Scholars@Duke
Steven Thornton

Steven Thornton

House Staff
Surgery

Selected Publications

Applying a Shame Lens to Understand Surgical Resident Well-Being: A Call for a Mixed Methods Research Agenda to Build Shame Competence.

Journal Article J Surg Educ · January 2026 There is a well-known but incompletely described well-being crisis in surgery. Rates of poor mental health, substance misuse, and self-harm ideation are concerningly high. There is a growing interest in, and a related body of literature seeking to understa ... Full text Link to item Cite

Quantitative assessment of laparoscopic camera navigation skill: a retrospective cross-sectional study.

Journal Article Surg Endosc · December 23, 2025 OBJECTIVE: To evaluate whether a low-cost, automated tool using trajectory-based metrics and real-time computer vision can objectively assess laparoscopic camera navigation (LCN) skill and distinguish between levels of surgical experience. Laparoscopic cam ... Full text Link to item Cite

Shame Competent Response to Medical Error.

Journal Article Am Fam Physician · September 2025 Link to item Cite

Impact of a Surgical Skills Curriculum on Medical Student Procedural Experience and Confidence.

Journal Article J Surg Res · June 2025 INTRODUCTION: There is a documented decline in formal procedural skill training in undergraduate medical education. We evaluated a simulation-based skills curriculum before the core surgical clerkship at a large academic institution on its concordance with ... Full text Link to item Cite

The Anatomy of Gossip: Dissecting Dynamics and Impacts in Surgical Residency.

Journal Article Surgery · April 2025 BackgroundGossip, defined by social scientists as "evaluative talk about an absent third party," is anecdotally pervasive yet poorly understood in surgical residency programs. Gossip is known to have both positive and negative impacts. This study ... Full text Cite

Use of photon-counting CT and three-dimensional printing for an intra-thoracic retained ballistic fragment in a 9-year-old.

Journal Article Pediatr Radiol · April 2025 Retained ballistic fragments from gunshot wounds pose diagnostic and management challenges for radiologists and surgeons alike. Imaging and clinical decision-making regarding removal warrant comprehensive risk/benefit discussions, considering anatomic loca ... Full text Link to item Cite

Pediatric Resuscitative Thoracotomy in Infants, Children, and Early Adolescents: A Scoping Review.

Journal Article J Surg Res · April 2025 INTRODUCTION: Recent publications sought to define the role of resuscitative thoracotomy (RT) in the pediatric population; however, few studies guide its use in young children and infants. This review characterizes the presentation and outcomes of patients ... Full text Link to item Cite

Low-Fidelity, In Situ, Accessible Pediatric Mass Casualty Incident Simulation to Evaluate and Improve Pediatric Readiness.

Journal Article MedEdPORTAL · 2025 INTRODUCTION: Existing mass casualty incident (MCI) simulations rely on high-fidelity patient simulators, which are cost-prohibitive and often exclude pediatric patients. To address the need for deployable, low-fidelity pediatric MCI simulations, we develo ... Full text Link to item Cite

Textbook Outcome for the Fontan Operation: A Holistic Quality Metric in Congenital Heart Surgery.

Journal Article Innovations (Phila) · 2025 OBJECTIVE: To develop a holistic measure of congenital heart center performance, we created a composite "textbook outcome" (TO) for the Fontan operation using postoperative endpoints. We hypothesized that achieving the TO would have a positive prognostic a ... Full text Link to item Cite

Filter Out the Noise: How to Narrow Your Search for the Perfect Match by the Collaboration of Surgical Education Fellows (CoSEF).

Journal Article Journal of surgical education · October 2024 The residency match process can be overwhelming. We are the Collaboration of Surgical Education Fellows (CoSEF), a multi-institutional group of surgical residents. Our perspectives represent our current experiences as residents at academic programs, but al ... Full text Cite

Find Your Perfect Match for Surgical Residency: Six Steps to Building your BRANDD from the Collaboration of Surgical Education Fellows.

Journal Article Annals of surgery open : perspectives of surgical history, education, and clinical approaches · September 2024 Full text Cite

Roles, Responsibilities, and Expectations of Medical Students on Surgical Subinternships: A Modified Delphi Consensus Study.

Journal Article Acad Med · August 1, 2024 PURPOSE: Surgical subinternships are important rotations for students preparing for a career in general surgery; however, these rotations often vary by institution and service. This modified Delphi study was conducted to reach a consensus set of roles, res ... Full text Link to item Cite

Educational Strategies in Pediatric Trauma Resuscitation Across Disciplines: A Scoping Review.

Journal Article J Surg Res · June 2024 INTRODUCTION: Trauma is the leading cause of death and disability in children. Differences in mechanism, injury pattern, severity, and physiology in this population distinguish pediatric trauma patients from adults. Educational techniques including simulat ... Full text Link to item Cite

Reimagining general surgery resident selection: Collaborative innovation through design thinking.

Journal Article Surgery open science · June 2024 IntroductionThe process by which surgery residency programs select applicants is complex, opaque, and susceptible to bias. Despite attempts by program directors and educational researchers to address these issues, residents have limited ability to ... Full text Cite

Quality improvement initiative to increase radial artery usage as a second arterial conduit in coronary artery bypass grafting

Journal Article Interdisciplinary Cardiovascular and Thoracic Surgery · May 1, 2024 OBJECTIVES: Use of radial artery as a second arterial graft, compared to a saphenous vein, in coronary artery bypass grafting (CABG) can improve late outcomes. However, the radial artery remains underutilized. We initiated a quality improvement (QI) initia ... Full text Cite

Longitudinal Integrated Clerkships and Undergraduate Surgical Education: A Scoping Review and Gap Analysis.

