Using Concurrent Complication Reporting to Evaluate Resident Critical Thinking and Enhance Adult Learning

A Needs Assessment of Video-based Education Resources Among General Surgery Residents

Are university-based residency training programs lacking in resident education of proper diagnosis and treatment for common skin and breast lesions?

Surgery Residents Spend Nearly 8 Months of Their 5-Year Training on the Electronic Health Record (EHR)

The goal of training in orthopedic residency is to produce surgeons who are proficient in all aspects of the practice of orthopedic surgery; however, most residents receive either inadequate or no training in medical coding. The purpose of this study was to determine how well orthopedic residents code when compared with practicing surgeons and to identify whether coding education improves accuracy in medical coding. A mock coding survey was developed using commonly encountered orthopedic clinical scenarios. The survey was distributed to orthopedic trainees post-graduate years (PGY) 1 to 6 at 2 training programs and to attending surgeons. Results were analyzed in 3 groups: junior residents (PGY 1-3), senior residents (PGY 4-6), and attending surgeons. Overall and subcategory scores of (1) type of visit, (2) modifiers, (3) Evaluation and Management (E/M), and (4) Current Procedural Terminology code identification were recorded. Participants were also asked if they had ever received various forms of coding education. Sixty-seven total participants were enrolled, including 28 junior residents, 24 senior residents, and 15 attendings. Practicing surgeons performed significantly better than both senior (P<.027) and junior (P<.001) residents in all categories, with a mean overall correct response rate of 72.8%, 51.0%, and 47.4%, respectively. Any form of coding education was associated with a significantly improved overall score for residents (P=.013) and a nonsignificant increase for attending surgeons (P=.390). This study demonstrates that residents performed poorly when identifying proper billing codes for common procedures and encounters in orthopedic surgery. Further, those participants who received coding education did better than those who did not. [Orthopedics. 2020;43(6):380-383.].

54 STABCric 3: Surgical Technique Against Bougie Cricothyrotomy

In the Republic of Congo, formal teacher training is comprised of both theoretical and practical components. Theoretical training takes the form of theoretical courses within the training institution itself. On the other hand, practical training takes place in professional settings such as secondary school. The purpose of this comparative study was to identify the conceptions of critical thinking development held by pedagogical supervisors and student trainees. Rooted in a qualitative methodological approach, this research was based on Eric Lavertu's (2013) conceptual approach to the development of critical thinking during internships. Eight (08) pedagogical supervisors and nineteen (19) student-interns voluntarily participated in the study via focus groups. The results revealed a categorization of several didactic-pedagogical devices for the development of student-interns' critical thinking, according to both the pedagogical supervisors and the studentinterns themselves. To foster the development of critical thinking in student trainees, the devices mentioned specify that the supervisor must implement a supervisory pedagogical approach anchored in a socio-constructivist paradigm to accompany the student's development while employing a reflective approach in coaching. In addition, these systems stress the importance of placing the student at the center of their learning, making them a real player in their own development.

Invited Commentary

Declining Surgical Resident Operative Autonomy—All Trainees Are Not Created Equal

An Interdisciplinary Approach to Surgical Skills Training Decreases Programmatic Costs

