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Shafa G, Kiani P, Masino C, Okrainec A, Pasternak JD, Alseidi A, Madani A. Training for excellence: using a multimodal videoconferencing platform to coach surgeons and improve intraoperative performance. Surg Endosc 2023; 37:9406-9413. [PMID: 37670189 DOI: 10.1007/s00464-023-10374-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/30/2023] [Indexed: 09/07/2023]
Abstract
INTRODUCTION Continuing Professional Development opportunities for lifelong learning are fundamental to the acquisition of surgical expertise. However, few opportunities exist for longitudinal and structured learning to support the educational needs of surgeons in practice. While peer-to-peer coaching has been proposed as a potential solution, there remains significant logistical constraints and a lack of evidence to support its effectiveness. The purpose of this study is to determine whether the use of remote videoconferencing for video-based coaching improves operative performance. METHODS Early career surgeon mentees participated in a remote coaching intervention with a surgeon coach of their choice and using a virtual telestration platform (Zoom Video Communications, San Jose, CA). Feedback was articulated through annotating videos. The coach evaluated mentee performance using a modified Intraoperative Performance Assessment Tool (IPAT). Participants completed a 5-point Likert scale on the educational value of the coaching program. RESULTS Eight surgeons were enrolled in the study, six of whom completed a total of two coaching sessions (baseline, 6-month). Subspecialties included endocrine, hepatopancreatobiliary, and surgical oncology. Mean age of participants was 39 (SD 3.3), with mean 5 (SD 4.1) years in independent practice. Total IPAT scores increased significantly from the first session (mean 47.0, SD 1.9) to the second session (mean 51.8, SD 2.1), p = 0.03. Sub-category analysis showed a significant improvement in the Advanced Cognitive Skills domain with a mean of 33.2 (SD 2.5) versus a mean of 37.0 (SD 2.4), p < 0.01. There was no improvement in the psychomotor skills category. Participants agreed or strongly agreed that the coaching programs can improve surgical performance and decision-making (coaches 85%; mentees 100%). CONCLUSION Remote surgical coaching is feasible and has educational value using ubiquitous commercially available virtual platforms. Logistical issues with scheduling and finding cases aligned with learning objectives continue to challenge program adoption and widespread dissemination.
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Affiliation(s)
- Golsa Shafa
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Surgical Artificial Intelligence Research Academy, University Health Network, Toronto, ON, Canada
| | - Parmiss Kiani
- Surgical Artificial Intelligence Research Academy, University Health Network, Toronto, ON, Canada
| | - Caterina Masino
- Surgical Artificial Intelligence Research Academy, University Health Network, Toronto, ON, Canada
| | - Allan Okrainec
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | | | - Adnan Alseidi
- Department of Surgery, University of California, San Francisco, CA, USA
| | - Amin Madani
- Department of Surgery, University of Toronto, Toronto, ON, Canada.
- Surgical Artificial Intelligence Research Academy, University Health Network, Toronto, ON, Canada.
- University Health Network - Toronto Western Hospital, Main Pavilion, 13MP-312B, 399, Bathurst St, Toronto, ON, M5T 2S8, Canada.
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Kishimoto N, Sanuki T, Liu Y, Tran SD, Seo K. Simulation training for medical emergencies of dental patients: A review of the dental literature. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:104-113. [PMID: 36937224 PMCID: PMC10017307 DOI: 10.1016/j.jdsr.2023.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 02/07/2023] [Accepted: 02/23/2023] [Indexed: 03/09/2023] Open
Abstract
In recent years, due to the aging of the population, the number of dental patients with comorbidities such as hypertension and diabetes has increased. Although it has been reported that these patients are increasingly developing medical emergencies during their dental treatments, many dental providers still do not possess the skills to manage medical emergencies appropriately. Simulation training is essential to improve this situation however, there is no report describing how to conduct an effective simulation in detail for dental office medical emergencies. The purpose of this review is to provide information on simulations that is effective and practical. The authors will highlight the key characteristics for providing effective simulation trainings, such as the selection of simulators, simulation locations, instructors, debriefings, methods for evaluating educational effectiveness, and the use of telesimulation as a method for simulation training due to the global COVID-19 pandemic. In addition, this review provides recommendations on tailoring an ideal simulation training course for those who wish to create one. The authors hope that this review will promote the spread of effective simulation training and in turn, contribute to improving the medical safety of dental patients.
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Affiliation(s)
- Naotaka Kishimoto
- Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
- Corresponding author at: Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan.
| | - Takuro Sanuki
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Younan Liu
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - Simon D. Tran
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - Kenji Seo
- Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Rasic G, Parikh PP, Wang ML, Keric N, Jung HS, Ferguson BD, Altieri MS, Nahmias J. The silver lining of the pandemic in surgical education: virtual surgical education and recommendations for best practices. GLOBAL SURGICAL EDUCATION : JOURNAL OF THE ASSOCIATION FOR SURGICAL EDUCATION 2023; 2:59. [PMID: 38013862 PMCID: PMC10205563 DOI: 10.1007/s44186-023-00137-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/04/2023] [Accepted: 05/14/2023] [Indexed: 11/29/2023]
Abstract
Virtual education is an evolving field within the realm of surgical training. Since the onset of the COVID-19 pandemic, the application of virtual technologies in surgical education has undergone significant exploration and advancement. While originally developed to supplement in-person curricula for the development of clinical decision-making, virtual surgical education has expanded into the realms of clinical decision-making, surgical, and non-surgical skills acquisition. This manuscript aims to discuss the various applications of virtual surgical education as well as the advantages and disadvantages associated with each education modality, while offering recommendations on best practices and future directions.
