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Moller F, Figueroa Ú, Miguieles M, Belmar F, Jarry C, Varas J, Searle S, Soza JF, Botello E. From FUSE to a hands-on electrosurgery course using a cadaveric model. Surg Endosc 2024:10.1007/s00464-024-11033-0. [PMID: 38992283 DOI: 10.1007/s00464-024-11033-0] [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: 04/17/2024] [Accepted: 06/30/2024] [Indexed: 07/13/2024]
Abstract
INTRODUCTION Surgical procedures in contemporary practice frequently employ energy-based devices, yet comprehensive education surrounding their safety and effectiveness remains deficient. We propose an innovative course for residents that aims to provide basic electrosurgery knowledge and promote the safe use of these devices. METHODS We developed a simulated training course for first-year general surgery and orthopedic residents. First, a survey was conducted regarding their knowledge perception about energy devices. The course consisted of two online theoretical sessions, followed by three in-person practical sessions. First-year residents performed three video-recorded attempts using a cadaveric model and were assessed through a digital platform using the Objective Structured Assessment of Technical Skill (OSATS), a Specific Rating Scale (SRS), and a surgical energy-based devices scale (SEBS). Third-year residents were recruited as a control group. RESULTS The study included 20 first-year residents and 5 third-year residents. First-year residents perceived a knowledge gap regarding energy devices. Regarding practical performance, both OSATS and checklist scores were statistically different between novices at their first attempt and the control group. When we analyzed the novice's performance, we found a significant increase in OSATS (13 vs 21), SRS (13 vs 17.5), and SEBS (5 vs 7) pre- and post-training scores. The amount of feedback referred to skin burns with the electro-scalpel reduced from 18 feedbacks in the first attempt to 2 in the third attempt (p-value = 0.0002). When comparing the final session of novices with the control group, no differences were found in the SRS (p = 0.22) or SEBS (p = 0.97), but differences remained in OSATS (p = 0.017). CONCLUSION This study supports the implementation of structured education in electrosurgery among surgical trainees. By teaching first-year residents about electrosurgery, they can acquire a skill set equivalent to that of third-year residents. The integration of such courses can mitigate complications associated with energy device misuse, ultimately enhancing patient safety.
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Affiliation(s)
- Francesca Moller
- Orthopedics Department, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 3rd Floor, Santiago, Chile
| | - Úrsula Figueroa
- Experimental Surgery and Simulation Center, Catholic University of Chile, Santiago, Chile
| | - Mariana Miguieles
- Experimental Surgery and Simulation Center, Catholic University of Chile, Santiago, Chile
| | - Francisca Belmar
- Experimental Surgery and Simulation Center, Catholic University of Chile, Santiago, Chile
| | - Cristián Jarry
- Experimental Surgery and Simulation Center, Catholic University of Chile, Santiago, Chile
| | - Julián Varas
- Experimental Surgery and Simulation Center, Catholic University of Chile, Santiago, Chile
| | - Susana Searle
- Section of Plastic and Reconstructive Surgery, Surgery Division, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile
| | - Jose Francisco Soza
- Orthopedics Department, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 3rd Floor, Santiago, Chile
| | - Eduardo Botello
- Orthopedics Department, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 3rd Floor, Santiago, Chile.
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Steindorff JV, Redlich LM, Paulicke D, Jahn P. Use and Design of Virtual Reality-Supported Learning Scenarios in the Vocational Qualification of Nursing Professionals: Scoping Review. JMIR Serious Games 2024; 12:e53356. [PMID: 38976873 PMCID: PMC11263887 DOI: 10.2196/53356] [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: 10/04/2023] [Revised: 03/16/2024] [Accepted: 04/16/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Numerous reviews advocate using virtual reality (VR) in educational contexts. This medium allows learners to test experiences in realistic environments. Virtually supported scenarios offer a safe and motivating way to explore, practice, and consolidate nursing skills in rare and critical nursing tasks. This is also cited as one of the reasons why VR can significantly increase the knowledge acquisition of nursing students. Nevertheless, studies are limited in their significance owing to the chosen design. Despite great interest, this results in a low level of confidence in VR as a curricular teaching method for nursing education. Therefore, defining concrete design and didactic-methodological parameters that support teachers in the use and implementation of VR is more relevant. OBJECTIVE This scoping review aims to provide an overview of significant design aspects for VR scenario conception and its transfer to generalist nursing education to generate value for the development of teaching scenarios and their sustainable implementation in teaching. METHODS A comprehensive literature search was performed using the MEDLINE (via PubMed) and CINAHL databases, and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist was applied. The search was conducted from May to July 2022, using a specific search principle corresponding to the focus and the growing study corpus. A previously defined "population, concept, and context" scheme was employed as the basis for the double-blind review of all relevant international German and English publications released up to May 1, 2022. RESULTS In accordance with the predefined selection procedure, 22 publications were identified. The identified aspects aided in the development of design, didactic, and research recommendations. The intuitive operation of realistically designed VR scenarios, which are standardized, reliable, and modifiable, as well as clear instructions and specific multimodal feedback functions were described positively. The same applied to the linear structure of the sequences with graduated demands and high image quality for increased immersion with low sensory overload. Changes in perspectives, multiuser options, dialogs, and recording functions can contribute to an interactive care practice. On the research side, it is advisable to define VR terminologies. In addition to considering larger samples, varying settings, and financial issues, it is recommended to conduct long-term studies on knowledge acquisition or improved patient outcomes. CONCLUSIONS VR scenarios offer high potential in the context of nursing education if teachers and learners develop them co-creatively according to design features and implement them by means of a well-conceived concept. VR enables trainees to develop practical skills continuously in a standardized way. In addition, its deployment supports the sensitization of trainees to digital nursing technologies and the expansion of their digital skills in a practical setting. Furthermore, it allows sustainability issues to be addressed.
