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Haider S, Air E, Kou Z, Rock J. Anatomic Review in 3D Augmented Reality Alters Craniotomy Planning Among Residents. World Neurosurg 2024; 184:e524-e529. [PMID: 38325703 DOI: 10.1016/j.wneu.2024.01.163] [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] [Received: 01/18/2024] [Accepted: 01/29/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Objectively examine the effect of 3D-Augmented Reality anatomic review on craniotomy planning among neurosurgical residents as it pertains to craniotomy size, skull positioning, and knowledge of significant anatomic relationships. METHODS Postgraduate year 1-7 neurosurgery residents were instructed to review standard 2D radiographs, pin a skull, and tailor a craniotomy for 6 different lesions and case vignettes. Participants then reviewed the lesion in a 3D-augmented reality (AR) environment, followed by repeating the craniotomy station for a variety of lesion types and locations (superficial, subcortical, deep, skull base). Quiz with case-specific anatomic and surgical questions followed by an exit survey for qualitative impressions. RESULTS Eleven of thirteen eligible residents participated. Skull position significantly changed in 5 out of 6 cases after 3D-AR view (P < 0.05, 20° angular adjustment). No significant change in incision length or craniotomy size. Subgroup analysis of junior versus senior residents revealed that craniotomy size was significantly altered in 2 out of 6 cases. Qualitative testimonials (Likert scale 5 = strongly agree) reported a change in craniotomy approach after 3D-review (3.5), improved appreciation of anatomy (4.2), increased confidence in surgical approach (4.33 junior residents, 3.5 senior residents), smaller incision (3.5 junior residents, 1.75 senior residents), better appreciation of white matter tracts (4.6). CONCLUSIONS The augmented reality platform offers a medium to examine surgical planning skills. Residents uniformly appreciated 3D-AR as a valuable tool for improving appreciation of critical anatomic structures and their relationship to lesional pathology. 3D-AR review significantly altered skull positioning for various lesions and craniotomy approaches, particularly among junior residents.
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Affiliation(s)
- Sameah Haider
- Department of Neurosurgery, Henry Ford Health, Detroit, Michigan, USA.
| | - Ellen Air
- Department of Neurosurgery, Henry Ford Health, Detroit, Michigan, USA
| | - Zhifeng Kou
- College of Engineering, Wayne State University, Detroit, Michigan, USA
| | - Jack Rock
- Department of Neurosurgery, Henry Ford Health, Detroit, Michigan, USA
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Devine M, Morris M, Kavanagh D. Transferability of Technical Skills Across Robotic Surgery Platforms: A Scoping Review. Cureus 2024; 16:e56429. [PMID: 38638798 PMCID: PMC11024662 DOI: 10.7759/cureus.56429] [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] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
As the application of robotic approaches to surgery continues to broaden, new consoles have been introduced to the market. Due to the global utilization of a single platform, previously validated curricula have not been assessed on new robotic systems. Surgery by its nature occurs in a high-stakes environment, potentially exacerbated by non-standardized robotic systems. The aim of this review is to critique the evidence available regarding the transferability of technical skills across robotic platforms. A scoping review utilizing the Medline (Pubmed) and Cochrane Databases was conducted. Full texts were reviewed and appraised. Selected articles were eligible for inclusion if they investigated the ability or implications of the transfer of skill across robotic platforms. Data was extracted, coded inductively, and themes synthesized. NVIVO software was used as an adjunct for this qualitative analysis. Following the removal of duplicates a total of 278 papers were screened according to the eligibility criteria. Fifty full-text articles were reviewed and four met the criterion for inclusion. Novices' performance across platforms was comparable. Increasing levels of prior robotic experience revealed an improvement in technical performance on a novel robotic platform. Safety metrics appear comparable across systems. Quantifying learning curves across robotic platforms and their implications for the robotic surgeon in training remains to be determined. Future research needs to address the gaps in the literature by clearly defining the extent of technical skills transfer between robotic platforms. These factors will guide the next iteration of surgical training curriculums and regulations for robotic surgery.