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Affiliation(s)
- Gordana Rasic
- Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA USA
| | - Priti P. Parikh
- Department of Surgery, Boonshoft School of Medicine, Wright State University, Dayton, OH USA
| | - Ming-Li Wang
- Department of Surgery, University of New Mexico, Albuquerque, NM USA
| | - Natasha Keric
- Division of Trauma, Acute Care Surgery, and Surgical Critical Care, Department of Surgery, Banner-University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix, AZ USA
| | - Hee Soo Jung
- Division of Acute Care and Regional General Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI USA
| | - Benjamin D. Ferguson
- Division of Hepatopancreatobiliary Surgery, Department of Surgery, University of New Mexico, Albuquerque, NM USA
| | - Maria S. Altieri
- Division of Gastrointestinal Surgery, Department of Surgery, Pennsylvania Hospital, Penn Medicine, Philadelphia, PA USA
| | - Jeffry Nahmias
- Division of Trauma, Burns, and Surgical Critical Care, Department of Surgery, University of California Irvine, Orange, CA USA
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4
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Falcioni AG, Yang HC, de Mattos E Silva E, Maricic MA, Ruvinsky S, Bailez MM. Comparative effectiveness of telesimulation versus standard simulation for pediatric Minimally Invasive Surgery (MIS) essential skills training. J Pediatr Surg 2023; 58:669-674. [PMID: 36658075 PMCID: PMC9773740 DOI: 10.1016/j.jpedsurg.2022.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Proctored on site simulation-based surgical education has been integrated in our residents curricula since 2012. Due to COVID-19 pandemic and social distance protocols, we developed a Tele-assisted Essential Skills Training Module (T-ESTM). The aim of this study is to evaluate comparative effectiveness between Telesimulation (T) versus Standard Simulation (S) for minimally invasive surgery (MIS) essential skills training. METHODS ESTM includes academic lectures, tutorials for ergonomics and 7 hands-on tasks scheduled into 2 sessions of 3 hours. Initial and final assessment scoring (adapted from GOALS) as well as timing for 3 of the tasks were registered. Telesimulation (T) group accessed the content online and completed their Hands-On practice through a digital communication platform. Standard Simulation (S) group attended conferences and Hands-On practice at the simulation center. Both groups were proctored by the same educators with summative and formative feedback and debriefing. Data was analyzed with the R-studio software program. RESULTS Each group had 20 participants with a mean age of 28 ± 5 years. 67.5% were surgeons in training, 47.5% had performed low complexity procedures and 40% had previous experience with simulation training. We observed a significant improvement in scoring and time reduction for all assessed tasks in S and T groups (p < 0.001), with no statistically significant differences when comparing both groups. Similar performance could be achieved with both strategies. CONCLUSION Telesimulation is a reproducible and effective educational tool for remote MIS essential skills training, and should be considered as an alternative to on-site simulation programs. LEVEL OF EVIDENCE Level II. TYPE OF STUDY Clinical Research.
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Affiliation(s)
| | - Hsien Chen Yang
- Hospital de Pediatría Dr. J.P. Garrahan, Combate de los Pozos 1881 (C1245), Buenos Aires, Argentina
| | | | | | - Silvina Ruvinsky
- Hospital de Pediatría Dr. J.P. Garrahan, Combate de los Pozos 1881 (C1245), Buenos Aires, Argentina
| | - Maria Marcela Bailez
- Hospital de Pediatría Dr. J.P. Garrahan, Combate de los Pozos 1881 (C1245), Buenos Aires, Argentina
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Taylor C, Ikiroma A, Crowe A, Felix DH, Grant G, Mitchell L, Ross T, Saunderson M, Young L. Using live stream technology to conduct workplace observation assessment of trainee dental nurses: an evaluation of effectiveness and user experience. BDJ Open 2023; 9:4. [PMID: 36750549 PMCID: PMC9904864 DOI: 10.1038/s41405-023-00132-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/22/2022] [Accepted: 01/13/2023] [Indexed: 02/09/2023] Open
Abstract
AIM/OBJECTIVE This study evaluates the effectiveness and users' experience of using live stream technology to conduct workplace observation assessments of trainee dental nurses. Information on the usability, accessibility, and general satisfaction of this technological technique were collected. MATERIALS AND METHODS This nationwide cross-sectional survey was conducted in Scotland and included one focus group and three online questionnaires with qualitative and quantitative questions. The quantitative responses were described using standard descriptive analysis, while the quantitative data were investigated using thematic analysis. RESULTS Eighty-one trainee dental nurses, 35 clinicians and 19 assessors participated in this study. Live stream observation was generally well received by the trainee dental nurses and clinicians, who thought that it had helped increase their confidence to perform practical skills. The assessors also stated that overall satisfaction was high, and that live stream observation met their expectations for efficacy. However, several technical challenges, such as network issues were brought up by responders. CONCLUSION This study provides evidence that workplace observation assessments can be performed in the future by using live stream technology. However, additional investigation and comparison will aid in determining the most effective way of using this approach and providing feedback to promote learning among dental trainees.