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Affiliation(s)
- Jenny-Victoria Steindorff
- Health Service Research Working Group, Acute Care, Department of Internal Medicine, Faculty of Medicine, University Medicine Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Lisa-Marie Redlich
- Interdisciplinary Center for Health Sciences, Institute of Health and Nursing Science, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Denny Paulicke
- Health Service Research Working Group, Acute Care, Department of Internal Medicine, Faculty of Medicine, University Medicine Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Department of Medical Pedagogy, Akkon University of Human Sciences, Berlin, Germany
| | - Patrick Jahn
- Health Service Research Working Group, Acute Care, Department of Internal Medicine, Faculty of Medicine, University Medicine Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
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Zaga-Galante J, Tse R, Hopper RA, Arnold A, Fisher DM, Wong-Riff KW, Podolsky DJ. Bilateral Cleft lip Simulation. Cleft Palate Craniofac J 2024:10556656241230882. [PMID: 38354301 DOI: 10.1177/10556656241230882] [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: 02/16/2024] Open
Abstract
OBJECTIVE To evaluate the features, anatomic accuracy, and educational value of a high-fidelity bilateral cleft lip simulator. DESIGN Evaluation of the simulator by expert cleft surgeons after performing a simulated bilateral cleft lip repair. SETTING The simulator was evaluated by the surgeons during the Latin American Craniofacial Association meeting. PARTICIPANTS Eleven experienced cleft surgeons evaluated the simulator. The cleft surgeons were selected based on their availability during the meeting. INTERVENTIONS The participants performed a simulated bilateral cleft lip repair. They were each provided with a questionnaire assessing the simulator's features, realism and value as a training tool. MAIN OUTCOME MEASURE (S) The main outcome measure are the scores obtained from a Likert-type questionnaire assessing the simulators features, realism and value. RESULTS Overall, the surgeons agreed with the simulator's realism and anatomic accuracy (average score of 3.7 out of 5). Overall, the surgeons strongly agreed with the value of the simulator as a training tool (average score of 4.6 out of 5). CONCLUSIONS A high-fidelity bilateral cleft lip simulator was developed that is realistic and valuable as a training tool. The simulator provides a comprehensive training platform to gain hands-on experience in bilateral cleft lip repair before operating on real patients.
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Affiliation(s)
- Jonathan Zaga-Galante
- Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Raymond Tse
- Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
| | - Richard A Hopper
- Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
| | | | - David M Fisher
- Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen W Wong-Riff
- Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Dale J Podolsky
- Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
- Posluns Center for Image Guided Innovation and Therapeutic Intervention (PCIGITI), Toronto, Ontario, Canada
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Yi WS, Rouhi AD, Duffy CC, Ghanem YK, Williams NN, Dumon KR. A Systematic Review of Immersive Virtual Reality for Nontechnical Skills Training in Surgery. JOURNAL OF SURGICAL EDUCATION 2024; 81:25-36. [PMID: 38036388 DOI: 10.1016/j.jsurg.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 11/01/2023] [Accepted: 11/05/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE Immersive virtual reality (IVR) can be utilized to provide low cost and easily accessible simulation on all aspects of surgical education. In addition to technical skills training in surgery, IVR simulation has been utilized for nontechnical skills training in domains such as clinical decision-making and pre-operative planning. This systematic review examines the current literature on the effectiveness of IVR for nontechnical skill acquisition in surgical education. DESIGN A literature search was performed using MEDLINE, EMBASE, and Web of Science for primary studies published between January 1, 1995 and February 9, 2022. Four reviewers screened titles, abstracts, full texts, extracted data, and analyzed included studies to answer 5 key questions: How is IVR being utilized in nontechnical skills surgical education? What is the methodological quality of studies? What technologies are being utilized? What metrics are reported? What are the findings of these studies? RESULTS The literature search yielded 2340 citations, with 12 articles included for qualitative synthesis. Of included articles, 33% focused on clinical decision-making and 67% on anatomy/pre-operative planning. Motion sickness was a recorded metric in 25% of studies, with an aggregate incidence of 13% (11/87). An application score was reported in 33% and time to completion in 16.7%. A commercially developed application was utilized in 25%, while 75% employed a noncommercial application. The Oculus Rift was used in 41.7% of studies, HTC Vive in 25%, Samsung Gear in 16.7% of studies, Google Daydream in 8%, and 1 study did not report. The mean Medical Education Research Quality Instrument (MERSQI) score was 10.3 ± 2.3 (out of 18). In all studies researching clinical decision-making, participants preferred IVR to conventional teaching methods and in a nonrandomized control study it was found to be more effective. Averaged across all studies, mean scores were 4.33 for enjoyment, 4.16 for utility, 4.11 for usability, and 3.73 for immersion on a 5-point Likert scale. CONCLUSIONS The IVR nontechnical skills applications for surgical education are designed for clinical decision-making or anatomy/pre-operative planning. These applications are primarily noncommercially produced and rely upon a diverse array of HMDs for content delivery, suggesting that development is primarily coming from within academia and still without clarity on optimal utilization of the technology. Excitingly, users find these applications to be immersive, enjoyable, usable, and of utility in learning. Although a few studies suggest that IVR is additive or superior to conventional teaching or imaging methods, the data is mixed and derived from studies with weak design. Motion sickness with IVR remains a complication of IVR use needing further study to determine the cause and means of mitigation.
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Affiliation(s)
- William S Yi
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgical Education, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Penn Medicine Clinical Simulation Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Armaun D Rouhi
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Caoimhe C Duffy
- Department of Anesthesiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Yazid K Ghanem
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Noel N Williams
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgical Education, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Penn Medicine Clinical Simulation Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kristoffel R Dumon
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgical Education, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Penn Medicine Clinical Simulation Center, University of Pennsylvania, Philadelphia, Pennsylvania.