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Affiliation(s)
- Michael Devine
- Department of Surgical Affairs, Royal College of Surgeons in Ireland/Hermitage Medical Clinic, Dublin, IRL
| | - Marie Morris
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Dara Kavanagh
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, IRL
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Vajsbaher T, Schultheis H, Janssen S, Weyhe D, Bektas H, Uslar V, Francis N. The development of visuospatial abilities and their impact on laparoscopic skill acquisition: a clinical longitudinal study. Surg Endosc 2022; 36:8908-8917. [PMID: 35641701 PMCID: PMC9154204 DOI: 10.1007/s00464-022-09328-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/30/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To investigate how visuospatial abilities develop and influence intraoperative laparoscopic performance during surgical residency training programmes. BACKGROUND Laparoscopic surgery is a challenging technique to acquire and master. Visuospatial ability is an important attribute but most prior research have predominantly explored the influence of visuospatial abilities in lab-based settings and/or among inexperienced surgeons. Little is known about the impact of visuospatial profiles on actual laparoscopic performance and its role in shaping competency. METHOD A longitudinal observational cohort study using a pair-matched design over 27 months. At baseline, visuospatial profiles of 43 laparoscopic surgeons of all expertise levels and 19 control subjects were compared. The development of visuospatial abilities and their association with intraoperative performance of 18 residency surgeons were monitored during the course of their laparoscopic training. RESULTS Laparoscopic surgeons significantly outperformed the control group on the measure of spatial visualisation (U = 273.0, p = 0.03, η2 = 0.3). Spatial visualisation was found to be a significant predictor of laparoscopic expertise (R2 = 0.70, F (1.60) = 6.788, p = 0.01) and improved with laparoscopic training (B = 4.01, SE = 1.83, p = 0.02, 95% CI [0.40, 7.63]). From month 6 to 18, a strong positive correlation between spatial visualisation and intraoperative depth perception (r = 0.67, p < 0.01), bimanual dexterity (r = 0.60, p < 0.01), autonomy (r = 0.78, p < 0.01) and the total score (r = 0.70, p < 0.01) were observed but a strong relationship remained only with autonomy (r = 0.89, p < 0.01) and total score (r = 0.80, p < 0.01) at 18 months. CONCLUSION In this longitudinal cohort study, visuospatial abilities associate with laparoscopic skills and improve with training. Spatial visualisation may be characteristic of laparoscopic expertise as it has clear association with competency development during laparoscopy residency training programme.
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Affiliation(s)
- Tina Vajsbaher
- Bremen Spatial Cognition Center, University of Bremen, Enrique-Schmidt-Straße 5, 28359, Bremen, Germany.
- Faculty for Human and Health Sciences, University of Bremen, Bremen, Germany.
| | - Holger Schultheis
- Bremen Spatial Cognition Center, University of Bremen, Enrique-Schmidt-Straße 5, 28359, Bremen, Germany
- Institute for Artificial Intelligence, University of Bremen, Bremen, Germany
| | - Sonja Janssen
- University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Dirk Weyhe
- University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Hüseyin Bektas
- Department for General, Visceral-and-Surgical Oncology, Klinikum Bremen-Mitte, Germany
| | - Verena Uslar
- University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Nader Francis
- Division of Surgery and Interventional Science, University College London, London, UK
- The Griffin Institute, Northwick Park and St Mark's Hospital, Y Block, Watford Road, Harrow, HA1 3UJ, Middlesex, UK
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Schaefer SY, Hooyman A, Haikalis NK, Essikpe R, Lohse KR, Duff K, Wang P. Efficacy of Corsi Block Tapping Task training for improving visuospatial skills: a non-randomized two-group study. Exp Brain Res 2022; 240:3023-3032. [PMID: 36227343 PMCID: PMC9558013 DOI: 10.1007/s00221-022-06478-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/30/2022] [Indexed: 11/04/2022]
Abstract
Even though impaired visuospatial abilities can negatively affect daily functioning, there are very few training programs that attempt to improve visuospatial abilities. The purpose of this study was to examine if a single training session with a computerized version of the Corsi Block Tapping Task could improve mental rotation skills. Fifty-three young adults were assigned to one of two groups: (1) control group (mean age = 21.4; 10 females), who had 20 min of rest after their baseline assessment, or (2) training group (mean age = 21.5; 17 females), who had 20 min of training on the Corsi Block Tapping Task after their baseline assessment. The primary outcome was reaction time on a computer-based mental rotation task, and it was assessed both before and after the rest or training. There was a significant interaction between time (pre vs. post) and group (control vs. training) on mental rotation performance (p = 0.04), with the training group performing on average 124 ms faster on accurate trials than the control group at post-test. This preliminary study suggested that improving mental rotation may be feasible through targeted cognitive training. Future studies will consider multiple sessions of Corsi Block Tapping Task training to maximize training benefits (i.e., dose-response), as well as longer term retention in cognitively intact and impaired individuals.
