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53. Resident training and the dictated operative report: a national perspective

Author

Gillman, Lawrence M., Vergis, Ashley, Hardy, Krista, Park, Jason, and Taylor, Mark

Subjects
Residents (Medicine) -- Surveys, Medical personnel -- Training, Surgeons -- Surveys
Abstract

Background: Using a nationwide survey, we aimed to determine the current status of operative dictation training in Canada. Methods: Residents and program directors in general surgery programs in Canada participated in this survey. Results: In all, 274 residents and 11 program directors responded to the survey (70% and 79% response rates, respectively). Among residents, 73% reported that their dictations were in need of improvement, and 56% reported never receiving feedback about their dictations. Most residents (80%) stated that they learned to dictate by reading old operative dictations, 75% reported that their program did not use any formal methods to help improve dictations, and 70% requested further training in dictation. In all, 91% of program directors felt that residency programs should include formal training in dictation but half could not identify any formal methods currently used in their programs. Conclusion: There appears to be a marked deficiency in resident training in operative dictation nationwide. Contexte : Nous avons effectue un sondage national pour determiner la situation actuelle de la formation en dictee operatoire au Canada. Methodes : Des medecins residents et des directeurs de programmes de chirurgie generale au Canada ont participe au sondage. Resultats : Au total, 274 medecins residents et 11 directeurs de programme ont repondu au sondage (taux de reponse de 70 % et 79 %, respectivement). Chez les medecins residents, 73 % ont signale qu'ils devaient ameliorer leur dictee et 56 % ont declare n'avoir jamais recu de commentaires au sujet de leur dictee. La plupart des medecins residents (80 %) ont declare avoir appris a dicter en lisant de vieilles dictees operatoires, 75 % ont signale que leur programme n'utilisait pas de methodes structurees pour les aider a ameliorer leur dictee et 70 % ont demande une formation plus poussee a la dictee. Au total, 91 % des directeurs de programme etaient d'avis que les programmes de residence devraient inclure une formation structuree a la dictee, mais la moitie n'ont pu decrire de methode structuree utilisee couramment dans leur programme. Conclusion : Il semble y avoir, a l'echelle nationale, une lacune marquee dans la formation des medecins residents a la dictee operatoire., The dictated operative note is an integral component of patients' medical records. Its importance in communication mandates that it be included in the medical reports of all surgical patients. (1) [...]

Published
2010

56. Decolonising qualitative research to explore the experiences of Manitoba’s urban Indigenous population living with type 2 diabetes mellitus, obesity and bariatric surgery

Author

Hardy, Krista, primary, Clouston, Kathleen, additional, Zmudzinski, Marta, additional, Fowler-Woods, Melinda, additional, Shingoose, Geraldine, additional, Fowler-Woods, Amanda, additional, Daeninck, Felicia, additional, Hatala, Andrew, additional, and Vergis, Ashley, additional

Published
2020
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61. Structured operative reporting: a randomized trial using dictation templates to improve operative reporting

Author

Gillman, Lawrence M., Vergis, Ashley, Park, Jason, Minor, Sam, and Taylor, Mark

Subjects
Health
Abstract

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.amjsurg.2009.06.030 Byline: Lawrence M. Gillman (a), Ashley Vergis (a), Jason Park (a)(b), Sam Minor (c), Mark Taylor (a) Keywords: Surgical education; Dictated operative report; Quality assurance; Documentation Abstract: Few studies have addressed the quality of dictated operative reports (ORs). This study documents changes in resident dictation after the introduction of a standardized OR template. Author Affiliation: (a) Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada (b) Department of Surgery, University of Toronto, Toronto, Ontario, Canada (c) Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada Article History: Received 12 May 2009; Revised 23 June 2009 Article Note: (footnote) Supported by the Bell University Laboratory Fellowship for Research in Health Communication, University of Toronto, Toronto, ON and the Royal College of Physicians and Surgeons of Canada Medical Education Research Grant. Drs. Gillman and Vergis were supported by the R. Samuel McLaughlin/Manitoba Medical Service Foundation Research and Education Fellowship Award in Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.

Published
2010

64. Structured assessment format for evaluating operative reports in general surgery

Author

Vergis, Ashley, Gillman, Lawrence, Minor, Samuel, Taylor, Mark, and Park, Jason

Subjects
Surgery, Health
Abstract

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.amjsurg.2007.08.053 Byline: Ashley Vergis (a), Lawrence Gillman (a), Samuel Minor (b), Mark Taylor (a), Jason Park (a) Keywords: Operative; Dictation; Structured assessment; Evaluation Abstract: Despite its multifaceted importance, no validated or reliable tools assess the quality of the dictated operative note. This study determined the construct validity, interrater reliability, and internal consistency of a Structured Assessment Format for Evaluating Operative Reports (SAFE-OR) in general surgery. Author Affiliation: (a) Section of General Surgery, University of Manitoba, Winnipeg, Manitoba, Canada (b) Dalhousie University, Halifax, Nova Scotia, Canada Article History: Received 6 April 2007; Revised 12 August 2007