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Abbas JR, Chu MMH, Jeyarajah C, Isba R, Payton A, McGrath B, Tolley N, Bruce I. Virtual reality in simulation-based emergency skills training: A systematic review with a narrative synthesis. Resusc Plus 2023; 16:100484. [PMID: 37920857 PMCID: PMC10618508 DOI: 10.1016/j.resplu.2023.100484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 11/04/2023] Open
Abstract
Objective An important role is predicted for virtual reality (VR) in the future of medical education. We performed a systematic review of the literature with a narrative synthesis, to examine the current evidence for VR in simulation-based emergency skills training. We broadly define emergency skills as any clinical skill used in the emergency care of patients across all clinical settings. Methods This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. The data sources accessed during this study included: PubMed, CINAHL, EMBASE, AMED, EMCARE, HMIC, BNI, PsychINFO, Medline, CENTRAL, SCOPUS, Web of Science, BIOSIS Citation Index, ERIC, ACM Digital Library, IEEE Xplore, and ProQuest Dissertations and Thesis Global. Cochrane's Rob 2 and ROBVIS tools were used during study quality assessment. No ethical review was required for this work. Results Thirty-four articles published between 14th March 1998 and 1st March 2022 were included in this review. Studies were predominantly conducted in the USA and Europe and focussed on a variety of healthcare disciplines including medical, nursing, and allied health. VR education was delivered using head-mounted displays, Cave Automatic Virtual Environment systems, and bespoke setups. These systems delivered education in a variety of areas (emergency medicine, equipment training, obstetrics, and basic/advanced life support). Subjective potential advantages of this technology included realism, replayability, and time-effectiveness. Reports of adverse events were low in frequency across the included studies. Whilst clear educational benefit was generally noted, this was not reflected in changes to patient-based outcomes. Conclusion There may be educational benefit to using VR in the context of simulation-based emergency skills training including knowledge gain and retention, skill performance, acceptability, usability, and validity. Currently, there is insufficient evidence to demonstrate clear cost-effectiveness, or direct improvement of patient or institutional outcomes, at this stage.
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Affiliation(s)
- Jonathan R Abbas
- The University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
- Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, United Kingdom
| | - Michael M H Chu
- Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, United Kingdom
| | - Ceyon Jeyarajah
- Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, United Kingdom
| | - Rachel Isba
- Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, United Kingdom
- Lancaster Medical School, Lancaster University, Lancaster LA1 4YW, United Kingdom
- Alder Hey Children's NHS Foundation Trust, Eaton Road Liverpool, L12 2AP, United Kingdom
| | - Antony Payton
- The University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
- VREvo Ltd, The University of Manchester Core Technology Facility, 46 Grafton Street, Manchester, M13 9NT
| | - Brendan McGrath
- Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, United Kingdom
- Manchester Academic Critical Care, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Neil Tolley
- Imperial College Healthcare NHS Trust, The Bays, South Wharf Road, St Mary's Hospital, London W2 1NY, United Kingdom
| | - Iain Bruce
- The University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
- Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, United Kingdom
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Taghian A, Abo-Zahhad M, Sayed MS, Abd El-Malek AH. Virtual and augmented reality in biomedical engineering. Biomed Eng Online 2023; 22:76. [PMID: 37525193 PMCID: PMC10391968 DOI: 10.1186/s12938-023-01138-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 07/12/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND In the future, extended reality technology will be widely used. People will be led to utilize virtual reality (VR) and augmented reality (AR) technologies in their daily lives, hobbies, numerous types of entertainment, and employment. Medical augmented reality has evolved with applications ranging from medical education to picture-guided surgery. Moreover, a bulk of research is focused on clinical applications, with the majority of research devoted to surgery or intervention, followed by rehabilitation and treatment applications. Numerous studies have also looked into the use of augmented reality in medical education and training. METHODS Using the databases Semantic Scholar, Web of Science, Scopus, IEEE Xplore, and ScienceDirect, a scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. To find other articles, a manual search was also carried out in Google Scholar. This study presents studies carried out over the previous 14 years (from 2009 to 2023) in detail. We classify this area of study into the following categories: (1) AR and VR in surgery, which is presented in the following subsections: subsection A: MR in neurosurgery; subsection B: spine surgery; subsection C: oral and maxillofacial surgery; and subsection D: AR-enhanced human-robot interaction; (2) AR and VR in medical education presented in the following subsections; subsection A: medical training; subsection B: schools and curriculum; subsection C: XR in Biomedicine; (3) AR and VR for rehabilitation presented in the following subsections; subsection A: stroke rehabilitation during COVID-19; subsection B: cancer and VR, and (4) Millimeter-wave and MIMO systems for AR and VR. RESULTS In total, 77 publications were selected based on the inclusion criteria. Four distinct AR and/or VR applications groups could be differentiated: AR and VR in surgery (N = 21), VR and AR in Medical Education (N = 30), AR and VR for Rehabilitation (N = 15), and Millimeter-Wave and MIMO Systems for AR and VR (N = 7), where N is number of cited studies. We found that the majority of research is devoted to medical training and education, with surgical or interventional applications coming in second. The research is mostly focused on rehabilitation, therapy, and clinical applications. Moreover, the application of XR in MIMO has been the subject of numerous research. CONCLUSION Examples of these diverse fields of applications are displayed in this review as follows: (1) augmented reality and virtual reality in surgery; (2) augmented reality and virtual reality in medical education; (3) augmented reality and virtual reality for rehabilitation; and (4) millimeter-wave and MIMO systems for augmented reality and virtual reality.
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Affiliation(s)
- Aya Taghian
- Department of Electronics and Communications Engineering, Egypt-Japan University of Science and Technology, New Borg El-Arab City, Alexandria, Egypt.
