Canadian Surgery Forum 2019 Montreal, Que. Sept. 5–7, 2019 ABSTRACTS

The Canadian Surgery Forum Steering Committee acknowledges and thanks the following organizations for their support of the 2019 Forum: Collaborator Partner: Ethicon and Medtronic Contributor Partners: Olympus and Stryker Abstracts Vol. 62 (4 Suppl 2) August/août 2019 DOI: 10.1503/cjs.011719 CANADIAN ASSOCIATION OF GENERAL SURGEONS © 2019 Joule Inc. or its licensors Can J Surg (4 Suppl 2), August 2019 — Abstracts S89 CANADIAN ASSOCIATION OF GENERAL SURGEONS 01 The future of general surgery training: a Canadian resident nationwide Delphi consensus statement. C. Huynh, N. Wong-Chong, P. Vourtzoumis, S. Lim, W. Marini, G. Johal, M. Strickland, A. Madani. From the University of British Columbia, Vancouver, B.C. (Huynh, Johal); McGill University, Montreal, Que. (Wong-Chong, Vourtzoumis); the University of Manitoba, Winnipeg, Man. (Lim); the University of Toronto, Toronto, Ont. (Marini, Strickland); and the Columbia University College of Physicians and Surgeons, New York, N.Y. (Madani). Various pedagogical models have been introduced in an attempt to improve and restructure surgical training, but significant obstacles remain. Before implementing national guidelines, it is critical to explore residents’ opinions to ensure a successful transition that meets their needs and addresses the challenges of reformatting surgical residency. This study aimed to establish a nationwide Delphi consensus statement on the opinions and perceptions of Canadian residents regarding the future of general surgery training. Canadian general surgery resident representatives participated in a moderated semistructured focus group using the nominal group technique to discuss issues related to general surgery training across 3 domains: early subspecialization, competency-based medical education (CBME) and a transition-to-practice (TTP) period. Qualitative verbal data were transcribed, grouped into themes and synthesized into a list of recommendation statements. During an iterative Delphi survey, residents ranked each statement on a 5-point Likert scale in terms of agreement. The survey was terminated once consensus was achieved (≥ 2 survey rounds and internal consistency Cronbach’s α ≥ 0.80). Sixty-six statements were synthesized by 16 members of the Canadian Association of General Surgeons Resident Committee. Forty-nine residents participated in the Delphi consensus achieved after 2 voting rounds (Cronbach’s α = 0.93). Participants agreed that (a) residency should be remodelled to focus on achieving standardized competencies and milestones, based on residents’ ability to meet specific measurable metrics; (b) early streaming should be offered after “core” milestones and competencies have been achieved; and (c) an explicit period should allow transition to independent practice with tailored rotations, greater autonomy, patient ownership and resident-run clinics. Ten barriers to CBME implementation were also identified. A nationwide consensus regarding the future of surgical training was established among current residents. These findings can help in the implementation of guidelines and new national curricula that meet trainees’ needs and address the many challenges they face in their training. 02 Traumatized: Can mindfulness lead to improved mental health outcomes after multisystem trauma? E. Clement, A. Lee, A. Ericson, C. Gratton, J. Ryan, T. Clements, M. Kim, C. Ball, S. Widder. From the University of Alberta, Edmonton, Alta. (Clement, Lee, Ericson, Ryan, Kim, Widder); and the University of Calgary, Calgary, Alta. (Gratton, Clements, Ball). The incidence of mental health consequences such as depression, anxiety and post-traumatic stress disorders is reported to be as high as 50% in trauma patients. Recently, mindfulness has been used in the treatment of patients with post-traumatic mental health conditions, and there is mounting evidence for its use in this population. This study sets out to evaluate the utility of a mindfulness-based online tool in patients admitted after traumatic injury. In this prospective cohort study, all adult trauma patients admitted to 2 tertiary care hospitals were screened for inclusion. Eligible patients were enrolled within 48 hours of admission using validated questionnaires for anxiety, depression and resiliency. Patients in the intervention group were introduced to the online tool Stop, Breathe & Think, which they were asked to use daily for 28 days, while patients in the control group had no intervention. After 4 weeks, all participants were contacted, and the questionnaires were repeated. Those in the intervention group also completed a survey about patient experience. One hundred and twenty-three patients were recruited, and 81 completed follow-up. Decreased anxiety scores were seen in both control and experimental groups. Resiliency scores improved in both control and experimental groups but did not reach significance. Of those in the experimental group, 72% used the tool consistently, and 52% said they felt better after use. Fifty-three percent intended to continue using the app, and 77% stated they would recommend it to a friend. Mindfulness-based activities may have a role in improved mental health outcomes in trauma patients. Further studies are warranted to determine which subgroups are likely to achieve the most benefit. 03 Operating room availability for general surgery in 2007 versus 2017 at a regional hospital in BC. D. DeGirolamo, D. Hwang. From the University of British Columbia, Vancouver, B.C. Access to surgical care in Canada is a complex issue. The population is aging, but elective operative time is often cut back. Here we examine all general surgery operations done in the operating room (OR) comparing 2007 with 2017 at a single community hospital focusing on case mix, age of patients, percentage of after-hours OR utilization and cancer diagnosis. All general surgery operations performed in 2007 and 2017 at Vernon Jubilee Hospital (VJH) were collected using Medical Services Plan billing data. VJH is a 165-bed regional hospital located in Vernon, British Columbia. Case mix, after-hours OR