Holding the Knife on Perceptions of Surgery.

OBJECTIVE: Negative stereotypes associated with surgery by medical students are well documented in literature. Many cite long hours, poor work-life balance, pessimism, mean personalities, and cynicism as pervasive among surgeons and operating room culture. If allowed to persist, these negative perceptions can deter otherwise interested students from pursuing surgical subspecialties. DESIGN: Incorporation of peer-teaching in the third-year clerkship to not only illuminate the hidden curriculum in surgery but adequately prepare students to participate in the operating room is paramount to taking steps to improve student perception as well as success as clerkship students. SETTING: An academic medical center. PARTICIPANTS: Pre-clinical medical students. RESULTS: One-hundred and forty-three third year clerkship students were surveyed with pre- and postinstruments. Students who participated in these pre clerkship peer-teaching sessions reported significant improvements in their ability to identify surgical anatomy (p < 0.001), an increased confidence in answering questions from attendings about anatomy and function as well as in identifying anatomical abnormalities (all p < 0.001). Students also reported significantly improved perceptions about surgeons as teachers and their willingness to support students pursuing surgery. CONCLUSION: This study demonstrates that the incorporation of an immersive orientation prior to the start of the surgery clerkship has significantly positive impacts on the learning experience and confidence of medical students. Increased efforts should be made to introduce students to surgeons, surgical careers, and the operating room prior to the surgery clerkship, being sure to incorporate aspects of the hidden curriculum, to address the negative perceptions that continue to exist regarding surgical fields.

Intimidating Attendings: The Importance of Near-Peer Mentorship During Third-Year Surgical Clerkship.

INTRODUCTION: Near-peer instruction has grown in popularity in medical education; however, limited data exist to support its effectiveness. This study investigates the perceptions of near-peer style instruction in third-y medical students undergoing a surgical clinical clerkship. We hypothesized that near-peer instruction would provide a beneficial educational experience to third-y medical students during their surgical clinical clerkship. METHODS: The authors anonymously surveyed third-y medical students undergoing their clinical clerkship in surgery on their perception of the near-peer instruction and mentorship they received from fourth-y medical students at the beginning of the clerkship. Near-peer instruction included teaching suturing techniques, surgical procedures and anatomy, operating room literacy, and sharing anecdotal experiences. Surveys were distributed 24 h after receiving the formal instruction. RESULTS: A total of 85 students completed the survey (78% response rate). Students reported a similar or increase in value of learning from near-peer mentors compared to attending physicians (less valuable: 1.2%; just as valuable: 52.9%; more valuable: 45.9%). The majority of students indicated they would like to experience more near-peer style instruction in medical school as demonstrated in surgical clerkship training (absolutely no: 0%; probably not: 0%; on the fence: 4.7%; probably yes: 25.9%; absolutely yes: 69.4%). After experiencing near-peer instruction and mentoring, students were more interested in becoming near-peer mentors (less interested: 1.2%; just as interested: 29.4%; more interested: 69.4%). CONCLUSIONS: Students appreciate and desire near-peer instruction, seeing it as an effective learning method. Mentees undergoing near-peer style instruction have an increased interest in becoming near-peer mentors.

Belantamab in Combination with Dexamethasone in Patients with Triple-class Relapsed/Refractory Multiple Myeloma.

BACKGROUND: Triple-class relapsed/refractory multiple myeloma (RRMM) has a poor prognosis. This study analyzed the clinical outcomes of Belantamab mafadotin in combination with dexamethasone (Bd) in triple-class RRMM. METHODS: We identified 35 patients with triple-class RRMM who received Bd at the University of Kansas from October 2019 to November 2021. RESULTS: The median age was 66 years (42-85) and the median prior lines of therapy was 5 (3-15). Nineteen (54%) patients had R-ISS stage III disease, 15 (43%) patients had high-risk cytogenetics, and 15 patients (43%) had extramedullary disease (EMD). Eight patients received prior BCMA-targeted therapy. Overall response rate (ORR) was 43%, with 23% achieving very good partial response and better. At a median follow up of 10.7 months, the median progression-free survival and survival were 4.9 and 10.7 months, respectively. The most common adverse event was keratopathy, which occurred in 30 (86%) patients. Twenty-four patients required dose reduction or delay due to keratopathy. Other common toxicities included anemia (83%), thrombocytopenia (80%), neutropenia (34%), and elevated liver function tests (51%). CONCLUSION: Our analysis shows Bd has good activity in triple-class RRMM. Keratopathy remains a challenging AE and the leading cause of dose reduction, delay and treatment cessation.

Suture Education with Soft-Embalmed Cadavers: A Cut Above the Rest.

Introduction: The efficacy of a surgical skills curriculum was assessed for third-year medical students focused on suturing training on soft embalmed cadavers, which simulate natural tissue more effectively for surgical procedures than traditionally preserved cadavers or surgical practice pads. Methods: A retrospective cohort study compared pre- and post-survey results at a premier, accredited, nationally ranked academic medical center. Study participants were third-year medical students completing their required surgical clerkship rotation who participated in suturing sessions on both synthetic suture practice pads and soft-embalmed cadavers prior to beginning their operating room experience. Results: A total of 40 participants were included, with slightly more male participants. The majority of participants (52%) were interested in pursuing a non-surgical career. After participating in Clinical Anatomy Mentorship Program (CAMP), participants felt significantly more confident in their ability to suture in the operating room (median 4 [3-4] vs. 2 [1-3], p < 0.001); in their knowledge of basic suturing supplies and instruments (median 4 [4-4] vs. 3 [2-3], p < 0.001); and in their ability to determine when different suture techniques are appropriate in the operating room (median 3 [3-4] vs. 1 [1-2], p < 0.001). Participants felt more confident in their ability to suture in the operating room after their experience suturing on soft-embalmed cadavers compared to suture practice pads (median 5 [4-5] vs. 4 [4-4], p = 0.002). Conclusions: Medical students' confidence in suturing skills and in the knowledge of important characteristics of suturing practice was improved significantly after a suture training session on soft-embalmed cadavers.