How We Do It: Surgery IMPACT - Integrated Mentorship Program for Advancing Clinical Training.

OBJECTIVE: Effective mentorship plays a crucial role in the professional development of surgical residents by providing guidance, support, networking, and facilitating personal, and career growth. This is particularly significant for female and underrepresented minority residents who often encounter additional challenges due to discrimination and historical lack of representation. Our objective is to present a framework for structuring a progressive and inclusive formal mentorship program- Surgery IMPACT- which embodies a panoramic perspective of surgery residency. DESIGN: A holistic mentorship program was created through the conceptualization of WISE Domains (Work-Life Balance, Interpersonal and cultural proficiency, Scholarly and career advancement, Effective learning and study techniques). Mentor-Mentee partnerships were created between current surgical faculty and general surgery residents. The foundation of the program is built upon four essential mentor roles: Core faculty mentor, research mentor, fellowship mentor, alongside a concurrent incorporation of peer mentorship. Over the academic year, we encouraged at least 3 formal mentorship meeting prefaced by a reflective exercise by the residents. CONCLUSIONS: The implementation of Surgery IMPACT has been successful in formalizing mentorship opportunities at our institution. By incorporating WISE domains, structured meeting centered on well-defined objectives, we have effectively created an all-inclusive mentorship program to foster resident growth and equal opportunities. Our ongoing commitment is to further refine and expand this innovative program with the aspiration of galvanizing similar mentorship models across diverse surgical programs.

Temporal trends in mortality location in patients with anal cancer in the USA: an analysis of the National Center for Health Statistics mortality data.

OBJECTIVES: Investigate trends in where patients died of anal cancer in the USA. METHODS: Retrospective cohort study using the US National Center for Health Statistics Wide-Ranging ONline Data for Epidemiologic Research platform from 2003 to 2020; all patients with death certificates listing anal cancer as the underlying cause of death in the USA. Main outcome measure of location of patient death: inpatient facility, home, hospice, nursing home/long-term care facility and other. RESULTS: There were a total of 16 296 deaths with anal cancer as the underlying diagnosis during the study period. The crude rate increased from 0.191 per 100 000 deaths in 2003 to 0.453 per 100 000 deaths in 2020. Over the study period, 22.4% of patient deaths occurred in inpatient facilities, 44.9% at home, 12.2% at hospice facilities and 13.1% at nursing homes/long-term care facilities. The percentage of deaths occurring in hospice facilities increased from 1.0% to 13.3% during the study period. Deaths at home also increased from 42.7% in 2003 to 55.8% in 2020. Meanwhile, inpatient deaths decreased from 33.5% in 2003 to 14.4% in 2020. CONCLUSIONS: There has been a significant increase in the proportion of patients with anal cancer dying at home or hospice from 2003 to 2020.

A Cross-Sectional Geographic Information Systems Study of a Pediatric Emergency Department Child Restraint System Distribution Program.

INTRODUCTION: A pediatric ED program sought to promote injury prevention through distribution of child restraint systems. Program funds are paid for child passenger safety technician certification of all personnel. Pediatric emergency nurses distributed child restraint systems at hospital discharge and dedicated technicians at fitting stations. Researchers described program characteristics, developed a baseline understanding of program outreach using geographic information systems, and evaluated adherence to manufacturer guidelines with a sensitivity analysis. METHODS: This retrospective cross-sectional study used distribution forms linked to hospital records from 2013 to 2016. Testing for differences used nonparametric methods. Median values and interquartile ranges for weight and height of children were compared with manufacturer guidelines. Geographic information systems visualized recipients' street addresses and motor vehicle crashes on an underlying base map. RESULTS: There were 312 child restraint systems distributed: of which 179 (57.4%) at the hospital, 126 (40.4%) at fitting stations, and 7 (2.2%) missing a location. Among those on Medicaid, 64.4% received a child restraint system at the hospital compared with 35.6% at fitting stations (χ2 = 5.40, P < .02). Fitting stations had limited outreach to rural residents. Finally, results from the sensitivity analysis showed that devices were issued according to manufacturer guidelines. DISCUSSION: Despite the workplace pressures of clinical care, pediatric emergency nurses delivered educational information and demonstrated hands-on installation at similar rates to dedicated technicians. Distribution of child restraint systems through the hospital reached a uniquely underserved population. Further research should investigate methods to improve fitting station outreach among Medicaid recipients.