Evidence map›Paper›PMID 39261888›Full record

ArticleBMC surgery2024

When the first try fails: re-implementation of SIMPL in a general surgery residency.

Phillip J Hsu, Gregory Wnuk, Lisa Leininger, Samantha Peterson, David T Hughes, Gurjit Sandhu, Jay B Zwischenberger, Brian C George, Staci Aubry

Abstract read
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In one paragraph

Article in BMC surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. 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

9 authors.

Phillip J HsuDepartment of Surgery, University of Michigan, Ann Arbor, MI, USA. phillipjhsu@gmail.com.
Gregory WnukDepartment of Surgery, University of Michigan, Ann Arbor, MI, USA.
Lisa LeiningerDepartment of Surgery, University of Michigan, Ann Arbor, MI, USA.
Samantha PetersonDepartment of Surgery, University of Michigan, Ann Arbor, MI, USA.
David T HughesDepartment of Surgery, University of Michigan, Ann Arbor, MI, USA.
Gurjit SandhuDepartment of Surgery, University of Michigan, Ann Arbor, MI, USA.
Jay B ZwischenbergerDepartment of Surgery, University of Kentucky, Lexington, KY, USA.
Brian C GeorgeDepartment of Surgery, University of Michigan, Ann Arbor, MI, USA.
Staci AubryDepartment of Surgery, University of Michigan, Ann Arbor, MI, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWorkplace-based assessment (WBA) can facilitate evaluation of operative performance; however, implementation of WBA is sometimes unsuccessful. The American Board of Surgery Entrustable Professional Activities WBA project was launched in July 2023. Some programs will face the challenge of re-implementation of a WBA following previous failures. It is unknown what interventions are most effective for WBA re-implementation. Our goal is to identify barriers and facilitators to re-implementing SIMPL, an operative performance WBA.

methodsThe System for Improving and Measuring Procedural Learning (SIMPL) was implemented at our residency in 2018, but usage rates were low. We interviewed residents and faculty to identify barriers to usage and opportunities for improvement. Residents reported that SIMPL usage declined because of several factors, including a low faculty response rate, while some faculty reported not responding because they were unable to login to the app and because usage was not mandated. We then re-implemented SIMPL using a plan based on Kotter's Model of Change. To evaluate impact, we analyzed rates of SIMPL usage when it was first implemented, as well as before and after the date of re-implementation.

resultsIn September 2022, we re-implemented SIMPL at our program with measures addressing the identified barriers. We found that, in the six months after re-implementation, an average of 145.8 evaluations were submitted by residents per month, compared with 47 evaluations per month at the start of the original implementation and 5.8 evaluations per month just prior to re-implementation. Faculty completed 60.6% of evaluations and dictated feedback for 59.1% of these evaluations, compared with 69.1% at implementation (44% dictated) and 43% prior to re-implementation (53% dictated).

conclusionsAfter identifying barriers to implementation of a WBA, we re-implemented it with significantly higher usage by faculty and residents. Future opportunities exist to implement or re-implement assessment tools within general surgery programs. These opportunities may have a significant impact in the setting of national standardization of workplace-based assessment among general surgery residencies.

Indexed as

Clinical CompetenceGeneral SurgeryInternship and ResidencyEducational MeasurementEducation, Medical, GraduateHumansWorkplaceBarriers to usageChange in cultureEvaluationRe-implementationWorkplace-based assessment

Identifiers

PMID39261888
PMCPMC11389305

What OpenQuestion holds

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Registered trials

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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.