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Affiliation(s)
- Sydney Y Schaefer
- School of Biological and Health Systems Engineering, Arizona State University, 501 E. Tyler Mall, MC 9709, Tempe, AZ, 85287-9709, USA.
| | - Andrew Hooyman
- School of Biological and Health Systems Engineering, Arizona State University, 501 E. Tyler Mall, MC 9709, Tempe, AZ, 85287-9709, USA
| | - Nicole K Haikalis
- School of Biological and Health Systems Engineering, Arizona State University, 501 E. Tyler Mall, MC 9709, Tempe, AZ, 85287-9709, USA
| | - Randy Essikpe
- School of Biological and Health Systems Engineering, Arizona State University, 501 E. Tyler Mall, MC 9709, Tempe, AZ, 85287-9709, USA
| | - Keith R Lohse
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging and Research, University of Utah, Salt Lake City, UT, USA
| | - Peiyuan Wang
- School of Biological and Health Systems Engineering, Arizona State University, 501 E. Tyler Mall, MC 9709, Tempe, AZ, 85287-9709, USA
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Intraoperative MRI versus intraoperative ultrasound in pediatric brain tumor surgery: is expensive better than cheap? A review of the literature. Childs Nerv Syst 2022; 38:1445-1454. [PMID: 35511271 DOI: 10.1007/s00381-022-05545-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/25/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The extent of brain tumor resection (EOR) is a fundamental prognostic factor in pediatric neuro-oncology in association with the histology. In general, resection aims at gross total resection (GTR). Intraoperative imaging like intraoperative US (iOUS) and MRI have been developed in order to find any tumoral remnant but with different costs. Aim of our work is to review the current literature in order to better understand the differences between costs and efficacy of MRI and iOUS to evaluate tumor remnants intraoperatively. METHODS We reviewed the existing literature on PubMed until 31st December 2021 including the sequential keywords "intraoperative ultrasound and pediatric brain tumors", "iUS and pediatric brain tumors", "intraoperative magnetic resonance AND pediatric brain tumors", and "intraoperative MRI AND pediatric brain tumors. RESULTS A total of 300 papers were screened through analysis of title and abstract; 254 were excluded. After selection, a total of 23 articles were used for this systematic review. Among the 929 patients described, a total of 349(38%) of the cases required an additional resection after an iMRI scan. GTR was measured on 794 patients (data of 69 patients lost), and it was achieved in 552(70%) patients. In case of iOUS, GTR was estimated in 291 out of 379 (77%) cases. This finding was confirmed at the post-operative MRI in 256(68%) cases. CONCLUSIONS The analysis of the available literature demonstrates that expensive equipment does not always mean better. In fact, for the majority of pediatric brain tumors, iOUS is comparable to iMRI in estimating the EOR.
