Innovation and Design Experiments in Academic Surgery (I.D.E.A.S.)

Tejas S. Sathe

Recently, Asim A, MD had a thoughtful post on X about a question he thinks that applicants should ask interviewers in the 2024 Match. This is a very insightful question because of how much the answer reveals about the program. First, the answer will tell you about the practical support systems that exist.

Do you have any questions for me?

Meghal Shah

I embarked on my year of academic development with the goal of making operating less painful for surgeons. The field of surgical ergonomics is nascent, and while there is an appetite for technological solutions, behavioral interventions are one of the only effective (albeit limited) tools available to us right now.

Fumbling at the Five Yard Line

This tool represents my own ideas and is not currently in use or endorsed by any institution. Medical students applying to residency often have to grapple with an incredible amount of information when evaluating prospective training programs. The increased number of applications and interviews inherent to the Zoom era further exacerbates this issue.

The Residency Visual Abstract

Imagine that you want to read a paper. You probably either search the subject area of interest on PubMed or Google Scholar. Perhaps you were directed to the paper from an interesting Twitter thread or other social media site. Or maybe you were assigned the paper for a journal club or weekly educational activity. If you're trying to read the paper from within your institution's network, the process is usually seamless.

Why Surgery Needs I.D.E.A.S.

We are amidst a revolution in artificial intelligence (AI). In this paper, we aim to share our early experience with creating custom AI-powered chatbots in surgical education. While our versions are prototypes, we hypothesize that similar chatbots will one day play a significant role in the field. In brief, AI is the ability of a computer to perform human-like tasks.

How I GPT It: Development of Custom AI Chatbots for Surgical Education

Analysis of Reported Voting Behaviors of US Physicians, 2000-2020

Barriers to Voting in 2020 Among Resident Physicians

As residents within the healthcare profession, our first duty is to care for our patients. While working upwards of 80 hours per week pursuing that mission, it is hard to think of ourselves as anything beyond our job title. But we are also citizens. And while patient care remains a worthy North Star, decisions made by faraway policymakers can impact our patients as much as the assessments and plans we ourselves craft.

Voter Turnout Among General Surgery Residents in the 2022 U.S. Midterm Election

"Do you have an IRB?" is often the first question anyone asks when a new research idea is proposed. It shouldn't be the last. Despite the personal frustrations of surgeons who deal with them, institutional review boards (IRBs) maintain a revered status within our profession. For instance, the perceived necessity of IRB review is so ubiquitous that most readers will know to ask the above question even if they do not know why.

Silencing with Red Tape

One of the most counter-intuitive principles when applying design thinking to healthcare and surgery specifically is the idea that quantity of ideas is initially more important than quality of ideas.

Design Thinking: A Method for Building Creative Immunity

Joseph L'Huillier

This is a preprint of a manuscript currently under peer review.

 
 Abstract
 

Importance: Gossip, defined by social scientists as “evaluative talk about an absent third party,” is anecdotally pervasive, yet poorly understood in surgical residency programs. Objective: This study sought to deconstruct the role of gossip in surgical residency and evaluate its impact through the lens of surgical residents.

The Anatomy of Gossip: Dissecting Dynamics and Impacts in Surgical Residency

Use of Open Science Practices in Surgical Journals

Preprints in Health Professions Education: Raising Awareness and Shifting Culture

The evolving role of preprints in the dissemination of COVID-19 research and their impact on the science communication landscape

Releasing a preprint is associated with more attention and citations for the peer-reviewed article

The effect of bioRxiv preprints on citations and altmetrics

Hate the peer-review process? Einstein did too

Journal policies and practices

This is a preprint of a perspective paper that has been submitted for peer review. Think about the last time you submitted a paper. After meticulous editing, you uploaded your manuscript and hit the "submit" button. Then, you waited. And waited. The reviewers requested revisions, which you obliged. More waiting. Finally, the paper was accepted and sent for proofing. You were one of the lucky ones.

