasons for the rapid diffusion of laparoscopic cholecystectomy. Policies that accelerate current trends toward payment of physicians based on salary or capitation and promote the growth of multispecialty group practice could slow the diffusion of new physician-based product innovations in health care.

Benchmarking surgeon satisfaction at academic health centers: a nationwide comparative survey.

Science.gov (United States)

Drachman, D A

1996-01-01

Forty-six academic health centers (AHCs) belonging to the University HealthSystem consortium joined forces to compare the efficiency of their surgical services and to identify best practices. In addition to measures of operational performance, surgeon satisfaction with the surgical services provided was measured by using a standardized questionnaire. From hospital records, indicators of the efficiency of surgical services were collected in three main areas: scheduling, preoperative testing and assessment, and the intraoperative process. Responding to a mail questionnaire, a sample of surgeons rated their satisfaction with key aspects of surgical services including scheduling, operating room staff, and equipment/supplies. On the basis of a review of the operational measures and the survey results, high performers were identified. Site visits were made to several of these high performers to uncover the critical factors responsible for their success. The survey revealed distinct variations in surgeon satisfaction across the participating institutions. Numerical benchmarks were obtained for surgeon satisfaction with each key component of surgical services. Scheduling was the most important component of overall surgeon satisfaction, explaining 71% of the variance in the rating of overall satisfaction with surgical services. High operational efficiency and high surgeon satisfaction were not incompatible. Several of the participating institutions were able to achieve both. These results were disseminated to all of the participants at a national meeting as well as in written form. The surgeon satisfaction survey allowed the participants to establish benchmarks for surgeon satisfaction for each key component of the surgical services they receive. The site visits revealed several common characteristics of highly efficient surgical services. Taken by themselves, the participating institutions might have been reluctant to consider adopting these best practices for fear of

Structural equation modeling assessing relationship between mathematics beliefs, teachers' attitudes and teaching practices among novice teachers in Malaysia

Science.gov (United States)

Borhan, Noziati; Zakaria, Effandi

2017-05-01

This quantitative study was conducted to investigate the perception level of novice teachers about mathematics belief, teachers' attitude towards mathematics and teaching practices of mathematics in the classroom. In addition, it also aims to identify whether there is a correspondence model with the data obtained and to identify the relationship between the variables of beliefs, attitudes and practices among novice teachers in Malaysia. A total of 263 primary novice teachers throughout the country were involved in this study were selected randomly. Respondents are required to provide a response to the questionnaire of 66 items related to mathematics beliefs, attitudes and practices of the teaching mathematics. There are ten sub-factors which have been established in this instrument for three major constructs using a Likert scale rating of five points. The items of the constructs undergo the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) procedure involve of unidimensionality test, convergent validity, construct validity and discriminant validity. Descriptive statistics were used to describe the frequency, percentage, the mean and standard deviation for completing some research questions that have been expressed. As for inferential statistical analysis, the researchers used structural equation modeling (SEM) to answer the question of correspondents model and the relationship between these three variables. The results of the study were found that there exist a correspondence measurement and structural model with the data obtained. While the relationship between variable found that mathematics beliefs have a significant influence on teachers' attitudes towards mathematics as well as the relationship between the attitudes with teaching practices. Meanwhile, mathematics belief had no significant relationship with mathematics teaching practices among novice teachers in Malaysia.

Parent involvement in novice teen driving: a review of the literature

OpenAIRE

Simons‐Morton, B; Ouimet, M C

2006-01-01

Motor vehicle crashes remain elevated among novice teen drivers for at least several years after licensure. Licensing policies and driver education are the two primary countermeasures employed to decrease young driver crash risks. Graduated driver licensing policies have proved to be effective in reducing crash rates where evaluated. Driver education is an essential part of teaching teens the rules of the road and operating a vehicle, but requires few hours of professional driver training, re...

Psychomotor skills acquisition of novice learners: a case for contextual learning.

Science.gov (United States)

DeBourgh, Gregory A

2011-01-01

Deficiencies in procedural competency compromise patient safety and the quality of care provided. Educators in prelicensure nursing programs are challenged to design effective instruction to develop psychomotor skills abilities among novice learners. Highly contextualized learning and frequent opportunities for performance rehearsal promote knowledge retention and procedural competence. The author discusses data from an evaluation study that explored students' perceptions of the effectiveness of skills instruction and suggests strategies for curricular integration and effective instruction.

MODELING PARADOXES IN NOVICE AND EXPERT DESIGN

DEFF Research Database (Denmark)

Dorst, Kees; Hansen, Claus Thorp

2011-01-01

In their ICED09 paper ‘Problem formulation as a discursive activity’, the authors have used an extensive educational case study to explore a framework for describing design as a discursive activity, centered around the paradoxical nature of the problem situation. The ‘working definition’ for para......In their ICED09 paper ‘Problem formulation as a discursive activity’, the authors have used an extensive educational case study to explore a framework for describing design as a discursive activity, centered around the paradoxical nature of the problem situation. The ‘working definition...... at play in a design situation, and extract themes that can lead to reformulation of the problem as well as the creation of innovative solutions. This behaviour is compared to the ways of working of novice designers (students) in the original case study....

The Impact of Novice Counselors' Note-Taking Behavior on Recall and Judgment

Science.gov (United States)

Lo, Chu-Ling; Wadsworth, John

2014-01-01

Purpose: To examine the effect of note-taking on novice counselors' recall and judgment of interview information in four situations: no notes, taking notes, taking notes and reviewing these notes, and reviewing notes taken by others. Method: The sample included 13 counselors-in-training recruited from a master's level training program in…

Chronic stress and coping among cardiac surgeons: a single center study

Directory of Open Access Journals (Sweden)

Kyriakos Spiliopoulos

2014-09-01

Full Text Available Introduction: Cardiac surgeons stress may impair their quality of life and professional practice. Objective: To assess perceived chronic stress and coping strategies among cardiac surgeons. Methods: Twenty-two cardiac surgeons answered two self-assessment questionnaires, the Trier Inventory for Chronic Stress and the German SGV for coping strategies. Results: Participants mean age was 40±14.1 years and 13 were male; eight were senior physicians and 14 were residents. Mean values for the Trier Inventory for Chronic Stress were within the normal range. Unexperienced physicians had significantly higher levels of dissatisfaction at work, lack of social recognition, and isolation (P<0.05. Coping strategies such as play down, distraction from situation, and substitutional satisfaction were also significantly more frequent among unexperienced surgeons. "Negative" stress-coping strategies occur more often in experienced than in younger colleagues (P=0.029. Female surgeons felt more exposed to overwork (P=0.04 and social stress (P=0.03. Conclusion: Cardiac surgeons show a tendency to high perception of chronic stress phenomena and vulnerability for negative coping strategies.

Projections of Demand for Cardiovascular Surgery and Supply of Surgeons

Directory of Open Access Journals (Sweden)

Jung Jeung Lee

2016-12-01

Full Text Available Background: While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. Methods: After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. Results: The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040—an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309—an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Conclusion: Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time

English law for the surgeon II: clinical negligence.

Science.gov (United States)

Jerjes, Waseem; Mahil, Jaspal; Upile, Tahwinder

2011-12-21

Traditionally, in the United Kingdom and Europe, the surgeon was generally not troubled by litigation from patients presenting as elective as well as emergency cases, but this aspect of custom has changed. Litigation by patients now significantly affects surgical practice and vicarious liability often affects hospitals. We discuss some fundamental legal definitions, a must to know for a surgeon, and highlight some interesting cases.

Psychomotor skills assessment in practicing surgeons experienced in performing advanced laparoscopic procedures.

Science.gov (United States)

Gallagher, Anthony G; Smith, C Daniel; Bowers, Steven P; Seymour, Neal E; Pearson, Adam; McNatt, Steven; Hananel, David; Satava, Richard M

2003-09-01

Minimally invasive surgery (MIS) has introduced a new and unique set of psychomotor skills for a surgeon to acquire and master. Although assessment technologies have been proposed, precise and objective psychomotor skills assessment of surgeons performing laparoscopic procedures has not been detailed. Two hundred ten surgeons attending the 2001 annual meeting of the American College of Surgeons in New Orleans who reported having completed more than 50 laparoscopic procedures participated. Subjects were required to complete one box-trainer laparoscopic cutting task and a similar virtual reality task. These tasks were specifically designed to test only psychomotor and not cognitive skills. Both tasks were completed twice. Performance of tasks was assessed and analyzed. Demographic and laparoscopic experience data were also collected. Complete data were available on 195 surgeons. In this group, surgeons performed the box-trainer task better with their dominant hand (p psychomotor skills is now possible. Surgeons who had performed more than 50 laparoscopic procedures showed considerable variability in their performance on a simple laparoscopic and virtual reality task. Approximately 10% of surgeons tested performed the task significantly worse than the group's average performance. Studies such as this may form the methodology for establishing criteria levels and performance objectives in objective assessment of the technical skills component of determining surgical competence.

Sustainability of Routine Notification and Request legislation on eye bank tissue supply and corneal transplantation wait times in Canada.