| | - Mohammed Abo-Zahhad
- Department of Electronics and Communications Engineering, Egypt-Japan University of Science and Technology, New Borg El-Arab City, Alexandria, Egypt
- Department of Electrical Engineering, Assiut University, Assiut, Egypt
| | - Mohammed S Sayed
- Department of Electronics and Communications Engineering, Egypt-Japan University of Science and Technology, New Borg El-Arab City, Alexandria, Egypt
- Department of Electronics and Communications Engineering, Zagazig University, Zagazig, Ash Sharqia, Egypt
| | - Ahmed H Abd El-Malek
- Department of Electronics and Communications Engineering, Egypt-Japan University of Science and Technology, New Borg El-Arab City, Alexandria, Egypt
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Eidelman Pozin I, Zabida A, Friedman Z, Ivry M, Friedman M, Zahavi G, Yahav Shafir DD, Orkin D, Berkenstadt H. Simulation training results in performance retention for the management of airway fires: A prospective observational study. Anaesth Intensive Care 2023; 51:114-119. [PMID: 36688353 DOI: 10.1177/0310057x221113591] [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: 01/24/2023]
Abstract
Given the severity of the consequences of operating room fires, it is recommended that every anaesthesiologist master fire safety protocols and periodically participate in operating room fire drills. The aim of the present study was to evaluate skill retention one year after an airway fire training programme. Anaesthesiology residents were evaluated using an airway fire simulation-based scenario one year after an educational programme that included a one-h long problem-based learning session, a simulation-based airway fire drill with debriefing, and a formal group discussion. The same simulation scenario was used for both the initial training and the one-year assessment. Thirty-eight anaesthesiology residents participated as pairs in the initial training programme. Of these, 36 participated in the evaluation a year later. Performance after one year was better than performance during the initial simulation. Time to removal of tracheal tube was 7.0 (4.0-12.8) s (median (interquartile range)) at the one-year assessment compared with 22.0 (18.5-52.5) s at the time of initial training (P < 0.001). Performance improvement was also demonstrated by a higher incidence of performance of crucial action items (cessation of airway gases, removal of sponges and pouring of saline), as well as shorter duration of time necessary to perform these tasks. After controlling the fire, the time to re-establish ventilation by bag-mask ventilation or intubation was shorter at one year: 18.0 (11.0-29.0 ) s, compared with initial training 54.0 s (36.2-69.8) s (P = 0.001). We conclude that skills are effectively retained for a year after an airway fire management training session.
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Affiliation(s)
- Inna Eidelman Pozin
- Department of Anaesthesiology, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Amir Zabida
- Department of Anaesthesiology, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Zeev Friedman
- Department of Anaesthesia, Sinai Health System, University of Toronto, Toronto, Canada
| | - Michal Ivry
- Department of Anaesthesiology, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Maria Friedman
- Department of Anaesthesiology, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Guy Zahavi
- Department of Anaesthesiology, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Dana D Yahav Shafir
- Department of Anaesthesiology, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Dina Orkin
- Department of Anaesthesiology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Haim Berkenstadt
- Department of Anaesthesiology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Carmack D, Hegeman E, Vizurraga D. Orthopaedic Operating Room Fire Risks: FDA Database and Literature Review. JBJS Rev 2023; 11:01874474-202302000-00005. [PMID: 36791218 DOI: 10.2106/jbjs.rvw.22.00159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
» Inadvertent activation of electrosurgical device was more likely to result in patient burns and harm. » There are significant knowledge gaps in the orthopaedic surgery community relating to fire prevention, fire safety, and fire management. » Arthroplasty was the most common procedure with reported fire events. » It is the responsibility of the orthopaedic surgeon to understand the risks of surgical fire in the operating room and implement actions to reduce those risks.
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Affiliation(s)
- David Carmack
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Erik Hegeman
- Department of Orthopaedic Surgery, San Antonio Military Medical Center, Fort Sam Houston, Texas
| | - David Vizurraga
- Department of Orthopaedic Surgery, San Antonio Military Medical Center, Fort Sam Houston, Texas
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Abstract
SUMMARY STATEMENT Simulation-based training using virtual reality head-mounted displays (VR-HMD) is increasingly being used within the field of medical education. This article systematically reviews and appraises the quality of the literature on the use of VR-HMDs in medical education. A search in the databases PubMed/MEDLINE, Embase, ERIC, Scopus, Web of Science, Cochrane Library, and PsychINFO was carried out. Studies were screened according to predefined exclusion criteria, and quality was assessed using the Medical Education Research Study Quality Instrument. In total, 41 articles were included and thematically divided into 5 groups: anatomy, procedural skills, surgical procedures, communication skills, and clinical decision making. Participants highly appreciated using VR-HMD and rated it better than most other training methods. Virtual reality head-mounted display outperformed traditional methods of learning surgical procedures. Although VR-HMD showed promising results when learning anatomy, it was not considered better than other available study materials. No conclusive findings could be synthesized regarding the remaining 3 groups.
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Truong H, Qi D, Ryason A, Sullivan AM, Cudmore J, Alfred S, Jones SB, Parra JM, De S, Jones DB. Does your team know how to respond safely to an operating room fire? Outcomes of a virtual reality, AI-enhanced simulation training. Surg Endosc 2022; 36:3059-3067. [PMID: 34264400 PMCID: PMC10771129 DOI: 10.1007/s00464-021-08602-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 06/06/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Operating room (OR) fires are rare but devastating events requiring immediate and effective response. Virtual Reality (VR) simulation training can provide a safe environment for practice of skills in such highly stressful situation. This study assessed interprofessional participants' ability to respond to VR-simulated OR fire scenarios, attitudes, numbers of attempt of the VR simulation do participants need to successfully respond to OR fires and does prior experience, confidence level, or professional role predict the number of attempts needed to demonstrate safety and pass the simulation. METHODS 180 surgical team members volunteered to participate in this study at Beth Israel Deaconess Medical Center, Boston, MA. Each participant completed five VR OR simulation trials; the final two trials incorporated AI assistance. Primary outcomes were performance scores, number of attempts needed to pass, and pre- and post-survey results describing participant confidence and experiences. Differences across professional or training role were assessed using chi-square tests and analyses of variance. Differences in pass rates over time were assessed using repeated measures logistic regression. RESULTS One hundred eighty participants completed simulation testing; 170 (94.4%) completed surveys. Participants included surgeons (17.2%), anesthesiologists (10.0%), allied health professionals (41.7%), and medical trainees (31.1%). Prior to training, 45.4% of participants reported feeling moderately or very confident in their ability to respond to an OR fire. Eight participants (4.4%) responded safely on the first simulation attempt. Forty-three participants (23.9%) passed by the third attempt (VR only); an additional 97 participants (53.9%) passed within the 4-5th attempt (VR with AI assistance). CONCLUSIONS Providers are unprepared to respond to OR fires. VR-based simulation training provides a practical platform for individuals to improve their knowledge and performance in the management of OR fires with a 79% pass rate in our study. A VR AI approach to teaching this essential skill is innovative, feasible, and effective.
