You're a new attending leading a busy surgical service. You’re tasked with teaching a team that includes every learner from medical students to junior and senior residents—all from different generations. How do you adapt your teaching style to effectively reach everyone? Dr. Abbey Fingeret, Endocrine Surgeon at University of Nebraska and passionate Surgical Educator, joins our host, Dr. Elizabeth Maginot, to explore strategies for engaging learners across generations and creating inclusive, dynamic teaching environments.

Hosts:

Learning Objectives:

-  Understand the defining characteristics of Baby Boomers, Gen X, Millennials, and Gen Z, and how these traits influence their learning and teaching styles in medical education.

-  Explore how to adapt teaching strategies for multigenerational learners by understanding and addressing their unique perceptions of education, feedback, and expectations in the clinical setting.

-  Discuss methods to build a positive learning environment that fosters collaboration and inclusivity across all levels of trainees.

-  Recognize the strengths and challenges different generations bring to medical education and how to leverage these to enhance team learning and patient care."

Stillman, D., & Stillman, J. (2017). Gen Z@ work: How the next generation is transforming the workplace. HarperCollins. https://pubmed.ncbi.nlm.nih.gov/?term=Stillman%2C+D.%2C+%26+Stillman%2C+J.+%282017%29.+Gen+Z%40+work%3A+How+the+next+generation+is+transforming+the+workplace.+HarperCollins.

Elmore, T., & McPeak, A. (2019). Generation Z unfiltered: Facing nine hidden challenges of the most anxious population. Poet Gardener Publishing.

Twenge, J. M. (2023). Generations: The Real Differences Between Gen Z, Millennials, Gen X, Boomers, and Silents—and What They Mean for America's Future. Simon and Schuster.

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Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Join the Behind the Knife Surgical Oncology Team as we discuss the presentation, work-up, and management of neuroendocrine tumors of the small bowel.

In this episode, we review the basics of neuroendocrine (NE) tumors of the small bowel, including how to evaluate patients with presenting symptoms consistent with NE tumors, initial work-up, staging, and management.  We discuss key concepts including DOTATATE scans and medical therapies high yield for direct patient care and board exams. 

Hosts:

Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center

Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist/HPB surgeon at Kaiser LAMC in Los Angeles.

Connor Chick, MD (@connor_chick) is a 2nd Year Surgical Oncology fellow at Ohio State University.

Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a 1st Year Surgical Oncology fellow at MD Anderson.

Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a PGY-6 General Surgery resident at Brooke Army Medical Center

Strosberg J, El-Haddad G, Wolin E, Hendifar A, Yao J, Chasen B, Mittra E, Kunz PL, Kulke MH, Jacene H, Bushnell D, O'Dorisio TM, Baum RP, Kulkarni HR, Caplin M, Lebtahi R, Hobday T, Delpassand E, Van Cutsem E, Benson A, Srirajaskanthan R, Pavel M, Mora J, Berlin J, Grande E, Reed N, Seregni E, Öberg K, Lopera Sierra M, Santoro P, Thevenet T, Erion JL, Ruszniewski P, Kwekkeboom D, Krenning E; NETTER-1 Trial Investigators. Phase 3 Trial of 177Lu-Dotatate for Midgut Neuroendocrine Tumors. N Engl J Med. 2017 Jan 12;376(2):125-135. doi: 10.1056/NEJMoa1607427. PMID: 28076709; PMCID: PMC5895095.

https://pubmed.ncbi.nlm.nih.gov/28076709/

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Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Join Patrick Georgoff to learn more about how YOU can make amazing digital education content. At Behind the Knife we are often asked how to create digital education content. Thanks to the democratization of technology and rise of the creator economy, all of the tools are at your fingertips. Would you like to enhance your next lecture, grant application, manuscript submission, or patient educational material? You can, even if you are part luddite! You don't need a publisher, advanced computer skills, or tons of money. Don't believe us? Listen to this short podcast for tipsand tricks on how you can make great content. 

Patrick Georgoff (@georgoff) is an Acute Care Surgeon at Duke University. He went to medical school at the University of Pennsylvania, completed General Surgery residency and Surgical Critical Care fellowship at the University of Michigan, and a Trauma Surgery fellowship at the University of Texas in Houston. His clinical practice includes the full spectrum of Acute Care Surgery in addition to elective hernia surgery. Patrick is deeply involved in surgical education and the is the Associate Program of the General Surgery Residency at Duke and Co-Director of Behind the Knife. He is passionate about trauma system performance and holds the position of associate Trauma Medical Director at Duke. 