Science.gov (United States)

Lee, Kenneth; Boimer, Corey; Hershenfeld, Samantha; Sharpen, Linda; Slomovic, Allan R

2011-10-01

To assess whether provinces with Routine Notification and Request (RNR) legislation have sustained increases in corneal tissue supply and decreases in wait times for corneal transplantation surgery. Cross-sectional survey of Canadian corneal transplant (CT) surgeons and eye banks. Canadian CT surgeons and representatives from the 10 Canadian eye banks. Voluntary and anonymous surveys were distributed between July and October 2009. Eligible CT surgeons were defined as ophthalmologists who practice in Canada; currently perform Penetrating keratoplasty (PKP), Deep anterior lamellar keratoplasty (DALK), Deep lamellar endothelial keratoplasty (DLEK), Descemet stripping endothelial keratoplasty (DSEK), or Descemet membrane endothelial keratoplasty (DMEK); and have obtained tissues from a Canadian eye bank. From 2006 to 2009, for provinces with RNR legislation and where data are available, mean wait times from date of diagnosis to date of CT surgery have increased: in Ontario, from 31 ± 34 weeks to 36 ± 27 weeks; in British Columbia, from 39 ± 20 weeks to 42 ± 35 weeks; in Manitoba, from 32 ± 23 weeks to 49 ± 36 weeks. In addition, the amount of corneal tissue in RNR provinces suitable for transplant, with the exception of British Columbia, has declined between 2006 and 2008: in Ontario, 1186 tissues to 999 tissues (16% decline); in Manitoba, 92 tissues to 83 tissues (10% decline); in New Brunswick, 129 tissues to 98 tissues (24% decline). Although initially effective, RNR legislation has not sustained an increase in corneal tissue availability nor has it shortened wait times in most provinces. Incorporation of community hospitals into the RNR catchment, improved enforcement, and continued education of hospital staff regarding the RNR process may be effective in making this legislation more sustainable in the long term. Copyright © 2011 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Estimating Tool-Tissue Forces Using a 3-Degree-of-Freedom Robotic Surgical Tool.

Science.gov (United States)

Zhao, Baoliang; Nelson, Carl A

2016-10-01

Robot-assisted minimally invasive surgery (MIS) has gained popularity due to its high dexterity and reduced invasiveness to the patient; however, due to the loss of direct touch of the surgical site, surgeons may be prone to exert larger forces and cause tissue damage. To quantify tool-tissue interaction forces, researchers have tried to attach different kinds of sensors on the surgical tools. This sensor attachment generally makes the tools bulky and/or unduly expensive and may hinder the normal function of the tools; it is also unlikely that these sensors can survive harsh sterilization processes. This paper investigates an alternative method by estimating tool-tissue interaction forces using driving motors' current, and validates this sensorless force estimation method on a 3-degree-of-freedom (DOF) robotic surgical grasper prototype. The results show that the performance of this method is acceptable with regard to latency and accuracy. With this tool-tissue interaction force estimation method, it is possible to implement force feedback on existing robotic surgical systems without any sensors. This may allow a haptic surgical robot which is compatible with existing sterilization methods and surgical procedures, so that the surgeon can obtain tool-tissue interaction forces in real time, thereby increasing surgical efficiency and safety.

Was the real Sherlock Holmes a pediatric surgeon?

Science.gov (United States)

Raffensperger, John

2010-07-01

This article reviews the pioneering efforts of Joseph Bell, the model for Sherlock Holmes, in the surgical care of children during the antiseptic era. I reviewed biographies of Sir Arthur Conan Doyle; the biography of Joseph Bell; his surgical textbook, Edinburgh Medical Journals; and the history of the Royal Edinburgh Hospital for Sick Children. Dr Bell was a colleague of Joseph Lister and one of the first surgeons to apply antiseptic methods to operations involving children. He was the surgeon appointed to the first surgical ward of the Royal Edinburgh Hospital for Sick Children; in that role, he cared for many children with surgical diseases. Dr Joseph Bell, by his compassion for children and his surgical skill, was indeed a pioneer pediatric surgeon. Copyright 2010 Elsevier Inc. All rights reserved.

The anatomy lessons of the Amsterdam Guild of Surgeons

NARCIS (Netherlands)

IJpma, F.F.A.

2014-01-01

Mandatory lessons in anatomy, taught by the praelector anatomiae (lecturer in anatomy) of the Amsterdam Guild of Surgeons, were an important part of the surgical training starting in the 16th century. We describe how surgeons were trained approximately 350 years ago at the Surgeons’ Guild. The role

Review of CD Rom: The Virtual Surgeon: ACL Reconstruction ...

African Journals Online (AJOL)

THE VIRTUAL SURGEON: ACL RECONSTRUCTION Professor George Bentley ChM FRCS, Russell E LVindsor MD, Mr Andrew Williams FRCS(0rth); 4150 + VAT(UK) The Virtual Surgeon - 3D Anatomy of the Knee 469 + VAT(UK). TVF Multimedia Ltd, 375 City Road, London, EClV lNB, UK ...

Evaluation of muscle activity during a standardized shoulder resistance training bout in novice individuals

DEFF Research Database (Denmark)

Jakobsen, Markus D; Sundstrup, Emil; Andersen, Christoffer H

2012-01-01

training bout. The purpose of this study was to evaluate muscle activity during a shoulder resistance training bout with 15 repetitions maximum (RM) loadings in novice individuals. Twelve healthy sedentary women (age = 27-58 years; weight = 54-85 kg; height = 160-178 cm) were recruited for this study...

Charting an Arid Landscape: The Preparation of Novice Primary Principals in Western Australia

Science.gov (United States)

Wildy, Helen; Clarke, Simon

2008-01-01

This paper examines the complex matter of initial principal preparation in a context where traditionally beginning principals have learned their role from experience, on the job. Using data from both novice and experienced primary principals it was found that while what was needed in the job was agreed upon--how to deal with place, with people,…

Non-technical skills of surgical trainees and experienced surgeons.

Science.gov (United States)

Gostlow, H; Marlow, N; Thomas, M J W; Hewett, P J; Kiermeier, A; Babidge, W; Altree, M; Pena, G; Maddern, G

2017-05-01

In addition to technical expertise, surgical competence requires effective non-technical skills to ensure patient safety and maintenance of standards. Recently the Royal Australasian College of Surgeons implemented a new Surgical Education and Training (SET) curriculum that incorporated non-technical skills considered essential for a competent surgeon. This study sought to compare the non-technical skills of experienced surgeons who completed their training before the introduction of SET with the non-technical skills of more recent trainees. Surgical trainees and experienced surgeons undertook a simulated scenario designed to challenge their non-technical skills. Scenarios were video recorded and participants were assessed using the Non-Technical Skills for Surgeons (NOTSS) scoring system. Participants were divided into subgroups according to years of experience and their NOTSS scores were compared. For most NOTSS elements, mean scores increased initially, peaking around the time of Fellowship, before decreasing roughly linearly over time. There was a significant downward trend in score with increasing years since being awarded Fellowship for six of the 12 NOTSS elements: considering options (score -0·015 units per year), implementing and reviewing decisions (-0·020 per year), establishing a shared understanding (-0·014 per year), setting and maintaining standards (-0·024 per year), supporting others (-0·031 per year) and coping with pressure (-0·015 per year). The drop in NOTSS score was unexpected and highlights that even experienced surgeons are not immune to deficiencies in non-technical skills. Consideration should be given to continuing professional development programmes focusing on non-technical skills, regardless of the level of professional experience. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

Expert-novice differences in brain function of field hockey players.

Science.gov (United States)

Wimshurst, Z L; Sowden, P T; Wright, M

2016-02-19

The aims of this study were to use functional magnetic resonance imaging to examine the neural bases for perceptual-cognitive superiority in a hockey anticipation task. Thirty participants (15 hockey players, 15 non-hockey players) lay in an MRI scanner while performing a video-based task in which they predicted the direction of an oncoming shot in either a hockey or a badminton scenario. Video clips were temporally occluded either 160 ms before the shot was made or 60 ms after the ball/shuttle left the stick/racquet. Behavioral data showed a significant hockey expertise×video-type interaction in which hockey experts were superior to novices with hockey clips but there were no significant differences with badminton clips. The imaging data on the other hand showed a significant main effect of hockey expertise and of video type (hockey vs. badminton), but the expertise×video-type interaction did not survive either a whole-brain or a small-volume correction for multiple comparisons. Further analysis of the expertise main effect revealed that when watching hockey clips, experts showed greater activation in the rostral inferior parietal lobule, which has been associated with an action observation network, and greater activation than novices in Brodmann areas 17 and 18 and middle frontal gyrus when watching badminton videos. The results provide partial support both for domain-specific and domain-general expertise effects in an action anticipation task. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Patient-specific hip prostheses designed by surgeons

Directory of Open Access Journals (Sweden)

Coigny Florian

2016-09-01

Full Text Available Patient-specific bone and joint replacement implants lead to better functional and aesthetic results than conventional methods [1], [2], [3]. But extracting 3D shape information from CT Data and designing individual implants is demanding and requires multiple surgeon-to-engineer interactions. For manufacturing purposes, Additive Manufacturing offers various advantages, especially for low volume manufacturing parts, such as patient specific implants. To ease these new approaches and to avoid surgeon-to-engineer interactions a new design software approach is needed which offers highly automated and user friendly planning steps.

Orthopaedic traumatology: fundamental principles and current controversies for the acute care surgeon.

Science.gov (United States)

Pharaon, Shad K; Schoch, Shawn; Marchand, Lucas; Mirza, Amer; Mayberry, John

2018-01-01

Multiply injured patients with fractures are co-managed by acute care surgeons and orthopaedic surgeons. In most centers, orthopaedic surgeons definitively manage fractures, but preliminary management, including washouts, splinting, reductions, and external fixations, may be performed by selected acute care surgeons. The acute care surgeon should have a working knowledge of orthopaedic terminology to communicate with colleagues effectively. They should have an understanding of the composition of bone, periosteum, and cartilage, and their reaction when there is an injury. Fractures are usually fixed urgently, but some multiply injured patients are better served with a damage control strategy. Extremity compartment syndrome should be suspected in all critically injured patients with or without fractures and a low threshold for compartment pressure measurements or empiric fasciotomy maintained. Acute care surgeons performing rib fracture fixation and other chest wall injury reconstructions should follow the principles of open fracture reduction and stabilization.

