Vol. 219, No. 4S, October 2014 Scientific Poster Presentations: 2014 Clinical Congress e165

exposure is decreasing, the educational benefit of ATOM for resi-dents with different amounts of trauma exposure remains unclear.

Our aim was to determine whether residents from trauma centersexperienced less benefit from the ATOM course when comparedwith residents from non-trauma centers.

METHODS: ATOM pre- and post- course evaluations of knowl-edge and self-efficacy were collected from October 2007 to June

2013. All residents scores from the three programs were thencompared using a two-tail t-test.

RESULTS: All resident groups had statistically significant

improvement in knowledge and self-efficacy after taking theATOM course (p<0.0001). There was no statistically significantdifference in improvement relative to each of the groups in the

ATOM categories of knowledge and self-efficacy.

CONCLUSIONS: Our data shows that residents with different

levels of trauma exposure had similar pre- and post- course scoresas well as improvement in the ATOM evaluations. As operativetrauma continues to decrease the ATOM course shows benefit

for all residents regardless of the depth of their clinical traumaexposure in surgical residency.

Influence of a short term camera navigation training onlaparoscopic performance and team cooperation in avirtual reality settingMarkus Paschold, MD, Tobias Huber, MD,Hauke Lang, MD, FACS, MA, Werner Kneist, MDJohannes Gutenberg University Mainz Medical Center, Mainz,

Rhineland Palatinate, Germany

INTRODUCTION: Due to a shortage of physicians an optimally

trained assistant is more and more often not available. Virtual re-ality laparoscopic (VRL) simulation is an effective tool to shortenthe learning curve of novices in preparation for their function as

an assistant in the operating room. The study was conducted toevaluate the influence of a short-term VRL camera training onmanual laparoscopic performance of novices and team cooperation

in a virtual reality environment.

METHODS: 145 medical students were randomized to the camera

training group (CTG) and no training group (NTG). CTG per-formed a one-time zero and thirty degree LCN training prior toa grasping and placing task. NTG directly started the manualtask on the VRL simulator. Participants were grouped into teams

with operator and assistant for the manual task.

RESULTS: Better performance in trained participants was ob-

tained. A better rating of the other team partner, self confiedenceto assist in a bacis laparoscopic procedure and male gender corre-lated significantly with better performance scores in CTG. No as-

sociation with performance was obtained for NTG.

CONCLUSIONS: This is the first study on the influence of virtual

reality laparoscopic camera navigation training on the operator’sperformance. Trained novices have a noticeable positive effect on

the team member’s performance even after a one-time VRL cameratraining. A correlation with self confidence shows that trained nov-

ices are able to assess their skills level more realistically.

Over 80% of posters presented at the 2009 AmericanCollege of Surgeons are never accepted for publicationJoel B Durinka, MD, Afshin Parsikia, MD, Po-Nan Chang, MS,Jorge Ortiz, MDAlbert Einstein Medical Center, Philadelphia, PA

INTRODUCTION: The American College of Surgeons (ACS)holds annual meetings to present research. It is not entirely clearwhether research presented in a poster format is scientifically

rigorous. We therefore sought to determine the publication rateof abstracts presented at the 2009 ACS meeting.

METHODS: We searched the abstracts presented in the ACS 2009annual meeting in PubMed. We collected the title, content, first,second and last/senor author to confirm that what we found in

Pubmed were the same abstarct presented in the ACS meeting asposters. We analyzed the publication year, category, country oforigin, academic status of the institution, single vs multi-center

study, and the impact factor of the journals.

RESULTS: 64 out of 335 (19.1%) abstracts we found in ACS

2009 abstract book were eventually published. 36/60 (60%) ofthe published studies were from United States. The average timeto publication was 1.4 years for all the stuides. 51/60 (85%)were conducted in academic institutions. The average impact factor

was 2.88. The median impact factor for US studies was 3.3 (0.71-4.5). The median impact factor for international studies was 2.38(0-7.22). This observation did not reach statistical significance

(p¼0.102).

CONCLUSIONS: The vast minority of presented abstracts become

full fledged publications. The scientific community must be carefulnot to place too much stock in information only presented in ab-stract form.

Initiating surgical resident involvement in qualityimprovement processesRod Grim, MA, Natalee G Young, MD, Virginia S Wesner, MPA,Vanita Ahuja, MD, FACSWellSpan Health Emig Research Center, York, PA

INTRODUCTION: Current trends in healthcare are demanding

accountability and transparency. Our hospital goal was to prepareour residents to lead and participate in quality and processimprovement initiatives. To this end, a Quality Curriculum was

developed to: 1) Train residents in rapid cycle techniques (rotationperiod is three months), 2) Surgical Resident Clinic for under-served population serves as training site, 3) Gain hands-on experi-

ence with clinical staff in leading quality improvement projects,and 4) Present findings.