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Affiliation(s)
- Caroline Taylor
- Dental Care Professionals Workstream, NHS Education for Scotland, Edinburgh, UK.
| | - Adalia Ikiroma
- grid.451102.30000 0001 0164 4922Dental Clinical Effectiveness Workstream, NHS Education for Scotland, Edinburgh, UK
| | - Anne Crowe
- grid.451102.30000 0001 0164 4922Dental Care Professionals Workstream, NHS Education for Scotland, Edinburgh, UK
| | - David H Felix
- grid.451102.30000 0001 0164 4922Dental Directorate, NHS Education for Scotland, Edinburgh, UK
| | - Gillian Grant
- grid.451102.30000 0001 0164 4922Dental Care Professionals Workstream, NHS Education for Scotland, Edinburgh, UK
| | - Lucy Mitchell
- grid.451102.30000 0001 0164 4922Dental Care Professionals Workstream, NHS Education for Scotland, Edinburgh, UK
| | - Teresa Ross
- grid.451102.30000 0001 0164 4922Dental Care Professionals Workstream, NHS Education for Scotland, Edinburgh, UK
| | - Margaret Saunderson
- grid.451102.30000 0001 0164 4922Dental Care Professionals Workstream, NHS Education for Scotland, Edinburgh, UK
| | - Linda Young
- grid.451102.30000 0001 0164 4922Dental Clinical Effectiveness Workstream, NHS Education for Scotland, Edinburgh, UK
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6
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Chen Z, An J, Wu S, Cheng K, You J, Liu J, Jiang J, Yang D, Peng B, Wang X. Surgesture: a novel instrument based on surgical actions for objective skill assessment. Surg Endosc 2022; 36:6113-6121. [PMID: 35737138 DOI: 10.1007/s00464-022-09108-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 02/07/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Due to varied surgical skills and the lack of an efficient rating system, we developed Surgesture based on elementary functional surgical gestures performed by surgeons, which could serve as objective metrics to evaluate surgical performance in laparoscopic cholecystectomy (LC). METHODS We defined 14 LC basic Surgestures. Four surgeons annotated Surgestures among LC videos performed by experts and novices. The counts, durations, average action time, and dissection/exposure ratio (D/E ratio) of LC Surgestures were compared. The phase of mobilizing hepatocystic triangle (MHT) was extracted for skill assessment by three professors using a modified Global Operative Assessment of Laparoscopic Skills (mGOALS). RESULTS The novice operation time was significantly longer than the expert operation time (58.12 ± 19.23 min vs. 26.66 ± 8.00 min, P < 0.001), particularly during MHT phase. Novices had significantly more Surgestures than experts in both hands (P < 0.05). The left hand and inefficient Surgesture of novices were dramatically more than those of experts (P < 0.05). The experts demonstrated a significantly higher D/E ratio of duration than novices (0.79 ± 0.37 vs. 2.84 ± 1.98, P < 0.001). The counts and time pattern map of LC Surgestures during MHT demonstrated that novices tended to complete LC with more types of Surgestures and spent more time exposing the surgical scene. The performance metrics of LC Surgesture had significant but weak associations with each aspect of mGOALS. CONCLUSION The newly constructed Surgestures could serve as accessible and quantifiable metrics for demonstrating the operative pattern and distinguishing surgeons with various skills. The association between Surgestures and Global Rating Scale laid the foundation for establishing a bridge to automated objective surgical skill evaluation.
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Affiliation(s)
- Zixin Chen
- Department of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Jingjing An
- Department of Operating Room, West China Hospital, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
| | - Shangdi Wu
- Department of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Ke Cheng
- Department of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Jiaying You
- Department of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Jie Liu
- ChengDu Withai Innovations Technology Company, Chengdu, China
| | - Jingwen Jiang
- West China Biomedical Big Data Center of West China Hospital, Chengdu, China
| | - Dewei Yang
- West China Biomedical Big Data Center of West China Hospital, Chengdu, China.,Chongqing University of Posts and Telecommunications, Chongqing, China
| | - Bing Peng
- Department of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu, China.
| | - Xin Wang
- Department of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu, China.
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Jackson HT, Hung CMS, Potarazu D, Habboosh N, DeAngelis EJ, Amdur RL, Estroff JM, Quintana MT, Lin P, Vaziri K, Lee J. Attending guidance advised: educational quality of surgical videos on YouTube. Surg Endosc 2022; 36:4189-4198. [PMID: 34668066 DOI: 10.1007/s00464-021-08751-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 09/27/2021] [Indexed: 01/29/2023]
Abstract
INTRODUCTION YouTube is the most used platform for case preparation by surgical trainees. Despite its popular use, studies have noted limitations in surgical technique, safety, and vetting of these videos. This study identified the most viewed laparoscopic cholecystectomy (LC) videos on YouTube and analyzed the ability of attendings, residents, and medical students to identify critical portions of the procedure, technique, and limitations of the videos. METHODS An incognito search was conducted on YouTube using the term "laparoscopic cholecystectomy." Results were screened for length, publication date, and language. The top ten most viewed videos were presented to general surgery attendings, residents, and medical students at a single academic institution. Established rubrics were used for evaluation, including the Critical View of Safety (CVS) for LC, a modified Global Operative Assessment of Laparoscopic Skills (GOALS) score, a task-specific checklist, and visual analog scales for case difficulty and operator competence. Educational quality and likelihood of video recommendation for case preparation were evaluated using a Likert scale. Attending assessments were considered the gold standard. RESULTS Six attending surgeons achieved excellent internal consistency on CVS, educational quality, and likelihood of recommendation scales, with Cronbach alpha (⍺) of 0.93, 0.92, and 0.92, respectively. ⍺ was ≥ 0.7 in all the other scales measured. Attending evaluations revealed that only one of the ten videos attained all three established CVS criteria. Four videos demonstrated none of the CVS criteria. The mean educational quality (mEQ) was 4.63 on a 10-point scale. The mean likelihood of recommendation (mLoR) for case preparation was 2.3 on a 5-point scale. Senior resident assessments (Postgraduate Year (PGY)4 + , n = 12) aligned with attending surgeons, with no statistically significant differences in CVS attainment, mEQ, and mLoR. Junior residents (PGY1-3, n = 17) and medical students (MS3-4, n = 20) exhibited significant difference with attendings in CVS attainment, mEQ, and mLoR for more than half the videos. Both groups tended to overrate videos compared to attendings. CONCLUSION YouTube is the most popular unvetted resource used for case presentation by surgical trainees. Attending evaluations revealed that the most viewed LC videos on YouTube did not attain the CVS, and were deemed as inappropriate for case preparation, with low educational value. Senior resident video assessments closely aligned with attendings, while junior trainees were more likely to overstate video quality and value. Attending guidance and direction of trainees to high-quality, vetted resources for surgical case preparation is needed. This may also suggest a need for surgical societies with platforms for video sharing to prioritize the creation and dissemination of high-quality videos on easily accessible public platforms.