Orthopaedic traumatology: fundamental principles and current controversies for the acute care surgeon

Science.gov (United States)

Pharaon, Shad K; Schoch, Shawn; Marchand, Lucas; Mirza, Amer

2018-01-01

Multiply injured patients with fractures are co-managed by acute care surgeons and orthopaedic surgeons. In most centers, orthopaedic surgeons definitively manage fractures, but preliminary management, including washouts, splinting, reductions, and external fixations, may be performed by selected acute care surgeons. The acute care surgeon should have a working knowledge of orthopaedic terminology to communicate with colleagues effectively. They should have an understanding of the composition of bone, periosteum, and cartilage, and their reaction when there is an injury. Fractures are usually fixed urgently, but some multiply injured patients are better served with a damage control strategy. Extremity compartment syndrome should be suspected in all critically injured patients with or without fractures and a low threshold for compartment pressure measurements or empiric fasciotomy maintained. Acute care surgeons performing rib fracture fixation and other chest wall injury reconstructions should follow the principles of open fracture reduction and stabilization. PMID:29766123

The Effect of Price on Surgeons' Choice of Implants: A Randomized Controlled Survey.

Science.gov (United States)

Wasterlain, Amy S; Melamed, Eitan; Bello, Ricardo; Karia, Raj; Capo, John T

2017-08-01

Surgical costs are under scrutiny and surgeons are being held increasingly responsible for cost containment. In some instances, implants are the largest component of total procedure cost, yet previous studies reveal that surgeons' knowledge of implant prices is poor. Our study aims to (1) understand drivers behind implant selection and (2) assess whether educating surgeons about implant costs affects implant selection. We surveyed 226 orthopedic surgeons across 6 continents. The survey presented 8 clinical cases of upper extremity fractures with history, radiographs, and implant options. Surgeons were randomized to receive either a version with each implant's average selling price ("price-aware" group), or a version without prices ("price-naïve" group). Surgeons selected a surgical implant and ranked factors affecting implant choice. Descriptive statistics and univariate, multivariable, and subgroup analyses were performed. For cases offering implants within the same class (eg, volar locking plates), price-awareness reduced implant cost by 9% to 11%. When offered different models of distal radius volar locking plates, 25% of price-naïve surgeons selected the most expensive plate compared with only 7% of price-aware surgeons. For cases offering different classes of implants (eg, plate vs external fixator), there was no difference in implant choice between price-aware and price-naïve surgeons. Familiarity with the implant was the most common reason for choosing an implant in both groups (35% vs 46%). Price-aware surgeons were more likely to rank cost as a factor (29% vs 21%). Price awareness significantly influences surgeons' choice of a specific model within the same implant class. Merely including prices with a list of implants leads surgeons to select less expensive implants. This implies that an untapped opportunity exists to reduce surgical expenditures simply by enhancing surgeons' cost awareness. Economic/Decision Analyses I. Copyright © 2017 American

Anatomy of the Gynecomastia Tissue and Its Clinical Significance

Science.gov (United States)

Blau, Mordecai; Hazani, Ron

2016-01-01

Background: Gynecomastia is a very common entity in men, and several authors estimate that approximately 50% to 70% of the male population has palpable breast tissue. Much has been published with regard to the etiology, diagnosis, and treatment of gynecomastia. However, the anatomy of the gynecomastia tissue remains elusive to most surgeons. Purpose: The purpose of this article was to define the shape and consistency of the glandular tissue based on the vast experience of the senior author (MB). Patients and Methods: Between the years 1980 and 2014, a total of 5124 patients have been treated for gynecomastia with surgical excision, liposuction, or a combination of both. A total of 3130 specimens were collected with 5% of the cases being unilateral. Results: The specimens appear to have a unifying shape of a head, body, and tail. The head is semicircular in shape and is located more medially toward the sternum. The majority of the glandular tissue consists of a body located immediately deep to the nipple areolar complex. The tail appears to taper off of the body more laterally and toward the insertion of the pectoralis major muscle onto the humerus. Conclusions: This large series of gynecomastia specimens demonstrates a unique and unifying finding of a head, body, and tail. Understanding the anatomy of the gynecomastia gland can serve as a guide to gynecomastia surgeons to facilitate a more thorough exploration and subsequently sufficient gland excision. PMID:27622122

Contemporary use of social media by consultant colorectal surgeons.

Science.gov (United States)

McDonald, J J; Bisset, C; Coleman, M G; Speake, D; Brady, R R W

2015-02-01

There is evidence of significant growth in the engagement of UK health-care professionals with 'open' social media platforms, such as Twitter and LinkedIn. Social media communication provides many opportunities and benefits for medical education and interaction with patients and colleagues. This study was undertaken to evaluate the uptake of public social media membership and the characteristics of use of such media channels amongst contemporary UK consultant colorectal surgeons. Colorectal surgeons were identified from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) national registry of colorectal mortality outcomes and were cross-referenced with the General Medical Council (GMC) register. Individuals were identified by manual searching on a number of social media platforms. Matching accounts were then examined to confirm ownership and to evaluate key markers of use. Six-hundred and eighteen individual consultant colorectal surgeons from 142 health authorities were studied (79.5% were ACPGBI members and 90.8% were male). Two-hundred and twenty-nine (37.1%) had LinkedIn profiles (37.7% male surgeons, 29.8% female surgeons; P = 0.2530). LinkedIn membership was significantly higher in ACPGBI members (P social media than reported studies from other health-care professional groups. Further education and appropriate guidance on usage may encourage uptake and confidence, particularly in younger consultants. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

Effect of Thoracic Surgeons on Lung Cancer Patients’ Survival

Directory of Open Access Journals (Sweden)

Ning LI

2018-02-01

Full Text Available Background and objective Surgeons are the direct decision-makers and performers in the surgical treatment of patients with lung cancer. Whether the differences among doctors affect the survival of patients is unclear. This study analyzed the five-year survival rates of different thoracic surgeries in patients undergoing surgery to assess the physician's impact and impact. Methods A retrospective analysis of five years between 2002-2007 in the Department of Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, for surgical treatment of lung cancer patients. According to different surgeons grouping doctors to compare the basic information of patients, surgical methods, short-term results and long-term survival differences. Results A total of 712 patients treated by 11 experienced thoracic surgeons were included in this study. The patients have nosignificant difference with gender, age, smoking, pathological type between groups. There were significant differences in clinical staging, surgery type, operation time, blood transfusion rate, number of lymph node dissection, palliative resection rate, postoperative complications and perioperative mortality. There was a significant difference in five-year survival rates among patients treated by different doctors. This difference can be seen in all clinical stage analyzes with consistency. In the multivariate analysis, it was suggested that surgeon was an independent factor influencing the prognosis of patients. Conclusion Thoracic surgeon has a significant effect on the therapeutic effect of lung cancer patients.

Comprehensive review of methicillin-resistant Staphylococcus aureus: screening and preventive recommendations for plastic surgeons and other surgical health care providers.

Science.gov (United States)

O'Reilly, Eamon B; Johnson, Mark D; Rohrich, Rod J

2014-11-01

Up to 2.3 million people are colonized with methicillin-resistant Staphylococcus aureus in the United States, causing well-documented morbidity and mortality. Although the association of clinical outcomes with community and hospital carriage rates is increasingly defined, less is reported about asymptomatic colonization prevalence among physicians, and specifically plastic surgeons and the subsequent association with the incidence of patient surgical-site infection. A review of the literature using the PubMed and Cochrane databases analyzing provider screening, transmission, and prevalence was undertaken. In addition, a search was completed for current screening and decontamination guidelines and outcomes. The methicillin-resistant S. aureus carriage prevalence of surgical staff is 4.5 percent. No prospective data exist regarding transmission and interventions for plastic surgeons. No studies were found specifically looking at prevalence or treatment of plastic surgeons. Current recommendations by national organizations focus on patient-oriented point-of-care testing and intervention, largely ignoring the role of the health care provider. Excellent guidelines exist regarding screening, transmission prevention, and treatment both in the workplace and in the community. No current such guidelines exist for plastic surgeons. No Level I or II evidence was found regarding physician screening, treatment, or transmission. Current expert opinion, however, indicates that plastic surgeons and their staff should be vigilant for methicillin-resistant S. aureus transmission, and once a sentinel cluster of skin and soft-tissue infections is identified, systematic screening and decontamination should be considered. If positive, topical decolonization therapy should be offered. In refractory cases, oral antibiotic therapy may be required, but this should not be used as a first-line strategy.

Classifying BCI signals from novice users with extreme learning machine

Directory of Open Access Journals (Sweden)

Rodríguez-Bermúdez Germán

2017-07-01

Full Text Available Brain computer interface (BCI allows to control external devices only with the electrical activity of the brain. In order to improve the system, several approaches have been proposed. However it is usual to test algorithms with standard BCI signals from experts users or from repositories available on Internet. In this work, extreme learning machine (ELM has been tested with signals from 5 novel users to compare with standard classification algorithms. Experimental results show that ELM is a suitable method to classify electroencephalogram signals from novice users.

Outlier experienced surgeon's performances impact on benchmark for technical surgical skills training.

Science.gov (United States)

Gallagher, Anthony G; Henn, Patrick J; Neary, Paul C; Senagore, Anthony J; Marcello, Peter W; Bunting, Brendan P; Seymour, Neal E; Satava, Richard M

2018-03-23

Training in medicine must move to an outcome-based approach. A proficiency-based progression outcome approach to training relies on a quantitative estimation of experienced operator performance. We aimed to develop a method for dealing with atypical expert performances in the quantitative definition of surgical proficiency. In study one, 100 experienced laparoscopic surgeons' performances on virtual reality and box-trainer simulators were assessed for two similar laparoscopic tasks. In study two, 15 experienced surgeons and 16 trainee colorectal surgeons performed one simulated hand-assisted laparoscopic colorectal procedure. Performance scores of experienced surgeons in both studies were standardized (i.e. Z-scores) using the mean and standard deviations (SDs). Performances >1.96 SDs from the mean were excluded in proficiency definitions. In study one, 1-5% of surgeons' performances were excluded having performed significantly below their colleagues. Excluded surgeons made significantly fewer correct incisions (mean = 7 (SD = 2) versus 19.42 (SD = 4.6), P 4 SDs for time to complete the procedure and >6 SDs for path length. After their exclusions, experienced surgeons' performances were significantly better than trainees for path length: P = 0.031 and for time: P = 0.002. Objectively assessed atypical expert performances were few. Z-score standardization identified them and produced a more robust quantitative definition of proficiency. © 2018 Royal Australasian College of Surgeons.