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Affiliation(s)
- Hung Truong
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard School of Medicine, 330 Brookline Ave, Shapiro Clinical Center 3rd Floor, Boston, MA, 02215, USA
| | - Di Qi
- Center for Modeling, Simulation, and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Adam Ryason
- Center for Modeling, Simulation, and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Amy M Sullivan
- Beth Israel Deaconess Medical Center, Carl J. Shapiro Institute for Research and Education, Harvard Medical School, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jaime Cudmore
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard School of Medicine, 330 Brookline Ave, Shapiro Clinical Center 3rd Floor, Boston, MA, 02215, USA
| | - Samuel Alfred
- Center for Modeling, Simulation, and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Stephanie B Jones
- Department of Anesthesia and Critical Care, Albany Medical Center, Albany, NY, USA
| | - Jose M Parra
- Beth Israel Deaconess Medical Center, Carl J. Shapiro Institute for Research and Education, Harvard Medical School, Boston, MA, USA
| | - Suvranu De
- Center for Modeling, Simulation, and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Daniel B Jones
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard School of Medicine, 330 Brookline Ave, Shapiro Clinical Center 3rd Floor, Boston, MA, 02215, USA.
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11
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Jung Y. Virtual Reality Simulation for Disaster Preparedness Training in Hospitals: Integrated Review. J Med Internet Res 2022; 24:e30600. [PMID: 35089144 PMCID: PMC8838598 DOI: 10.2196/30600] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 11/21/2021] [Accepted: 12/17/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND A critical component of disaster preparedness in hospitals is experiential education and training of health care professionals. A live drill is a well-established, effective training approach, but cost restraints and logistic constraints make clinical implementation challenging, and training opportunities with live drills may be severely limited. Virtual reality simulation (VRS) technology may offer a viable training alternative with its inherent features of reproducibility, just-in-time training, and repeatability. OBJECTIVE This integrated review examines the scientific evidence pertaining to the effectiveness of VRS and its practical usefulness in training health care professionals for in-hospital disaster preparedness. METHODS A well-known 4-stage methodology was used for the integrated review process. It consisted of problem identification, a literature search and inclusion criteria determination, 2-stage validation and analysis of searched studies, and presentation of findings. A search of diverse publication repositories was performed. They included Web of Science (WOS), PubMed (PMD), and Embase (EMB). RESULTS The integrated review process resulted in 12 studies being included. Principle findings identified 3 major capabilities of VRS: (1) to realistically simulate the clinical environment and medical practices related to different disaster scenarios, (2) to develop learning effects on increased confidence and enhanced knowledge acquisition, and (3) to enable cost-effective implementation of training programs. CONCLUSIONS The findings from the integrated review suggested that VRS could be a competitive, cost-effective adjunct to existing training approaches. Although the findings demonstrated the applicability of VRS to different training scenarios, these do not entirely cover all disaster scenarios that could happen in hospitals. This integrated review expects that the recent advances of VR technologies can be 1 of the catalysts to enable the wider adoption of VRS training on challenging clinical scenarios that require sophisticated modeling and environment depiction.
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Affiliation(s)
- Younhyun Jung
- School of Computing, Gachon University, Seongnam-si, Republic of Korea
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12
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Disruptions to shared mental models from poor quality of service in collaborative virtual environments. Sci Rep 2021; 11:23556. [PMID: 34876607 PMCID: PMC8651719 DOI: 10.1038/s41598-021-02567-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/16/2021] [Indexed: 11/22/2022] Open
Abstract
Collaborative virtual environments are being used in various applications ranging from online games to complex team training scenarios. The key to the success of such environments is the ability of the participants to form a shared mental model of the collaborative task being performed. Poor quality of service can deteriorate user performance and quality of experience, leading to a disruption of this mental model. While the effects of quality of service have been analyzed for traditional desktop environments, these effects remain unclear in collaborative virtual environments during user-to-user interactions. Here, we analyze the role of latency and packet bursts, two common problems in collaborative applications, on both simulator perception and actual task performance in a collaborative fire-fighting simulator. This exploratory study indicates that large latencies have a significant (p < 0.05) impact on the quality of experience, but not task performance. In contrast, packet bursts have a much larger impact on both the quality of experience and performance. Additionally, the network role, such as whether a user is a client or server, showed a significant (p < 0.05) impact on task performance in conditions impaired by packet bursts.
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13
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Dhar P, Rocks T, Samarasinghe RM, Stephenson G, Smith C. Augmented reality in medical education: students' experiences and learning outcomes. MEDICAL EDUCATION ONLINE 2021; 26:1953953. [PMID: 34259122 PMCID: PMC8281102 DOI: 10.1080/10872981.2021.1953953] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Augmented reality (AR) is a relatively new technology that allows for digitally generated three-dimensional representations to be integrated with real environmental stimuli. AR can make use of smart phones, tablets, or other devices to achieve a highly stimulating learning environment and hands-on immersive experience. The use of AR in industry is becoming widespread with applications being developed for use not just for entertainment and gaming but also healthcare, retail and marketing, education, military, travel and tourism, automotive industry, manufacturing, architecture, and engineering. Due to the distinct learning advantages that AR offers, such as remote learning and interactive simulations, AR-based teaching programs are also increasingly being adopted within medical schools across the world. These advantages are further highlighted by the current COVID-19 pandemic, which has caused an even greater shift towards online learning. In this review, we investigate the use of AR in medical training/education and its effect on students' experiences and learning outcomes. This includes the main goals of AR-based learning, such as to simplify the delivery and enhance the comprehension of complex information. We also describe how AR can enhance the experiences of medical students, by improving knowledge and understanding, practical skills and social skills. These concepts are discussed within the context of specific AR medical training programs, such as HoloHuman, OculAR SIM, and HoloPatient. Finally, we discuss the challenges of AR in learning and teaching and propose future directions for the use of this technology in medical education.
