Surgery Block Evaluation


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Surgery Block Evaluation

  1. 1. Surgery Block Evaluation Clerkship and Electives Committee June 21 st , 2004 Presented By: Nina Ghosh, Dina Popovic
  2. 2. Surgery Electives <ul><li>Anesthesia </li></ul><ul><li>Cardiac Surgery </li></ul><ul><li>General Surgery </li></ul><ul><li>Neurosurgery </li></ul><ul><li>Orthopedics </li></ul><ul><li>Ophtho/ENT </li></ul><ul><li>Pediatric Surgery </li></ul><ul><li>Plastic Surgery </li></ul><ul><li>Thoracic Surgery </li></ul><ul><li>Urology </li></ul><ul><li>Vascular Surgery </li></ul>
  3. 3. Survey Results
  4. 18. General Comments
  5. 19. General Comments – PRO’S <ul><li>resident teaching - a significant strength </li></ul><ul><li>good block organization </li></ul><ul><li>excellent teaching sessions </li></ul><ul><li>the consultants, residents and even fourth year elective students were all very helpful. </li></ul>
  6. 20. General Comments – CON’S <ul><li>the hours were absolutely gruelling </li></ul><ul><li>I only had cold site calls </li></ul><ul><li>More feedback would have been appreciated. </li></ul><ul><li>The consultants were not all too interested in teaching outside of the teaching sessions (over cases, in the OR, etc). </li></ul><ul><li>The definite emphasis on this part of the rotation was on service not on education. </li></ul>
  7. 21. Suggestions <ul><li>Buddy system with enthusiastic residents who like to teach </li></ul><ul><li>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. </li></ul><ul><li>Ensure that clerks have security of their belongings. </li></ul><ul><li>Ensure that clerks have desks in their sleep rooms. </li></ul><ul><li>More teaching at rounds rather than being a scribe </li></ul><ul><li>Supervisors and residents should be encouraged to quiz clerks more in the OR </li></ul>
  8. 22. General Comments - Windsor <ul><li>Surgery in Windsor was excellent in terms of the OR experiences </li></ul><ul><li>excellent hands-on training and one-on-one teaching with the consultant </li></ul><ul><li>videoconferencing leaves a lot to be desired - it was frustrating, poorly organized and not a good use of time </li></ul><ul><li>some residents are just unacceptable; not just unwilling to do informal teaching sessions, but unwilling to answer questions in general </li></ul><ul><li>should be able to do more in the OR on some services </li></ul><ul><li>it would be useful to have spent time in some clinics- more applicable to general practitioner training </li></ul>
  9. 23. Specific Comments/Suggestions
  10. 24. Specific Comments/Suggestions <ul><li>General Surgery </li></ul><ul><ul><li>Excellent 2-week elective </li></ul></ul><ul><ul><li>Students actively involved in all aspects of patient care </li></ul></ul><ul><ul><li>Important adjunct to alternative core rotations </li></ul></ul><ul><ul><li>On-call experience is extremely valuable </li></ul></ul><ul><ul><li>Strained team relationships among the other members of the team prior to my arrival also made this a rotation. </li></ul></ul><ul><ul><li>Clerks were overall bored in the OR because lack of involvement in cases </li></ul></ul>
  11. 25. Specific Comments/Suggestions <ul><li>Anesthesia </li></ul><ul><ul><li>Students enjoy active involvement </li></ul></ul><ul><ul><li>Consider making this a required rotation </li></ul></ul><ul><ul><li>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 </li></ul></ul><ul><ul><li>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. </li></ul></ul>
  12. 26. Specific Comments/Suggestions <ul><li>Cardiac Surgery </li></ul><ul><ul><li>Enthusiastic consultants and residents were very eager to teach </li></ul></ul><ul><ul><li>Students involvement in the OR is limited due to the type of procedures and the number of operators </li></ul></ul>
  13. 27. Specific Comments/Suggestions <ul><li>Neurosurgery </li></ul><ul><ul><li>Students involved in initial patient assessment (i.e. clinics) very valuable </li></ul></ul><ul><ul><li>Students involvement in the OR is limited due to the type of procedures and the number of operators </li></ul></ul><ul><ul><li>Consideration of student option to observe long procedures OR participate in “floor work” OR pursue self-directed learning </li></ul></ul>
  14. 28. Specific Comments/Suggestions <ul><li>Orthopedic Surgery </li></ul><ul><ul><li>Great exposure to trauma surgery and initial management of the trauma patient (SSC) </li></ul></ul><ul><ul><li>Some students felt they received limited (informal) teaching and little involvement in patient care. </li></ul></ul>
  15. 29. Specific Comments/Suggestions <ul><li>Plastic Surgery </li></ul><ul><ul><li>Good exposure to diversity of plastic surgery </li></ul></ul><ul><ul><li>Residents should make an effort to include clerks in ward involvement </li></ul></ul><ul><ul><li>Limited operative involvement </li></ul></ul><ul><ul><li>Some residents were less willing to teach </li></ul></ul>
  16. 30. Specific Comments/Suggestions <ul><li>Thoracic Surgery </li></ul><ul><ul><li>Very valuable introductory package and list of objectives provided to students </li></ul></ul><ul><ul><li>Excellent teaching by consultants and residents </li></ul></ul><ul><ul><li>Excellent student involvement in ward, clinic and OR </li></ul></ul><ul><ul><li>Very busy service requires students to sink or swim – although significant encouragement from staff and resident </li></ul></ul>
  17. 31. Specific Comments/Suggestions <ul><li>Urology </li></ul><ul><ul><li>Excellent teaching by consultants and residents </li></ul></ul><ul><ul><li>Excellent student involvement in ward, clinic and OR </li></ul></ul>
  18. 32. Specific Comments/Suggestions <ul><li>Vascular Surgery </li></ul><ul><ul><li>Excellent teaching by consultants and residents </li></ul></ul><ul><ul><li>Excellent student involvement </li></ul></ul>
  19. 33. Specific Comments/Suggestions <ul><li>Emergency Medicine </li></ul><ul><ul><li>Exposure to a wide variety of medical/surgical problems </li></ul></ul><ul><ul><li>Excellent student involvement in initial work-up of patients </li></ul></ul><ul><ul><li>Consultants should be encouraged to allow students to formulate an assessment and treatment plan instead of just obtaining a history and physical. </li></ul></ul>
  20. 34. Specific Comments/Suggestions <ul><li>Ophtho/Otolaryngology </li></ul><ul><ul><li>Introductory lecture was very well received </li></ul></ul><ul><ul><li>Proper use of otoscope and ophthalmoscope was well taught </li></ul></ul><ul><ul><li>Consultants and residents were very eager to teach </li></ul></ul><ul><ul><li>Some students were unable to assess patients on their own and present to consultants/residents </li></ul></ul><ul><ul><li>Restriction from attending formal teaching is a deterrent. </li></ul></ul><ul><ul><li>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) </li></ul></ul>
  21. 35. General Recommendations
  22. 36. General Recommendations <ul><li>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 </li></ul><ul><li>Consultants and residents should actively encourage student learning and participation in the OR </li></ul><ul><li>Consider making Anesthesia a mandatory rotation </li></ul><ul><li>Consider making Otolaryngology and Ophthalmology independent two-week electives </li></ul>
  23. 37. Thank you!