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Enregistrement W274204976 · doi:10.1177/229255030701500102

A day in the operating room

2007· article· en· W274204976 sur OpenAlexvenueno aff
John Russell Taylor

Notice bibliographique

RevueCanadian Journal of Plastic Surgery · 2007
Typearticle
Langueen
DomaineHealth Professions
ThématiqueHealthcare Operations and Scheduling Optimization
Établissements canadiensnon disponible
Organismes subventionnairesnon disponible
Mots-clésMedicine

Résumé

récupéré en direct d'OpenAlex

It is another day in the operating room, and you have too much surgery booked. You cannot say that, or your last case will be cancelled. You may be able to finish at 3:30 if everyone has a sandwich or coffee in the hall, but will the union object? You do not explain why it is hard to stay on time or why you cannot predict how long surgery will take, because today one of your operations is complex and the time you will take will depend on who your nurses are and what you find when you operate. You know that at about 2:30 today, the dragon lady will appear over your shoulder to ask whether you will finish on time. You hedge a little if you know the time will be close. You know the administration hired her for the bottom line. She is the enforcer. The hospital can never run over budget. You know running late is an offense punishable by some vague but definite penalty, such as not being able to book surgery or losing operating room blocks. And you, not the petit bureaucrat who made the decision, will have to tell your last patient that surgery is cancelled. John R Taylor These are just annoyances, and you have learned to live with them. Today, you are lucky. You have a fast anesthetist who starts anesthesia efficiently. Your operating room has several nurses who only do plastic surgery. Paradise! You count your blessings. You know the plastic surgery nurse will make surgery faster because routines will be familiar. It is likely other nurses will be there too, because it makes nurse schedules easier. This can slow surgery, but is related to how technically demanding you are as a surgeon. If you can use simpler instruments and dressings you can save time, but you may have to compromise or decide which special things you want are not important to the result. ‘Eliminate and streamline’ is your new motto. But you are obsessive...in a good way. This nature makes you slower even though you have told everyone what you need in advance, and have performed the same procedure in the same operating room before. You read that in Britain, surgeons were ranked for speed; faster surgeons getting higher marks, but faster surgeons ran two operating rooms simultaneously! So, you have two choices: change yourself or change your environment. You realize that nurses are your best allies, and that they are caught in the same pressure cooker as you are. They have families and jobs they are intent on keeping. They cannot do anything about surgical delays, so complaining to them does no good. They do not like the enforcer any more than you do. You realize that praising a good job well done helps everyone, so this becomes a habit. You find another solution for your dilemma. Humour. Humour is a solution in a difficult situation. Irony is a subtle self-mockery best used with yourself as the object of your fate. It is not cynicism, which is bitter, but rather a standing to one side, made by indirect but kind tongue-in-cheek observations. Irony does not seek everyone’s understanding, only those primed for the same observation. Irony completes unformed thoughts, and provokes a smile for those who know something is not quite right, but are uncertain what that is. Irony is an answer for those who take themselves seriously when they should be taking only their surgery seriously. Irony is a way of saying that no matter what anyone else says about what you have done, you at least are satisfied. After all, what more can you ask?

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.

Comment cette classification a été obtenuedéplier

Prédiction distillée sur la base complète

Imitation des enseignants

Ni prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.

score de la tête « metaresearch » (Codex)0,008
score de la tête « metaresearch » (Gemma)0,009
Version: codex-gemma-dda1882f352aStatut de validation: machine_predicted_unvalidated
Catégories candidatesMétarecherche
Catégories consensuellesaucune
DomaineSignal candidat: aucune · Signal consensuel: aucune
Devis d'étudeSignal candidat: Observationnel · Signal consensuel: Observationnel
GenreSignal candidat: Empirique · Signal consensuel: Empirique
Score de désaccord entre enseignants0,121
Score d'incertitude au seuil1,000

Scores Codex et Gemma par catégorie

CatégorieCodexGemma
Métarecherche0,0080,009
Méta-épidémiologie (sens strict)0,0000,000
Méta-épidémiologie (sens large)0,0000,000
Bibliométrie0,0000,000
Études des sciences et des technologies0,0010,000
Communication savante0,0000,000
Science ouverte0,0000,000
Intégrité de la recherche0,0000,001
Charge utile insuffisante (le modèle a refusé de juger)0,0000,000

Scores machine (provisoires)

Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.

Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.

Tête enseignante Opus0,083
Tête enseignante GPT0,377
Écart entre enseignants0,294 · la distance entre les deux têtes enseignantes sur ce seul travail
Statut de validationscore_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle

Classification

machine, non validée

Prédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.

Devis d'étudeObservationnel
Domainenon disponible
GenreEmpirique

Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».

En bref

Citations1
Publié2007
Routes d'admission1
Résumé présentoui

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