Innovation and Design Experiments in Academic Surgery (I.D.E.A.S.)

Tejas S. Sathe

A digital reference guide to sutures and needles (adapted from Twitter Thread)  As a student and junior resident, I didn’t understand how surgeons decided when to use each suture/needle. I tried to pick up on patterns but the info was never in one place.

What's the Stitch?

This tool represents my own ideas and is not currently in use or endorsed by any institution. Medical students applying to residency often have to grapple with an incredible amount of information when evaluating prospective training programs. The increased number of applications and interviews inherent to the Zoom era further exacerbates this issue.

The Residency Visual Abstract

Abstract
<strong>
 Background
</strong>
Reducing costs and carbon footprint are important, parallel priorities for the U.S. healthcare system. Within surgery, reducing the number of instruments that are sterilized and disposable supplies that are used for each operation can help achieve both goals.

Instrument and Supply Variability

We are amidst a revolution in artificial intelligence (AI). In this paper, we aim to share our early experience with creating custom AI-powered chatbots in surgical education. While our versions are prototypes, we hypothesize that similar chatbots will one day play a significant role in the field. In brief, AI is the ability of a computer to perform human-like tasks.

How I GPT It: Development of Custom AI Chatbots for Surgical Education

Joseph C. L'Huillier

This is a preprint of a manuscript currently under peer review.
<strong>
 <strong>
  Abstract
 </strong>
</strong>
Importance: Gossip, defined by social scientists as “evaluative talk about an absent third party,” is anecdotally pervasive, yet poorly understood in surgical residency programs. Objective: This study sought to deconstruct the role of gossip in surgical residency and evaluate its impact through the lens of surgical residents.

The Anatomy of Gossip: Dissecting Dynamics and Impacts in Surgical Residency

As residents within the healthcare profession, our first duty is to care for our patients. While working upwards of 80 hours per week pursuing that mission, it is hard to think of ourselves as anything beyond our job title. But we are also citizens. And while patient care remains a worthy North Star, decisions made by faraway policymakers can impact our patients as much as the assessments and plans we ourselves craft.

Voter Turnout Among General Surgery Residents in the 2022 U.S. Midterm Election

Recently, Asim A, MD had a thoughtful post on X about a question he thinks that applicants should ask interviewers in the 2024 Match. This is a very insightful question because of how much the answer reveals about the program. First, the answer will tell you about the practical support systems that exist.

Do you have any questions for me?

This is a preprint that has not yet been peer reviewed. Think about the last time you submitted a paper. After meticulous editing, you uploaded your manuscript and hit the "submit" button. Then, you waited. And waited. The reviewers requested revisions, which you obliged. More waiting. Finally, the paper was accepted and sent for proofing. You were one of the lucky ones.

Preprints: Opening Surgical Science to Greater Innovation and Transparency

Meghal Shah

I embarked on my year of academic development with the goal of making operating less painful for surgeons. The field of surgical ergonomics is nascent, and while there is an appetite for technological solutions, behavioral interventions are one of the only effective (albeit limited) tools available to us right now.

Fumbling at the Five Yard Line

<strong>
 Abstract
</strong>
The institutional knowledge required for residency is vast, complex, and frequently changing. Most institutions do not have a resource that serves as a singular source of truth for this information. Furthermore, since information is mostly presented on static documents such as emails or PDFs, there is no easy way to update and share the information in real time.

An Operating System for Residency

Imagine that you want to read a paper. You probably either search the subject area of interest on PubMed or Google Scholar. Perhaps you were directed to the paper from an interesting Twitter thread or other social media site. Or maybe you were assigned the paper for a journal club or weekly educational activity. If you're trying to read the paper from within your institution's network, the process is usually seamless.

Why Surgery Needs I.D.E.A.S.

One of the most counter-intuitive principles when applying design thinking to healthcare and surgery specifically is the idea that quantity of ideas is initially more important than quality of ideas.

Design Thinking: A Method for Building Creative Immunity

"Do you have an IRB?" is often the first question anyone asks when a new research idea is proposed. It shouldn't be the last. Despite the personal frustrations of surgeons who deal with them, institutional review boards (IRBs) maintain a revered status within our profession. For instance, the perceived necessity of IRB review is so ubiquitous that most readers will know to ask the above question even if they do not know why.