Journal Article J Surg Educ · March 2024 OBJECTIVE: Longitudinal integrated clerkships (LICs) are an increasingly popular approach to medical student clinical education, and the literature describing them is expanding. Despite this, there is a lack of understanding for how surgery didactics and s ... Full text Link to item Cite

Multidisciplinary pediatric trauma simulation curriculum in conjunction with a trauma resuscitation cognitive aid improves resident performance

Journal Article Global Surgical Education - Journal of the Association for Surgical Education · January 3, 2024 Full text Cite

Use of pediatric trauma simulations to facilitate exposure to pediatric trauma resuscitations during training.

Journal Article Surgery · December 2023 BACKGROUND: Pediatric traumas are often high-acuity but are low-frequency compared to adult trauma activations. This is reflected in the relatively limited experience with these events during training. Although some principles of trauma resuscitation are s ... Full text Link to item Cite

A National Comparison of Volume and Acuity for Adult and Pediatric Trauma: A Trauma Quality Improvement Program Cohort Study.

Journal Article J Surg Res · November 2023 INTRODUCTION: Most injured children receive trauma care outside of a pediatric trauma center. Differences in physiology, dosing, and injury pattern limit extrapolation of adult trauma principles to pediatrics. We compare US trauma center experience with pe ... Full text Link to item Cite

Impact of Ventricular Dominance on Long-Term Fontan Outcomes: A 25-year Single-institution Study.

Journal Article Ann Thorac Surg · September 2023 BACKGROUND: The long-term impact of ventricular dominance on Fontan outcomes is controversial. This study examined this issue in a 25-year cohort. METHODS: Patients undergoing the Fontan operation at a single institution (Duke University Medical Center, Du ... Full text Link to item Cite

Quality improvement strategies in pediatric ECMO.

Journal Article Semin Pediatr Surg · August 2023 Pediatric extracorporeal membrane oxygenation is an increasingly utilized, life-saving technology with high mortality and morbidity. A complex technology employed urgently or emergently for some of the sickest children in the hospital by a large multidisci ... Full text Link to item Cite

Risk of Surgical Intervention in Children with Diagnoses of Cancer and Preoperative Malnutrition: A National Analysis.

Journal Article J Pediatr Surg · June 2023 BACKGROUND: Perioperative nutrition is a critical component of appropriate healing and recovery after surgery. We sought to identify perioperative risk in children with cancer and low preoperative hypoalbuminemia undergoing surgical intervention. METHODS: ... Full text Link to item Cite

The Surgical Subinternship: A Unique Opportunity for Early Leadership Development.

Journal Article J Surg Educ · June 2023 Subinternships are formative rotations in the surgery-bound medical student's journey to surgical training. This experience allows for further exploration of career goals, plays an important evaluative role in the residency selection process, and offers on ... Full text Link to item Cite

Comparison of median sternotomy and left anterior mini-incision for pulmonary valve replacement following primary tetralogy of Fallot repair.

Journal Article Cardiol Young · January 2023 OBJECTIVE: Pulmonary insufficiency requiring reintervention frequently occurs after primary tetralogy of Fallot repair. Repeat interventions present a challenge for both the surgeon and patient. We compare a minimally invasive, 5 cm left anterior mini-inci ... Full text Link to item Cite

Improved survival and higher rates of surgical resection associated with hepatocellular carcinoma in children as compared to young adults.

Journal Article Int J Cancer · December 15, 2022 Hepatocellular adenocarcinoma (HCC) is the second most common primary hepatic malignancy in children with a 5-year overall survival of 30%. Few studies have examined the similarities and differences between pediatric and adult HCC. This article aims to exa ... Full text Link to item Cite

Thoracoscopic Lobectomy in Infants and Neonates

Journal Article Essentials of Pulmonary Lobectomy · November 14, 2022 Link to item Cite

Student-led anatomy seminars improve knowledge of surgical anatomy and teaching skills: a follow-up study

Journal Article Global Surgical Education - Journal of the Association for Surgical Education · August 12, 2022 Full text Cite

Biliary atresia in a neonate with a history of COVID-19: A case report.

Journal Article Int J Surg Case Rep · January 2022 INTRODUCTION AND IMPORTANCE: Biliary Atresia is the progressive destruction of the neonatal intra- and extra- hepatic bile ducts. The novel coronavirus has shown dramatic hepatic tropism, and patients experiencing liver injury appear to have worse outcomes ... Full text Link to item Cite

Use of a Structured Observation Tool to Promote Medical Student Engagement in Trauma Resuscitations.

Journal Article J Surg Educ · 2022 OBJECTIVE: We describe a novel approach to promoting medical student learning and engagement during trauma resuscitation with implementation of a structured observation and debriefing tool. DESIGN: In the context of a multifaceted quality improvement effor ... Full text Link to item Cite

Minimally Invasive Approach for Cardiac Hemangioma Resection in a Teenager.

Journal Article Innovations (Phila) · 2022 Cardiac hemangiomas are a rare tumor traditionally resected by median sternotomy. We performed a minimally invasive right ventricular cardiac hemangioma resection via a left anterior mini-incision (LAMI). The procedure was without complication, and the pat ... Full text Link to item Cite