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Competing Interests: The authors report no conflicts of interest.

This Special Communication summarizes the key points raised at the Society of Surgical Chairs mentorship panel sessions held at the 2014 and 2015 annual meetings of the society. Highlights of these expert panel discussions include senior chairs' insights into successfully dealing with increasingly complex academic medical organizations and horizontal department management expectations in the context of the arrival of the Millennial Generation into the work force. Three key tenets of effective surgery leadership that arose from these sessions deal with the importance of (1) collaboration and cooperativity, (2) humanized relationships and mentorship, and (3) operational efficiency. Overall, the panel consensus for the future of surgery leadership was optimistic while recognizing that the demands of chairmanship are considerable.

Background: Interprofessional education (IPE) in health care describes a process for training that places health care learners from different professional disciplines into an environment or situation in which shared or linked educational goals are pursued. IPE represents a new way of thinking about education as a value proposition directed at high-quality interprofessional patient care and as such is an innovative strategy endorsed in statements by the Institute of Medicine and the World Health Organization. The requirements of the American College of Surgeons-accredited Education Institutes (ACS-AEIs) for Comprehensive (Level I) accreditation state that education and training activities at the accredited institutes (simulation centers) must be multidisciplinary in nature. Until recently, concepts of shared interprofessional educational goals and facilitation of interdisciplinary colearning have not been addressed explicitly by the Consortium of ACS-AEIs., Methods: In March 2012, the ACS Education Division convened a forum on IPE at the Annual Meeting of the Consortium of ACS-accredited Education Institutes in Chicago, IL. Five different ACS-AEI perspectives on IPE and training were presented, covering (1) simulation-based crisis resource management training for operating room teams, (2) the use of multidisciplinary simulation at an academic medical center-based simulation facility, (3) the development of a collaborative IPE curriculum between nursing and medical schools at a major university, (4) the development of a simulation-based interprofessional obstetrics educational program at a university medical center, and (5) the development of an interprofessional macrosystem simulation program in conjunction with opening a new hospital facility. We describe these experiences and present them as best practices in simulation-based IPE in surgery., Conclusion: These IPE experiences in the ACS-AEIs reflect varied and robust approaches to integrated interdisciplinary teaching and learning. Demands and directives to increase these types of educational activities in the near future will have to be met with a wider range of offerings and greater specific knowledge and expertise within the ACS-AEI Consortium., (Copyright © 2013 Mosby, Inc. All rights reserved.)

Professionalism is an inherent attribute to the practice of surgery. Historically, the importance of this quality arose later than the earliest three fundamental principles of medical knowledge, diagnostic ability, and technical skill. In the modern era, society has clearly come to require that its surgeons embrace professionalism as a fundamental principle. It now stands among the six core competencies that all United States training programs teach and measure. We define professionalism as the pursuit of excellence, the display of humanism, an altruistic commitment, and accountability to all interactions with society. Surgeons teach professionalism to their trainees every day, sometimes by formal curricula but more often by the unspoken and unsuspected modeling of behavior. These methods can be structured into a teaching program. To that program, active practice and engagement in continuous professionalism improvement ought to be added. In this way, a true method of professionalism training can be made that allows for formal assessment., (Copyright © 2011 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.)

Purpose: To determine whether changing sign-out practices and decreasing the time spent in rounding and recopying patient data affect patient safety. Responding to limited resident duty hours, the University of Washington launched a computerized rounding and sign-out system ("UW Cores"). The system shortened duty hours by facilitating sign-out, decreasing rounding time, and sharply reducing the time spent in prerounds data recopying., Method: This 14-week, randomized, crossover study involved 14 inpatient resident teams (6 general surgery, 8 internal medicine) at two hospitals. The authors measured resident-reported deviations in expected care that occurred during cross-coverage, medical errors, and institutionally reported adverse drug events (ADEs)., Results: The mean number of resident-reported deviations from expected care per 1,000 patient-days did not differ significantly between the control and UW Cores groups: 14.29 and 13.81, respectively (P = .85). The mean number of reported incidents involving errors was 6.33 per 1,000 patient-days for the control group and 5.61 per 1,000 patient-days for the UW Cores group (P = .68). The odds ratio of a reported overnight medical error under the UW Cores system was 1.01 (95% CI: 0.64, 1.60; P = .96). The odds ratio of an ADE while a resident is on an intervention team was 1.10 (95% CI: 0.69, 1.74; P = .70)., Conclusions: Managing information for sign-out and rounding with the UW Cores system, to reduce time spent in recopying patient data and in rounding on patients, improved continuity and enhanced resident efficiency without weakening systemic defenses against error or jeopardizing patient safety.

Background: We evaluated the impact of expert instruction during laboratory-based basic surgical skills training on subsequent performance of more complex surgical tasks., Methods: Forty-five junior residents were randomized to learn basic surgical skills in either a self-directed or faculty-directed fashion. Residents returned to the laboratory 2 days later and were evaluated while performing 2 tasks: skin closure and bowel anastomosis. Outcome measures included Objective Structured Assessment of Technical Skill, time to completion, final product quality, and resident perceptions., Results: Objective Structured Assessment of Technical Skill, time to completion, and skin esthetic ratings were not better in the faculty-directed group, although isolated improvement in anastomotic leak pressure was seen. Residents perceived faculty-directed training to be superior., Conclusions: Our data provided minimal objective evidence that faculty-directed training improved transfer of learned skills to more complex tasks. Residents perceived that there was a benefit of faculty mentoring. Curriculum factors related to training of basic skills and subsequent transfer to more complex tasks may explain these contrasting results.

