This survey should be taken by surgeons who consider themselves to be in a rural practice.

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* 1. How long have you been in the practice of general surgery?

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* 2. How would you best qualify your surgical practice?

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* 4. What is the population of the community where you practice?

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* 5. What is the zip code for your hospital?

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* 6. How many licensed beds are in your hospital?

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* 7. Please select the option below that represents your primary employment setting:

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* 8. I practice primarily in a:

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* 9. I would describe my employment status as:

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* 10. I am:

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* 11. Approximately how many months did you spend on the Pediatric Surgery service as a general surgery resident?

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* 12. When considering your training in general surgery, was the time spent on the pediatric surgery service:

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* 13. The value of this training on pediatric surgery was

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* 14. Where did you train in General Surgery (or hospital type in which you primarily trained - community or University)?

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* 15. What age of patient do you care for in your practice (check all that apply)?

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* 16. Do you wish that you had more expertise in taking care of surgical problems in children in your current practice?

If you do not take care of children in your practice, please skip to Question 30. Otherwise, please continue to answer all of the questions. 

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* 17. Does your hospital have a NICU?

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* 18. If yes, do you provide surgical coverage for the NICU?

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* 19. Exclusive of newborns, which of the following cases do you feel comfortable doing in patients under 18-years-old?

  Not at all comfortable Slightly comfortable Moderately comfortable Very comfortable Extremely comfortable
Appendectomies
Umbilical Hernia Repairs
Inguinal Hernia Repairs
Pyloric stenosis
Central access procedures
Colorectal procedures for IBD and FP
VATS
Enterolysis for SBO
Thyroglossal duct cyst excision

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* 20. What are the current barriers for your ability to perform procedures on children (check all that apply)?

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* 21. Is your interest in performing any of these procedures age dependent (i.e. you do these operations in only certain age groups depending on the diagnosis)?

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* 22. Who routinely anesthetizes your pediatric patients (check all that apply)?

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* 23. What is the average number of pediatric cases that you do annually?

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* 24. If you are nearing retirement age and have routinely taken care of children, do you have a succession plan (i.e., are you training another surgeon to take your place)?

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* 25. Do you have transfer agreements and protocols with a pediatric hospital for your patients who need a higher level of care?

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* 26. If yes, do you receive feedback after sending your patients to another center?

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* 27. Do you have telemedicine capabilities where you work that are used for patient care?

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* 28. If yes, do you currently use them for advice for pediatric patients?

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* 29. Do you have on-site or telehealth pediatric CME activities at your hospital?

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* 30. If yes, who provides this service?

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* 31. If no, would this be of value to you?

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* 32. In today's practice climate for a general surgeon who will practice in an environment where there is no Board Certified Pediatric Surgeon, what do you view as the most appropriate training for a surgeon who will treat some children?

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* 33. In today's practice climate for a general surgeon who will practice in an environment where there is no Board Certified Pediatric Surgeon, what do you view as the appropriate hospital resources for a surgeon who will treat some children?

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* 34. Please list any pediatric topics that you would value for Pediatric CME credit. 

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