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Affiliation(s)
- Hope T Jackson
- Department of Surgery, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave, NW, Suite 6B-402, Washington, DC, 20037, USA.
| | - Chen-Min S Hung
- Department of Surgery, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave, NW, Suite 6B-402, Washington, DC, 20037, USA
| | - Deepika Potarazu
- Department of Surgery, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave, NW, Suite 6B-402, Washington, DC, 20037, USA
| | - Noor Habboosh
- Department of Surgery, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave, NW, Suite 6B-402, Washington, DC, 20037, USA
| | - Erik J DeAngelis
- Department of Surgery, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave, NW, Suite 6B-402, Washington, DC, 20037, USA
| | - Richard L Amdur
- Department of Surgery, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave, NW, Suite 6B-402, Washington, DC, 20037, USA
| | - Jordan M Estroff
- Department of Surgery, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave, NW, Suite 6B-402, Washington, DC, 20037, USA
| | - Megan T Quintana
- Department of Surgery, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave, NW, Suite 6B-402, Washington, DC, 20037, USA
| | - Paul Lin
- Department of Surgery, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave, NW, Suite 6B-402, Washington, DC, 20037, USA
| | - Khashayar Vaziri
- Department of Surgery, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave, NW, Suite 6B-402, Washington, DC, 20037, USA
| | - Juliet Lee
- Department of Surgery, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave, NW, Suite 6B-402, Washington, DC, 20037, USA
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Falcioni AG, Yang HC, Maricic MA, Rodriguez SP, Bailez MM. Effectiveness of telesimulation for pediatric minimally invasive surgery essential skills training. J Pediatr Surg 2022; 57:1092-1098. [PMID: 35241279 PMCID: PMC8806401 DOI: 10.1016/j.jpedsurg.2022.01.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND In the context of the COVID-19 pandemic and social distancing rules, access to in-person training activities had temporarily been interrupted, speeding up the implementation of telesimulation for minimally invasive surgery (MIS) essential skills training (T-ESTM, Telesimulation - Essential Skills Training Module) in our center. The aim of this study was to explore the effectiveness of T-ESTM. METHODS T-ESTM was scheduled into 2 sessions of 3 h through the Zoom® virtual meeting platform. The academic lectures, the tutorials for box-trainer set-up and 7 performance tasks were accessed through an online campus previous to the remote encounter for personalized guidance and debriefing. Initial (pre-telementoring) and final (post 6-hour telementoring) assessment scoring as well as timing for Task 2 (circle-cutting pattern), 3 (extracorporeal Roeder knot) and 5 (intracorporeal Square knot) were registered. RESULTS 61 participants were recruited. The mean age was 31±5 years. 65% were surgical residents. 48% performed low complexity procedures. 52% had previous experience with simulation training. In Task 2, there was a 21% improvement in the final score obtained, as well as a significant decrease in time of 33%; in Task 3, there was an increase of 39% in the scoring and a decrease of 49% in the timing; and in Task 5, participants improved their technique a 30% and decreased the performance time a 47%. All the differences were statistically significant. DISCUSSION Our data support T-ESTM as a reproducible and effective educational tool for remote MIS essential skills hands-on training. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Alejandra Georgina Falcioni
- Surgical Simulation Center, Pediatric Surgery Department, Hospital de Pediatría Dr. J.P. Garrahan, Buenos Aires, Argentina.
| | - Hsien Chen Yang
- Surgical Simulation Center, Pediatric Surgery Department, Hospital de Pediatría Dr. J.P. Garrahan, Buenos Aires, Argentina
| | - Maximiliano Alejo Maricic
- Surgical Simulation Center, Pediatric Surgery Department, Hospital de Pediatría Dr. J.P. Garrahan, Buenos Aires, Argentina
| | | | - Maria Marcela Bailez
- Surgical Simulation Center, Pediatric Surgery Department, Hospital de Pediatría Dr. J.P. Garrahan, Buenos Aires, Argentina
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Raborn LN, Janis JE. Overcoming the Impact of COVID-19 on Surgical Mentorship: A Scoping Review of Long-distance Mentorship in Surgery. JOURNAL OF SURGICAL EDUCATION 2021; 78:1948-1964. [PMID: 34059480 PMCID: PMC8894132 DOI: 10.1016/j.jsurg.2021.05.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/05/2021] [Accepted: 05/02/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND Mentorship in the surgical field has been increasingly recognized as a crucial component of career success. Distance mentorship models may be utilized to overcome geographic limitations, increase mentorship access, and strengthen mentoring relationships in surgery. OBJECTIVE This review aimed to identify the scope of literature on distance mentoring in surgery, the range of its application, its effectiveness, and any gaps in the literature that should be addressed in order to enhance mentorship in the surgical field. DESIGN A comprehensive PubMed review was performed in January 2021 on distance mentorship of students, trainees, and surgeons in the surgical field. Reviews, replies, and non-English articles were excluded. Data was extracted regarding publication year, author's country, specialty, subjects, aim of mentorship model, and efficacy. RESULTS 134 total studies met inclusion and exclusion criteria. Most studies were published in 2020, written by authors in the United States, from general surgery, and featured an expert surgeon paired with a more junior fully trained surgeon. In all, 93.3% of studies utilized distance mentorship to enhance surgical skill through telementoring and only 4.5% were focused on mentorship to enhance careers through professional development. The remaining studies utilized distance mentorship models to increase surgical research (0.7%) and clinical knowledge (1.5%). CONCLUSION The results of this review suggest successful implementation of distance mentoring in surgery through telementoring, but a lack of professionally aimed distance mentorship programs. Amidst COVID-19, distance mentorship is particularly important because of decreased face-to-face opportunity. Future studies in the surgical field should investigate distance mentoring as a means of increasing mentorship for professional development.