Hypothesis: Multimedia delivery of cognitive content paired with faculty-supervised partial task simulation for both excision of a simulated skin lesion with subsequent wound closure and hand-sewn bowel anastomosis would be an effective method for developing appropriate procedural skills among junior residents., Design: Prospective cohort study., Setting: University-based surgical residency., Participants: First- and second-year surgical residents (n = 45)., Interventions: Surgical residents were given comprehensive instructional materials, including structured curricula with goals and objectives, text, figures, and narrated expert digital video, before the training session. A 4-hour, standardized, laboratory-based instruction session was then performed in small groups, which emphasized faculty-supervised practice. Residents were asked to (1) excise a skin lesion and close the wound and (2) perform hand-sewn bowel anastomosis. These 2 tasks were assessed before and after supervised practice. Performances were video recorded. Residents were surveyed before and after training., Main Outcome Measures: Time to completion and Objective Structured Assessment of Technical Skill global rating scale score based on video recordings were evaluated by blinded reviewers. Final product quality was measured by anastomotic leak pressure and by wound closure aesthetic quality., Results: Residents perceived the laboratory training to be equal to training in the operating room for skin closure and superior to training in the operating room for bowel anastomosis. Residents perceived time spent on both tasks to be "perfect." Mean objective scores improved significantly on 5 of 6 outcome measures., Conclusions: Junior resident surgical performance improved substantially with 4 hours of laboratory-based, faculty-supervised practice. Both first- and second-year residents benefited from this training. These data show that curriculum-driven, faculty-supervised instruction in a laboratory setting is beneficial in the training of junior surgical residents.

Objective: To evaluate the effect of changing a 1-hour weekly all-resident didactic conference to an expanded 4-hour bimonthly level-specific didactic conference., Design: Prospective outcome measures included an anonymous 10-item perceptions survey administered at 4 time points (preintervention, 6 months postintervention, 1 year postintervention, and 2 years postintervention), mean attendance rates preintervention and postintervention, and mean ABSITE scores preintervention and postintervention., Setting: Large university-based surgical residency., Participants: Surgical residents (R1-R5, n = 75) were divided into junior (R1-R3, n = 56) and senior (R4-R5, n = 19) groups. Each group attended a session every other Wednesday., Results: Significant improvements were observed in overall resident satisfaction (55% vs 80%, p < 0.005) and level-specific appropriateness of content (81% vs 94%, p < 0.001). Furthermore, resident attendance rates were improved substantially (33% vs 55%, p < 0.001). ABSITE scores were not affected significantly by the change in curriculum structure., Conclusions: An expanded, bimonthly level-specific didactic curriculum is more effective than a shorter, weekly all-resident conference as evidenced by resident attitudes and attendance. Additional benefits of the alternating schedule include a reduced number of residents in each conference and the availability of residents for clinical educational activities (eg, operative cases or clinic). Expanded educational time has allowed the introduction of nontraditional topics that include leadership, communication, practice management, professionalism, and technical skills training.

The American College of Surgeons (ACS) recently launched a new program to provide regional support for simulation-based surgical education through the establishment of a consortium of accredited education institutes. The goals of the program are to enhance surgical patient safety, support efforts of surgeons to meet the requirements for Maintenance of Certification, address the core competencies that all surgeons and surgical residents need to achieve and demonstrate, and enhance access to contemporary surgical education. The ACS-accredited institutes will comprehensively address the needs of a broad spectrum of learners and advance the science of simulation-based surgical education. Accreditation is being offered at two levels--Level I (Comprehensive) and Level II (Basic)--based on three standards that focus on the learners served, the curricula offered, and the technological support and resources available. Initial plans of the consortium of ACS-accredited Education Institutes include development and dissemination of innovative curricula, peer review of new educational programs and products, sharing of limited educational resources, and pursuit of collaborative research and development. This program should be of great value in supporting the professional activities of surgeons, surgical residents, medical students, and members of the surgical team, and in delivering surgical care of the highest quality.

This paper reviews the rationale for the development of an accreditation program for Educational Institutes by the American College of Surgeons. It discusses the reasons why such accreditation program is beneficial to the institutes themselves as well as to the organizations that sponsor the institute. It analyzes the evolution of the accreditation program since its inception, and it provides advice as to how to start the accreditation process.

Background: We assessed educational needs with regard to leadership, communication, and emotional intelligence (EI) among surgical residents., Methods: General surgery residents (n = 74) were examined using the BarOn Emotional Quotient Inventory (EQ-i) and a 20-item survey., Results: Residents believed that leadership skills were important (mean 4.7, SD .5) and that they had skills in each the five EI areas (overall mean 4.1, SD .8). Both the overall group's EQ-i scores (mean 106.6, SD 11.6), as well as scores on the 20 components of the EQ-i (range of means 102-110), were higher than national norms. Individuals varied substantially on EQ-i subscale scores., Conclusions: Surgical residents believed that leadership skills are important and scored strongly on both an EI self-assessment and the EQ-i. Specific individual differences in subscale scores can potentially identify areas for direct educational intervention.