METHODS: A four week quality curriculum of one-on-one andgroup discussion was developed using the Institute for Health

e166 Scientific Poster Presentations: 2014 Clinical Congress J Am Coll Surg

Improvement (IHI) Open School Online Modules focused on thePlan Do Study Act (PDSA) rapid cycle format. The curriculum was

integrated into the weekly education period, and a team wasformed with different resident levels, clinic staff, and faculty.

RESULTS: Pre-survey results indicated that 40% of the residentsdid not know what a PDSA cycle was and 60% were moderatelycomfortable in using PDSA cycles. Residents and clinic staff iden-

tified five projects and ranked them in order of importance. Pro-jects were difficult to accomplish with any regularity due toconstant modifications made to accommodate the resident’s work

hour rules.

CONCLUSIONS: While residents are fairly comfortable using

PDSA a large percentage of residents are not. In order to allowfor a complete cycle of the PDSA it is imperative that residentsare provided both important projects which can accomplish withintheir time constraints.

Malignant mastocytosis: a rare and diversediseaseddemographics and clinical outcomes for 349patients from the Surveillance, Epidemiology, and EndResults (SEER) database (1973-2010)Krishnaraj Mahendraraj, MD, Saketh Gudipati, MD,Ronald S Chamberlain, MD, MPA, FACSSaint Barnabas Medical Center, Livingston, NJ

INTRODUCTION: Malignant Mastocytosis (MM) is a rare sys-temic disorder characterized by abnormal proliferation of mast cells

with a rapidly progressive clinical course. This study sought toanalyze clinical and survival characteristics of a large cohort ofMM patients to identify important clinical and prognostic factors.

METHODS: Demographic and clinical data on 349 patients withMM was abstracted from the SEER database (1973-2010). Stan-

dard statistical methodology was used.

RESULTS: The 349 cases of MM were evenly distributed be-

tween age groups <50, age 50-65, and age >65. A majority ofMM occurred in Caucasians (86.8%) and in the bone marrow(73.4%). 55.6% of patients < 50 were female and 54.1% of pa-

tients >65 were male. 55.6% of MM had lymph node invasion.28.6% of patients >65 had a history of a prior malignancycompared to only 4.8% of patients <50. Patients <50 had a

significantly longer overall survival and lower overall mortalitythan patients >50. Multivariate analysis identified age 50-65

(OR 4.9) and age >65 (OR 17.3) as associated with increasedmortality.

CONCLUSIONS: MM is a rare proliferative disease with variable

prognosis that predominantly occurs in Caucasians and is evenlydistributed across all ages. Patients >50 have significantly decreasedOS and disease free survival compared to younger patients, as well

as a decreased 1, 2, and 5 year survival. These findings may be dueto increased bone marrow involvement, higher lymph nodeinvolvement, and a higher association with a prior malignancy.

Residency “siblings”: a system for establishing peerresidency supportErin Brown, MD, Aaron C Baker, MD, Edgardo S Salcedo, MD,Joseph M Galante, MD, FACSUniversity of California-Davis, Davis, CA

INTRODUCTION: The transition from medical student to surgicalintern is an exciting and challenging time. Many residents rely onsame-level peers for support during this adjustment. Unfortunately,

many same-level peers lack the experience to provide appropriateguidance.

METHODS: A “big sibling-little sibling” mentoring program topair junior and senior residents was instituted in our academic gen-

eral surgery residency program. Residents were surveyed before andafter the sibling program was in place to assess attitudes relating tothe level of support in the residency.

RESULTS: Survey response rate was 70% (51/73 residents). Forty-

one percent of respondents were first-year residents. The majorityof residents report that they seek advice for interpersonal conflict,service expectations, and educational resources from peers of equallevel. While one third of respondents thought camaraderie between

junior and senior level residents was strong, almost half of respon-dents thought it could be better. Sixty-four percent of residentsthought that the program would be beneficial. The majority of re-

spondents believed that implementation of a big sibling-little sib-ling program improved camaraderie and was a source for adviceon educational resources and social support.

CONCLUSIONS: The majority of resident turn to peers at their

current level for support. Given increased reliance on same-levelpeers for guidance, fostering strong bonds between senior and ju-nior residents is important. We propose a system for establishing

a formal multi-level peer support that can be easily and successfullyestablished.