Silencing with Red Tape

This is a preprint of a manuscript currently under peer review. The American Board of Surgery In-Training Examination (ABSITE
<sup>
 ®
</sup>
) is a multiple-choice exam administered yearly to surgical residents. The ABS provides the following information on its website:  "The ABSITE is furnished to program directors as a formative evaluation instrument to assess residents’ progress.

Proposed Reforms to the American Board of Surgery In-Training Examination (ABSITE)

Recently, Drs. Robert Wachter and Erik Brynjolfsson published a viewpoint in the Journal of the American Medical Association JAMA on Generative AI in healthcare. We agree with their views and wished to add the following points in a response letter. While our letter was not accepted, we have pre-printed it here. Please find the original paper and our response below.

Response Letter

Students and residents aspiring for a career in academic surgery are looking for training programs that will help jumpstart their careers by exposing them to mentorship and opportunities to conduct research. While the gold standard of academic productivity (for the time being) remains peer-reviewed publications, conference posters and presentations are an important secondary metric.

How to Build an Academic Powerhouse: Let's Study Who's Doing it

We asked GPT-4 to pretend that it was an academic surgeon and write an essay on the biggest challenges in academic surgery and how to solve them. Here is an unedited output of what GPT-4 wrote as well as the series of prompts we used to get this output.
<strong>
 Disclaimer:
</strong>
AI large language models (LLM) can confidently state inaccurate information and make up facts.

GPT-4 on the Biggest Challenges in Academic Surgery

<strong>
 <strong>
  Abstract
 </strong>
</strong>
The field of surgery faces complex, systemic challenges that will require new academic frameworks. In this paper, we propose design thinking as a useful problem solving technique to apply to such challenges. We define design thinking and provide a brief history of this practice.

Teach Design to Surgical Trainees

I.D.E.A.S.

::: {.kg-card .kg-callout-card .kg-callout-card-grey}
::: {.kg-callout-text}
A digital reference guide to sutures and needles (adapted from Twitter
Thread)
:::
:::

As a student and junior resident, I didn't understand how surgeons
decided when to use each suture/needle. I tried to pick up on patterns
but the info was never in one place. This is an attempt to solve that
problem using
 [@NotionHQ](https://twitter.com/NotionHQ?ref=ideasurg.pub)

<figure class="kg-card kg-image-card kg-width-wide">
<img src="https://www.ideasurg.pub/content/images/2022/12/Guide1.png"
class="kg-image" loading="lazy"
srcset="https://www.ideasurg.pub/content/images/size/w600/2022/12/Guide1.png 600w, https://www.ideasurg.pub/content/images/size/w1000/2022/12/Guide1.png 1000w, https://www.ideasurg.pub/content/images/size/w1600/2022/12/Guide1.png 1600w, https://www.ideasurg.pub/content/images/2022/12/Guide1.png 1920w"
sizes="(min-width: 1200px) 1200px" width="1920" height="1080" />
</figure>

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In one click, you can see details about each suture and needle type and
convert between brands
[@Ethicon](https://twitter.com/Ethicon?ref=ideasurg.pub)
[@Medtronic](https://twitter.com/Medtronic?ref=ideasurg.pub)

<figure class="kg-card kg-image-card kg-width-wide">
<img src="https://www.ideasurg.pub/content/images/2022/12/Guide4.png"
class="kg-image" loading="lazy"
srcset="https://www.ideasurg.pub/content/images/size/w600/2022/12/Guide4.png 600w, https://www.ideasurg.pub/content/images/size/w1000/2022/12/Guide4.png 1000w, https://www.ideasurg.pub/content/images/size/w1600/2022/12/Guide4.png 1600w, https://www.ideasurg.pub/content/images/2022/12/Guide4.png 1920w"
sizes="(min-width: 1200px) 1200px" width="1920" height="1080" />
</figure>

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Using filters and tabs, display the information in a way that makes
sense to you

<figure class="kg-card kg-image-card kg-width-wide">
<img src="https://www.ideasurg.pub/content/images/2022/12/Guide2.png"
class="kg-image" loading="lazy"
srcset="https://www.ideasurg.pub/content/images/size/w600/2022/12/Guide2.png 600w, https://www.ideasurg.pub/content/images/size/w1000/2022/12/Guide2.png 1000w, https://www.ideasurg.pub/content/images/size/w1600/2022/12/Guide2.png 1600w, https://www.ideasurg.pub/content/images/2022/12/Guide2.png 1920w"
sizes="(min-width: 1200px) 1200px" width="1920" height="1080" />
</figure>