Preprints: Opening Surgical Science to Greater Innovation and Transparency

Validity: on the meaningful interpretation of assessment data

How Important Are American Board of Surgery In-Training Examination Scores When Applying for Fellowships?

The pediatric surgery match by the numbers: Defining the successful application

Predicting Performance on the American Board of Surgery Qualifying and Certifying Examinations

Using the American Board of Surgery In-Training Examination to Predict Board Certification: A Cautionary Study

Association Between American Board of Surgery In-Training Examination Scores and Resident Performance

Success in pediatric surgery: An updated survey of Program Directors 2020

Current Concepts in Validity and Reliability for Psychometric Instruments: Theory and Application

Relationships between study habits, burnout, and general surgery resident performance on the American Board of Surgery In-Training Examination

Let's Not Throw the Baby Out with the Bath Water – Keep the ABSITE a Numerically Scored Exam

The Effect of Prior Night Call Status on the American Board of Surgery In-Training Examination Scores: Eight Years of Data From a Single Institution

Effect of resident call status on ABSITE performance

Effect of January Vacations and Prior Night Call Status on Resident ABSITE Performance

Preliminary Development of a Program ABSITE Dashboard (PAD) to Guide Curriculum Innovation

Concurrent Validity Evidence for Entrustable Professional Activities in General Surgery Residents

Holistic Review

Holistic Review — Shaping the Medical Profession One Applicant at a Time

Diversity, Fairness, and Excellence: Three Pillars of Holistic Admissions

This is a preprint of a manuscript currently under peer review. The American Board of Surgery In-Training Examination (ABSITE

 ®

) is a multiple-choice exam administered yearly to surgical residents. The ABS provides the following information on its website: "The ABSITE is furnished to program directors as a formative evaluation instrument to assess residents’ progress.

Proposed Reforms to the American Board of Surgery In-Training Examination (ABSITE)

Abstract

The institutional knowledge required for residency is vast, complex, and frequently changing. Most institutions do not have a resource that serves as a singular source of truth for this information. Furthermore, since information is mostly presented on static documents such as emails or PDFs, there is no easy way to update and share the information in real time.

An Operating System for Residency

Recently, Drs. Robert Wachter and Erik Brynjolfsson published a viewpoint in the Journal of the American Medical Association JAMA on Generative AI in healthcare. We agree with their views and wished to add the following points in a response letter. While our letter was not accepted, we have pre-printed it here. Please find the original paper and our response below.

Response Letter

Students and residents aspiring for a career in academic surgery are looking for training programs that will help jumpstart their careers by exposing them to mentorship and opportunities to conduct research. While the gold standard of academic productivity (for the time being) remains peer-reviewed publications, conference posters and presentations are an important secondary metric.

How to Build an Academic Powerhouse: Let's Study Who's Doing it

A digital reference guide to sutures and needles (adapted from Twitter Thread)  As a student and junior resident, I didn’t understand how surgeons decided when to use each suture/needle. I tried to pick up on patterns but the info was never in one place.

What's the Stitch?

We asked GPT-4 to pretend that it was an academic surgeon and write an essay on the biggest challenges in academic surgery and how to solve them. Here is an unedited output of what GPT-4 wrote as well as the series of prompts we used to get this output.

 Disclaimer:

AI large language models (LLM) can confidently state inaccurate information and make up facts.

GPT-4 on the Biggest Challenges in Academic Surgery

Greenhouse Gases Equivalencies Calculator - Calculations and References | US EPA

Abstract

 Background

Reducing costs and carbon footprint are important, parallel priorities for the U.S. healthcare system. Within surgery, reducing the number of instruments that are sterilized and disposable supplies that are used for each operation can help achieve both goals.

Instrument and Supply Variability

Multiple Views of Participatory Design

Dilemmas in a general theory of planning

5 Examples of Design Thinking in Business | HBS Online

Abstract
 

The field of surgery faces complex, systemic challenges that will require new academic frameworks. In this paper, we propose design thinking as a useful problem solving technique to apply to such challenges. We define design thinking and provide a brief history of this practice.