A multi-method assessment of the vascular surgery program director experience in creating effective training environments.

Objectives: Surgical training has received significant attention in recent years with efforts to improve trainee wellness. Vascular surgery training is subject to unique challenges, and vascular program directors (PDs) are tasked with providing learning environments that produce effective and competent surgeons. The aim of this study is to examine the experience of vascular surgery PDs in promoting effective learning environments for vascular trainees.

The Relationships Between Hospital Support Staff and Vascular Trainee Educational Experience and Well-Being.

Background: Many stakeholders contribute to effective training environments for surgical residents, including program administrators and nursing staff. This study evaluates associations of hospital support staff with trainee educational time and wellness.

Methods: Data were collected via confidential voluntary survey of vascular trainees, who were asked about support staff interactions and protected educational time.

Implementation of enhanced recovery pathway for lower extremity arterial bypass decreases length of stay.

Objective: Frailty, nutrition, and comorbid conditions are all challenges that contribute to significant morbidity in patients undergoing lower extremity arterial bypass (LEAB). Evidence supports that enhanced recovery pathways (erps) can improve perioperative outcomes. However, few studies have demonstrated successful implementation of an ERP for LEAB.

The obstetric experience among vascular surgery trainees.

Background: Vascular surgery training poses unique risks to pregnancy, including long hours, physically demanding work, and radiation exposure. Our objectives were to (1) understand pregnancy and parenthood experiences among vascular surgery trainees, (2) assess the rate of obstetric complications among vascular trainees, and (3) evaluate factors associated with trainee-parent wellness.

Methods: A survey was administered after the 2021 Vascular Surgery In-Training Examination.

Trainee Perception of Virtual Interviews and Associations of Virtual Engagement with Vascular Surgery Culture and Community.

Background: In recent years, the vascular surgery community has increased the utilization of virtual interviews and virtual engagement or use of online technologies for educational, networking, and mentorship activities. This study evaluates trainee preferences of virtual interviews and associations of virtual engagement with wellness.

Methods: Deidentified data were collected from a confidential, voluntary survey of residents and fellows in vascular surgery programs administered following the 2023 Vascular Surgery In-Training Examination (VSITE).

Burnout is not associated with trainee performance on the Vascular Surgery In-Training Exam.

Objective: The Vascular Surgery In-Training Examination (VSITE) is a yearly exam evaluating vascular trainees' knowledge base. Although multiple studies have evaluated variables associated with exam outcomes, few have incorporated training program-specific metrics. The purpose of this study is to evaluate the impact of the learning environment and burnout on VSITE performance.

Reported pain at work is a risk factor for vascular surgery trainee burnout.

Background: Work-related pain is a known risk factor for vascular surgeon burnout. It risks early attrition from our workforce and is a recognized threat to the specialty. Our study aimed to understand whether work-related pain similarly contributed to vascular surgery trainee well-being.

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

Background: An enriching learning environment is integral to resident wellness and education. Integrated vascular (VS) and general surgery (GS) residents share 18 months of core GS rotations during the postgraduate years 1-3 (PGY1-3); differences in their experiences may help identify practical levers for change.

Methods: We used a convergent mixed-methods design.

Multidisciplinary Limb Salvage Service Reduces Major Amputations in Diabetic Foot Infections.

Background: Diabetic foot infections (DFIs) can lead to limb loss and mortality. To improve patient care at a safety-net teaching hospital, we created a multidisciplinary limb salvage service (LSS).

Methods: We recruited a cohort prospectively and compared it to a historical control group.

Defining sources and ramifications of mistreatment among female vascular surgery trainees.

Objective: Mistreatment among vascular surgery trainees is a known risk factor for physician burnout. This study aims to characterize forms of and identify sources of mistreatment.

Methods: This is a cross-sectional study of United States vascular surgery trainees who voluntarily participated in an anonymous survey administered after the 2021 Vascular Surgery In-Training Examination.

Impact of socioeconomic disparities on major lower extremity revascularization complications.

Introduction: Low socioeconomic status (SES), distance lived from hospital, and insurance status are well documented in the literature to increase the risk of post-operative morbidity and mortality for some disease processes however there is a paucity of data regarding how this association impacts patients with peripheral artery disease (PAD). This study aimed to evaluate if SES, distance lived from hospital, and insurance status increased the risk of developing major graft failure in patients undergoing revascularization procedures for symptomatic PAD in a prospective, observation study.

Methods: In this prospective, observational study, all patients undergoing lower extremity revascularization (endovascular or open) were included from December 2020 to February 2022.

Advance Directive and Do-Not-Resuscitate Status among Advanced Cancer Patients with Acute Care Surgical Consultation.

Formal communication of end-of-life preferences is crucial among patients with metastatic cancer. Our objective is to describe the prevalence of advance directives (AD) and do-not-resuscitate (DNR) orders among stage IV cancer patients with acute care surgery consultations, and the associated outcomes. This is a single institution retrospective review over an eight-year period.

Flow Rates at Thirty Days after Construction of Radiocephalic Arteriovenous Fistula Predict Hemodialysis Function.

Background: Construction of radiocephalic arteriovenous fistula (RC-AVF) results in successful hemodialysis (HD) in approximately 40% of end-stage renal disease patients. We investigated whether RC-AVF flow measured by ultrasound 30 days postoperative predicted successful HD.

Methods: In this prospective study, color Doppler ultrasound was used to measure cephalic vein outflow volume at 3 forearm sites at 1 and 3 months postoperatively.

The Burden of Tunneled Central Venous Catheters for Hemodialysis in a County Hospital.

Prolonged use of central venous catheters (CVCs) for hemodialysis (HD) is associated with greater morbidity and mortality when compared with autogenous arteriovenous fistulas (AVF). The objective was to assess compliance with CVC guidelines in adults referred for hemoaccess at a county teaching hospital. Out of 256 patients, 172 (67.

Follow-up trends after Emergency Department discharge for acutely symptomatic hernias.

Background: Patients frequently present to the Emergency Department (ED) with symptomatic hernias. This study evaluated the outcomes of patients presenting with symptomatic hernias without indication for immediate operation who are discharged for elective repair.

Methods: A three-year retrospective analysis of patients discharged from the ED with a symptomatic hernia was performed at a university affiliated county referral center.

Role of Preventability in Redefining Failure to Rescue Among Major Trauma Patients.

This cohort study assesses the role of preventability in the definition of failure to rescue when reviewing surgical performance for trauma patients who died after emergency surgery.

Financial and clinical outcomes of extracorporeal mechanical support.

Background: Over the past decade, extracorporeal mechanical support (ECMO) has been increasingly utilized in respiratory failure and cardiogenic shock. There is a need for assessing clinical and financial outcomes of ECMO use. This study presents our institution's experience with veno-arterial ECMO (VA-ECMO) over a 9-year period.