Fictitious Examples are listed below in orange: SAGES 2016 ANNUAL MEETING SESSION DESIGN FORM - SAMPLE SESSION CHAIR: Raul Rosenthal SESSION CO-CHAIR: Daniel Jones SESSION TITLE: PG Bariatric: What Every Safe Surgeon Needs to Know About Bariatric Surgery? SESSION DATE: Wednesday, March 16th SESSION TIME: 8am 1pm SESSION DESCRIPTION (Insert brief 2-3 Sentence Session Description, including who should attend): One in every three Americans is overweight and obesity is now a global epidemic. Nearly 250,000 weight loss operations will be performed in the U.S. this year, and the General Surgeon needs to be comfortable when these patients present to the ED or are seen years later for other problems. PRACTICE GAPS (Your session will address what professional practice gap(s) of the attendees derived from data source(s), see a list of potential data sources below): What is the Problem that you are trying to fix? What is needed to fix this problem? Why does this problem exist? (check all that apply) Example: Leaks after gastric bypass ( 1 %) and may go unrecognized and result in mortality. The SAGES Gap Bank indicates that of 2014 annual meeting attendees interested in the Bariatric learning theme, 28.5% (n=133) wanted to increase effective management of common complications associated with bariatric operations such as bleeding, obstructions, band slippage, leaks, ulcers, pulmonary embolism, strictures and small bowel obstructions. At three-month follow-up, 28.9% of those responding (n=52) reported inability to fully implement the intended practice change. Example: A thorough and detailed review of effective management options, including diagnosis, treatment and prevention. X Lack knowledge X Lack strategies to apply knowledge to practice X Don t do it What data supports the identified problem? Check boxes, describe below. Include at least 2 data sources. X SAGES Gap Bank (http://www.sages.org/meetings/sages-practice-gaps/). If prompted for a password, it is SAGESGAPBANK. X Clinical practice guidelines Health Performance Data AHRQ/Government/Snapshots X Research/Peer-reviewed literature Exam performance analysis Epidemiology data Government mandates/legislation Public Health Data Survey of Targeted Learners Expert opinion (committee, consensus of experts) Requirements of State licensing board, Specialty Societies New medical development/technology X Evaluation data/gaps identified by target audience (previous CME eval) Describe data sources here: Early signs of leak include tachycardia according to Hamilton EC, Sims TL, Hamilton TT, et al. Clinical predictors of leak after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Surg Endosc 2003;17:679-684 For what reasons might learners resist or be unable to fix this problem? How will you address this in your program? Management of complications requires the buy-in of all staff, including nurses & scrub techs. 25% of attendees at 2009 mtg listed staff as a barrier to implementation. This course will include references that attendees can share with their team.
SESSION OBJECTIVES: (Write your objectives focusing on what the learners will do as a result of this activity.) Use ACTION words like: Adjust Articulate Classify Convey Diagnose Distinguish Hypothesize Infer Organize Prioritize Relate Apply Assess Compare Create Diagram Employ Identify Integrate Plan Produce Select Appraise Categorize Conduct Demonstrate Differentiate Evaluate Illustrate Interpret Predict Recognize Solve Arrange Choose Construct Develop Discriminate Formulate Implement Manage Prepare Recommend Use Example Objectives: Differentiate between cancer detection options for patients, Apply these detection techniques to relevant cases in practice, Detect cancer earlier in patients. *If applicable to your session, draft at least one of your objectives to relate to patient safety. Example: Identify situations in which there is a high risk of bile duct injury. FILL IN THE FOLLOWING: At the conclusion of this session, participants will be able to: Describe indications for weight loss surgery and differentiate the types of procedures Employ new strategies to diagnose and treat internal hernia, band prolapse, leak, stenosis, and nutritional deficiency in the emergency setting Evaluate best practices for an accredited program and implement improvements to their own program (add lines if necessary) SESSION OUTLINE: (Complete the below making sure the total time allotted adds up to the total session time) Order Presentation Title Faculty Name Time Allotted What Can Go Wrong? My Three Biggest Errors in Judgment and Technique 1 st Laparoscopic Adjustable Gastric Band Jaime Ponce, MD 10 min 2 nd Gastric Bypass Dan Herron, MD 10 min 3 rd Duodenal Switch Alfons Pomp, MD 10 min 4 th Sleeve Gastrectomy James C. Ellsmere, MD 10 min GERD/Barrett s before and after LSG 5 th Reoperative Surgery John Morton, MD 10 min Panel Discussion 25 min Perioperative Consideration 6 th Airway and Sleep Apnea Scott Shikora, MD 10 min 7 th Thromboprophylaxis Michael Schweitzer,, MD 10 min Postoperative Challenges 8 th Leaks/Stenosis after RYGBP Bruce D. Schirmer, MD 10 min 9 th Leaks and Stenosis after LSG Sam Szomstein 10 min Panel Discussion 20 min Break 15 min Nutritional Metabolic Complications that I Need to Manage 10 th Malnutrition Daniel Smith, MD 10 min 11 th Hypoglycemia Shawn T. Tsuda, MD 10 min
Panel Discussion 10 min Conditions Requiring Urgent Attention and What I do First 12 th Slippage Christine Ren, MD 10 min 13 th Perforated Marginal Ulcer Ronald H. Clements, MD 10 min 14 th Small Bowel Obstruction Benjamin E. Schneider, MD 10 min 15 th GI Bleeding Ninh T. Nguyen, MD 10 min 16 th Bile Duct Complications Ron Andrews, MD 10 min Discussion 25 min Quality and Patient Safety Initiatives 17 th Best Practices and ACS-ASMBS Accreditation Robin L. Blackstone, MD 15 min Reminder! 1.Do not invite/ or notify your desired faculty yet; they must first be approved by the Program Chairs. 2. You may be required to peer review your faculty presentation(s) in advance of the meeting. GUIDELINES: Please identify any relevant SAGES Guidelines which may referenced during your session and which lecture(s) might address the guideline. The SAGES Guidelines are available at http://www.sages.org/publications/guidelines/ (The presenters and/or moderators may wish to take one or two points from the guideline and make specific reference to it during their talk. We will instruct the faculty accordingly in their invitation.) 