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Kornmehl DL, Aldosari M, Tabassian LJ, Park SE, Ohyama H. Association of admissions factors with student performance in preclinical operative dentistry. J Dent Educ 2022; 86:1390-1398. [PMID: 35534921 DOI: 10.1002/jdd.12946] [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: 10/10/2021] [Revised: 02/28/2022] [Accepted: 04/05/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE/OBJECTIVE Admission to dental school is based on various factors including academic achievements in undergraduate coursework and the Dental Admission Test (DAT) scores. Students' success in an operative course requires fundamental knowledge, hand skills, spatial awareness, and self-assessment ability. The goal of this study is to evaluate how admissions factors, such as Grade Point Average (GPA) and DAT, including the Perceptual Ability Test (PAT), relate to students' academic and preclinical performance and self-assessment skills in preclinical operative dentistry. METHODS A total of 239 students were included from seven class years (2016-2022). Third-year dental students participated in a preclinical operative dentistry course. At the end of the course, they took the final multiple-choice exam and performed four competency examination procedures: Class II amalgam preparation and restoration and Class III resin-composite preparation and restoration. Calibrated faculty graded students' work independently and students also self-assessed their performance using the same rubrics as faculty. Linear regressions were performed to estimate the association between the admission factors with the mean faculty scores (measuring preclinical performance), student-faculty (S-F) gap scores (evaluating self-assessment skills), and their final didactic exam scores. RESULTS Overall, students' self-assessment was higher compared to faculty score. Linear regression analysis demonstrated positive correlations between the PAT and students' preclinical performance as well as between the DAT and their didactic exam scores. In general, S-F gap score decreased as PAT score increased, and it was statistically significant lower for the Class III preparation, indicating a better self-assessment skill. No correlations were observed between student performance and GPA scores. CONCLUSION The findings from the association between student performance and admission factors may play an important role in the dental school admissions process and assist students who may benefit from early faculty intervention and support.
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Affiliation(s)
- David L Kornmehl
- Department of Dentistry, Montefiore Medical Center, Albert Einstein College of Medicine, New York City, New York.,Harvard School of Dental Medicine, Boston, Massachusetts
| | - Muath Aldosari
- Department of Periodontics and Community Dentistry, King Saud University College of Dentistry, Riyadh, Saudi Arabia.,Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts
| | | | - Sang E Park
- Office of Dental Education, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Hiroe Ohyama
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts
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Alsowaina KN, Atashzar SF, Pur DR, Eagleson R, Patel RV, Elnahas AI, Hawel JD, Alkhamesi NA, Schlachta CM. Video Context Improves Performance in Identifying Operative Planes on Static Surgical Images. JOURNAL OF SURGICAL EDUCATION 2022; 79:492-499. [PMID: 34702691 DOI: 10.1016/j.jsurg.2021.10.004] [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: 06/25/2021] [Revised: 09/10/2021] [Accepted: 10/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Correct identification of the surgical tissue planes of dissection is paramount at the operating room, and the needed skills seem to be improved with realistic dynamic models rather than mere still images. The objective is to assess the role of adding video prequels to still images taken from operations on the precision and accuracy of tissue plane identification using a validated simulation model, considering various levels of surgeons' experience. METHODS A prospective observational study was conducted involving 15 surgeons distributed to three equal groups, including a consultant group [C], a senior group [S], and a junior group [J]. Subjects were asked to identify and draw ideal tissue planes in 20 images selected at suitable operative moments of identification before and after showing a 10- second videoclip preceding the still image. A validated comparative metric (using a modified Hausdorff distance [%Hdu] for object matching) was used to measure the distance between lines. A precision analysis was carried out based on the difference in %Hdu between lines drawn before and after watching the videos, and between-group comparisons were analyzed using a one-way analysis of variance (ANOVA). The analysis of accuracy was done on the difference in %Hdu between lines drawn by the subjects and the ideal lines provided by an expert panel. The impact of videos on accuracy was assessed using a repeated-measures ANOVA. RESULTS The C group showed the highest preciseness as compared to the S and J groups (mean Hdu 9.17±11.86 versus 12.1±15.5 and 20.0±18.32, respectively, p <0.001) and significant differences between groups were found in 14 images (70%). Considering the expert panel as a reference, the interaction between time and experience level was significant ( F (2, 597) = 4.52, p <0.001). Although the subjects of the J group were significantly less accurate than other surgeons, only this group showed significant improvements in mean %Hdu values after watching the lead-in videos ( F (1, 597) = 6.04, p = 0.014). CONCLUSIONS Adding video context improved the ability of junior trainees to identify tissue planes of dissection. A realistic model is recommended considering experience-based differences in precision in training programs.