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Affiliation(s)
- Poshmaal Dhar
- Institute for Innovation in Mental and Physical Health and Clinical Translation, School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
| | - Tetyana Rocks
- Institute for Innovation in Mental and Physical Health and Clinical Translation, Food and Mood Centre, School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
| | - Rasika M Samarasinghe
- Institute for Innovation in Mental and Physical Health and Clinical Translation, School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
| | - Garth Stephenson
- Institute for Innovation in Mental and Physical Health and Clinical Translation, School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
| | - Craig Smith
- Institute for Innovation in Mental and Physical Health and Clinical Translation, School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
- CONTACT Craig Smith School of Medicine, Institute for Innovation in Mental and Physical Health and Clinical Translation, Deakin University, Australia
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14
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Tsuda S, Olasky J, Jones DB. Team training and surgical crisis management. J Surg Oncol 2021; 124:216-220. [PMID: 34245574 DOI: 10.1002/jso.26523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 04/27/2021] [Accepted: 04/29/2021] [Indexed: 11/11/2022]
Abstract
Team training and crisis management derive their roots from fundamental learning theory and the culture of safety that burgeoned forth from the industrial revolution through the rise of nuclear energy and aviation. The integral nature of telemedicine to many simulation-based activities, whether to bridge distances out of convenience or necessity, continues to be a common theme moving into the next era of surgical safety as newer, more robust technologies become available.
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Affiliation(s)
- Shawn Tsuda
- Valley Health System General Surgery Residency, Las Vegas, Nevada, USA
| | - Jaisa Olasky
- Mount Auburn Hospital, Cambridge, Massachusetts, USA
| | - Daniel B Jones
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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15
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Gunshin M, Doi K, Morimura N. Use of high-fidelity simulation technology in disasters: an integrative literature review. Acute Med Surg 2020; 7:e596. [PMID: 33364034 PMCID: PMC7750648 DOI: 10.1002/ams2.596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/12/2020] [Indexed: 12/29/2022] Open
Abstract
New innovative high‐fidelity simulation (HFS) technologies, including augmented reality and virtual reality, have begun being used for disaster response and preparedness. However, few studies have assessed the merit of these technologies in disaster simulation. This integrative literature review of 21 studies assesses the role of HFS technology in disaster. Most studies used a quantitative methodology (71.4%), followed by mixed (19%) or qualitative methods (9.6%). Nearly 60% covered only disaster preparedness phase, whereas 10% addressed disasters in middle‐income countries without including low‐income nations. The four most frequently mentioned technologies were immersive virtual reality simulation, computerized virtual reality simulation, full‐scale simulation, and augmented reality wearable smart glasses simulation. Nearly 50% of the studies used technology for purposes other than disaster simulation education, including telemedicine (14.3%), risk planning (14.3%), high‐risk map generation for preparedness purposes (9.5%), or rehabilitation medicine (4.8%). HFS technologies must be further evaluated outside of high‐income countries and in different disaster phases to better understand their full potential in disaster simulation. Future research should consider different health professions and more robust protocols to assist disaster response professionals and agencies in the adoption of HFS technologies.
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Affiliation(s)
| | - Kent Doi
- Department of Acute Medicine The University of Tokyo Hospital Tokyo Japan
| | - Naoto Morimura
- Department of Acute Medicine The University of Tokyo Hospital Tokyo Japan
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16
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Toward interprofessional team training for surgeons and anesthesiologists using virtual reality. Int J Comput Assist Radiol Surg 2020; 15:2109-2118. [PMID: 33083969 PMCID: PMC7671979 DOI: 10.1007/s11548-020-02276-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 10/01/2020] [Indexed: 01/09/2023]
Abstract
Purpose In this work, a virtual environment for interprofessional team training in laparoscopic surgery is proposed. Our objective is to provide a tool to train and improve intraoperative communication between anesthesiologists and surgeons during laparoscopic procedures. Methods An anesthesia simulation software and laparoscopic simulation software are combined within a multi-user virtual reality (VR) environment. Furthermore, two medical training scenarios for communication training between anesthesiologists and surgeons are proposed and evaluated. Testing was conducted and social presence was measured. In addition, clinical feedback from experts was collected by following a think-aloud protocol and through structured interviews. Results Our prototype is assessed as a reasonable basis for training and extensive clinical evaluation. Furthermore, the results of testing revealed a high degree of exhilaration and social presence of the involved physicians. Valuable insights were gained from the interviews and the think-aloud protocol with the experts of anesthesia and surgery that showed the feasibility of team training in VR, the usefulness of the system for medical training, and current limitations. Conclusion The proposed VR prototype provides a new basis for interprofessional team training in surgery. It engages the training of problem-based communication during surgery and might open new directions for operating room training. Electronic supplementary material The online version of this article (10.1007/s11548-020-02276-y) contains supplementary material, which is available to authorized users.
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17
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Abstract
Background: The occurrence of a fire when implementing anesthesia is a high-risk, low-frequency event. The operating room is a high-stakes environment that has no room for error. Mixed reality simulation may be a solution to better prepare healthcare professionals. The purpose of this quantitative, descriptive study was to evaluate the technical and non-technical skills of student registered nurse anesthetists (SRNAs) who participated in a mixed reality simulation of an operating room fire. Methods: Magic Leap OneTM augmented reality headsets were used by 32 student registered nurse anesthetists to simulate an emergent fire during a simulated tracheostomy procedure. Both technical and non-technical skills were evaluated by faculty members utilizing a checklist. Results: The SRNAs’ overall mean technical skill performance was 18.16 ± 1.44 out of a maximum score of 20, and the mean non-technical skill performance was 91.25% out of 100%. Conclusions: This study demonstrated the utility and limitations in applying novel technology in simulation. Participants demonstrated a strong performance of technical and non-technical skills in the management of a simulated operating room fire. Recommendations for future applications include the use of multiple sensory inputs into the scenario design and including all core team members in the immersive mixed reality environment.
