Susan Culican

Susan Culican

Washington University School of Medicine

Department of Ophthalmology and Visual Sciences, Washington University School of Medicine

Associate Professor, Ophthalmology Residency Program Director, and Director of Education

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Published on Apr 03, 2018

Lab Note 13: Conversion Factor

Today we are going to talk about another possible way to make the data that we have about resident surgical performance more predictive of expert assessment of surgical skill. We saw that crowds ar...

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Published on Mar 22, 2018

Lab Note 12: The time factor

This result suggest a few things: it suggests that time (an easily captured measurement) should be explored as a potentially robust indicator of surgical skill, either independently or in combinati...

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Published on Nov 08, 2017

Lab Note 11: And the crowd goes wild!!

Well, the data are in... and the mean crowd scores (red) ARE correlated with the mean expert scores (blue)! It is pretty clear when you look at the graphic... the higher the expert score the higher...

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Published on Oct 17, 2017

Lab Note 10: And the Experts Agree!

Congratulations to our expert reviewers who completed their task of each assessing the 50 videos prior to October 13!! Not only were the assessments completed on schedule, but the preliminary analy...

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Published on Sep 07, 2017

Making Progress

I just wanted to send a quick update to let everyone know where we stand.Video editing: COMPLETE. (Thank you, Tejas!)Video upload to CSATS: COMPLETE. (Grace is on top of everything)Lay rater evalua...

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Published on Jun 15, 2017

Lab Note 9: How will this project help us link skill with outcomes?

What we really want to know is what a resident surgeon can accomplish in terms of surgical outcomes. Were there complications during or after surgery? How well does a patient see after cataract sur...

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Published on Jun 08, 2017

Lab Note 8: Why we are Crowd Funding the Crowd Sourcing experiment

Let's talk about bias. We all have bias. Bias is why I am turning to the crowd, not just for assessments, but for funding. This project has been vetted before traditional study sections to procure...

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Published on Jun 04, 2017

Lab Note 7: Linking program specific assessments to the proposed standard assessment of resident surgical skill: the WU example.

This project proposes to generate a tool that can be used universally by any training program across the country to provide a standardized assessment of a resident's surgical skill. It is easily ac...

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Published on Jun 01, 2017

Lab Note 6: Can this study help us identify an evidence-based minimum surgical requirement for specific skills?

Yesterday we looked at hypothetical trajectories of skills acquisition by surgical learners. Today we'll explore how knowing the real data about how residents learn can inform our understanding abo...

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Ah yes! There is a lot here! Lies, damned lies, and statistics. The difference between statistically significant and effect size is lost on so many. Particularly in clinical medicine. The statistically significant result is not even close to clinically significant. An area in ophthalmology where this is rampant now is in imaging the nerve fiber layer in the retina in different disease states to try to establish retinal imaging as a diagnostic test (when you have a hammer everything is a nail). For example, in Alzheimers Disease the AVERAGE nerve fiber layer thickness is reduced relative to controls. However, the spread of the data in both groups is huge, and the difference in the means, while statistically significant, is not large enough to be useful. The means of both groups fall squarely in the range of scores for each population. Everyone gets all excited about this hoping for a non-invasive diagnostic test, but it is based on a statistical argument alone. If you look at the data it is clear to the naked eye why this will never be the case.
Apr 26, 2018
How do you know a surgeon in training is ready to operate independently?
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I will check it out. Thanks!
Apr 26, 2018
How do you know a surgeon in training is ready to operate independently?
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Thank you! Yes. I think this can be applied in other areas of health (see the following: https://www.ncbi.nlm.nih.gov/pubmed/29270257). One warning, however, one of the authors of that review has financial interest in the company created to do the crowd sourcing that we used (CSATS). They are for profit and I consider it a substantial conflict of interest. As our study has shown (see lab notes 11,12,13) it isn't as simple as just give it to the crowd. You have to figure out what the crowd is good at discriminating and what they miss. Here is another source of info (that discusses the good, the bad and the ugly) about our experience: https://peerspectrum.com/episodes/ How would you propose to do the checking? A photograph? Is there a standardized tool that is used by "experts" that you can apply to the assessment? I am happy to discuss with you further if you are interested in doing a project.
Apr 22, 2018
How do you know a surgeon in training is ready to operate independently?
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And the wheels of progress are turning (slowly, yes, but turning). Thanks to your support we are pleased to welcome Tejas Sekhar to the team!
Jul 18, 2017
How do you know a surgeon in training is ready to operate independently?
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Thank you everyone for your support! We are in the final week of video collection and thanks to all of you we can start the video editing ASAP and stay on track for our milestones timeline.
Jun 27, 2017
How do you know a surgeon in training is ready to operate independently?
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With regard to Lab Note 8 on bias. Usha Andley once suggested a fantastic book to me: The Emperor of All Maladies-- A Biography of Cancer by Siddhartha Mukherjee. It is a fantastic book and does a great job of explaining how bias can undermine the advancement of science. Thanks Usha for the recommendation and for you support!
Jun 10, 2017
How do you know a surgeon in training is ready to operate independently?
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Indeed! And thus the current study. Thanks again for your support!
Jun 02, 2017
How do you know a surgeon in training is ready to operate independently?
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