{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T05:08:43Z","timestamp":1791954523644,"version":"4.3.4"},"reference-count":16,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2022,12,18]],"date-time":"2022-12-18T00:00:00Z","timestamp":1671321600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Endowment for Plastic Surgery"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2024,5]]},"abstract":"\n Objective<\/jats:title>\n To identify specific areas for improvement in cleft lip repair teaching.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Secondary analysis of prospectively-collected, blinded data.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Three residency programs rotating at a single academic children's hospital.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Plastic surgery residents, and craniofacial\/pediatric plastic surgery fellows.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n Mean scores for each skill in an 18-item Unilateral Cleft Lip Repair competency assessment tool (UCLR) (1\u20133 scale for each item) were rank ordered. Correlation between level of training (PGY) and performance on steps of the procedure was examined using Pearson R.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Simulation participants (n\u2009=\u200926) scored highest on skills in the \u201cMarking\u201c subscale (2.38\u20132.63 mean score). Procedural steps that scored lowest were: closing the nasal floor (2.00), repairing oral mucosa (2.15) and avoiding over\/under-dissection (2.19). Interestingly, none of these skills correlated with PGY, suggesting they do not improve with training.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n These results suggest that marking cleft lip repair is taught well in our current teaching environment, while steps like closing the nasal floor and repairing the oral mucosa are taught less well. Improved teaching of these steps could be achieved with deliberate instruction, video, digital simulation, and high fidelity simulation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/10556656221146736","type":"journal-article","created":{"date-parts":[[2022,12,18]],"date-time":"2022-12-18T21:55:41Z","timestamp":1671400541000},"page":"834-843","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Teaching Unilateral Cleft lip Repair: Lessons from Simulation-Based Mining of Trainee Strengths and Performance Gaps"],"prefix":"10.1177","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2954-8849","authenticated-orcid":false,"given":"Krystof","family":"Stanek","sequence":"first","affiliation":[{"name":"Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA"},{"name":"Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline A.","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Shriner's Hospital for Children, Los Angeles, CA, USA"},{"name":"Operation Smile, Virginia Beach, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie A.","family":"Livingston","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital Simulator Program (SIMPeds), Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter H.","family":"Weinstock","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital Simulator Program (SIMPeds), Boston, MA, USA"},{"name":"Harvard Medical School, Boston, MA, USA"},{"name":"Department of Anesthesia and Critical Care, Boston Children's Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn R.","family":"Rogers-Vizena","sequence":"additional","affiliation":[{"name":"Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA"},{"name":"Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,12,18]]},"reference":[{"issue":"7","key":"bibr1-10556656221146736","volume":"10","author":"Rogers-Vizena CR","year":"2022","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"bibr2-10556656221146736","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004924"},{"issue":"7","key":"bibr3-10556656221146736","volume":"8","author":"Rogers-Vizena CR","year":"2020","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"bibr4-10556656221146736","doi-asserted-by":"publisher","DOI":"10.1111\/eje.12214"},{"key":"bibr5-10556656221146736","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.1989.tb03621.x"},{"key":"bibr6-10556656221146736","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002558"},{"key":"bibr7-10556656221146736","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000006375"},{"issue":"9","key":"bibr8-10556656221146736","volume":"7","author":"Kantar RS","year":"2019","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"bibr9-10556656221146736","doi-asserted-by":"publisher","DOI":"10.1177\/1055665620944781"},{"issue":"1","key":"bibr10-10556656221146736","first-page":"17","volume":"35","author":"Lohse CL","year":"1977","journal-title":"J Oral Surg"},{"key":"bibr11-10556656221146736","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000005093"},{"key":"bibr12-10556656221146736","doi-asserted-by":"publisher","DOI":"10.1016\/j.otorri.2016.04.007"},{"key":"bibr13-10556656221146736","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2019.0050"},{"issue":"9","key":"bibr14-10556656221146736","volume":"6","author":"Podolsky DJ","year":"2018","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"bibr15-10556656221146736","unstructured":"Smile Train. 2022. Our Model. https:\/\/www.smiletrain.org\/our-model. Accessed February 5, 2022."},{"key":"bibr16-10556656221146736","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e318231adbc"}],"container-title":["The Cleft Palate Craniofacial Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656221146736","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10556656221146736","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656221146736","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:20:57Z","timestamp":1777393257000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10556656221146736"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,18]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1177\/10556656221146736"],"URL":"https:\/\/doi.org\/10.1177\/10556656221146736","relation":{},"ISSN":["1055-6656","1545-1569"],"issn-type":[{"value":"1055-6656","type":"print"},{"value":"1545-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,18]]}}}