Asynchronous online discussions (AODs) are increasingly prevalent in higher education to adapt to educational changes and promote critical thinking among learners. Past research has emphasized instructors' facilitation roles in encouraging learners' critical thinking in AODs, while fewer studies explored peer facilitation and peer participants' critical thinking from the students' perspective as facilitators. This study used a lag sequential analysis approach to examine peer facilitation techniques and critical thinking in a peer‐facilitated AOD spanning six tasks over 12 weeks with 40 undergraduate participants. Results highlighted that the most frequently used peer facilitation techniques were giving own opinions or experiences and questioning, with the latter demonstrating the highest number of significant sequential patterns. Peer participants' critical thinking primarily involved analyse and evaluate, with significant sequential patterns observed in lower level and higher order critical thinking stages but not between them. Further investigation revealed the impact of peer facilitation techniques on critical thinking, and a new three‐phase model was developed to describe their associations. These findings suggest that dynamic peer facilitation techniques effectively enhance critical thinking, with specific techniques targeting distinct phases of its development in AODs. The study provides actionable insights for educators, offering strategies to optimize facilitation approaches and foster critical thinking skills in higher education settings. Practitioner notesWhat is already known about this topic Asynchronous online discussions are widely used in higher education to encourage learners' critical thinking. Instructors as facilitators play a positive role in encouraging learners' critical thinking in asynchronous online discussions, while the role of peer facilitators is less discussed. In peer‐facilitated asynchronous online discussions, the facilitation techniques used by peer facilitators affect the development of critical thinking in peer participants. What this paper adds Uses lag sequential analysis to examine the sequential patterns of peer facilitation techniques and critical thinking in peer‐facilitated asynchronous online discussions. Reports common peer facilitation techniques used by peer facilitators and observed significant sequential patterns. Presents the distribution and developmental sequential patterns of critical thinking in peer participants. Examines the association between peer facilitation techniques and critical thinking, and develops a new three‐phase model to describe this association. Implications for practice and/or policy Dynamic peer facilitation techniques can effectively promote the development of critical thinking in peer participants, with specific relationships existing between different phases of critical thinking and different types of peer facilitation techniques. This study reveals the facilitation of critical thinking in asynchronous online discussions from the perspective of learners as facilitators, filling a research gap. The findings provide practical guidance for effectively encouraging critical thinking among college students in higher education.

Today, the need for the formation and development of critical thinking attracts more and more attention from foreign and domestic scientists. It was found out that this is primarily due to the lack of independence, social orientation, motivation and effectiveness of thinking of the younger generation. There is a tendency to increase the flow of information with which a person interacts on a daily basis, but the question arises not only of perceiving and memorizing this information, but also of critical understanding, highlighting important characteristics, and achieving the truth of knowledge. The development of critical thinking becomes the main task of education, in particular higher education, it is an important component of the intellectual development of future teachers. The article considers the need to develop critical thinking skills in future educators. The didactic features of the mentioned phenomenon among students of higher education in the specialty 012 Preschool education during the study of the discipline «Formation of soft skills of a modern specialist in preschool education» were revealed. Education focused on the development of critical thinking is an urgent methodological problem of modern education. Techniques for the development of critical thinking make it possible to obtain positive results in the formation of active mental activity of students. The specified type of thinking is aimed at developing skills for working with information, the ability to analyze and apply this information in solving professional situations. Based on the analysis of scientific literature, the interpretation of the concept of «critical thinking» from the perspective of psychological and pedagogical science, namely the views of researchers of the past and modern scientists, is highlighted. The author describes the methods and techniques of developing critical thinking. Among them, the following were found to be effective: «INSERT», «Open microphone», «Brainstorming», «Conjecture tree», «Written discussion», «Thick and thin questions», «PRES-formula», «Fishbone». The specified methods and techniques accustom students to independent thinking, a critical look at alternative solutions to existing problems, and the choice of well-founded argumentation. Emphasis is placed on the application of the problem-based approach in the educational process, which is the main tool for the development of critical thinking, because it contains a contradiction that allows students to form their own attitude to the issues under consideration. It has been proven that during the study of micro- and macroeconomics, effective methods of developing critical thinking are the division of students into groups and teamwork during preparation for debates, and the important role of essay writing is also analyzed. Key words: critical thinking, professional training, future educator, «INSERT», «Written discussion», «PRES-formula», «Fishbone».

Perception of shared learning environment differs between vascular surgery and general surgery residents

