A5009535317- Surgical Simulation and Training
- Innovations in Medical Education
- Diversity and Career in Medicine
- Musculoskeletal pain and rehabilitation
- Anatomy and Medical Technology
- Pain Management and Treatment
- Cardiac, Anesthesia and Surgical Outcomes
- Mobile Health and mHealth Applications
- Clinical practice guidelines implementation
- Enhanced Recovery After Surgery
- Cardiac Health and Mental Health
- Hospital Admissions and Outcomes
- Health and Medical Research Impacts
- Women's cancer prevention and management
- Global Healthcare and Medical Tourism
- Congenital Heart Disease Studies
- Cardiovascular Issues in Pregnancy
- Dental Education, Practice, Research
- Cancer survivorship and care
- Transcranial Magnetic Stimulation Studies
INTRODUCTION: The Accreditation Council for Graduate Medical Education (ACGME) relies on case minimums as a standard competency indicator, set by expert opinion rather than individual resident performance. Exploring metrics may better tailor training needs. METHODS: Data from neurosurgery residents at Duke University five functional procedures (deep brain stimulation (DBS), epilepsy vagal nerve (VNS), percutaneous spinal cord stimulator placement (SCS), internal pulse generator implantation...
INTRODUCTION: Determining and measuring neurosurgical resident operative competency is challenging due to non-standardized methods for teaching evaluation. METHODS: We analyzed 2,260 functional neurosurgery cases performed by 146 residents across 14 institutions between the years of 2017 2024. TAGS scores, which measure surgical autonomy from 1 (lowest) 4 (highest), along with zones proximal development (ZPD) stages—ZPD1 (positioning opening), ZPD2 (second most complex portion), ZPD3 (most...
INTRODUCTION: Pediatric neurosurgery presents distinct challenges in training and evaluating competency of neurosurgical residents due to the uniquely vulnerable population, breadth surgical procedures, delicate neonatal tissue. METHODS: Data from across 12 institutions were compared for five procedures (ventriculo-peritoneal shunt, craniotomy tumor (supratentorial), (infratentorial), trauma, endoscopic third ventriculocisternostomy). TAGS scores, ranging 1 (lowest autonomy) 4 (highest),...
ManageMySurgery (MMS) is a digital health application (app) for patients undergoing surgery, including Transcatheter Aortic Valve Replacement (TAVR). Patients using MMS review procedure-specific education, view FAQs, and report patient-reported outcomes. This study assessed the impact of app use on postoperative
Contemporary breast cancer surgery often requires hospital stays of 1 day or less, presenting challenges to delivery high-quality care. Without sufficient time for proper education and guidance, patients may delay seeking care, experience anxiety, seek unnecessary leading poorer outcomes increased costs. To address this, we evaluated the feasibility a planning-, outcomes-, analytics-based mobile health application called Manage My Surgery (MMS) undergoing elective surgery.Patients at an...
Background There is a great unmet clinical need to provide patients undergoing spinal surgery and their caregivers with ongoing, high-quality care before after in an efficiency-focused health environment. Objective The objective of this study design, develop, evaluate the acceptability feasibility novel planning-, outcomes-, analytics-based smartphone app called ManageMySurgery (MMS) elective spine (MMS-Spine). Methods development process MMS was conducted over 2 sequential stages: (1)...
Abstract Over the last decade, strict duty hour policies, pressure for increased work related value units from faculty, and apprenticeship model of education have coalesced to make opportunities intraoperative teaching more challenging. Evidence is emerging that graduating residents are not exhibiting competence by failing recognize major complications, perform routine operations independently. In this pilot study, we combine Vygotsky's social learning theory with a modified version...
OBJECTIVE There is no standard way in which physicians teach or evaluate surgical residents intraoperatively, and are proving to not be fully competent at core procedures upon graduating. The Surgical Autonomy Program (SAP) a novel educational model that combines modified version of the Zwisch scale with Vygotsky’s social learning theory. objective this study was establish preliminary validity evidence SAP reliable measure autonomy useful tool for tracking competency over time. METHODS...
Spinal cord stimulation (SCS) effectively reduces opioid usage in some patients, but preoperatively, there is no objective measure to predict who will most benefit.
ABSTRACT Background The proportion of women surgeons is increasing, but studies show that in surgical residency are granted less autonomy than men. Objective We utilized the Surgical Autonomy Program (SAP), an educational framework, to evaluate gender differences self-reported autonomy, attending-reported and operative feedback among US neurosurgical residents. Methods SAP tracks resident progression guides teaching neurosurgery. Surgeries divided into zones proximal development (opening,...
BACKGROUND AND OBJECTIVES: The Accreditation Council for Graduate Medical Education (ACGME) requires neurosurgery residents to reach a set number of cases in specified procedure types (case minimums) before graduation and mandates completion Milestones. We used the Surgical Autonomy Program, validated method autonomy-based resident evaluation, determine it took become competent compared these with ACGME case minimums. METHODS: collected data from at Duke University on 7 procedures (tumor...
INTRODUCTION: Surgical education remains a core goal of all neurosurgical programs, however limited research exists on the impact highly effective educators vs. less trainee progression1. METHODS: The SAP breaks surgical case into four zones proximal development (ZPD). For each ZPD, residents are evaluated 4-tier autonomy scale (“stages) (TAGS scale: T: Teach/Demonstrate, A: Advise/Scaffold, G: Guide/Monitor, S: Solo/Observe) in case. All neurosurgery at Duke University Hospital from July...
INTRODUCTION: Education is at the core of neurosurgical residency, but little research has been done on opportunity cost surgical education. METHODS: SAP structures cases into zones proximal development (opening, exposure, key section, and closing) used to evaluate resident mastery. All 1-4 level ACDF non-reoperative between March 2014 2022 from one attending surgeon Duke University were divided three groups: without residents, with residents prior implementation (before June 2018) after...
INTRODUCTION: While efforts to recruit females into surgical fields have increased, gender differences in training exist. METHODS: The SAP divides a case four parts, or zones of proximal development (ZPD). For each ZPD, residents are evaluated on 4-tier autonomy scale (TAGS scale). Using logistic regression analysis, we neurosurgery at Duke University Hospital from July 2017-July 2021 compare male and female trainee as rated by both attendings residents. RESULTS: There were total 4,441 cases...
INTRODUCTION: Various new waveforms for spinal cord stimulation (SCS) have emerged in recent years, with limited data supporting their utility a real-world clinical setting. We report results of protocolized workflow algorithm that allows high dose (HD) and low (LD) neurostimulation patients chronic pain undergoing SCS trial or permanent procedures. METHODS: Prospective was collected using the ManageMySurgery (MMS) mobile device platform Medtronic implant E-consent obtained through HIPAA...
INTRODUCTION: Novel technologies to support real-time patient education, engagement and scalable outcomes monitoring make clinically meaningful decisions are needed. The ManageMySurgery (MMS) Spinal Cord Stimulation (SCS) module is a mobile clinical decision application that provides: (1) mobile, patient-centered tool for delivering pre-, peri- postoperative SCS information; (2) patient-reported collection; (3) HIPAA-compliant 2-way messaging platform with Clinical Specialist Educator goal...
<sec> <title>BACKGROUND</title> There is a great unmet clinical need to provide patients undergoing spinal surgery and their caregivers with ongoing, high-quality care before after in an efficiency-focused health environment. </sec> <title>OBJECTIVE</title> The objective of this study design, develop, evaluate the acceptability feasibility novel planning-, outcomes-, analytics-based smartphone app called ManageMySurgery (MMS) elective spine (MMS-Spine). <title>METHODS</title> development...