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Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Join Drs. Michael Rosen, Clayton Petro, and Sara Maskal as they review their recently published randomized controlled trial comparing open retromuscular Sugarbaker and Keyhole approaches to parastomal hernia repair  

Hosts:   

- Sara Maskal, MD, Cleveland Clinic 

- Clayton Petro, MD, Cleveland Clinic 

- Michael Rosen, MD, Cleveland Clinic 

- Understand the trial design

- Review trial outcomes

- Understand how to apply the outcomes to patients with parastomal hernias

- Maskal SM, Ellis RC, Fafaj A, et al. Open Retromuscular Sugarbaker vs Keyhole Mesh Placement for Parastomal Hernia Repair: A Randomized Clinical Trial. JAMA Surg. Published online June 12, 2024. doi:10.1001/jamasurg.2024.1686 https://pubmed.ncbi.nlm.nih.gov/38865142/

- Maskal SM, Thomas JD, Miller BT, Fafaj A, Zolin SJ, Montelione K, Ellis RC, Prabhu AS, Krpata DM, Beffa LR, Costanzo A. Open retromuscular keyhole compared with Sugarbaker mesh for parastomal hernia repair: Early results of a randomized clinical trial. Surgery. 2024 Mar 1;175(3):813-21. https://pubmed.ncbi.nlm.nih.gov/37770344/

- Moreno-Matias J, Serra-Aracil X, Darnell-Martin A, Bombardo-Junca J, Mora-Lopez L, Alcantara-Moral M, Rebasa P, Ayguavives-Garnica I, Navarro-Soto S. The prevalence of parastomal hernia after formation of an end colostomy. A new clinico-radiological classification. Colorectal Dis. 2009 Feb;11(2):173-7. doi: 10.1111/j.1463-1318.2008.01564.x. Epub 2008 May 3. PMID: 18462232. https://pubmed.ncbi.nlm.nih.gov/18462232/

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Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

You are planning to perform an APR on a patient with rectal cancer. How will you create your permanent stoma? Is there a role for prophylactic mesh? Post operatively at one year surveillance they have developed a parastomal hernia, when do you fix it and how? Join Drs. Abelson, Marcello and Aulet and special guest Dr. Paul Sturrock as they discuss key management considerations. 

Learning Objectives:

1.     Describe the different types of parastomal hernia repairs

2.     List indications for repair of parastomal hernias

3.     Discuss the approach to managing parastomal hernias

Articles:

Steele S, et al. The ASCRS Textbook of Colon and Rectal Surgery, fourth ed. 2022.  https://link.springer.com/book/10.1007/978-3-030-66049-9

J C Goligher, Extraperitoneal colostomy or ileostomy, British Journal of Surgery, Volume 46, Issue 196, September 1958, Pages 97–103, https://doi.org/10.1002/bjs.18004619602

 

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Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

In this episode, Drs. Patrick Georgoff, Teddy Puzio, and Jason Brill are joined by special guest Dr. Pat Murphy, who helps us delve into the evolving field of acute care surgery (ACS), exploring its history, challenges, and the nuances of defining full-time employment in this demanding specialty. The discussion highlights the origins of ACS as a response to unmet emergency surgical needs and its three foundational pillars: trauma surgery, emergency general surgery, and surgical critical care, with additional roles like surgical rescue evolving over time. Dr. Murphy share insights into the workload, including night shifts, call schedules, and the toll on surgeons' health, emphasizing the importance of fair compensation, equitable shift distribution, and transparency in job expectations. The episode underscores the value ACS surgeons bring to hospitals, likening them to essential infrastructure like firefighters, with their impact often unrecognized in traditional productivity metrics like RVUs.

 

 Dr. Murphy would like to thank the many collaborators who made this volume of work possible including the many acute care surgeons who have taken the time to participate in the research and their dedication to patient care and surgeon wellbeing

Learning Objectives:

1)        Define and understand the evolution of acute care surgery as a surgical subspecialty, including its historical development, key components (trauma, surgical critical care, emergency general surgery, surgical rescue), and its unique role within the surgical landscape.

2)        Analyze the concept of "full-time equivalent" (FTE) for acute care surgeons, considering factors such as call schedules, shift length, service demands, and the impact of varying case volumes and intensities on workload.

3)        Discuss the challenges of defining and measuring the value of acute care surgeons, considering factors beyond traditional productivity metrics (e.g., RVUs) such as the impact of surgical rescue, patient safety, and the value of 24/7 availability in preventing adverse outcomes.

4)        Explore the importance of recognizing the unique demands and contributions of acute care surgeons, including the impact of high-stress environments, irregular schedules, and the importance of work-life balance and clinician well-being on long-term sustainability within the specialty.

This episode of Big T Trauma was sponsored by Teleflex, a global provider of medical devices. Learn more at teleflex.com and at the Teleflex Trauma and Emergency Medicine LinkedIn page.

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Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. 

If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

BIG T Trauma Series: https://app.behindtheknife.org/podcast-series/big-t-trauma

In their BTK debut, the Surgical Endoscopy team from Endeavor Health (formerly Northshore University Health System) discusses why it is important for surgeons to acquire basic and advanced endoscopic skills. There are an increasing number of ways to endoscopically intervene and solve problems that were traditionally relegated to open and minimally invasive surgery. The Surg Endo team presents a number of case-based scenarios that are going to set the stage for future discussions about the role of therapeutic endoscopy in surgical practice. 