Published
2008

72. A Preliminary Investigation of General and Technique-specific Assessments for the Evaluation of Laparoscopic Technical Skills

Author

Vergis, Ashley and Steigerwald, Sarah

Subjects
technical skills, Medical Education, General Surgery, assessment tool, laparoscopic surgery
Abstract

Background Both general and technique-specific assessments of technical skill have been validated in surgical education. The purpose of this study was to assess the correlation between the objective structured assessment of technical skills (OSATS) and the global operative assessment of laparoscopic skills (GOALS) rating scales using a high-fidelity porcine laparoscopic cholecystectomy model. Methods Post-graduate year-one general surgery and urology residents (n=14) performed a live laparoscopic porcine cholecystectomy. Trained surgeons rated their performance using OSATS and GOALS assessment scales. Results Pearson's correlation coefficient between OSATS and GOALS was 0.96 for overall scores. It ranged from 0.78 - 0.89 for domains that overlapped between the two scales. Conclusion There is a very high correlation between OSATS and GOALS. This implies that they likely measure similar constructs and that either may be used for summative-type assessments of trainee skill. However, further investigation is needed to determine if technique-specific assessments may provide more useful feedback in formative evaluation.

Published
2017

75. Development and implementation of a consensus-derived synoptic operative report for Roux en Y gastric bypass surgery

Author

Gillman, Lawrence (Surgery) Rivard, Justin (Surgery) Francois, Jose (Family Medicine), Vergis, Ashley (Surgery), Stogryn, Shannon Elise, Gillman, Lawrence (Surgery) Rivard, Justin (Surgery) Francois, Jose (Family Medicine), Vergis, Ashley (Surgery), and Stogryn, Shannon Elise

Abstract

Background Operative reports (OR) are critical documents in the medical record but are often poor quality. Synoptic reporting (SR) is a potential solution. This has never been assessed in bariatric surgery. The objective was to design and trial a SR for Roux en Y gastric bypass (RYGB), a common bariatric procedure. Methods Systematic review and meta-analysis of comparative studies on SR and narrative reporting (NR) was conducted. A Delphi group developed quality indicators (QIs) for RYGB OR based on these findings. A national needs assessment and audit was then performed and a RYGB SR was subsequently designed and prospectively trailed against NRs. Results Meta-analysis found SRs more complete and efficient than NRs. Seventy-five QIs were established and found bariatric ORs of mediocre quality. RYGB SR was more complete for all items compared to NRs (>99% vs 64%). Conclusion SR for RYGB is superior to NR and should be implemented into clinical practice across Canada.

Published
2017

82. Sigmoid volvulus in an atypical patient: a letter to the editor/case report

Author

Vergis, Ashley and Hardy, Krista

Subjects
Colorectal diseases -- Case studies, Colorectal diseases -- Care and treatment, Colorectal diseases -- Diagnosis, Intestines -- Obstructions, Intestines -- Case studies, Intestines -- Care and treatment, Intestines -- Diagnosis, Health
Abstract

Sir: A previously healthy 20-year-old male presents with a several week history of recurrent, sudden onset abdominal distention, obstipation and emesis. He reports that previous episodes resolved spontaneously and he [...]

Published
2009

83. The dictated operative note: a survey of resident training perceptions and experiences

Author

Vergis, Ashley, Gillman, Lawrence, Hardy, Krista, Park, Jason, and Taylor, Mark

Subjects
Communication in medicine -- Surveys, Residents (Medicine) -- Surveys, Health
Abstract

Table of Contents Abstract Introduction Methods Results Discussion References Abstract Background: Despite its importance, evidence indicates that both attending surgeon and resident operative dictations are poor. Since no previous studies [...]

Published
2007

100. Do fundamentals of laparoscopic surgery (FLS) and LapVR evaluation metrics predict intra-operative performance?

Author

McKay, Andrew (Surgery) Gillman, Lawrence (Surgery) Francois, Jose (Family Medicine), Vergis, Ashley (Surgery), Steigerwald, Sarah, McKay, Andrew (Surgery) Gillman, Lawrence (Surgery) Francois, Jose (Family Medicine), Vergis, Ashley (Surgery), and Steigerwald, Sarah

Abstract

Background: Considerable resources have been invested in low and high fidelity simulators in surgical training. The purpose of this study was to establish construct and predictive validity for the Fundamentals of Laparoscopic Surgery (FLS, low fidelity box trainer) and LapVR (high fidelity virtually reality) training systems and to establish construct validity for two operative ratings scales (GOALS and OSATS) in our center. Methods: 26 participants performed tasks from the FLS program and the LapVR simulator as well as a human laparoscopic cholecystectomy. Performance was evaluated using FLS and LapVR metrics, and the previously validated global rating scales. Results: GOALS and OSATS demonstrated construct validity. Construct and predictive validity was also strongly demonstrated for FLS tasks but only indeterminately for LapVR. Conclusions: The high cost LapVR remains experimental in resource constrained training programs. Efforts should be focused on utilizing the well-validated, lower cost FLS video trainer for assessment of laparoscopic skills.

Published
2014

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