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Affiliation(s)
- Layne N Raborn
- Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Jeffrey E Janis
- Department of Plastic and Reconstructive Surgery, Ohio State University, Wexner Medical Center Columbus, Columbus, Ohio.
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10
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Roach E, Okrainec A. Telesimulation for remote simulation and assessment. J Surg Oncol 2021; 124:193-199. [PMID: 34245571 DOI: 10.1002/jso.26505] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/05/2021] [Accepted: 04/08/2021] [Indexed: 12/14/2022]
Abstract
Telesimulation (TS), the process of using the internet to link educators and trainees at locations remote from one another, harnesses the powers of technology to enable access to high-quality simulation-based education and assessment to learners across the globe. From its first uses in the teaching and assessment of laparoscopic skills to more recent interpretations during the current pandemic, TS has shown promise in helping educators to address pressing dilemmas in medical education.
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Affiliation(s)
- Eileen Roach
- Division of General Surgery, University Health Network, Toronto, Ontario, Canada
| | - Allan Okrainec
- Division of General Surgery, University Health Network, Toronto, Ontario, Canada.,Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Temerty Advanced Surgical Education and Simulation Center, University Health Network, Toronto, Ontario, Canada
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11
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Leveraging Videoconferencing Technology to Augment Surgical Training During a Pandemic. ANNALS OF SURGERY OPEN 2021; 2:e035. [PMID: 36590033 PMCID: PMC9793996 DOI: 10.1097/as9.0000000000000035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/01/2021] [Indexed: 01/04/2023] Open
Abstract
Our objective was to review the use of videoconferencing as a practical tool for remote surgical education and to propose a model to overcome the impact of a pandemic on resident training. Summary Background Data In response to the coronavirus disease 2019 pandemic, most institutions and residency programs have been restructured to minimize the number of residents in the hospital as well as their interactions with patients and to promote physical distancing measures. This has resulted in decreased resident operative exposure, responsibility, and autonomy, hindering their educational goals and ability to achieve surgical expertise necessary for independent practice. Methods We conducted a narrative review to explore the use of videoconferencing for remote broadcasting of surgical procedures, telecoaching using surgical videos, telesimulation for surgical skills training, and establishing a didactic lecture series. Results and Conclusions We present a multimodal approach for using practical videoconferencing tools that provide the means for audiovisual communication to help augment residents' operative experience and limit the impact of self-isolation, redeployment, and limited operative exposure on surgical training.
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Zahid A, Miskovic D. Proctorship in Minimally Invasive Colorectal Surgery. Clin Colon Rectal Surg 2021; 34:186-193. [PMID: 33815001 DOI: 10.1055/s-0040-1722765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Teaching an established surgeon in a novel technique by a colleague who has acquired a level of expertise is often referred to as "proctoring" or "precepting." Surgical preceptorships can be defined as supervised teaching programs, whereby individual or groups of surgeons (proctors) experienced in a certain technique support a colleague who wants to adopt this technique (sometimes referred to as "delegates" or "preceptees"). Preceptorship programs really focus on a specific technique, technology, or skill which is required to broaden, complement, or transform an established surgeon's practice. Within colorectal surgery, in the past 30 years, there is been an evolution of interventional options including open, laparoscopic, robotic, and endoscopic procedures. With each new emerging technology and technique, safe and effective uptake by established surgeons is best been attained by a period of proctorship by an experienced colleague. Formalizing this has been facilitated largely through industry support. There, however, remains a considerable chasm when it comes to standardization, quality control, and jurisprudence. This article aims to describe the requirements for a contemporary proctorship program, to examine instruments of quality control, and how to improve effectiveness.