Hosts:

- Dr. Sullivan “Sully” Ayuso, Minimally Invasive Surgery, Endeavor Health (Evanston, IL), @SAyusoMD (Twitter)

- Dr. Trevor Crafts, Minimally Invasive Surgeon, Rocky Mountain VA Medical Center (Denver, CO), @CraftsTrevor (Twitter)

- Dr. H. Masson Hedberg, Minimally Invasive Surgeon, Endeavor Health (Evanston, IL)

- Dr. Michael Ujiki, Professor and Louis Biegler Chair of Surgery, Endeavor Health (Evanston, IL), @UjikiMike

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Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

In this episode, Behind the Knife fellow Ayman Ali, and Dr. Patrick Georgoff introduce a new series on Behind the Knife – Artificial Intelligence for the Clinician. Over the course of a few episodes, we aim to go over all things AI, with a particular focus on how you can use AI today to enhance your quality of life as a clinician, with just enough detail to understand key concepts. 

This first episode features guest Dr. Monica Agrawal, an expert in artificial intelligence and a pioneer in large language models. She recently joined Duke after completing a PhD in Computer Science at MIT in the clinical machine learning group and is a co-founder of Layer Health, a healthcare AI company. With her expertise, we’ll define some key terms and give a brief introduction to what artificial intelligence is and is not, as well as some examples and use cases. 

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Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. 

If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Research is so critical to the field of surgery worldwide. But how does the world of academic surgery compare in the UK? Join BTK fellow Jon Williams and ASGBI partner Jared Wohlgemut  for another installment of our BTK/ASGBI collaborative series where we take a deep dive investigating the many facets of surgical research–everything from getting started, funding, collaboration, mentorship, and sage advice from two incredibly successful academic surgeons. Professor Susan Moug represents the UK while Dr. Lesly Dossett represents the US in this excellent episode for any trainee or surgeon who is academically-inclined. After listening, you get to decide–who does it better?? UK or US?

Professor Moug is an Honorary Professor at the University of Glasgow, Scotland. She is a Consultant Colorectal and Robotic surgeon at Golden Jubilee National University Hospital in Clydebank, and at the Royal Alexandra Hospital in Paisley, Scotland. She is also the Director of Research for the Association of Surgeons of Great Britain and Ireland since 2021, and the Surgical Specialty Lead for Colorectal Research at the Royal College of Surgeons of England. She has been awarded a Senior Fellowship from the Chief Scientist Office of the Scottish Government, and was the chief investigator for the Emergency Laparotomy in Frailty multicentre study, and the No-Laps follow-on study. Essentially, she is one of the leading researchers in emergency surgery in the UK, having been awarded over 1 million in grant funding for this under-researched and underfunded area.

Dr. Dossett is an associate professor and surgical oncologist at the University of Michigan. After completing her undergraduate degree at Western Kentucky University, She completed both medical school and her general surgery residency at Vanderbilt University in Nashville, TN, during which she obtained an Agency for Healthcare Research and Quality training grant as well as a Masters in Public Health during research time. Following residency, she served as an active duty staff surgeon in the US Navy for several years before pursuing surgical oncology fellowship training at Moffitt Cancer Center. In 2016 she came on to University of Michigan as faculty and has since held numerous academic leadership roles both institutionally and nationally, including vice chair for faculty development, chief of the division of surgical oncology, and president of the Surgical Outcomes Club. Dr. Dossett has an impressive portfolio of research work focusing on implementation and de-implementation of comprehensive cancer care, which is funded through multiple NIH grants. 

If you enjoyed this episode, stay tuned for more upcoming BTK/ASGBI collaborative content. If you have any questions or comments, please feel free to reach out to us at [email protected]. 

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Join University of Washington’s surgical palliative care team for another engaging role play episode, where we tackle the challenging goals-of-care conversation. Using the VitalTalk REMAP framework, we explore effective communication strategies, highlight common pitfalls, and simulate two real-world scenarios: an on-call surgeon discussing goals of care with a complex patient facing an emergent surgical issue, and a team member facilitating a family meeting about goals of care in the surgical ICU.

Dr. Katie O’Connell (@katmo15) is an associate professor of surgery at the University of Washington. She is a trauma surgeon, palliative care physician, director of surgical palliative care, and founder of the Advance Care Planning for Surgery clinic at Harborview Medical Center, Seattle, WA.

Dr. Ali Haruta is an assistant professor of surgery at the University of Washington. She is a trauma and emergency general surgeon and palliative care physician. Ali recently completed fellowships in palliative care at the University of Washington and Trauma and Critical Care fellowship at Parkland. 

Dr. Lindsay Dickerson (@lindsdickerson1) is a PGY6 general surgery resident at the University of Washington, with an interest in surgical oncology. 

Dr. Virginia Wang is a PGY3 general surgery resident at the University of Washington.

• Identify questions that elicit patients’ goals and values, particularly during emotionally charged conversations.  

• Name the three categories of patient values in the values triad.

• Describe the importance of aligning with patients’ and families’ values and demonstrate techniques to achieve alignment.  

• Develop a treatment plan that reflects patients’ stated values.  

“REMAP.” VitalTalk. Accessed December 2nd. https://www.vitaltalk.org/guides/transitionsgoals-of-care/

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