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18
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Lohre R, Bois AJ, Athwal GS, Goel DP. Improved Complex Skill Acquisition by Immersive Virtual Reality Training: A Randomized Controlled Trial. J Bone Joint Surg Am 2020; 102:e26. [PMID: 31972694 DOI: 10.2106/jbjs.19.00982] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND There has been limited literature on immersive virtual reality (VR) simulation in orthopaedic education. The purpose of this multicenter, blinded, randomized controlled trial was to determine the validity and efficacy of immersive VR training in orthopaedic resident education. METHODS Nineteen senior orthopaedic residents (resident group) and 7 consultant shoulder arthroplasty surgeons (expert group) participated in the trial comparing immersive VR with traditional learning using a technical journal article as a control. The examined task focused on achieving optimal glenoid exposure. Participants completed demographic questionnaires, knowledge tests, and a glenoid exposure on fresh-frozen cadavers while being examined by blinded shoulder arthroplasty surgeons. Training superiority was determined by the outcome measures of the Objective Structured Assessment of Technical Skills (OSATS) score, a developed laboratory metric, verbal answers, and time to task completion. RESULTS Immersive VR had greater realism and was superior in teaching glenoid exposure than the control (p = 0.01). The expert group outperformed the resident group on knowledge testing (p = 0.04). The immersive VR group completed the learning activity and knowledge tests significantly faster (p < 0.001) at a mean time (and standard deviation) of 11 ± 3 minutes than the control group at 20 ± 4 minutes, performing 3 to 5 VR repeats for a reduction in learning time of 570%. The immersive VR group completed the glenoid exposure significantly faster (p = 0.04) at a mean time of 14 ± 7 minutes than the control group at 21 ± 6 minutes, with superior OSATS instrument handling scores (p = 0.03). The immersive VR group scored equivalently in surprise verbal scores (p = 0.85) and written knowledge scores (p = 1.0). CONCLUSIONS Immersive VR demonstrated substantially improved translational technical and nontechnical skills acquisition over traditional learning in senior orthopaedic residents. Additionally, the results demonstrate the face, content, construct, and transfer validity for immersive VR. CLINICAL RELEVANCE This adequately powered, randomized controlled trial demonstrated how an immersive VR system can efficiently (570%) teach a complex surgical procedure and also demonstrate improved translational skill and knowledge acquisition when compared with a traditional learning method.
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Affiliation(s)
- Ryan Lohre
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Aaron J Bois
- Section of Orthopaedic Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - George S Athwal
- Roth McFarlane Hand and Upper Limb Center, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Danny P Goel
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
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19
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20
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Surgical Smoke Evacuators Reduce the Risk of Fires From Alcohol-Based Skin Preparations. Surg Laparosc Endosc Percutan Tech 2019; 29:e94-e97. [DOI: 10.1097/sle.0000000000000734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Calder LA, Héroux DL, Bernard CA, Liu R, Neilson HK, Gilchrist AD, Fish JS. Surgical Fires and Burns: A 5-Year Analysis of Medico-legal Cases. J Burn Care Res 2019; 40:886-892. [PMID: 31287853 DOI: 10.1093/jbcr/irz108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Surgical fires and unintended intraoperative burns cause serious patient harm, yet surveillance data are lacking in Canada. Medico-legal data provide unique descriptions of these events which can inform burn prevention strategies. We extracted 5 years of data on closed (2012-2016) medico-legal cases involving surgical fires and burns from the database of our organization which, in 2016, provided medico-legal support to >93,000 Canadian physicians. We performed a retrospective descriptive analysis of contributing factors using an in-house coding system and case reviews. We identified 53 eligible burn cases: 26 from thermal sources (49.1%), 16 from fires (30.2%), 5 from chemical sources (9.4%), and 6 from undetermined sources (11.3%). Common burn sources were electrosurgical equipment, lasers, lighting, and improper temperatures (causing thermal burns), cautery or lasers combined with supplemental oxygen and/or a flammable fuel source (causing fire), and improperly applied solutions including antiseptics (causing chemical burns). Nontechnical factors also contributed to patient outcomes, such as nonadherence to protocols (15 cases, 28.3%), failures in surgical team communication (3 cases, 5.7%), and lost situational awareness leading to delays in recognizing and treating burns (7 cases, 13.2%). This retrospective study highlights a need for improved surgical safety interventions to address surgical fires and burns. These interventions could include: effectively implemented surgical safety protocols, surgical team communication strategies, and raising awareness about preventing, diagnosing, and managing surgical burns.
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Affiliation(s)
- Lisa A Calder
- Medical Care Analytics, Canadian Medical Protective Association, Ottawa, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Canada
| | - Diane L Héroux
- Medical Care Analytics, Canadian Medical Protective Association, Ottawa, Canada
| | - Catherine A Bernard
- Medical Care Analytics, Canadian Medical Protective Association, Ottawa, Canada
| | - Richard Liu
- Medical Care Analytics, Canadian Medical Protective Association, Ottawa, Canada
| | - Heather K Neilson
- Medical Care Analytics, Canadian Medical Protective Association, Ottawa, Canada
| | - Andrew D Gilchrist
- Physician Consulting Services, Canadian Medical Protective Association, Ottawa, Canada
| | - Joel S Fish
- Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, Canada
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22
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Rodger D. Surgical fires: Still a burning issue in England and Wales. J Perioper Pract 2019; 30:135-140. [PMID: 31524063 DOI: 10.1177/1750458919861906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A significant number of surgical fires occur each year and can have devastating effects on patients. The National Reporting and Learning System database identified 37 reports of surgical fires in England and Wales between January 2012 and December 2018 - over 52% resulting in some degree of harm. Surgical fires remain preventable adverse events that can be avoided by adherence to effective preventative strategies and improved education. This article surveys the existing literature, addressing the fire triad and how to effectively manage and prevent a surgical fire.
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Affiliation(s)
- Daniel Rodger
- Perioperative Practice, London South Bank University, London, UK
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23
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Rossler KL, Sankaranarayanan G, Duvall A. Acquisition of Fire Safety Knowledge and Skills With Virtual Reality Simulation. Nurse Educ 2019; 44:88-92. [PMID: 29847356 PMCID: PMC6252293 DOI: 10.1097/nne.0000000000000551] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prelicensure nursing students seeking to enter perioperative nursing need preparatory fire safety knowledge and skills training to participate as a member of an operating room (OR) team. PURPOSE This pilot study examined the effectiveness of the Virtual Electrosurgery Skill Trainer (VEST) on OR fire safety skills among prelicensure nursing students. METHODS An experimental pretest-posttest design was used in this study. Twenty nursing students were randomized to a control or an intervention group. Knowledge and skills acquisition of OR fire safety were assessed. RESULTS There were no statistically significant findings in knowledge for either group. Fisher exact test demonstrated significant relationships between the skills performance criteria of following emergency procedures for a fire and demonstrating PASS (pull-aim-squeeze-sweep) technique (P = .001). CONCLUSIONS Academic and hospital educators may consider incorporating virtual reality simulation to teach fire safety education or reinforce general fire safety practices to nursing students and novice nurses.
