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3 results on '"Jonathan M. Dort"'

1. Retrospective Review of Outcomes in Non-Invasive Mucinous Appendiceal Neoplasms with and without Peritoneal Spread: A Cohort Study

Author

Arkadii Sipok, Jonathan M. Dort, Anthony Visioni, and Lana Bijelic

Subjects
pseudomyxoma peritonei, mucinous carcinoma peritonei, peritoneal metastases, cytoreductive surgery, heated intraperitoneal chemotherapy, appendix, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Patients treated surgically for local non-invasive mucinous appendiceal neoplasm (NI-MAN) may recur with the development of peritoneal dissemination (PD). The risk of recurrence and predictive factors are not well studied. Patients with NI-MAN, with or without peritoneal dissemination at presentation, were included. Patients with limited disease underwent surgical resection only. Patients with peritoneal dissemination underwent cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC). Patients without PD (nPD) were compared to those who presented with PD. Thirty-nine patients were included, 25 in nPD and 14 in PD. LAMN was diagnosed in 96% and 93% of patients in nPD and PD, respectively. Acellular mucin on the peritoneal surface was seen in 16% of nPD patients vs. 50% of PD patients (p = 0.019). Two (8%) patients in the nPD group who had LAMN without wall rupture recurred, at 57 and 68 months, with a PCI of 9 and 22. The recurrence rate in the PD group was 36%. All recurred patients underwent CRS+HIPEC. A peritoneal recurrence is possible in NI-MANs confined to the appendix even with an intact wall at initial diagnosis. The peritoneal disease may occur with significant delay, which is longer than a conventional follow-up.

Published
2022
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2. Building Rapport and Earning the Surgical Patients Trust in the Era of Social Distancing: Teaching Patient-Centered Communication During Video Conference Encounters to Medical Students

Author

Muneera R. Kapadia, Jonathan M. Dort, Margaret Duval, Denise Mohess, Anna B. Newcomb, and Sharon L Bachman

Subjects
SP, Simulated patient, Telemedicine, Best practice, PCP, Primary care physician, Physical Distancing, education, computer.software_genre, Trust, Simulated patient, Article, Education, 03 medical and health sciences, 0302 clinical medicine, Videoconferencing, Internship, Patient-Centered Care, ComputingMilieux_COMPUTERSANDEDUCATION, Humans, 030212 general & internal medicine, Curriculum, Pandemics, Interpersonal and Communication Skills, virtual education, Medical education, Physician-Patient Relations, SARS-CoV-2, Debriefing, patient-centered communication, COVID-19, Body movement, Professionalism, video conference encounters, 030220 oncology & carcinogenesis, General Surgery, communication education, CT, Computerized tomography, Surgery, Patient Care, Psychology, medical education, computer, Education, Medical, Undergraduate
Abstract

Background Effective physician communication improves care, and many medical schools and residency programs have adopted communication focused curricula. The COVID-19 pandemic has shifted the doctor-patient communication paradigm with the rapid adoption of video-based medical appointments by the majority of the medical community. The pandemic has also necessitated a sweeping move to online learning, including teaching and facilitating the practice of communication skills remotely. We aimed to identify effective techniques for surgeons to build relationships during a video consult, and to design and pilot a class that increased student skill in communicating during a video consult. Methods Fourth-year medical students matched into a surgical internship attended a 2-hour class virtually. The class provided suggestions for building rapport and earning trust with patients and families by video, role play sessions with a simulated patient, and group debriefing and feedback. A group debriefing generated lessons learned and best practices for telemedicine communication in surgery. Results Students felt the class introduced new skills and reinforced current ones; most reported higher self-confidence in target communication skills following the module. Students were particularly appreciative of opportunity for direct observation of skills and immediate faculty feedback, noting that the intimate setting was unique and valuable. Several elements of virtual communications required increased focus to communicate empathy and concern. Proper lighting and positioning relative to the camera were particularly important and body movement required “narration” to minimize misinterpretation. A patient's distress was more difficult to interpret; asking direct questions was recommended to understand the patient's emotional state. Conclusions There is a need to teach video-conference communication skills to enable surgical teams to build rapport in this distinct form of consultation. Our training plan appears effective at engaging learners and improving skills and confidence, and identifies areas of focus when teaching virtual communication skills.

Published
2021
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3. The SAGES Manual of Quality, Outcomes and Patient Safety

Author

John R. Romanelli, Jonathan M. Dort, Rebecca B. Kowalski, Prashant Sinha, John R. Romanelli, Jonathan M. Dort, Rebecca B. Kowalski, and Prashant Sinha

Subjects
Outcome assessment (Medical care), Surgery--Practice--Handbooks, manuals, etc, Surgery, Operative--Handbooks, manuals, etc
Abstract

In this thoroughly revised second edition of the frequently downloaded manual, The SAGES Manual of Quality, Outcomes, and Patient Safety. A panel of experts update and expand their survey of the many factors that influence quality in the world of surgery, surgical outcomes, and threats to patient safety. Among the highlights include a section devoted to threats to quality and outcomes and safety, such as surgeon wellness and burnout, disruptive behavior, second victims, the surgeon with declining skills, and maintaining quality in the setting of a crisis. Another all-new section focuses on surgical controversies, such as whether or not to use robotic surgical technology and whether or not it influences surgical outcomes; whether or not routine cholangiography reduces the common bile duct injury rate; whether or not having a consistent operating room team influences surgical outcomes, and whether a conflict of interest truly influences surgical quality. Further, this manual updates chapters on surgical simulation, teamwork and team training, teleproctoring, mentoring, and error analysis. State-of-the-art and readily accessible, The SAGES Manual of Quality, Outcomes, and Patient Safety, Second Edition will offer physicians strategies to maintain surgical quality in a rapidly changing practice environment the tools they require to succeed.

Published
2022

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