Evidence map›Paper›PMID 36747289›Full record

ArticleWorld journal of emergency surgery : WJES2023

Surgical resident experience with common bile duct exploration and assessment of performance and autonomy with formative feedback.

Molly Q Nyren, Amanda C Filiberto, Patrick W Underwood, Kenneth L Abbott, Jeremy A Balch, Francesca Dal Mas, Lorenzo Cobianchi, Philip A Efron, Brian C George, Benjamin Shickel and 3 more

Open access · goldAbstract read
In one paragraph

Article in World journal of emergency surgery : WJES, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 2 countries.

Molly Q NyrenUniversity of Florida College of Medicine, Gainesville, FL, USA.
Amanda C FilibertoDepartment of Surgery, University of Florida Health, PO Box 100286, Gainesville, FL, 32610, USA.
Patrick W UnderwoodDepartment of Surgery, University of Florida Health, PO Box 100286, Gainesville, FL, 32610, USA.
Kenneth L AbbottDepartment of Surgery, University of Florida Health, PO Box 100286, Gainesville, FL, 32610, USA.
Jeremy A BalchDepartment of Surgery, University of Florida Health, PO Box 100286, Gainesville, FL, 32610, USA.
Francesca Dal MasDepartment of Management, Ca' Foscari University of Venice, Venice, Italy.
Lorenzo CobianchiDepartment of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
Philip A EfronDepartment of Surgery, University of Florida Health, PO Box 100286, Gainesville, FL, 32610, USA.
Brian C GeorgeDepartment of Surgery, University of Michigan, Ann Arbor, MI, USA.
Benjamin ShickelDepartment of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
Gilbert R UpchurchDepartment of Surgery, University of Florida Health, PO Box 100286, Gainesville, FL, 32610, USA.
George A SarosiDepartment of Surgery, University of Florida Health, PO Box 100286, Gainesville, FL, 32610, USA.
Tyler J LoftusDepartment of Surgery, University of Florida Health, PO Box 100286, Gainesville, FL, 32610, USA. Tyler.Loftus@surgery.ufl.edu.ORCID 0000-0001-5354-443X
University of Florida Health · USUniversity of Florida · USCa' Foscari University of Venice · ITUniversity of Michigan · USUniversity of Pavia · IT

Funding

Molecular Biology in Burns and TraumaT32GM008721 · NIGMS · UNIVERSITY OF FLORIDA · PI Philip A Efron · 1999 to 2026
$5.0M
Aligning Patient Acuity with Intensity of Care after SurgeryK23GM140268 · NIGMS · UNIVERSITY OF FLORIDA · PI LOFTUS, TYLER J · 2020 to 2023
$619k
NIGMS NIH HHS K23 GM140268NIGMS NIH HHS T32 GM008721
6 · The paper itself

Abstract

backgroundCommon bile duct exploration (CBDE) is safe and effective for managing choledocholithiasis, but most US general surgeons have limited experience with CBDE and are uncomfortable performing this procedure in practice. Surgical trainee exposure to CBDE is limited, and their learning curve for achieving autonomous, practice-ready performance has not been previously described. This study tests the hypothesis that receipt of one or more prior CBDE operative performance assessments, combined with formative feedback, is associated with greater resident operative performance and autonomy.

methodsResident and attending assessments of resident operative performance and autonomy were obtained for 189 laparoscopic or open CBDEs performed at 28 institutions. Performance and autonomy were graded along validated ordinal scales. Cases in which the resident had one or more prior CBDE case evaluations (n = 48) were compared with cases in which the resident had no prior evaluations (n = 141).

resultsCompared with cases in which the resident had no prior CBDE case evaluations, cases with a prior evaluation had greater proportions of practice-ready or exceptional performance ratings according to both residents (27% vs. 11%, p = .009) and attendings (58% vs. 19%, p < .001) and had greater proportions of passive help or supervision only autonomy ratings according to both residents (17% vs. 4%, p = .009) and attendings (69% vs. 32%, p < .01).

conclusionsResidents with at least one prior CBDE evaluation and formative feedback demonstrated better operative performance and received greater autonomy than residents without prior evaluations, underscoring the propensity of feedback to help residents achieve autonomous, practice-ready performance for rare operations.

Indexed as

CholedocholithiasisInternship and ResidencyLaparoscopyCommon Bile DuctFormative FeedbackHumansAutonomyCommon bile duct explorationFeedbackPerformanceSurgery

Identifiers

PMID36747289
PMCPMC9901129
OpenAlexW4319297460

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.