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Affiliation(s)
- Khalid N Alsowaina
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada
| | - Seyed F Atashzar
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Electrical and Computer Engineering, Western University, London, Ontario, Canada
| | - Daiana R Pur
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
| | - Roy Eagleson
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada
| | - Rajni V Patel
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Electrical and Computer Engineering, Western University, London, Ontario, Canada
| | - Ahmad I Elnahas
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada
| | - Jeffrey D Hawel
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada
| | - Nawar A Alkhamesi
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada
| | - Christopher M Schlachta
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada
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Changiz T, Amouzeshi Z, Najimi A, Adibi P. A narrative review of psychomotor abilities in medical sciences: Definition, categorization, tests, and training. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2021; 26:69. [PMID: 34759986 PMCID: PMC8548887 DOI: 10.4103/jrms.jrms_965_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 08/31/2020] [Accepted: 03/23/2021] [Indexed: 11/04/2022]
Abstract
Extensive research in the past decades has evidenced differences in the psychomotor ability of individuals resulting from varying levels of experience, age, gender, response precision, compatibility, performance, and ability. Many studies have called for the need to identify psychomotor ability and appropriate tests that can assess it. This review article surveys the definition, categorization, and tests of psychomotor ability as well as training based on psychomotor ability in medical sciences. We searched the literature with no time limit, using the ProQuest, PubMed, and Eric databases, as well as the Google Scholar search engine. The keywords for the search involved psychomotor, psychomotor performance, assessment, psychomotor ability, motor learning, education, training, psychomotor ability testing, and psychomotor skills. Other relevant papers found through hand searching and snowballing were also included in the review. The EndNote X8 was employed as a reference manager tool. Only abstracts of the papers whose full texts were accessible were reviewed after repetitious papers were excluded. The documents were categorized into five groups: definition of psychomotor skills and ability, psychomotor ability components, psychomotor ability tests, identification of psychomotor ability (task analysis), and training. This review article revealed that there is not a single definition for psychomotor ability and its components. However, it can be said that motor abilities are the foundation for the rapid acquisition of skills and according to the neuroplasticity process are learned through training and practice. Given psychomotor abilities vary among individuals, training courses should also provide different levels of psychomotor training for learners. The literature introduces psychomotor tests as a selection tool, a predictor of future professional behavior, and a means to evaluate progress in performance, academic guidance (ability-oriented medical specialty), and curriculum implementation tailored to the needs of learners of varying graduate disciplines. The tests should be profession-specific because each profession entails its peculiar characteristics and abilities. On the other hand, the major problem in studying and analyzing underlying psychomotor skills and abilities is that the components are being investigated by researchers from varying, and usually unrelated, scientific fields. Therefore, it is necessary to have a holistic view through close interaction between the researchers of different sciences to better understand this area.