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Affiliation(s)
- Assad Zahid
- St Mark's Hospital, London, United Kingdom.,University of Sydney, Australia
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McQueen S, McKinnon V, VanderBeek L, McCarthy C, Sonnadara R. Video-Based Assessment in Surgical Education: A Scoping Review. JOURNAL OF SURGICAL EDUCATION 2019; 76:1645-1654. [PMID: 31175065 DOI: 10.1016/j.jsurg.2019.05.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/15/2019] [Accepted: 05/18/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND OBJECTIVE Video-based assessment of residents' surgical skills may offer several advantages over direct observations of clinical performance in terms of objectivity, time-efficiency, and feasibility. Although video-based assessment is becoming more common in surgical training, a broad understanding of its utility is lacking. This scoping review explores video-based assessment in surgical training and presents the evidence supporting its use. DESIGN A literature search was conducted using the Web of Science database with key words related to video-based assessment and surgical training. Exclusion criteria included articles not published in English and articles on undergraduate medical education, continuing professional development, or non-surgical disciplines. Initially, 702 articles were identified; after title, abstract, and full-text screening by two independent reviewers (SM and VM), 199 articles remained. RESULTS We present the benefits of video-based assessment, including the ability to capture clinical ability in the operating room without decreasing intraoperative efficiency, as well as the potential to improve formative assessment and feedback practices. We describe the validity, reliability, and challenges of video-based assessment, as well as the use of video-based methods in clinical and simulated settings. We conclude by discussing questions that remain to be addressed. CONCLUSIONS Although further research and cost-benefit analyses are required, greater adoption of video-based assessment into surgical training may help meet increased assessment demands in an era of competency-based medical education.
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Affiliation(s)
- Sydney McQueen
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Victoria McKinnon
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Laura VanderBeek
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Colm McCarthy
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Ranil Sonnadara
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
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Nikouline A, Jimenez MC, Okrainec A. Feasibility of remote administration of the fundamentals of laparoscopic surgery (FLS) skills test using Google wearable device. Surg Endosc 2019; 34:443-449. [DOI: 10.1007/s00464-019-06788-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 04/04/2019] [Indexed: 01/15/2023]
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Papanikolaou I, Haidopoulos D, Paschopoulos M, Chatzipapas I, Loutradis D, Vlahos N. Changing the way we train surgeons in the 21th century: A narrative comparative review focused on box trainers and virtual reality simulators. Eur J Obstet Gynecol Reprod Biol 2019; 235:13-18. [DOI: 10.1016/j.ejogrb.2019.01.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/04/2019] [Accepted: 01/14/2019] [Indexed: 10/27/2022]
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McCoy CE, Sayegh J, Alrabah R, Yarris LM. Telesimulation: An Innovative Tool for Health Professions Education. AEM EDUCATION AND TRAINING 2017; 1:132-136. [PMID: 30051023 PMCID: PMC6001828 DOI: 10.1002/aet2.10015] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 12/05/2016] [Accepted: 12/12/2016] [Indexed: 05/11/2023]
Abstract
Telesimulation is a new and innovative concept and process that has been used to provide education, training, and assessment in health-related fields such as medicine. This new area of simulation, and its terminology, has its origins within the past decade. The face validity and ability to provide the benefits of simulation education to learners at off-site locations has allowed the wide and rapid adoption of telesimulation in the field of medical education. Telesimulation has been implemented in areas such as pediatric resuscitation, surgery, emergency medicine, ultrasound-guided regional anesthesia in anesthesiology, nursing, and neurosurgery. However, its rapid expansion and current use has outgrown its recent description less than a decade ago. To date, there is no unifying definition of telesimulation that encompasses all the areas where it has been used while simultaneously allowing for growth and expansion in this field of study. This article has two main objectives. The first objective is to provide a comprehensive and unifying definition of telesimulation that encompasses all the areas where it has been used while allowing for growth and expansion in the field of study. The secondary objective is to describe the utility of telesimulation for emergency medicine educators in the context of the current evidence to serve as a background and framework that educators may use when considering creating educational programs that incorporate telecommunication and simulation resources. This article is complementary to the large group presentation where this new comprehensive and unifying definition was introduced to the simulation community at the International Meeting on Simulation in Healthcare in January 2016.
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Affiliation(s)
| | - Julie Sayegh
- Department of Emergency MedicineUC IrvineIrvineCA
| | - Rola Alrabah
- Department of Emergency MedicineUC IrvineIrvineCA
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Damas E, Norcéide C, Zephyr Y, Williams KL, Renouf T, Dubrowski A. Development of a Sustainable Simulator and Simulation Program for Laparoscopic Skills Training in Haiti. Cureus 2016; 8:e632. [PMID: 27433411 PMCID: PMC4934796 DOI: 10.7759/cureus.632] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Laparoscopic surgery has been shown to have many favorable effects on surgical outcomes and postoperative recovery times. However, the cost of currently available training programs, such as the Fundamentals of Laparoscopic Surgery (FLS), limits their adoption in developing countries. To address this cost constraint, educators at the Justinian University Hospital (JUH) in Northern Haiti used local materials to build their own laparoscopic skills box trainer. This trainer is used to teach all surgical and OB/GYN residents in their laparoscopic skills program. The progressive curriculum consists of seven modules, three of which are for all trainees and four of which are specifically for surgery and OB/GYN (2). The seven modules are arranged in the order of difficulty; they start with basic maneuvers and progress to complex skills. This report describes both the preparation of the seven models and evaluation of the skills that are learned. This approach may facilitate global access to feasible, progressive, and sustainable laparoscopic training.
