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1. Utilizing resident needs-based assessments, the participants will self-report the ability to survey residents in order to identify and fill resident-reported training deficiencies. 2. Utilizing a multimodal approach, the participants will self-report the ability to design, integrate, implement, and tailor a surgical palliative care curriculum. Formal integration of palliative care education is a recognized deficiency of general surgery education. A needs assessment of general surgery residents identified a desire to implement a resident-driven surgical palliative care curriculum. A novel, resident-driven surgical palliative care curriculum was created and implemented with close interprofessional collaboration. Palliative care is essential for optimal surgical care. Currently, there is a lack of palliative care education within general surgery training. A palliative care needs/knowledge assessment was performed with general surgery residents of a tertiary care center academic program. The survey identified clinical subject matter of emphasis. A curriculum was then created, validated, and implemented, in collaboration with the palliative care department, to target these resident-driven initiatives. A post-curriculum survey will be conducted to assess resident comfort and effectiveness in providing palliative care, including usage of a surgical palliative care note template. The assessment was answered by 38/77 (49.4%) residents. Majority of respondents (60.5%) lacked formal palliative care education/training. Most respondents (74.3%) have participated in palliative care conferences with 42.1% of respondents being the primary surgical liaison. There was no correlation between PGY level and palliative care conference participation. Eighty-seven percent of respondents were interested in a palliative care curriculum. Seventy-six percent of respondents were unaware of the surgical palliative care note template and only 3.9% of respondents used the template within the past 6 months. Residents identified several palliative care topics for curriculum emphasis including DNR/DNI discussions (77%), goals of care/conducting family conference (69%), delivering serious news (63%), palliative surgery (63%), and palliative care and hospice referrals (60%). Despite their need to practice surgical palliative care, the majority of general surgery residents were not comfortable with essential surgical palliative care subjects and skills and desired formal training. To address this educational gap, a novel surgical palliative care curriculum was developed and is currently being implemented with interprofessional collaboration between the surgical and palliative care departments. A post-curriculum survey will be conducted to assess resident understanding and application of the curriculum. Surgical Palliative Care/Interdisciplinary Teamwork / Professionalism [ABSTRACT FROM AUTHOR]

Objective: Our objective was to determine the utility of enteral contrast-based protocols in the diagnosis and management of adhesive small bowel obstruction (ASBO) for children., Background: Enteral contrast-based protocols for adults with ASBO are associated with decreased need for surgery and shorter hospitalization. Pediatric-specific data are limited., Methods: We conducted a prospective observational study between October 2020 and December 2022 at nine children's hospitals who are members of the Western Pediatric Surgery Research Consortium. Inclusion criteria were children aged 1-20 years diagnosed with ASBO who underwent a trial of nonoperative management (NOM) at hospital admission. Comparisons were made between those children who received an enteral contrast challenge and those who did not. The primary outcome was need for surgery., Results: We enrolled 136 children (71% male; median age: 12 y); 84 (62%) received an enteral contrast challenge. There was no difference in rate of operative intervention between the no contrast (34.6%) and contrast groups (36.9%; P=0.93). Eighty-seven (64%) were successfully managed nonoperatively with no difference in median length of stay (P=0.10) or rate of unplanned readmission (P=0.14). Among the 49 children who required an operation, there was no significant difference in time from admission to surgery or rate of small bowel resection based on prior contrast administration., Conclusions: The addition of enteral contrast-based protocols for management of pediatric ASBO does not decrease the likelihood of surgery or shorten hospitalization. Larger randomized studies may be needed to further define the role of radiologic contrast in the management of ASBO in children., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)