<figure class="kg-card kg-image-card kg-width-wide">
<img src="https://www.ideasurg.pub/content/images/2022/12/Guide3.png"
class="kg-image" loading="lazy"
srcset="https://www.ideasurg.pub/content/images/size/w600/2022/12/Guide3.png 600w, https://www.ideasurg.pub/content/images/size/w1000/2022/12/Guide3.png 1000w, https://www.ideasurg.pub/content/images/size/w1600/2022/12/Guide3.png 1600w, https://www.ideasurg.pub/content/images/2022/12/Guide3.png 1920w"
sizes="(min-width: 1200px) 1200px" width="1920" height="1080" />
</figure>

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I\'m sure I didn\'t get it all right and that some info is missing or
incorrect. I suspect number of knots and use cases vary among surgeons.

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Thanks to everyone who has already given feedback, including students,
residents, and faculty from
[@ColumbiaSurgery](https://twitter.com/ColumbiaSurgery?ref=ideasurg.pub)
and [@UCSFSurgery](https://twitter.com/UCSFSurgery?ref=ideasurg.pub)

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Using
[\#humancentered](https://twitter.com/hashtag/humancentered?src=hashtag_click&ref=ideasurg.pub)[\#design](https://twitter.com/hashtag/design?src=hashtag_click&ref=ideasurg.pub)
principles, I hope to iteratively improve this tool with feedback from
the
[\#SurgTwitter](https://twitter.com/hashtag/SurgTwitter?src=hashtag_click&ref=ideasurg.pub)[\#SurgEd](https://twitter.com/hashtag/SurgEd?src=hashtag_click&ref=ideasurg.pub)
community!

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<figure class="kg-card kg-embed-card kg-card-hascaption">
<blockquote>
<p>🧵about 🪡<br />
Hi <a
href="https://twitter.com/hashtag/SurgTwitter?src=hash&amp;ref_src=twsrc%5Etfw&amp;ref=ideasurg.pub">#SurgTwitter</a>,
I am building a digital guide to sutures and needles and would love your
feedback! <a
href="https://twitter.com/hashtag/SurgTwitter?src=hash&amp;ref_src=twsrc%5Etfw&amp;ref=ideasurg.pub">#SurgTwitter</a>
<a
href="https://twitter.com/hashtag/SurgEd?src=hash&amp;ref_src=twsrc%5Etfw&amp;ref=ideasurg.pub">#SurgEd</a>
<a
href="https://twitter.com/hashtag/gensurgmatch2023?src=hash&amp;ref_src=twsrc%5Etfw&amp;ref=ideasurg.pub">#gensurgmatch2023</a><a
href="https://twitter.com/SAGES_Updates?ref_src=twsrc%5Etfw&amp;ref=ideasurg.pub">@SAGES_Updates</a>
<a
href="https://twitter.com/AcademicSurgery?ref_src=twsrc%5Etfw&amp;ref=ideasurg.pub">@AcademicSurgery</a>
<a
href="https://twitter.com/AmCollSurgeons?ref_src=twsrc%5Etfw&amp;ref=ideasurg.pub">@AmCollSurgeons</a>
<a
href="https://twitter.com/Surg_Education?ref_src=twsrc%5Etfw&amp;ref=ideasurg.pub">@Surg_Education</a>
<a
href="https://twitter.com/BehindTheKnife?ref_src=twsrc%5Etfw&amp;ref=ideasurg.pub">@BehindTheKnife</a>
<a
href="https://twitter.com/modern_surgeon?ref_src=twsrc%5Etfw&amp;ref=ideasurg.pub">@modern_surgeon</a>
<a
href="https://t.co/hp9OnBDBvz?ref=ideasurg.pub">https://t.co/hp9OnBDBvz</a></p>
<p>— Tejas Sathe (@tssathe) <a
href="https://twitter.com/tssathe/status/1586073932867653632?ref_src=twsrc%5Etfw&amp;ref=ideasurg.pub">October
28, 2022</a></p>
</blockquote>
<figcaption>Original Twitter Post</figcaption>
</figure>
