The Business Engineering Surgical Technologies (BEST) teaching method: incubating talents for surgical innovation

Barriers to Surgical Innovation Research: A Canadian Study on Public Funding Trends

Background

A decline in research funding has been cited as a potential cause for limited surgical innovation in the United States. We aim to understand if this is a North American phenomenon and explore whether a lack of public funding is a barrier to surgical innovation in Canada.

Methods

Publicly available funding data from Canadian Institutes of Health Research (CIHR) were reviewed from 2008 to 2019 to determine the yearly funding distributed to surgical departments. Surgical innovation studies were identified and total yearly funding was calculated. All amounts were adjusted for inflation to reflect 2019 Canadian dollar value.

Results

From 2008 to 2019, surgical departments were granted 1.82–4.70% of total CIHR funding. In total, 902 grants were allocated to surgical departments and 126 (14.0%) met criteria for surgical innovation. Surgical innovation research was allocated a total annual amount ranging from 1.52 to 9.01 million CAD. There appears to be an upward trend in public funding for surgical innovation over this time period.

Discussion

Contrary to the landscape in the United States, there is no evidence of decreasing trends in public funding for surgical innovation in Canada. Considerations should be given to other potential barriers precluding surgeons from participating in innovation.

Conclusion

Only a small percentage of research dollars to departments in Canada are spent on innovation research, despite an overall increasing trend in total public research funding over the past 10 years. We need to foster an environment in which surgical innovation is encouraged through medical curriculum changes, multidisciplinary collaboration opportunities, and dedicated faculty resources.

Pushing the Needle of Entrepreneurship and Innovation: Where Do Plastic and Reconstructive Surgeons Stand?

Background:

Plastic and reconstructive surgery has a well-recognized history of disruption and innovation. It remains unclear, however, how the specialty’s priority on innovation materializes into commercialization or bench to bedside led by plastic surgeons.

Methods:

Our analysis utilized Pitchbook (Seattle, Wash.), a market database of companies and investors, for ventures that have designed innovations related to plastic and reconstructive surgery. Companies were categorized into 5 focus areas: provider (outpatient surgical or hospital entity), aesthetics (cosmetics/injectables), devices (instrumentation, lasers, implants), regenerative medicine (tissue engineering/wound healing), and software (digital solutions). Company websites, LinkedIn (Sunnyvale, Calif.) profiles, and Crunchbase (San Francisco, Calif.) were reviewed to determine the leadership roles of plastic surgeons.

Results:

Plastic surgeons primarily serve as advisors, as opposed to founders or chief executive officers (CEOs). Our analysis additionally found that provider and software solutions had a greater degree of plastic surgeon-led leadership, whereas regenerative medicine and device innovation remains less frequented. There was a relatively balanced representation of academic and private plastic surgeons in entrepreneurial pursuits.

Conclusions:

Plastic surgeons typically serve as board advisors, as opposed to founders and CEOs. Reasons for disengagement from leadership roles may include satisfaction with clinical work, time constraint, lack of business knowledge, financial constraint, and opportunity cost associated with starting a venture. To promote participation in innovation, future studies should explore tangible ways to engage in such opportunities. In doing so, plastic surgeons can own the “organ” of innovation, and continue to contribute to the legacy and the advancement of the specialty.

Exploring the Cost of eLearning in Health Professions Education: Scoping Review

BACKGROUND

Existing research on the costs associated with the design and deployment of eLearning in health professions education is limited. The relative costs of these learning platforms to those of face-to-face learning are also not well understood. The lack of predefined costing models used for eLearning cost data capture has made it difficult to complete cost evaluation.

OBJECTIVE

The key aim of this scoping review was to explore the state of evidence concerning cost capture within eLearning in health professions education. The review explores the available data to define cost calculations related to eLearning.

METHODS

The scoping review was performed using a search strategy with Medical Subject Heading terms and related keywords centered on eLearning and cost calculation with a population scope of health professionals in all countries. The search was limited to articles published in English. No restriction was placed on literature publication date.

RESULTS

In total, 7344 articles were returned from the original search of the literature. Of these, 232 were relevant to associated keywords or abstract references following screening. Full-text review resulted in 168 studies being excluded. Of these, 61 studies were excluded because they were unrelated to eLearning and focused on general education. In addition, 103 studies were excluded because of lack of detailed information regarding costs; these studies referred to cost in ways either indicating cost favorability or unfavorability, but without data to support findings. Finally, 4 studies were excluded because of limited cost data that were insufficient for analysis. In total, 42 studies provided data and analysis of the impact of cost and value in health professions education. The most common data source was total cost of training (n=29). Other sources included cost per learner, referring to the cost for individual students (n=13). The population most frequently cited was medical students (n=15), although 12 articles focused on multiple populations. A further 22 studies provide details of costing approaches for the production and delivery of eLearning. These studies offer insight into the ways eLearning has been budgeted and project-managed through implementation.