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Affiliation(s)
- Emile Damas
- Surgery Department, Justinien University Hospital
| | | | - Yvel Zephyr
- Department of OBGYN, Director of Training and Research, Justinien University Hospital
| | | | - Tia Renouf
- Emergency Medicine, Memorial University of Newfoundland
| | - Adam Dubrowski
- Emergency Medicine, Pediatrics, Memorial University of Newfoundland ; Marine Institute, Memorial University of Newfoundland
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Nahas S, Ieong E, Logishetty K, Mahapatra P, Nathwani D. The Use of Personalized Video Training for Orthopaedic Surgeons. Musculoskeletal Care 2016; 14:180-4. [PMID: 26987575 DOI: 10.1002/msc.1137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Hadley C, Lam SK, Briceño V, Luerssen TG, Jea A. Use of a formal assessment instrument for evaluation of resident operative skills in pediatric neurosurgery. J Neurosurg Pediatr 2015; 16:497-504. [PMID: 26314202 DOI: 10.3171/2015.1.peds14511] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Currently there is no standardized tool for assessment of neurosurgical resident performance in the operating room. In light of enhanced requirements issued by the Accreditation Council for Graduate Medical Education's Milestone Project and the Matrix Curriculum Project from the Society of Neurological Surgeons, the implementation of such a tool seems essential for objective evaluation of resident competence. Beyond compliance with governing body guidelines, objective assessment tools may be useful to direct early intervention for trainees performing below the level of their peers so that they may be given more hands-on teaching, while strong residents can be encouraged by faculty members to progress to conducting operations more independently with passive supervision. The aims of this study were to implement a validated assessment tool for evaluation of operative skills in pediatric neurosurgery and determine its feasibility and reliability. METHODS All neurosurgery residents completing their pediatric rotation over a 6-month period from January 1, 2014, to June 30, 2014, at the authors' institution were enrolled in this study. For each procedure, residents were evaluated by means of a form, with one copy being completed by the resident and a separate copy being completed by the attending surgeon. The evaluation form was based on the validated Objective Structured Assessment of Technical Skills for Surgery (OSATS) and used a 5-point Likert-type scale with 7 categories: respect for tissue; time and motion; instrument handling; knowledge of instruments; flow of operation; use of assistants; and knowledge of specific procedure. Data were then stratified by faculty versus resident (self-) assessment; postgraduate year level; and difficulty of procedure. Descriptive statistics (means and SDs) were calculated, and the results were compared using the Wilcoxon signed-rank test and Student t-test. A p value < 0.05 was considered statistically significant. RESULTS Six faculty members, 1 fellow, and 8 residents completed evaluations for 299 procedures, including 32 ventriculoperitoneal (VP) shunt revisions, 23 VP shunt placements, 19 endoscopic third ventriculostomies, and 18 craniotomies for tumor resection. There was no significant difference between faculty and resident self-assessment scores overall or in any of the 7 domains scores for each of the involved residents. On self-assessment, senior residents scored themselves significantly higher (p < 0.02) than junior residents overall and in all domains except for "time and motion." Faculty members scored senior residents significantly higher than junior residents only for the "knowledge of instruments" domain (p = 0.05). When procedure difficulty was considered, senior residents' scores from faculty members were significantly higher (p = 0.04) than the scores given to junior residents for expert procedures only. Senior residents' self-evaluation scores were significantly higher than those of junior residents for both expert (p = 0.03) and novice (p = 0.006) procedures. CONCLUSIONS OSATS is a feasible and reliable assessment tool for the comprehensive evaluation of neurosurgery resident performance in the operating room. The authors plan to use this tool to assess resident operative skill development and to improve direct resident feedback.
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Affiliation(s)
- Caroline Hadley
- Division of Pediatric Neurosurgery, Texas Children's Hospital and Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | - Sandi K Lam
- Division of Pediatric Neurosurgery, Texas Children's Hospital and Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | - Valentina Briceño
- Division of Pediatric Neurosurgery, Texas Children's Hospital and Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | - Thomas G Luerssen
- Division of Pediatric Neurosurgery, Texas Children's Hospital and Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | - Andrew Jea
- Division of Pediatric Neurosurgery, Texas Children's Hospital and Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
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Ahlborg L, Weurlander M, Hedman L, Nisell H, Lindqvist PG, Felländer-Tsai L, Enochsson L. Individualized feedback during simulated laparoscopic training:a mixed methods study. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2015; 6:93-100. [PMID: 26223033 PMCID: PMC4537795 DOI: 10.5116/ijme.55a2.218b] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 07/12/2015] [Indexed: 06/01/2023]
Abstract
OBJECTIVE This study aimed to explore the value of individualized feedback on performance, flow and self-efficacy during simulated laparoscopy. Furthermore, we wished to explore attitudes towards feedback and simulator training among medical students. METHODS Sixteen medical students were included in the study and randomized to laparoscopic simulator training with or without feedback. A teacher provided individualized feedback continuously throughout the procedures to the target group. Validated questionnaires and scales were used to evaluate self-efficacy and flow. The Mann-Whitney U test was used to evaluate differences between groups regarding laparoscopic performance (instrument path length), self-efficacy and flow. Qualitative data was collected by group interviews and interpreted using inductive thematic analyses. RESULTS Sixteen students completed the simulator training and questionnaires. Instrument path length was shorter in the feedback group (median 3.9 m; IQR: 3.3-4.9) as compared to the control group (median 5.9 m; IQR: 5.0-8.1), p<0.05. Self-efficacy improved in both groups. Eleven students participated in the focus interviews. Participants in the control group expressed that they had fun, whereas participants in the feedback group were more concentrated on the task and also more anxious. Both groups had high ambitions to succeed and also expressed the importance of getting feedback. The authenticity of the training scenario was important for the learning process. CONCLUSIONS This study highlights the importance of individualized feedback during simulated laparoscopy training. The next step is to further optimize feedback and to transfer standardized and individualized feedback from the simulated setting to the operating room.