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Affiliation(s)
- Kelly L Rossler
- Author Affiliations: Assistant Professor (Dr Rossler), Lecturer (Dr Duvall), Louise Herrington School of Nursing, Baylor University; and Assistant Director (Dr Sankaranarayanan), Center for Evidence Based Simulation, Baylor University Medical Center, Dallas, Texas
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24
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Abstract
"Innovation" has become a ubiquitous term in the business of health care. The concept of disruptive innovation adds a new complexity to this popular notion. The emergence of artificial intelligence, virtual reality, and venture capitalists generates excitement, doubt, and curiosity for stakeholders across health care organizations. As companies such as Amazon, Apple, CVS, and JP Morgan enter this sector, disruptions will emerge that aim to improve the quality of care while reducing overall cost. The purpose of this article is to differentiate the concepts of innovation and disruptive innovation, explore their significance to the nursing profession, and outline 3 key roles nurse leaders can occupy as they navigate the future ever-changing trajectory of health care.
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Affiliation(s)
- Ryan Fuller
- Nurse Scholars Academy, Kaiser Permanente Northern California, Oakland (Mr Fuller); and Aya Healthcare, San Diego, California (Ms Hansen)
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25
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Fuchshuber P, Schwaitzberg S, Jones D, Jones SB, Feldman L, Munro M, Robinson T, Purcell-Jackson G, Mikami D, Madani A, Brunt M, Dunkin B, Gugliemi C, Groah L, Lim R, Mischna J, Voyles CR. The SAGES Fundamental Use of Surgical Energy program (FUSE): history, development, and purpose. Surg Endosc 2017; 32:2583-2602. [PMID: 29218661 DOI: 10.1007/s00464-017-5933-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 10/09/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Adverse events due to energy device use in surgical operating rooms are a daily occurrence. These occur at a rate of approximately 1-2 per 1000 operations. Hundreds of operating room fires occur each year in the United States, some causing severe injury and even mortality. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) therefore created the first comprehensive educational curriculum on the safe use of surgical energy devices, called Fundamental Use of Surgical Energy (FUSE). This paper describes the history, development, and purpose of this important training program for all members of the operating room team. METHODS The databases of SAGES and the FUSE committee as well as personal photographs and documents of members of the FUSE task force were used to establish a brief history of the FUSE program from its inception to its current status. RESULTS The authors were able to detail all aspects of the history, development, and national as well as global implementation of the third SAGES Fundamentals Program FUSE. CONCLUSIONS The written documentation of the making of FUSE is an important contribution to the history and mission of SAGES and allows the reader to understand the idea, concept, realization, and implementation of the only free online educational tool for physicians on energy devices available today. FUSE is the culmination of the SAGES efforts to recognize gaps in patient safety and develop state-of-the-art educational programs to address those gaps. It is the goal of the FUSE task force to ensure that general FUSE implementation becomes multinational, involving as many countries as possible.
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Affiliation(s)
- P Fuchshuber
- Department of Surgery, Kaiser Walnut Creek Medical Center, The Permanente Medical Group, Inc., 1425 South Main Street, Walnut Creek, CA, 94596, USA.
| | - S Schwaitzberg
- Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, The State University of New York, Buffalo General Hospital, 100 High Street, D-352, Buffalo, NY, 14203, USA
| | - D Jones
- Harvard Medical School, Boston, MA, USA.,Office of Technology and Innovation, Boston, MA, USA.,Division of Minimally Invasive Surgical Services, Boston, MA, USA.,Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA
| | - S B Jones
- Department of Anesthesiology, Harvard Medical School, Boston, MA, USA.,Department of Anesthesia/Crit Care/Pain, BIDMC, Boston, MA, USA
| | - L Feldman
- Department of Surgery, McGill University Health Centre, 1650 Cedar Ave L9-309, Montreal, QC, H3G 1A4, Canada
| | - M Munro
- Department of Obstetrics & Gynecology, David Geffen School of Medicine at UCLA and Kaiser Permanenete Los Angeles Medical Center, Los Angeles, CA, USA
| | - T Robinson
- Rocky Mountain VA Medical Center, University of Colorado, Aurora, Colorado, USA
| | - G Purcell-Jackson
- Vanderbilt University Medical Center, 2200 Children's Way, Doctor's Office Tower Suite 7100, Nashville, TN, 37232, USA
| | - D Mikami
- John A. Burn School of Medicine, University of Hawaii, 1356 Lusitania Street, 6th Floor, Honolulu, HI, 96813, USA
| | - A Madani
- Department of Surgery, McGill University, 1650 Cedar Ave, Rm D6-257, Montreal, QC, H3G 1A4, Canada
| | - M Brunt
- Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - B Dunkin
- Houston Methodist Institute for Technology, Innovation & Education, Institute for Academic Medicine, Houston Methodist, Weill Cornell Medical College, 6550 Fannin St #1601, Houston, TX, 77030, USA
| | - C Gugliemi
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA
| | - L Groah
- AORN, 2170 South Parker Road. Suite 400, Denver, CO, 80231, USA
| | - R Lim
- Uniformed Services University of Health Sciences, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI, 95869, USA
| | - J Mischna
- Fundamentals Department SAGES, 11300 West Olympic Blvd Suite 600, Los Angeles, CA, 90064, USA
| | - C R Voyles
- , 3838 Eastover Drive, Jackson, MS, 39211, USA
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26
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Byrne MD. PACU Go! Augmented and Virtual Realities in Perianesthesia Care. J Perianesth Nurs 2017; 32:257-259. [PMID: 28527556 DOI: 10.1016/j.jopan.2017.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 04/07/2017] [Indexed: 10/19/2022]
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