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Donald A Risucci

Publications and source records attributed to Donald A Risucci.

5 recordsLinked to original sources
PubMed2005

Management of adverse surgical events: a structured education module for residents.

BACKGROUND: This pilot project involved the development of a structured, experiential, educational module using a bench model technical skills simulation and standardized patients. It integrated teaching and assessment of clinical, technical, and interpersonal skills, as well as professionalism within the context of an adverse surgical event. METHODS: General surgery residents (postgraduate year [PGY] 2, 3) were asked to participate in the pre-, intra-, and postoperative management of a patient with a retroperitoneal sarcoma. Residents' performances during the module were assessed by standardized patients and faculty, and residents were provided feedback during debriefing sessions. RESULTS: Resident performance during the module was appropriate for the level of training. Residents found this module to be a realistic, challenging, and beneficial learning experience. CONCLUSIONS: Novel educational modules such as this one may serve as a useful addition to resident education in surgery residency programs, particularly in addressing patient safety and the core competencies. Reliability of the model may be enhanced by modifications of the module.

Clinical Competence↗
PubMed2004

Injury prevention priority score: a new method for trauma centers to prioritize injury prevention initiatives.

BACKGROUND: Trauma centers are expected to develop injury prevention programs that address needs of the local population. A relatively simple, objective, and quantitative method is needed for prioritizing local injury prevention initiatives based on both injury frequency and severity. STUDY DESIGN: Pediatric trauma patients (16 years or younger; n= 7,958) admitted to two Level I regional trauma centers (Johns Hopkins Children Center and Westchester Medical Center) from 1993 to 1999 were grouped by injury causal mechanism according to ICD-9 external cause codes. An Injury Prevention Priority Score (IPPS), balancing the influences of severity (based on the Injury Severity Score) and frequency, was calculated for each mechanism and mechanisms were ranked accordingly. RESULTS: IPPS-based rank lists differed across centers. The highest ranked mechanism of injury among children presenting to Johns Hopkins Children Center was "pedestrian struck by motor vehicle," and at Westchester Medical Center it was "motor vehicle crash." Different age groups also had specific injury prevention priorities, eg, "child abuse" was ranked second highest among infants at both centers. IPPS was found to be stable (r = 0.82 to 0.93, p < 0.05) across alternate measures of injury severity. CONCLUSIONS: IPPS is a relatively simple and objective tool that uses data available in trauma center registries to rank injury causes according to both frequency and severity. Differences between two centers and across age groups suggest IPPS may be useful in tailoring injury prevention programs to local population needs.

Adolescent↗
PubMed2002

Visual spatial perception and surgical competence.

BACKGROUND: Proficiency in visual spatial perception (VSP) is a hypothetical component of surgical competence. METHODS: Four tests of VSP, taken from the Cognitive Laterality Battery (CLB), were administered to 301 surgeons and surgical residents. Mean scores on each test were compared by Student t tests to those of the normative sample (n = 251) on which the test was originally standardized. RESULTS: Mean scores on two of the tests (Orientation, Touching Blocks) were significantly greater (P <0.01) for the study sample than for the normative sample, while mean scores on the other two subtests (Form Completion, Localization) were not. CONCLUSIONS: Surgeons tend to outperform the general population on tests of high-level VSP abilities (ie, envisioning depth and mentally manipulating two-dimensional representations of three-dimensional structures) identified previously as correlates of surgical skill acquisition. VSP proficiency is a valid component of surgical competence that should perhaps be included in career selection discussions with medical students and in assessment of the competence of surgeons.

Adult↗
PubMedDate not supplied

Assessing educational validity of the Morbidity and Mortality conference: a pilot study.

PURPOSE: To assess inter-rater agreement in perceptions of cases presented during Morbidity & Mortality conference (M&M) and changes associated with initiation of a modified M&M. METHODS: Faculty, residents, fellows, and students at weekly M&M between June 2001 and March 2002 voluntarily completed an anonymous questionnaire after each M&M case presentation, which asked: if the complication was avoidable (yes/no/not sure), if consensus was reached among participants (yes/no/not sure), the primary cause of the complication (diagnostic error, technical error, judgment error, nature of disease, other), when the primary cause occurred (preoperatively, intraoperatively, postoperatively), and which, if any, of 16 listed actions could prevent similar future problems. On September 24, 2001, the conference was lengthened and modified. Data collected before (n = 30 cases) and after M&M modification (n = 46 cases) were compared. RESULTS: A total of 76 cases were evaluated for a total of 860 completed forms. In 57 cases (75%), majority opinion (ie, > or =50% of participants) indicated that the complication resulted from either nature of disease (n = 32, 41%), or error in diagnosis (n = 5, 7%), technique (n = 8, 11%) or judgment (n = 12, 17%). There was no clear majority for the remainder of the cases. Relative to cases presented prior to M&M modification, for those presented post-modification, the majority perceived that consensus was reached more often (96% of cases vs. 70% of cases, p<.01), and that complications were more often avoidable (54% of cases vs. 23% of cases, p <.05), more likely caused during the preoperative period (26% of cases vs. 7% of cases, p <.01) and less likely caused during the postoperative period (28% of cases vs. 67% of cases, p <.01). CONCLUSIONS: The variability in questionnaire responses suggests that an evaluation instrument such as that reported here can be useful in assessing educational needs, quantifying the efficacy of case presentations, and assessing the effects of modifications to conference content and structure. Modifying M&M in accordance with published recommendations appears to improve case analysis and consensus among participants.

Clinical Clerkship↗