Using Texting for Clinical Communication in Surgery: A Survey of Academic Staff Surgeons.

Science.gov (United States)

Firdouse, Mohammed; Devon, Karen; Kayssi, Ahmed; Goldfarb, Jeremy; Rossos, Peter; Cil, Tulin D

2018-03-01

Text messaging has become ubiquitous and is being increasingly used within the health care system. The purpose of this study was to understand texting practices for clinical communication among staff surgeons at a large academic institution. Staff surgeons in 4 subspecialties (vascular, plastics, urology, and general surgery) were surveyed electronically. A total of 62 surgeons from general surgery (n = 33), vascular surgery (n = 6), plastic surgery (n = 13), and urology (n = 10) completed the study (response rate 30%). When conveying urgent patient-related information, staff surgeons preferred directly calling other staff surgeons (61.5%) and trainees (58.8%). When discussing routine patient information, staff surgeons used email to reach other staff surgeons (54.9%) but preferred texting (62.7%) for trainees. The majority of participants used texting because it is fast (65.4%), convenient (69.2%) and allows transmitting information to multiple recipients simultaneously (63.5%). Most felt that texting enhances patient care (71.5%); however, only half believed that it enhanced trainees' educational experiences. The majority believed that texting identifiable patient information breaches patient confidentiality. Our data showed high adoption of text messaging for clinical communication among surgeons, particularly with trainees. The majority of surgeons acknowledge security concerns inherent in texting for patient care. Existing mobile communication platforms fail to meet the needs of academic surgeons. Further research should include guidelines related to texting in clinical practice, educational implications of texting, and technologies to better meet the needs of clinicians working in an academic surgical settings.

Validation of the da Vinci Surgical Skill Simulator across three surgical disciplines: A pilot study

Science.gov (United States)

Alzahrani, Tarek; Haddad, Richard; Alkhayal, Abdullah; Delisle, Josée; Drudi, Laura; Gotlieb, Walter; Fraser, Shannon; Bergman, Simon; Bladou, Frank; Andonian, Sero; Anidjar, Maurice

2013-01-01

Objective: In this paper, we evaluate face, content and construct validity of the da Vinci Surgical Skills Simulator (dVSSS) across 3 surgical disciplines. Methods: In total, 48 participants from urology, gynecology and general surgery participated in the study as novices (0 robotic cases performed), intermediates (1–74) or experts (≥75). Each participant completed 9 tasks (Peg board level 2, match board level 2, needle targeting, ring and rail level 2, dots and needles level 1, suture sponge level 2, energy dissection level 1, ring walk level 3 and tubes). The Mimic Technologies software scored each task from 0 (worst) to 100 (best) using several predetermined metrics. Face and content validity were evaluated by a questionnaire administered after task completion. Wilcoxon test was used to perform pair wise comparisons. Results: The expert group comprised of 6 attending surgeons. The intermediate group included 4 attending surgeons, 3 fellows and 5 residents. The novices included 1 attending surgeon, 1 fellow, 13 residents, 13 medical students and 2 research assistants. The median number of robotic cases performed by experts and intermediates were 250 and 9, respectively. The median overall realistic score (face validity) was 8/10. Experts rated the usefulness of the simulator as a training tool for residents (content validity) as 8.5/10. For construct validity, experts outperformed novices in all 9 tasks (p < 0.05). Intermediates outperformed novices in 7 of 9 tasks (p < 0.05); there were no significant differences in the energy dissection and ring walk tasks. Finally, experts scored significantly better than intermediates in only 3 of 9 tasks (matchboard, dots and needles and energy dissection) (p < 0.05). Conclusions: This study confirms the face, content and construct validities of the dVSSS across urology, gynecology and general surgery. Larger sample size and more complex tasks are needed to further differentiate intermediates from experts. PMID:23914275

A study of psychomotor skills in minimally invasive surgery: what differentiates expert and nonexpert performance.

Science.gov (United States)

Hofstad, Erlend Fagertun; Våpenstad, Cecilie; Chmarra, Magdalena Karolina; Langø, Thomas; Kuhry, Esther; Mårvik, Ronald

2013-03-01

A high level of psychomotor skills is required to perform minimally invasive surgery (MIS) safely. To assure high quality of skills, it is important to be able to measure and assess these skills. For that, it is necessary to determine aspects that indicate the difference between performances at various levels of proficiency. Measurement and assessment of skills in MIS are best done in an automatic and objective way. The goal of this study was to investigate a set of nine motion-related metrics for their relevance to assess psychomotor skills in MIS during the performance of a labyrinth task. Thirty-two surgeons and medical students were divided into three groups according to their level of experience in MIS; experts (>500 MIS procedures), intermediates (31-500 MIS), and novices (no experience in MIS). The participants performed the labyrinth task in the D-box Basic simulator (D-Box Medical, Lier, Norway). The task required bimanual maneuvering and threading a needle through a labyrinth of 10 holes. Nine motion-related metrics were used to assess the MIS skills of each participant. Experts (n = 7) and intermediates (n = 14) performed significantly better than the novices (n = 11) in terms of time and parameters measuring the amount of instrument movement. The experts had significantly better bimanual dexterity, which indicated that they made more simultaneous movements of the two instruments compared to the intermediates and novices. The experts also performed the task with a shorter instrument path length with the nondominant hand than the intermediates. The surgeon's performance in MIS can be distinguished from a novice by metrics such as time and path length. An experienced surgeon in MIS can be differentiated from a less experienced one by the higher ability to control the instrument in the nondominant hand and the higher degree of simultaneous (coordinated) movements of the two instruments.

Decreased heart rate variability in surgeons during night shifts

DEFF Research Database (Denmark)

Amirian, Ilda; Toftegård Andersen, Lærke; Rosenberg, Jacob

2014-01-01

BACKGROUND: Heart rate variability (HRV) has been used as a measure of stress and mental strain in surgeons. Low HRV has been associated with death and increased risk of cardiac events in the general population. The aim of this study was to clarify the effect of a 17-hour night shift on surgeons'...

Tissue Banking in Malaysia-amniotic membrane

International Nuclear Information System (INIS)

Hashim bin Mohamad; Norimah binti Yusof

1991-01-01

Burn treatment using amniotic membranes in some of our patients initiate our own tissue bank starting with a pilot project on procurement, processing and clinical application of irradiated amniotic membrane. The irradiation of amniotic membrane was made possible by the availability of cobalt source at the Nuclear Energy Agency (UTN). With the technical help from the Inter-national Atomic Energy Agency (IAEA) we soon should be able to embark on bone bank to supply local surgeons. Thus the establishment of tissue bank at our institution will further enhance our programme which will include keratinocytes culture for burn, osteocytes culture for bone replacement as well as the use of animal skin for temporary coverage of open wounds

Surgeon Experience and Complications of Transvaginal Prolapse Mesh.

Science.gov (United States)

Kelly, Erin C; Winick-Ng, Jennifer; Welk, Blayne

2016-07-01

To measure the proportion of women with transvaginal prolapse mesh complications and their association with surgeon volume. We conducted a retrospective, population-based cohort study of all women who underwent a mesh-based prolapse procedure using administrative data (hospital procedure and physician billing records) between 2002 and 2013 in Ontario, Canada. The primary outcome was surgical revision of the mesh. Primary exposure was surgeon volume: high (greater than the 75th percentile, requiring a median of five [interquartile range 5-6] procedures per year) and very high (greater than the 90th percentile, requiring a median of 13 [interquartile range 11-14] procedures per year) volume mesh implanters were identified each year. Primary analysis was an adjusted Cox proportional hazards model. A total of 5,488 women underwent mesh implantation by 1 of 368 unique surgeons. Median follow-up time was 5.4 (interquartile range 3.0-8.0) years. We found that 218 women (4.0%) underwent mesh reoperation a median of 1.17 (interquartile range 0.58-2.90) years after implantation. The hazard of reoperation for complications was only lower for patients of very high-volume surgeons (3.0% [145/3,001] compared with 4.8% [73/2,447], adjusted hazards ratio 0.59, 95% confidence interval 0.40-0.86). In multivariable modeling, younger age, concomitant hysterectomy, blood transfusion, and increased medical comorbidity were all associated with vaginal mesh reoperation. Approximately 5% of women who underwent mesh-based prolapse surgery required reoperation for a mesh complication within 10 years. The risk of reoperation was lowest for surgeons performing 14 or more procedures per year.

Antimicrobial Stewardship: A Call to Action for Surgeons

Science.gov (United States)

Duane, Therese M.; Catena, Fausto; Tessier, Jeffrey M.; Coccolini, Federico; Kao, Lillian S.; De Simone, Belinda; Labricciosa, Francesco M.; May, Addison K.; Ansaloni, Luca; Mazuski, John E.

2016-01-01

Abstract Despite current antimicrobial stewardship programs (ASPs) being advocated by infectious disease specialists and discussed by national and international policy makers, ASPs coverage remains limited to only certain hospitals as well as specific service lines within hospitals. The ASPs incorporate a variety of strategies to optimize antimicrobial agent use in the hospital, yet the exact set of interventions essential to ASP success remains unknown. Promotion of ASPs across clinical practice is crucial to their success to ensure standardization of antimicrobial agent use within an institution. To effectively accomplish this standardization, providers who actively engage in antimicrobial agent prescribing should participate in the establishment and support of these programs. Hence, surgeons need to play a major role in these collaborations. Surgeons must be aware that judicious antibiotic utilization is an integral part of any stewardship program and necessary to maximize clinical cure and minimize emergence of antimicrobial resistance. The battle against antibiotic resistance should be fought by all healthcare professionals. If surgeons around the world participate in this global fight and demonstrate awareness of the major problem of antimicrobial resistance, they will be pivotal leaders. If surgeons fail to actively engage and use antibiotics judiciously, they will find themselves deprived of the autonomy to treat their patients. PMID:27828764

A cohort of novice Danish science teachers

DEFF Research Database (Denmark)

Nielsen, Birgitte Lund

2011-01-01

A survey on science background and argumentation about science teaching was conducted on a local cohort of newly qualified Danish science teachers. The survey was administered before the novice teachers began their first jobs in primary and lower secondary schools and focused on their reflections...... on specific scenarios of science teaching and themselves as teachers in various science fields. Three areas of concern were identified:There was evidence of reflection upon and argumentation for the practice of science teaching being student centered, but many respondents showed a tendency to focus...... on students' activities as a goal in themselves, few considered what the students learned through the activities. Results furthermore suggest that the teachers' own assessment of their subject matter knowledge in the physics field may, for a large subgroup in the cohort, affect their approach to teaching...