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Affiliation(s)
- Liv Ahlborg
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Karolinska University Hospital, Sweden
| | - Maria Weurlander
- School of Education and Communication in Engineering Science (ECE), KTH Royal Institute of Technologyg, Sweden
| | - Leif Hedman
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Karolinska University Hospital, Sweden
| | - Henry Nisell
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Karolinska University Hospital, Sweden
| | - Pelle G. Lindqvist
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Karolinska University Hospital, Sweden
| | - Li Felländer-Tsai
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Karolinska University Hospital, Sweden
| | - Lars Enochsson
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Karolinska University Hospital, Sweden
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Watanabe Y, Bilgic E, Lebedeva E, McKendy KM, Feldman LS, Fried GM, Vassiliou MC. A systematic review of performance assessment tools for laparoscopic cholecystectomy. Surg Endosc 2015; 30:832-44. [PMID: 26092014 DOI: 10.1007/s00464-015-4285-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 05/23/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Multiple tools are available to assess clinical performance of laparoscopic cholecystectomy (LC), but there are no guidelines on how best to implement and interpret them in educational settings. The purpose of this systematic review was to identify and critically appraise LC assessment tools and their measurement properties, in order to make recommendations for their implementation in surgical training. METHODS A systematic search (1989-2013) was conducted in MEDLINE, Embase, Scopus, Cochrane, and grey literature sources. Evidence for validity (content, response process, internal structure, relations to other variables, and consequences) and the conditions in which the evidence was obtained were evaluated. RESULTS A total of 54 articles were included for qualitative synthesis. Fifteen technical skills and two non-technical skills assessment tools were identified. The 17 tools were used for either: recorded procedures (nine tools, 60%), direct observation (five tools, 30%), or both (three tools, 18%). Fourteen (82%) tools reported inter-rater reliability and one reported a Generalizability Theory coefficient. Nine (53%) had evidence for validity based on clinical experience and 11 (65%) compared scores to other assessments. Consequences of scores, educational impact, applications to residency training, and how raters were trained were not clearly reported. No studies mentioned cost. CONCLUSIONS The most commonly reported validity evidence was inter-rater reliability and relationships to other known variables. Consequences of assessments and rater training were not clearly reported. These data and the evidence for validity should be taken into consideration when deciding how to select and implement a tool to assess performance of LC, and especially how to interpret the results.
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Affiliation(s)
- Yusuke Watanabe
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650, Cedar Avenue, L9. 316, Montreal, QC, H3G 1A4, Canada.
- Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
| | - Elif Bilgic
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650, Cedar Avenue, L9. 316, Montreal, QC, H3G 1A4, Canada
| | - Ekaterina Lebedeva
- The Henry K.M. De Kuyper Education Centre, McGill University Health Centre, Montreal, QC, Canada
| | - Katherine M McKendy
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650, Cedar Avenue, L9. 316, Montreal, QC, H3G 1A4, Canada
| | - Liane S Feldman
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650, Cedar Avenue, L9. 316, Montreal, QC, H3G 1A4, Canada
| | - Gerald M Fried
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650, Cedar Avenue, L9. 316, Montreal, QC, H3G 1A4, Canada
| | - Melina C Vassiliou
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650, Cedar Avenue, L9. 316, Montreal, QC, H3G 1A4, Canada.
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A blinded assessment of video quality in wearable technology for telementoring in open surgery: the Google Glass experience. Surg Endosc 2015; 30:372-8. [DOI: 10.1007/s00464-015-4178-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 03/20/2015] [Indexed: 10/23/2022]
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Ahlborg L, Hedman L, Nisell H, Felländer-Tsai L, Enochsson L. Simulator training and non-technical factors improve laparoscopic performance among OBGYN trainees. Acta Obstet Gynecol Scand 2014; 92:1194-201. [PMID: 24461067 DOI: 10.1111/aogs.12218] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 07/10/2013] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To investigate how simulator training and non-technical factors affect laparoscopic performance among residents in obstetrics and gynecology. DESIGN In this prospective study, trainees were randomized into three groups. The first group was allocated to proficiency-based training in the LapSimGyn(®) virtual reality simulator. The second group received additional structured mentorship during subsequent laparoscopies. The third group served as control group. At baseline an operation was performed and visuospatial ability, flow and self-efficacy were assessed. All groups subsequently performed three tubal occlusions. Self-efficacy and flow were assessed before and/or after each operation. SETTING Simulator training was conducted at the Center for Advanced Medical Simulation and Training, Karolinska University Hospital. Sterilizations were performed at each trainee's home clinic. POPULATION Twenty-eight trainees/residents from 21 hospitals in Sweden were included. METHODS/MAIN OUTCOME MEASURES Visuospatial ability was tested by the Mental Rotation Test-A. Flow and self-efficacy were assessed by validated scales and questionnaires. Laparoscopic performance was measured as the duration of surgery. Visuospatial ability, self-efficacy and flow were correlated to the laparoscopic performance using Spearman's correlations. Differences between groups were analyzed by the Mann-Whitney U-test. RESULTS No differences across groups were detected at baseline. Self-efficacy scores before and flow scores after the third operation were significantly higher in the trained groups. Duration of surgery was significantly shorter in the trained groups. Flow and self-efficacy correlate positively with laparoscopic performance. CONCLUSIONS Simulator training and non-technical factors appear to improve the laparoscopic performance among trainees/residents in obstetrics and gynecology.
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Affiliation(s)
- Liv Ahlborg
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden; Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden; Department of Obstetrics and Gynecology, Södertälje Hospital, Södertälje, Sweden; Division of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden
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Laurent DAB, Niazi AU, Cunningham MS, Jaeger M, Abbas S, McVicar J, Chan VW. A Valid and Reliable Assessment Tool for Remote Simulation-Based Ultrasound-Guided Regional Anesthesia. Reg Anesth Pain Med 2014; 39:496-501. [DOI: 10.1097/aap.0000000000000165] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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