In 2011, the American Board of Surgery (ABS) implemented a policy to permit greater flexibility in the structure of general surgery (GS) residency training. Our goal was to investigate the impact of flexibility in surgical training (FIST) on resident success in obtaining ABS board eligibility and certification. A prospective, multi-institutional study was conducted to examine the feasibility of incorporating flexibility tracks across residency programs and measure educational outcomes including ABS In-service Training Exam (ABSITE) scores, Accreditation Council for Graduate Medical Education (ACGME) Milestones, operative case log volumes, and ABS Qualifying (QE) and Certifying (CE) Examinations scores. We compared residents participating in flexibility tracks ("FIST residents") to contemporaneous residents not involved in subspecialty tracks ("non-FIST residents"). Seven academic GS residency programs. GS residents at participating institutions were granted the opportunity to customize up to 12 of the final 24 months of residency with subspecialty rotations. From 2013 to 2019, 186 (52.2%) of 356 residents participated in a flexibility track. The most frequently selected subspecialty tracks were hepatobiliary (26.9%), gastrointestinal (15.1%), and cardiothoracic surgery (15.1%). There were no significant differences in ABSITE scores (573.0 vs. 562.0; p = 0.191) or total major operations performed (1056.5 vs 1018.0; p = 0.074) between FIST and non-FIST post-graduate year 5 residents. Residents participating in FIST scored significantly higher on 15 of 16 ACGME Milestones when compared to non-FIST residents. The first-time pass rate for the ABS QE was 92.2% and 91.1% for FIST and non-FIST residents, respectively (p = 0.756). The first-time pass rate for the ABS CE was 85.8% and 83.6% for FIST and non-FIST residents, respectively (p = 0.687). Overall, FIST residents had a higher first-time pass rate on both the QE (92.2% vs. 90.6%) and CE (85.8% vs. 81.7%), when compared to the national average. Despite spending more time on subspecialty-focused flexible rotations, residents participating in FIST perform similarly to their peers in multiple measures, including on the ABS QE and CE. Incorporating integrated subspecialty training within GS residency does not interfere with the future success of trainees in obtaining ABS board certification. These findings could help inform modifications to the structure of surgical training, including allowing for earlier entry into subspecialty training.

We attribute the development of critical thinking to the urgent problem of teachers’ training in the additional professional education (APE) system, allowing them to design tasks for the development of students’ critical thinking, which determines the formation of their functional literacy. The paper reveals a solution to the problem of developing didactic tools and conditions by teachers within the framework of professional development in the APE system that ensure the development of students’ critical thinking. The aim is to describe the use of techniques for contextual understanding of the text in the APE courses for teachers, which determine the development of critical thinking of education subjects. Project teams of teachers (112 people) from the Lyceum of Istra, Secondary School No. 17 in Odintsovo, Moscow Region, took part in the experimental work on the implementation of techniques for the development of critical thinking designed by teachers trained in the DPO system. Diagnostics of the development of teachers’ critical thinking was carried out on the basis of the methodology for determining the level of development of teachers’ critical thinking (E.N. Volkova), an individual measure of reflexivity (A.V. Karpova). The techniques for contextual perception and analysis of text have been developed, including interpretation, explanation, evaluation, interpretation, questions and critical analysis of videos, works of art and texts through the prism of a certain context. These techniques represent the novelty of the study. A methodology for constructing techniques for interpreting and treating any content, video material, critical analysis of texts in the context of certain concepts and theories is presented. A methodology for designing a technique for explaining, interpreting and critically analyzing materials, including educational videos and texts, in the context of the content of various subjects is also proposed. All the proposed techniques are related to the theoretical significance of this study. The practical significance of the study is revealed in a specific assignment for teachers undergoing their qualification mastering at the level of APE, consisting of a multi-contextual interpretation of the video «Stand to the end, don’t you dare break!» The techniques developed in the study for contextual perception, comprehension of the text, and the methods for their development by teachers improving their qualifications in the APE system expand and enrich the theory of modeling pedagogical means for developing critical thinking in education subjects and create new opportunities for its development.

In the context of globalization, critical thinking is still regarded as the core content of higher education. The difference between Eastern and Western cultures has a key impact on understanding critical thinking. When the current literature studies the influence of culture on critical thinking, it mainly considers from the macro level, mainly including ethnic history, traditional customs, religious beliefs, art, ethics, and so on. However, from a specific and micro cultural perspective, how critical thinking is influenced by a culture still lacks effective research. This paper studies the influence of Confucian paternalistic leadership on the development of critical thinking in the East from a specific cultural perspective. The study discovers that Asians are easier to understand how things change and they are more tolerant to conflict, which means that they see things as interrelated and interdependent. They are more likely to use intuitive and experience-based reasoning if there is a conflict between intuitive and logical reasoning. Benevolence and hierarchy in paternalistic leadership promote the formation of cooperative critical thinking in improving the operation of organizations so that the characteristics of oriental critical thinking can be analyzed more comprehensively.