Quantitative characterization of viscoelastic behavior in tissue-mimicking phantoms and ex vivo animal tissues.

Directory of Open Access Journals (Sweden)

Ashkan Maccabi

Full Text Available Viscoelasticity of soft tissue is often related to pathology, and therefore, has become an important diagnostic indicator in the clinical assessment of suspect tissue. Surgeons, particularly within head and neck subsites, typically use palpation techniques for intra-operative tumor detection. This detection method, however, is highly subjective and often fails to detect small or deep abnormalities. Vibroacoustography (VA and similar methods have previously been used to distinguish tissue with high-contrast, but a firm understanding of the main contrast mechanism has yet to be verified. The contributions of tissue mechanical properties in VA images have been difficult to verify given the limited literature on viscoelastic properties of various normal and diseased tissue. This paper aims to investigate viscoelasticity theory and present a detailed description of viscoelastic experimental results obtained in tissue-mimicking phantoms (TMPs and ex vivo tissues to verify the main contrast mechanism in VA and similar imaging modalities. A spherical-tip micro-indentation technique was employed with the Hertzian model to acquire absolute, quantitative, point measurements of the elastic modulus (E, long term shear modulus (η, and time constant (τ in homogeneous TMPs and ex vivo tissue in rat liver and porcine liver and gallbladder. Viscoelastic differences observed between porcine liver and gallbladder tissue suggest that imaging modalities which utilize the mechanical properties of tissue as a primary contrast mechanism can potentially be used to quantitatively differentiate between proximate organs in a clinical setting. These results may facilitate more accurate tissue modeling and add information not currently available to the field of systems characterization and biomedical research.

Quantitative characterization of viscoelastic behavior in tissue-mimicking phantoms and ex vivo animal tissues.

Science.gov (United States)

Maccabi, Ashkan; Shin, Andrew; Namiri, Nikan K; Bajwa, Neha; St John, Maie; Taylor, Zachary D; Grundfest, Warren; Saddik, George N

2018-01-01

Viscoelasticity of soft tissue is often related to pathology, and therefore, has become an important diagnostic indicator in the clinical assessment of suspect tissue. Surgeons, particularly within head and neck subsites, typically use palpation techniques for intra-operative tumor detection. This detection method, however, is highly subjective and often fails to detect small or deep abnormalities. Vibroacoustography (VA) and similar methods have previously been used to distinguish tissue with high-contrast, but a firm understanding of the main contrast mechanism has yet to be verified. The contributions of tissue mechanical properties in VA images have been difficult to verify given the limited literature on viscoelastic properties of various normal and diseased tissue. This paper aims to investigate viscoelasticity theory and present a detailed description of viscoelastic experimental results obtained in tissue-mimicking phantoms (TMPs) and ex vivo tissues to verify the main contrast mechanism in VA and similar imaging modalities. A spherical-tip micro-indentation technique was employed with the Hertzian model to acquire absolute, quantitative, point measurements of the elastic modulus (E), long term shear modulus (η), and time constant (τ) in homogeneous TMPs and ex vivo tissue in rat liver and porcine liver and gallbladder. Viscoelastic differences observed between porcine liver and gallbladder tissue suggest that imaging modalities which utilize the mechanical properties of tissue as a primary contrast mechanism can potentially be used to quantitatively differentiate between proximate organs in a clinical setting. These results may facilitate more accurate tissue modeling and add information not currently available to the field of systems characterization and biomedical research.

Psychophysical workload in the operating room: primary surgeon versus assistant.

Science.gov (United States)

Rieger, Annika; Fenger, Sebastian; Neubert, Sebastian; Weippert, Matthias; Kreuzfeld, Steffi; Stoll, Regina

2015-07-01

Working in the operating room is characterized by high demands and overall workload of the surgical team. Surgeons often report that they feel more stressed when operating as a primary surgeon than in the function as an assistant which has been confirmed in recent studies. In this study, intra-individual workload was assessed in both intraoperative functions using a multidimensional approach that combined objective and subjective measures in a realistic work setting. Surgeons' intraoperative psychophysiologic workload was assessed through a mobile health system. 25 surgeons agreed to take part in the 24-hour monitoring by giving their written informed consent. The mobile health system contained a sensor electronic module integrated in a chest belt and measuring physiological parameters such as heart rate (HR), breathing rate (BR), and skin temperature. Subjective workload was assessed pre- and postoperatively using an electronic version of the NASA-TLX on a smartphone. The smartphone served as a communication unit and transferred objective and subjective measures to a communication server where data were stored and analyzed. Working as a primary surgeon did not result in higher workload. Neither NASA-TLX ratings nor physiological workload indicators were related to intraoperative function. In contrast, length of surgeries had a significant impact on intraoperative physical demands (p NASA-TLX sum score (p < 0.01; η(2) = 0.287). Intra-individual workload differences do not relate to intraoperative role of surgeons when length of surgery is considered as covariate. An intelligent operating management that considers the length of surgeries by implementing short breaks could contribute to the optimization of intraoperative workload and the preservation of surgeons' health, respectively. The value of mobile health systems for continuous psychophysiologic workload assessment was shown.

Accompanying role of hepato-biliary-pancreas surgeon in urological surgery

Directory of Open Access Journals (Sweden)

Atsushi Nanashima

Full Text Available Introduction: The present case reports demonstrated the accompanying surgical support from hepato-biliary-pancreas (HBP surgeons for urological surgery to secure operative safety because HBP surgeons are well experienced in dissecting techniques for mobilization of the liver or pancreas. We experienced 9 consecutive patients who underwent nephrectomy, adrenectomy or resection of retroperitoneal tumors by urological surgeons. Cardiovascular intervention was also required in cases of long tumor thrombus into the vena cava. Cases: All patients had no severe co-existing diseases except the main tumor. Reverse T-shape incision was performed in 7 cases and thoracolaparotomy in two. Dissection and mobilization at the site of severe compression by the urinary tumors were performed in three cases. Partial liver resection was performed for testicular liver metastases in two, and right hepatectomy for right renal cancer was performed in one. Encircling the vena cava and preparation of transection for tumor thrombi were performed in three, and among these, cardiovascular intervention was necessary in two because of extension into the right atrium. During admission, all patient outcomes were uneventful without severe complications. We herein showed the representative two cases of combined surgery. Discussion: and conclusion The point of this case report is the coordination between each surgeon and anesthesiologist under precise perioperative planning or management. The role of HBP surgeons is to provide information as a specialist on the operative field for urological or cardiovascular surgery to achieve operative safety. Keywords: Hepato-biliary-pancreas surgeon, Joint surgery, Urology

Uncertain but able: Entrepreneurial self-efficacy and novices׳ use of expert decision-logic under uncertainty

NARCIS (Netherlands)

Engel, Y.; Dimitrova, N.G.; Khapova, S.N.; Elfring, T.

2014-01-01

Entrepreneurs' initial strategy choices are made in the face of inherently uncertain and fundamentally unpredictable futures. Yet, unlike experts, novice entrepreneurs still tend to rely on predictions and forecasts as they move their ideas through t h e venture creation process. This study examines

Action ethical dilemmas in surgery: an interview study of practicing surgeons

Directory of Open Access Journals (Sweden)

Nordam Ann

2005-07-01

Full Text Available Abstract Background The aim of this study was to describe the kinds of ethical dilemmas surgeons face during practice. Methods Five male and five female surgeons at a University hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of physicians and nurses about ethically difficult situations in surgical units. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation. Results No gender differences were found in the kinds of ethical dilemmas identified among male and female surgeons. The main finding was that surgeons experienced ethical dilemmas in deciding the right treatment in different situations. The dilemmas included starting or withholding treatment, continuing or withdrawing treatment, overtreatment, respecting the patients and meeting patients' expectations. The main focus in the narratives was on ethical dilemmas concerning the patients' well-being, treatment and care. The surgeons narrated about whether they should act according to their own convictions or according to the opinions of principal colleagues or colleagues from other departments. Handling incompetent colleagues was also seen as an ethical dilemma. Prioritization of limited resources and following social laws and regulations represented ethical dilemmas when they contradicted what the surgeons considered was in the patients' best interests. Conclusion The surgeons seemed confident in their professional role although the many ethical dilemmas they experienced in trying to meet the expectations of patients, colleagues and society also made them professionally and personally vulnerable.

Transitions Between Art and Pedagogy: Mentoring Music Teacher Novices in Austria

Directory of Open Access Journals (Sweden)

Isolde Malmberg

2017-12-01

Full Text Available Teacher education in Austria is currently undergoing a fundamental reform process. Investigations into teachers’ first experience in school indicate that the transition from university life to professional life is not smooth for teachers. In the arts, the adjustment seems to be even more complex (De Vugt, 2013. Artistically well-trained university graduates seem to have difficulty in applying their knowledge and artistic skills. Career crashes and a shortage of music teachers in Austria are some of the consequences (Bailer, 2009. Recently I commenced the Grounded Theory Study, mentoring in music, investigating how mentors act in the induction phase, as well as how mentees cope with it. Narrative interviews beyond mentors and mentees, expert interviews, as well as group discussions with mentor teams, show that mentoring in music education has to find ways to support trainee teachers’ transition between art and pedagogy since they are two fundamentally different practices (Benner, 2001. In this article, I present and discuss two main results of the study: First I show the multilayered status passage (Glaser & Strauss, 1971 that music teacher novices move through from their identity as music students to their identity as music teachers in schools. Second, I suggest and discuss four types of music teacher novices who cope with this status passage in music education differently and how they can be supported by mentors

Role of the plastic surgeon in a cancer hospital

International Nuclear Information System (INIS)

Sinclair, M.H.