1. SAGES guideline for clinical application of laparoscopic bariatric surgery 2. SAGES guidelines for deep venous thrombosis prophylaxis during laparoscopic surgery 3. SAGES Position Statement on Advanced Laparoscopic Training LEARNING THEME: Which of the following learning themes are applicable to your course/session/panel? (check all that apply) Solid organ New technologies/skills acquisition Professional/Economic Colorectal Academic/Educational X Bariatrics HPB X Hernias Flex Endo X Foregut Educational Delivery Method (check all that apply): X Didactic lecture Simulations/skills lab Panel or discussions Roundtable discussion Question and answer session Webinar X Case presentations Self-directed online learning Other: Why did you select this type of delivery method? (check all that apply): X Knowledge conveyed in a short time Point/counterpoint for controversial topics Complicated topic, extra time for questions X Application of knowledge to potential practice Improve skills or technique Discussion of difficult or unusual cases or data Other:
ABMS/MOC COMPETENCY: What ABMS/MOC competency or competencies are related to this session? (Check all that are related) X Patient Care - Provide care that is compassionate, appropriate and effective treatment for health problems and to promote health. X Medical Knowledge - Demonstrate knowledge about established and evolving biomedical, clinical and cognate sciences and their application in patient care. Interpersonal and Communication Skills - Demonstrate skills that result in effective information exchange and teaming with patients, their families and professional associates (e.g. fostering a therapeutic relationship that is ethically sounds, uses effective listening skills with non-verbal and verbal communication; working as both a team member and at times as a leader). X Professionalism - Demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to diverse patient populations. Systems-based Practice - Demonstrate awareness of and responsibility to larger context and systems of healthcare. Be able to call on system resources to provide optimal care (e.g. coordinating care across sites or serving as the primary case manager when care involves multiple specialties, professions or sites). Practice-based Learning and Improvement - Able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence and improve their practice of medicine. Other DESCRIBE HOW THE ABOVE COMPETENCIES ARE INCORPORATED INTO THE ACTIVITY: In addition to reviewing techniques for diagnosis and treatment, the faculty will describe best practices for implementation of SAGES guidelines, as well as potential collaborations with other health care professionals to improve patient outcomes. NATIONAL QUALITY PRIORITIES: The AHRQ has identified the following priorities to improve the delivery of healthcare services, patient health outcomes and population health. Indicate if you will address any of these priorities in your session. Making care safer by reducing harm caused in the delivery of care. Ensuring that each person and family is engaged as partners in their care. X Promoting effective communication and coordination of care. Promoting the most effective prevention and treatment practices for the leading causes of mortality. Working with communities to promote wide use of best practices to enable healthy living. Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models. HANDS-ON COURSE Chairs Only: Are there any additional criteria for participants taking the course (e.g. the course is geared towards practicing physicians and requires a minimum of 20 lap colectomies)? If yes, please describe below. Yes X No I don t know please contact me. Describe criteria:
QUESTIONS FOR PARTICIPANTS (Part 2 Self-Assessment credit will be granted to meeting attendees) Session, Panel & PG Chairs must write 2 questions. The SAGES Program Committee will review and group all questions into Learning Themes. Participants will answer 4 questions per Learning Theme. REQUIREMENTS: a) The question must be clear and succinct (no longer than 2-3 sentences). b) The question must represent an important patient care recommendation. c) Questions must be framed as a case (see example). d) The question must be associated with one of the course objectives. e) There must be 4 answer options with explanations for why they are correct/incorrect. f) The answer must be non-controversial. g) The answer must be supported by high-level literature or SAGES guidelines. h) A reference must be provided that would help the learner answer the question (for re-tests). i) The reference should be formatted as required by the Surgical Endoscopy style guide (see page 8 of this document). EXAMPLE: A 45 year old female presents with virilizing symptoms and an elevated testosterone level. On CT scanning, she has a heterogenous 7cm left adrenal mass with irregular borders and an attenuation value of 40 Hounsfield units. The most likely diagnosis in this patient is: Answer A: Pheochromocytoma Explanation A: Incorrect. Pheochromocytomas may be large and are higher attenuation on CT but do not present with virilizing features and elevated testosterone levels and so would be less likely in this case. However, all adrenal masses should be screened biochemically to exclude a pheochromocytoma before proceeding with adrenalectomy. Answer B: Adrenal adenoma Explanation B: Incorrect. The size, irregular borders, and high attenuation values of this adrenal lesion make a benign adenoma unlikely. Most cortical adenomas have an abundant amount of intracellular lipid and attenuation values are typically 10 Hounsfield units or less. Answer C: Adrenal cortical carcinoma Explanation C: Correct. The features of this adrenal lesion are highly suggestive of an adrenal cortical carcinoma large size, virilizing features and the higher attenuation values on CT imaging. Answer D: Myelolipoma Explanation D: Incorrect. Myelolipomas are benign lesions comprised of fat and bone marrow elements. While myelolipomas may be quite large, they have a characteristic imaging appearance with areas of macroscopic fat and a smooth rounded border. Such lesions are benign, rarely cause symptoms, and do not typically need to be removed. Correct Answer: C Reference: Brunt LM. Minimal access adrenal surgery. Surg Endosc 2006;20:351-361.