Left congenital diaphragmatic hernia and gastroschisis in a term male infant.

A term male infant was born to a healthy 24-year-old mother with antenatally diagnosed liver-up, left congenital diaphragmatic hernia (CDH) and gastroschisis. The infant was stabilised in the neonatal intensive care unit and then underwent primary repair of the CDH via left subcostal incision and silo placement for the gastroschisis. Serial silo reductions were started postoperatively and umbilical flap closure for the gastroschisis was performed on day of life 6. The patient was weaned from respiratory support, started on enteral feeds, and discharged home at 1 month of age. He was weaned from supplemental nasogastric feeds by 6 weeks of age and is currently well and thriving at 11 months of age.

Implementation of an E-Learning Academic Elective for Hands-On Basic Surgical Skills to Supplement Medical School Surgical Education.

OBJECTIVE: To examine the feasibility and utility of a completely online surgical skills elective for undergraduate medical students. DESIGN: The fully asynchronous, one-week, online learning elective addressed surgical instrument identification, knot tying, and suturing. Tools for knowledge acquisition and self-practice were outlined and individualized performance feedback on technical skills performance was incorporated from peers and experts through video conference. SETTING: University of Rochester School of Medicine & Dentistry, Rochester, NY. PARTICIPANTS: A total of 86 third- and fourth-year medical students enrolled and successfully completed the elective. RESULTS: At elective completion, nearly all students met their course objectives and significantly increased their confidence in surgical instrument identification, knot tying, and suturing. Objective measures of student knowledge and technical skills acquisition were overwhelmingly positive, and faculty and students were very satisfied with providing and receiving performance feedback. Students reported that expert feedback was more useful than peer feedback, and more students than faculty reported that the online modality was equivalent to an in-person session for performance review. CONCLUSIONS: This innovative online surgical skills elective improved undergraduate medical student confidence, knowledge, and skillset with surgical instrument identification, knot tying, and suturing while also facilitating effective expert feedback on individual performance.