1979-01-01

This paper discusses and illustrates the complicated problems faced by the plastic surgeon in a cancer hospital. His patients are often weakened, both physically and psychologically, not only by the cancer itself, but also by extensive ablative surgery. The goal of the plastic surgeon is rehabilitation of the patient after he is cured of cancer. Good planning with the cancer surgeon before the ablative operation is very important, as is immediate repair, whenever possible. The simplest procedure with the fewest stages that can accomplish satisfactory repair in the shortest time should be chosen, as we can never, even after the most extensive cancer operation, be sure that no recurrence will appear. Partial surgical repair and the use of a prosthesis should be considered for complicated defects in old and weak patients. Postoperative radiation therapy, if indicated, can be given after the flap has healed into the defect but before the pedicle is separated. The plastic surgeon should always be aware that his most important goal is speedy and satisfactory rehabilitation of the patient

[Women pioneers: first female cardiothoracic surgeons in the USA and in Israel].

Science.gov (United States)

Fertouk, Michal; Bekerman, Ziv; Kremer, Ran; Adler, Zvi; Bolotin, Gil

2014-08-01

At the beginning of the 1960's, three female doctors managed to break the glass ceiling and become the first female cardiothoracic surgeons in the USA. Since then, the number of certified female cardiothoracic surgeons has steadily increased. Nevertheless, females stilt only account for a minority of cardiothoracic surgeons in the USA. In Israel, three women have become specialists in cardiothoracic surgery over the last two decades, aLthough these surgeons are working as general thoracic surgery consultants, without any representative females in cardiac surgery.

Clinical decision making: how surgeons do it.

Science.gov (United States)

Crebbin, Wendy; Beasley, Spencer W; Watters, David A K

2013-06-01

Clinical decision making is a core competency of surgical practice. It involves two distinct types of mental process best considered as the ends of a continuum, ranging from intuitive and subconscious to analytical and conscious. In practice, individual decisions are usually reached by a combination of each, according to the complexity of the situation and the experience/expertise of the surgeon. An expert moves effortlessly along this continuum, according to need, able to apply learned rules or algorithms to specific presentations, choosing these as a result of either pattern recognition or analytical thinking. The expert recognizes and responds quickly to any mismatch between what is observed and what was expected, coping with gaps in information and making decisions even where critical data may be uncertain or unknown. Even for experts, the cognitive processes involved are difficult to articulate as they tend to be very complex. However, if surgeons are to assist trainees in developing their decision-making skills, the processes need to be identified and defined, and the competency needs to be measurable. This paper examines the processes of clinical decision making in three contexts: making a decision about how to manage a patient; preparing for an operative procedure; and reviewing progress during an operative procedure. The models represented here are an exploration of the complexity of the processes, designed to assist surgeons understand how expert clinical decision making occurs and to highlight the challenge of teaching these skills to surgical trainees. © 2013 The Authors. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

The impact of sleep deprivation on surgeons' performance during night shifts.

Science.gov (United States)

Amirian, Ilda

2014-09-01

The median incidence of adverse events that may result in patient injury is a total of 9% of all in-hospital admissions. In order to reduce this high incidence initiatives are continuously worked on that can reduce the risk of patient harm during admission by strengthening hospital systems. However, the influence of physicians' shift work on the risk on adverse events in patients remains controversial. In the studies included in this PhD thesis we wished to examine the impact of sleep deprivation and circadian rhythm disturbances on surgeons' during night shifts. Further we wished to examine the impact sleep deprivation had on surgeons' performance as a measure of how patient safety would be affected. We found that sleep deprivation subjectively had an impact on the surgeons and that they were aware of the effect fatigue had on their work performance. As a result they applied different mechanisms to cope with fatigue. Attending surgeons felt that they had a better overview now, due to more experience and better skills, than when they were residents, despite the fatigue on night shifts. We monitored surgeons' performance during night shifts by laparoscopic simulation and cognitive tests in order to assess their performance; no deterioration was found when pre call values were compared to on call values. The surgeons were monitored prospectively for 4 days across a night shift in order to assess the circadian rhythm and sleep. We found that surgeons' circadian rhythm was affected by working night shifts and their sleep pattern altered, resembling that of shift workers on the post call day. We assessed the quality of admission in medical records as a measure of surgeons' performance, during day, evening and night hours and found no deterioration in the quality of night time medical records. However, consistent high errors were found in several categories. These findings should be followed up in the future with respect of clarifying mechanism and consequences for

Clinical decision making of experienced and novice nurses.

Science.gov (United States)

Tabak, N; Bar-Tal, Y; Cohen-Mansfield, J

1996-10-01

Decision making is an important daily nursing activity. Given contradictory past findings concerning the ease of use cognitive schema for reaching decisions among experts and novices, we chose to examine consistency of information as a parameter that may clarify the process of decision making. Ninety-two experienced nurses and 65 nursing students rated their decisional difficulty and levels of certainty in reaching a diagnosis for two scenarios: one including consistent information and one providing information that was partly inconsistent with the given diagnosis. For the consistent information, students showed more difficulty and less certainty in the given diagnosis than the experienced nurses. The inconsistent scenario was perceived as more difficult by nurses in comparison to students. The cognitive processes responsible for these results are discussed.

Does surgeon volume matter in the outcome of endoscopic inguinal hernia repair?

Science.gov (United States)

Köckerling, F; Bittner, R; Kraft, B; Hukauf, M; Kuthe, A; Schug-Pass, C

2017-02-01

For open and endoscopic inguinal hernia surgery, it has been demonstrated that low-volume surgeons with fewer than 25 and 30 procedures, respectively, per year are associated with significantly more recurrences than high-volume surgeons with 25 and 30 or more procedures, respectively, per year. This paper now explores the relationship between the caseload and the outcome based on the data from the Herniamed Registry. The prospective data of patients in the Herniamed Registry were analyzed using the inclusion criteria minimum age of 16 years, male patient, primary unilateral inguinal hernia, TEP or TAPP techniques and availability of data on 1-year follow-up. In total, 16,290 patients were enrolled between September 1, 2009, and February 1, 2014. Of the participating surgeons, 466 (87.6 %) had carried out fewer than 25 endoscopic/laparoscopic operations (low-volume surgeons) and 66 (12.4 %) surgeons 25 or more operations (high-volume surgeons) per year. Univariable (1.03 vs. 0.73 %; p = 0.047) and multivariable analysis [OR 1.494 (1.065-2.115); p = 0.023] revealed that low-volume surgeons had a significantly higher recurrence rate compared with the high-volume surgeons, although that difference was small. Multivariable analysis also showed that pain on exertion was negatively affected by a lower caseload <25 [OR 1.191 (1.062-1.337); p = 0.003]. While here, too, the difference was small, the fact that in that group there was a greater proportion of patients with small hernia defect sizes may have also played a role since the risk in that group was higher. In this analysis, no evidence was found that pain at rest [OR 1.052 (0.903-1.226); p = 0.516] or chronic pain requiring treatment [OR 1.108 (0.903-1.361); p = 0.326] were influenced by the surgeon volume. As confirmed by previously published studies, the data in the Herniamed Registry also demonstrated that the endoscopic/laparoscopic inguinal hernia surgery caseload impacted the outcome. However

Assessment, surgeon, and society.

Science.gov (United States)

Norcini, John; Talati, Jamsheer

2009-08-01

An increasing public demand to monitor and assure the quality of care provided by physicians and surgeons has been accompanied by a deepening appreciation within the profession of the demands of self-regulation and the need for accountability. To respond to these developments, the public and the profession have turned increasingly to assessment, both to establish initial competence and to ensure that it is maintained throughout a career. Fortunately, this comes at a time when there have been significant advances in the breadth and quality of the assessment tools available. This article provides an overview of the drivers of change in assessment which includes the educational outcomes movement, the development of technology, and advances in assessment. It then outlines the factors that are important in selecting assessment devices as well as a system for classifying the methods that are available. Finally, the drivers of change have spawned a number of trends in the assessment of competence as a surgeon. Three of them are of particular note, simulation, workplace-based assessment, and the assessment of new competences, and each is reviewed with a focus on its potential.

Planning for success: desired characteristics of special operations surgeons, a pilot study.

Science.gov (United States)

Campbell, Barrett H; Alderman, Shawn M

2012-01-01

Selection criteria for Special Operations Forces (SOF) physicians are often unclear to potential candidates without prior SOF experience. To date, no published career resource exists to guide the careers of physicians interested in becoming a SOF surgeon. Using a survey tool, desirable characteristics and personal attributes were identified that can be used to inform candidate career decisions and better prepare them for a future position in Special Operations. A descriptive, cross-sectional survey instrument was developed and distributed to current Army SOF Command Surgeons for further distribution to subordinate surgeons. RESULTS were analyzed as a cohort and by subordinate command. Respondents consisted of current SOF Surgeons. Uniformly, the individual characteristics most strongly desired are professionalism, being a team player, and leadership. Possessing or obtaining Airborne and Flight Surgeon qualifications prior to consideration for a surgeon position was highly desired. Residency training within Family Medicine or Emergency Medicine constituted the vast majority of specialty preference. Understanding which characteristics and attributes are desirable to current surgeons and commanders can aid physicians interested in SOF surgeon positions. Using this study and future studies can guide career planning and foster the selection of ideally trained physicians who will operate at the tip of the spear. The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government. 2012.

Quality assurance of lower limb venous duplex scans performed by vascular surgeons.

