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Surgery Block Evaluation

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  • 1. Surgery Block Evaluation Clerkship and Electives Committee June 21 st , 2004 Presented By: Nina Ghosh, Dina Popovic
  • 2. Surgery Electives
    • Anesthesia
    • Cardiac Surgery
    • General Surgery
    • Neurosurgery
    • Orthopedics
    • Ophtho/ENT
    • Pediatric Surgery
    • Plastic Surgery
    • Thoracic Surgery
    • Urology
    • Vascular Surgery
  • 3. Survey Results
  • 4.  
  • 5.  
  • 6.  
  • 7.  
  • 8.  
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  • 12.  
  • 13.  
  • 14.  
  • 15.  
  • 16.  
  • 17.  
  • 18. General Comments
  • 19. General Comments – PRO’S
    • resident teaching - a significant strength
    • good block organization
    • excellent teaching sessions
    • the consultants, residents and even fourth year elective students were all very helpful.
  • 20. General Comments – CON’S
    • the hours were absolutely gruelling
    • I only had cold site calls
    • More feedback would have been appreciated.
    • The consultants were not all too interested in teaching outside of the teaching sessions (over cases, in the OR, etc).
    • The definite emphasis on this part of the rotation was on service not on education.
  • 21. Suggestions
    • Buddy system with enthusiastic residents who like to teach
    • No lectures for clerks on resident teaching days, because it’s our only chance to do extra stuff in the OR, and if we’re in teaching we miss the chance.
    • Ensure that clerks have security of their belongings.
    • Ensure that clerks have desks in their sleep rooms.
    • More teaching at rounds rather than being a scribe
    • Supervisors and residents should be encouraged to quiz clerks more in the OR
  • 22. General Comments - Windsor
    • Surgery in Windsor was excellent in terms of the OR experiences
    • excellent hands-on training and one-on-one teaching with the consultant
    • videoconferencing leaves a lot to be desired - it was frustrating, poorly organized and not a good use of time
    • some residents are just unacceptable; not just unwilling to do informal teaching sessions, but unwilling to answer questions in general
    • should be able to do more in the OR on some services
    • it would be useful to have spent time in some clinics- more applicable to general practitioner training
  • 23. Specific Comments/Suggestions
  • 24. Specific Comments/Suggestions
    • General Surgery
      • Excellent 2-week elective
      • Students actively involved in all aspects of patient care
      • Important adjunct to alternative core rotations
      • On-call experience is extremely valuable
      • Strained team relationships among the other members of the team prior to my arrival also made this a rotation.
      • Clerks were overall bored in the OR because lack of involvement in cases
  • 25. Specific Comments/Suggestions
    • Anesthesia
      • Students enjoy active involvement
      • Consider making this a required rotation
      • Efforts should be made to have the clerks active in as many cases as possible - Especially when the bulk of what we can do is intubating
      • 5-6 hour cases are boring and not much learning occurs in these settings. Clerks should be assigned to OR’s that have short cases.
  • 26. Specific Comments/Suggestions
    • Cardiac Surgery
      • Enthusiastic consultants and residents were very eager to teach
      • Students involvement in the OR is limited due to the type of procedures and the number of operators
  • 27. Specific Comments/Suggestions
    • Neurosurgery
      • Students involved in initial patient assessment (i.e. clinics) very valuable
      • Students involvement in the OR is limited due to the type of procedures and the number of operators
      • Consideration of student option to observe long procedures OR participate in “floor work” OR pursue self-directed learning
  • 28. Specific Comments/Suggestions
    • Orthopedic Surgery
      • Great exposure to trauma surgery and initial management of the trauma patient (SSC)
      • Some students felt they received limited (informal) teaching and little involvement in patient care.
  • 29. Specific Comments/Suggestions
    • Plastic Surgery
      • Good exposure to diversity of plastic surgery
      • Residents should make an effort to include clerks in ward involvement
      • Limited operative involvement
      • Some residents were less willing to teach
  • 30. Specific Comments/Suggestions
    • Thoracic Surgery
      • Very valuable introductory package and list of objectives provided to students
      • Excellent teaching by consultants and residents
      • Excellent student involvement in ward, clinic and OR
      • Very busy service requires students to sink or swim – although significant encouragement from staff and resident
  • 31. Specific Comments/Suggestions
    • Urology
      • Excellent teaching by consultants and residents
      • Excellent student involvement in ward, clinic and OR
  • 32. Specific Comments/Suggestions
    • Vascular Surgery
      • Excellent teaching by consultants and residents
      • Excellent student involvement
  • 33. Specific Comments/Suggestions
    • Emergency Medicine
      • Exposure to a wide variety of medical/surgical problems
      • Excellent student involvement in initial work-up of patients
      • Consultants should be encouraged to allow students to formulate an assessment and treatment plan instead of just obtaining a history and physical.
  • 34. Specific Comments/Suggestions
    • Ophtho/Otolaryngology
      • Introductory lecture was very well received
      • Proper use of otoscope and ophthalmoscope was well taught
      • Consultants and residents were very eager to teach
      • Some students were unable to assess patients on their own and present to consultants/residents
      • Restriction from attending formal teaching is a deterrent.
      • A two-week elective in either ophtho or ENT should be an option (missing teaching sessions wouldn’t be such an issue in this circumstance)
  • 35. General Recommendations
  • 36. General Recommendations
    • Each elective/selective should try to provide students with a list of core objectives, a schedule, and a description of how the elective/selective works
    • Consultants and residents should actively encourage student learning and participation in the OR
    • Consider making Anesthesia a mandatory rotation
    • Consider making Otolaryngology and Ophthalmology independent two-week electives
  • 37. Thank you!