CONCLUSIONS

Although cost is a recognized factor in studies detailing eLearning design and implementation, the way cost is captured is inconsistent. Despite a perception that eLearning is more cost-effective than face-to-face instruction, there is not yet sufficient evidence to assert this conclusively. A rigorous, repeatable data capture method is needed, in addition to a means to leverage existing economic evaluation methods that can then test eLearning cost-effectiveness and how to implement eLearning with cost benefits and advantages over traditional instruction.

Surgical team: improving teamwork, a review

Teams within surgery have been through countless cycles of refinement with an ever-increasing list of surgical team members. This results in a more dispersed team, making effective teamwork harder to achieve. Furthermore, the ad hoc nature of surgical teams means that team familiarity is not always given. The impact of this is seen across the field, with inadequacies leading to disastrous outcomes. This is a review of research that has been done into the topic of surgical teams. It will investigate barriers and consider the evidence available on how to improve the current system. Studies show an increased effectiveness of surgical teams with structures that allowed consistency in team members. The research advocates that advancements made in improving teamwork and efficiency can prove to be a low-cost but high-yield strategy for development. This can be in terms of simulated training, staff turnover management and fixed team allocation.

LapTrain: multi-modality training curriculum for laparoscopic cholecystectomy-results of a randomized controlled trial

BACKGROUND

Multiple training modalities for laparoscopy have different advantages, but little research has been conducted on the benefit of a training program that includes multiple different training methods compared to one method only. This study aimed to evaluate benefits of a combined multi-modality training program for surgical residents.

METHODS

Laparoscopic cholecystectomy (LC) was performed on a porcine liver as the pre-test. Randomization was stratified for experience to the multi-modality Training group (12 h of training on Virtual Reality (VR) and box trainer) or Control group (no training). The post-test consisted of a VR LC and porcine LC. Performance was rated with the Global Operative Assessment of Laparoscopic Skills (GOALS) score by blinded experts.

RESULTS

Training (n = 33) and Control (n = 31) were similar in the pre-test (GOALS: 13.7 ± 3.4 vs. 14.7 ± 2.6; p = 0.198; operation time 57.0 ± 18.1 vs. 63.4 ± 17.5 min; p = 0.191). In the post-test porcine LC, Training had improved GOALS scores (+ 2.84 ± 2.85 points, p < 0.001), while Control did not (+ 0.55 ± 2.34 points, p = 0.154). Operation time in the post-test was shorter for Training vs. Control (40.0 ± 17.0 vs. 55.0 ± 22.2 min; p = 0.012). Junior residents improved GOALS scores to the level of senior residents (pre-test: 13.7 ± 2.7 vs. 18.3 ± 2.9; p = 0.010; post-test: 15.5 ± 3.4 vs. 18.8 ± 3.8; p = 0.120) but senior residents remained faster (50.1 ± 20.6 vs. 25.0 ± 1.9 min; p < 0.001). No differences were found between groups on the post-test VR trainer.

CONCLUSIONS

Structured multi-modality training is beneficial for novices to improve basics and overcome the initial learning curve in laparoscopy as well as to decrease operation time for LCs in different stages of experience. Future studies should evaluate multi-modality training in comparison with single modalities.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00011040.

The Baetylus Theorem-the central disconnect driving consumer behavior and investment returns in Wearable Technologies

The Wearable Technology market may increase fivefold by the end of the decade. There is almost no academic investigation as to what drives the investment hypothesis in wearable technologies. This paper seeks to examine this issue from an evidence-based perspective. There is a fundamental disconnect in how consumers view wearable sensors and how companies market them; this is called The Baetylus Theorem where people believe (falsely) that by buying a wearable sensor they will receive health benefit; data suggest that this is not the case. This idea is grounded social constructs, psychological theories and marketing approaches. A marketing proposal that fails to recognize The Baetylus Theorem and how it can be integrated into a business offering has not optimized its competitive advantage. More importantly, consumers should not falsely believe that purchasing a wearable technology, improves health.

Application of robotics in gastrointestinal endoscopy: A review

Multiple robotic flexible endoscope platforms have been developed based on cross specialty collaboration between engineers and medical doctors. However, significant number of these platforms have been developed for the natural orifice transluminal endoscopic surgery paradigm. Increasing amount of evidence suggest the focus of development should be placed on advanced endolumenal procedures such as endoscopic submucosal dissection instead. A thorough literature analysis was performed to assess the current status of robotic flexible endoscopic platforms designed for advanced endolumenal procedures. Current efforts are mainly focused on robotic locomotion and robotic instrument control. In the future, advances in actuation and servoing technology, optical analysis, augmented reality and wireless power transmission technology will no doubt further advance the field of robotic endoscopy. Globally, health systems have become increasingly budget conscious; widespread acceptance of robotic endoscopy will depend on careful design to ensure its delivery of a cost effective service.