Science.gov (United States)

Kordowicz, A; Ferguson, G; Salaman, R; Onwudike, M

2015-02-01

Duplex scanning is the gold standard for investigating venous reflux; increasingly surgeons perform these scans themselves. There has been no data published analysing the accuracy of Duplex scans performed by vascular surgeons. We aimed to evaluate an objective method of comparing the results of lower limb Duplex scans performed by one consultant vascular surgeon with those performed by a vascular technologist. We assessed 100 legs with symptomatic varicose veins. Each patient underwent two lower limb venous Duplex scans; one performed by a consultant vascular surgeon and one by a vascular technologist. Scan results were randomised and sent to two consultant vascular surgeons blinded to the identity and experience of the sonographer. They were asked to recommend treatment. A k score was calculated in each case to assess the level of agreement between the scans performed by the consultant and the technologist. Eighty-one patients were studied (53 females). The kappa score for assessor 1 was 0.60 (95%CI:0.44-0.75) and for assessor 2 was 0.62 (95%CI:0.48-0.75). k scores >0.60 represent a substantial strength of agreement. Duplex scans performed by this surgeon were comparable to those performed by a vascular technologist. It is possible to quality-assure duplex performed by vascular surgeons without directly observing the scanning process or reviewing digitally recorded images. We propose standardisation of training, assessment and quality assurance for vascular surgeons wishing to perform ultrasound scans.

South African novice driver behaviour: findings from a naturalistic driving study

CSIR Research Space (South Africa)

Venter, Karien

2014-07-01

Full Text Available experienced drivers in similar circumstances;  Informing the development of approaches that could improve driver training methods and systems in South Africa. 4. METHODOLOGY 4.1. Naturalistic Driving Studies NDS is a fairly new methodology... important that novice drivers should be able to not only obey the law, but should be able to recognise hazards associated with stop streets. Scan behaviour especially to the left and the right is considered important to cross and clear the intersection...

Mapping the work-based learning of novice teachers: charting some rich terrain.

Science.gov (United States)

Cook, Vivien

2009-12-01

Work-based non-formal learning plays a key role in faculty development yet these processes are yet to be described in detail in medical education. This study sets out to illuminate these processes so that potential benefits for new and inexperienced medical educators and their mentors can be realised. The non-formal learning processes of 12 novice teachers were investigated across hospital, general practice and medical school settings. The research sought to describe 'what' and 'how' non-formal learning takes place, and whether these processes differ across teaching sites. Both clinical and non-clinical teachers of medical undergraduates from one inner city medical school were recruited for the study. Through semi-structured interviews and a 'concept map', participants were asked to identify the people and tasks which they considered central to helping them become more expert as educators. Results identified non-formal learning across a number of key dimensions, including personal development, task and role performance, and optimising clinical teaching. This learning takes place as an outcome of experience, observation, reflection and student feedback. Non-formal learning is a significant aspect of the development of novice teachers and as such it needs to be placed more firmly upon the agenda of faculty development.

A prospective study on time to recovery in 254 injured novice runners.

Directory of Open Access Journals (Sweden)

Rasmus Oestergaard Nielsen

Full Text Available Describe the diagnoses and the time to recovery of running-related injuries in novice runners.Prospective cohort study on injured runners.This paper is a secondary data analysis of a 933-person cohort study (DANO-RUN aimed at characterizing risk factors for injury in novice runners. Among those sustaining running-related injuries, the types of injuries and time to recovery is described in the present paper. All injured runners were diagnosed after a thorough clinical examination and then followed prospectively during their recovery. If they recovered completely from injury, time to recovery of each injury was registered.A total of 254 runners were injured. The proportion of runners diagnosed with medial tibial stress syndrome was 15%, 10% for patellofemoral pain, 9% for medial meniscal injury, 7% for Achilles tendinopathy and 5% for plantar fasciitis. Among the 220 runners (87% recovering from their injury, the median time to recovery was 71 days (minimum  = 9 days, maximum  = 617 days.Medial tibial stress syndrome was the most common injury followed by patellofemoral pain, medial meniscal injury and Achilles tendinopathy. Half of the injured runners were unable to run 2×500 meters without pain after 10 weeks. Almost 5% of the injured runners received surgical treatment.

Do Surgeons React?: A Retrospective Analysis of Surgeons' Response to Harassment of a Colleague During Simulated Operating Theatre Scenarios.

Science.gov (United States)

Gostlow, Hannah; Vega, Camila Vega; Marlow, Nicholas; Babidge, Wendy; Maddern, Guy

2017-07-24

To assess and report on surgeons' ability to identify and manage incidences of harassment. The Royal Australasian College of Surgeons is committed to driving out discrimination, bullying, harassment, and sexual harassment from surgical training and practice, through changing the culture of the workplace. To eradicate these behaviors, it is first critical to understand how the current workforce responds to these actions. A retrospective analysis of video data of an operating theatre simulation was conducted to identify how surgeons, from a range of experience levels, react to instances of harassment. Thematic analysis was used to categorize types of harassment and participant response characteristics. The frequency of these responses was assessed and reported. The type of participant response depended on the nature of harassment being perpetuated and the seniority of the participant. In the 50 instances of scripted harassment, active responses were enacted 52% of the time, acknowledgment responses 16%, and no response enacted in 30%. One senior surgeon also perpetuated the harassment (2%). Trainees were more likely to respond actively compared with consultants. It is apparent that trainees are more aware of instances of harassment, and were more likely to intervene during the simulated scenario. However, a large proportion of harassment was unchallenged. The hierarchical nature of surgical education and the surgical workforce in general needs to enable a culture in which the responsibility to intervene is allowed and respected. Simulation-based education programs could be developed to train in the recognition and intervention of discrimination, bullying, harassment and sexual harassment.

CUE USAGE IN VOLLEYBALL: A TIME COURSE COMPARISON OF ELITE, INTERMEDIATE AND NOVICE FEMALE PLAYERS

Directory of Open Access Journals (Sweden)

P Vansteenkiste

2015-01-01

Full Text Available This study compared visual search strategies in adult female volleyball players of three levels. Video clips of the attack of the opponent team were presented on a large screen and participants reacted to the final pass before the spike. Reaction time, response accuracy and eye movement patterns were measured. Elite players had the highest response accuracy (97.50 ± 3.5% compared to the intermediate (91.50 ± 4.7% and novice players (83.50 ± 17.6%; p<0.05. Novices had a remarkably high range of reaction time but no significant differences were found in comparison to the reaction time of elite and intermediate players. In general, the three groups showed similar gaze behaviour with the apparent use of visual pivots at moments of reception and final pass. This confirms the holistic model of image perception for volleyball and suggests that expert players extract more information from parafoveal regions.

Patient views on financial relationships between surgeons and surgical device manufacturers.

Science.gov (United States)

Camp, Mark W; Gross, Allan E; McKneally, Martin F

2015-10-01

Over the past decade, revelations of inappropriate financial relationships between surgeons and surgical device manufacturers have challenged the presumption that surgeons can collaborate with surgical device manufacturers without damaging public trust in the surgical profession. We explored postoperative Canadian patients' knowledge and opinions about financial relationships between surgeons and surgical device manufacturers. This complex issue was explored using qualitative methods. We conducted semistructured face-to-face interviews with postoperative patients in follow-up arthroplasty clinics at an academic hospital in Toronto, Canada. Interviews were audiotaped, transcribed and analyzed. Patient-derived concepts and themes were uncovered. We interviewed 33 patients. Five major themes emerged: 1) many patients are unaware of the existence of financial relationships between surgeons and surgical device manufacturers; 2) patients approve of financial relationships that support innovation and research but are opposed to relationships that involve financial incentives that benefit only the surgeon and the manufacturer; 3) patients do not support disclosure of financial relationships during the consent process as it may shift focus away from the more important risks; 4) patients support oversight at the professional level but reject the idea of government involvement in oversight; and 5) patients entrust their surgeons to make appropriate patient-centred choices. This qualitative study deepens our understanding of financial relationships between surgeons and industry. Patients support relationships with industry that provide potential benefit to current or future patients. They trust our ability to self-regulate. Disclosure combined with appropriate oversight will strengthen public trust in professional collaboration with industry.

The working experiences of novice psychiatric nurses in Taiwanese culture: a phenomenological study.

Science.gov (United States)

Hung, B J; Huang, X Y; Cheng, J F; Wei, S J; Lin, M J

2014-08-01

Novice psychiatric nurses experience heavy workloads, insufficient training and support in Taiwan. The aim of this study was to understand the working experiences of novice psychiatric nurses during their first year in a clinical setting. A qualitative phenomenological approach, using semi-structured face-to-face interviews was used. Narratives were analyzed using Colaizzi's seven-step method. Data saturation was reached after interviews were conducted with 15 nurses based on the purposive sampling. Four themes and eight sub-themes were identified: struggling (lacking a sense of security and competency), emulating (learning the process of interaction with clients and families, learning an appropriate role from nursing staff), prevailing (developing core competency, creating a therapeutic environment) and belonging (coping with the job, becoming a part of the psychiatric nursing staff). The findings from this study demonstrate that nurses are often inadequately prepared for psychiatric nursing. They have little understanding of mental illness, are unable to communicate appropriately with clients and struggle to cope with the conditions. Our study supports the importance for helping nurses to improve their essential knowledge and skills for coping with the job and providing good quality care, particularly in the first year. © 2014 John Wiley & Sons Ltd.

Surgeon Involvement in Pre-Clinical Medical Education: Attitudes of Directors of Education

Directory of Open Access Journals (Sweden)

Simon Turner

2012-04-01

Full Text Available Background: Application rates to surgical residencies have shown a downward trend recently. Introducing students to surgeons early in medical school can increase interest in surgery as a career and enhance the instruction of important surgical topics. Directors of undergraduate medical education have unique insight and influence regarding the participation of surgeons in pre-clinical education. Methods: To understand the attitudes of these educators towards surgeons as teachers in pre-clinical programs, a survey was administered to the directors of undergraduate medical education at each of the English-language medical schools in Canada. Results: Educators estimate the participation of surgeons in all categories of pre-clinical education to be low, despite being valuable, and think that it should be increased. The most significant barrier to participation identified was a lack of surgeons’ time. Conclusions: Despite the value of surgeons participating in pre-clinical education, their rate of participation is low. Steps should be taken to facilitate the involvement of surgeons in this phase of education, which may lead to improved education for students and increased student interest in surgery residencies.

Cost analysis when open surgeons perform minimally invasive hysterectomy.

Science.gov (United States)

Shepherd, Jonathan P; Kantartzis, Kelly L; Ahn, Ki Hoon; Bonidie, Michael J; Lee, Ted

2014-01-01

The costs to perform a hysterectomy are widely variable. Our objective was to determine hysterectomy costs by route and whether traditionally open surgeons lower costs when performing laparoscopy versus robotics. Hysterectomy costs including subcategories were collected from 2011 to 2013. Costs were skewed, so 2 statistical transformations were performed. Costs were compared by surgeon classification (open, laparoscopic, or robotic) and surgery route. A total of 4,871 hysterectomies were performed: 34.2% open, 50.7% laparoscopic, and 15.1% robotic. Laparoscopic hysterectomy had the lowest total costs (P depreciation included (P < .001) but similar costs if these variables were excluded. Although laparoscopic hysterectomy had lowest costs overall, robotics may be no more costly than laparoscopic hysterectomy when performed by surgeons who predominantly perform open hysterectomy.

Shared Teaching Culture in Different Forms: A Comparison of Expert and Novice Teachers' Practices

Science.gov (United States)

Arani, Mohammad Reza Sarkar

2017-01-01

This study aims to reveal the teaching script and structure of lesson practice of two seventh-grade Japanese mathematics teachers--a "novice" and "expert"--through comparative analysis of mathematics lessons. Specifically, it aims to clarify how the teachers' views of teaching as tacit knowledge determine lesson structure and…

Real-time three-dimensional soft tissue reconstruction for laparoscopic surgery.

Science.gov (United States)

Kowalczuk, Jędrzej; Meyer, Avishai; Carlson, Jay; Psota, Eric T; Buettner, Shelby; Pérez, Lance C; Farritor, Shane M; Oleynikov, Dmitry

2012-12-01

Accurate real-time 3D models of the operating field have the potential to enable augmented reality for endoscopic surgery. A new system is proposed to create real-time 3D models of the operating field that uses a custom miniaturized stereoscopic video camera attached to a laparoscope and an image-based reconstruction algorithm implemented on a graphics processing unit (GPU). The proposed system was evaluated in a porcine model that approximates the viewing conditions of in vivo surgery. To assess the quality of the models, a synthetic view of the operating field was produced by overlaying a color image on the reconstructed 3D model, and an image rendered from the 3D model was compared with a 2D image captured from the same view. Experiments conducted with an object of known geometry demonstrate that the system produces 3D models accurate to within 1.5 mm. The ability to produce accurate real-time 3D models of the operating field is a significant advancement toward augmented reality in minimally invasive surgery. An imaging system with this capability will potentially transform surgery by helping novice and expert surgeons alike to delineate variance in internal anatomy accurately.

Effect of Individual Surgeons and Anesthesiologists on Operating Room Time

NARCIS (Netherlands)

van Eijk, Ruben P A; van Veen-Berkx, Elizabeth; Kazemier, Geert; Eijkemans, Marinus J C

BACKGROUND:: Variability in operating room (OR) time causes overutilization and underutilization of the available ORs. There is evidence that for a given type of procedure, the surgeon is the major source of variability in OR time. The primary aim was to quantify the variability between surgeons and

Meeting Increasing Demands for Rural General Surgeons.

Science.gov (United States)

Mccarthy, Mary C; Bowers, Howard E; Campbell, Damon M; Parikh, Priti P; Woods, Randy J

2015-12-01

Dynamic assessment of the effective surgical workforce recommends 27,300 general surgeons in 2030; 2,525 more than are presently being trained. Rural shortages are already critical and there has been insufficient preparation for this need. A literature review of the factors influencing the choice of rural practice was performed. A systematic search was conducted of PubMed and the Web of Science to identify applicable studies in rural practice, surgical training, and rural general surgery. These articles were reviewed to identify the pertinent reports. The articles chosen for review are directed to four main objectives: 1) description of the challenges of rural practice, 2) factors associated with the choice of rural practice, 3) interventions to increase interest and preparation for rural practice, and 4) present successful rural surgical practice models. There is limited research on the factors influencing surgeons in the selection of rural surgery. The family practice literature suggests that physicians are primed for rural living through early experience, with reinforcement during medical school and residency, and retained through community involvement, and personal and professional satisfaction. However, more research into the factors drawing surgeons specifically to rural surgery, and keeping them in the community, is needed.

Risk adjustment for case mix and the effect of surgeon volume on morbidity.

Science.gov (United States)

Maas, Matthew B; Jaff, Michael R; Rordorf, Guy A

2013-06-01

Retrospective studies of large administrative databases have shown higher mortality for procedures performed by low-volume surgeons, but the adequacy of risk adjustment in those studies is in doubt. To determine whether the relationship between surgeon volume and outcomes is an artifact of case mix using a prospective sample of carotid endarterectomy cases. Observational cohort study from January 1, 2008, through December 31, 2010, with preoperative, immediate postoperative, and 30-day postoperative assessments acquired by independent monitors. Urban, tertiary academic medical center. All 841 patients who underwent carotid endarterectomy performed by a vascular surgeon or cerebrovascular neurosurgeon at the institution. Carotid endarterectomy without another concurrent surgery. Stroke, death, and other surgical complications occurring within 30 days of surgery along with other case data. A low-volume surgeon performed 40 or fewer cases per year. Variables used in a comparison administrative database study, as well as variables identified by our univariate analysis, were used for adjusted analyses to assess for an association between low-volume surgeons and the rate of stroke and death as well as other complications. RESULTS The rate of stroke and death was 6.9% for low-volume surgeons and 2.0% for high-volume surgeons (P = .001). Complications were similarly higher (13.4% vs 7.2%, P = .008). Low-volume surgeons performed more nonelective cases. Low-volume surgeons were significantly associated with stroke and death in the unadjusted analysis as well as after adjustment with variables used in the administrative database study (odds ratio, 3.61; 95% CI, 1.70-7.67, and odds ratio, 3.68; 95% CI, 1.72-7.89, respectively). However, adjusting for the significant disparity of American Society of Anesthesiologists Physical Status classification in case mix eliminated the effect of surgeon volume on the rate of stroke and death (odds ratio, 1.65; 95% CI, 0.59-4.64) and other

Practice patterns and career satisfaction of Canadian female general surgeons.

Science.gov (United States)

Hebbard, Pamela C; Wirtzfeld, Debrah A

2009-06-01

We wanted to study how female general surgeons in Canada manage lifestyle and career demands. All female Canadian general surgeons registered with the Royal College of Physicians and Surgeons of Canada were asked to complete a survey evaluating their practice patterns, personal lives, and levels of satisfaction related to these factors. Eighty-five surveys (66%) were returned. Most respondents work in full-time clinical practices. While it was rare to find women in part-time or shared practices, 35% of women reported interest in these alternative models. Respondents described the necessary factors for a transition into alternative models. Job satisfaction was high (3.8 out of 5), with personal and parenting satisfaction being less highly rated (3.3 and 3.2, respectively). Canadian female general surgeons have active and satisfying careers, although many would like to work in alternative practice models that better conform to their lifestyle demands. This pressure will have a significant impact on the future surgical workforce.

Social media and your practice: navigating the surgeon-patient relationship.

Science.gov (United States)

McLawhorn, Alexander S; De Martino, Ivan; Fehring, Keith A; Sculco, Peter K

2016-12-01

Utilization of social media both in the private and professional arenas has grown rapidly in the last decade. The rise of social media use within health care can be viewed as the Internet-based corollary of the patient-centered care movement, in which patient perspectives and values are central to the delivery of quality care. For orthopedic surgeons and their practices, general-purpose online social networks, such as Facebook and Twitter, are convenient platforms for marketing, providing patient education and generating referrals. Virtual health communities are used less frequently by orthopedic surgeons but provide forums for patient engagement and active surgeon-to-patient communication via blogs and ask-the-doctor platforms. This commentary reviews the current state of social media use in orthopedic practice, with particular emphasis on managing the extension of the surgeon-patient relationship online, including the unique practice risks social media poses, such as privacy concerns, potential liability, and time consumption.

Orthopedic surgeons' knowledge regarding risk of radiation exposition: a survey analysis.

Science.gov (United States)

Tunçer, Nejat; Kuyucu, Ersin; Sayar, Şafak; Polat, Gökhan; Erdil, İrem; Tuncay, İbrahim

2017-01-01

The purpose of this study is to evaluate the knowledge levels of orthopedic surgeons working in Turkey about the uses and possible risks of fluoroscopy and assess methods for preventing radiation damage. A questionnaire with a total of 12 questions was sent to 1121 orthopedic surgeons working in Turkey. The questionnaire evaluated participants' knowledge about the uses and risks of fluoroscopy and methods for preventing damage. One thousand and twenty-four orthopedic surgeons were found to be suitable for inclusion in the study. The effects of fluoroscopy on patients were not assessed in our study. The data obtained were statistically evaluated. Of the surveyed surgeons, 313 (30%) had used fluoroscopy in over 50% of their operations. The average number of fluoroscopy shots per case was 54.5. A lead apron was the most commonly used (88%) protection from the harmful effects of radiation. Fluoroscopy shots were performed with the help of operating room personnel (86%). A dosimeter was used 5% of the time. According to the survey results, the need for fluoroscopy was very high in orthopedic surgery. However, orthopedic surgeons have inadequate knowledge about the uses and risks of fluoroscopy and methods for preventing damage. Therefore, we believe that training on this topic should be provided to all orthopedic surgeons. © The Authors, published by EDP Sciences, 2017.