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Affiliation(s)
- Tahereh Changiz
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Amouzeshi
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arash Najimi
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Beattie KL, Hill A, Horswill MS, Grove PM, Stevenson ARL. Aptitude and attitude: predictors of performance during and after basic laparoscopic skills training. Surg Endosc 2021; 36:3467-3479. [PMID: 34370121 PMCID: PMC8351236 DOI: 10.1007/s00464-021-08668-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/24/2021] [Indexed: 11/26/2022]
Abstract
Background Manual dexterity and visual-spatial ability are considered key to the development of superior laparoscopic skills. Nevertheless, these abilities do not reliably explain all the variance found in the technical performance of surgical trainees. Consequently, we must look beyond these abilities to improve our understanding of laparoscopic skills and to better identify/develop surgical potential earlier on. Purpose To assess the individual and collective impact of physical, cognitive, visual, and psychological variables on performance during and after basic simulation-based laparoscopic skills training. Method Thirty-four medical students (laparoscopic novices) completed a proficiency-based laparoscopic skills training program (using either a 2D or 3D viewing mode). This was followed by one testing session, a follow-up testing session with new (yet similar) tasks, and a series of physical, cognitive, visual, and psychological measures. Results The statistical models that best predicted variance in training performance metrics included four variables: viewingmode (2D vs 3D), psychologicalflexibility, perceivedtaskdemands, and manualdexterity (bimanual). In subsequent testing, a model that included viewingmode and manualdexterity (assembly) best predicted performance on the pre-practiced tasks. However, for a highly novel, spatially complex laparoscopic task, performance was best predicted by a model that comprised viewingmode, visual-spatialability, and perceivedtaskdemands. At follow-up, manualdexterity (assembly) alone was the best predictor of performance on new (yet similar) tasks. Conclusion By focussing exclusively on physical/cognitive abilities, we may overlook other important predictors of surgical performance (e.g. psychological variables). The present findings suggest that laparoscopic performance may be more accurately explained through the combined effects of physical, cognitive, visual, and psychological variables. Further, the results suggest that the predictors may change with both task demands and the development of the trainee. This study highlights the key role of psychological skills in overcoming initial training challenges, with far-reaching implications for practice.
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Affiliation(s)
- Kirsty L Beattie
- School of Psychology, The University of Queensland, Brisbane, Australia.
| | - Andrew Hill
- School of Psychology, The University of Queensland, Brisbane, Australia
- Clinical Skills Development Service, Metro North Hospital and Health Service, Brisbane, Australia
- Minerals Industry Safety and Health Centre, Sustainable Minerals Institute, The University of Queensland, Brisbane, Australia
| | - Mark S Horswill
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Philip M Grove
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Andrew R L Stevenson
- School of Medicine, The University of Queensland, Brisbane, Australia
- Department of Colon and Rectal Surgery, Royal Brisbane and Women's Hospital, Brisbane, Australia
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Sun RR, Wang Y, Fast A, Dutka C, Cadogan K, Burton L, Kubay C, Drachenberg D. Influence of musical background on surgical skills acquisition. Surgery 2021; 170:75-80. [PMID: 33608147 DOI: 10.1016/j.surg.2021.01.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/25/2020] [Accepted: 01/09/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is growing interest in identifying trainees with surgical aptitude predictive of eventual technical proficiency. Musical tasks involve complex, cerebral activity, and ambidextrousity, which may have a positive impact on the acquisition of surgical skill sets. The purpose of this study was to investigate the influence of prior musical experience on the performance of basic surgical skills. METHODS This was a prospective cross-sectional study involving 51 novice undergraduate and medical school trainees with no prior surgical exposure. Musicality was assessed with a detailed survey and objectively with the Mini-Profile of Music Perception Skills test. Dexterity was assessed using the Purdue Pegboard test. Surgical skills were then evaluated by performing 2 timed suturing trials after observing tutorial video, followed by a timed laparoscopic peg transfer test. Outcomes included both speed and quality of performance. RESULTS Participants with prior musical experience performed better than nonmusicians on the Mini-Profile of Music Perception Skills test (P = .015), dominant hand dexterity (P = .05), suture quality (P < .03), and laparoscopic peg transfer speed (P < .01). There was no significant difference in the suturing speed between musicians and nonmusicians. The dexterity and Mini-Profile of Music Perception Skills scores were predictive of suture quality (P < .01). Among musicians, duration of musical training, inactivity, instrument type, and certification levels did not correlate with differences in surgical task performance. CONCLUSION Musical background is associated with better performance of fundamental surgical skills among surgical novices, particularly technique quality. Although this does not imply superior ultimate surgical ability, musicality may be a marker for basic surgical skill development useful in identifying suitable candidates for surgical training.
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Affiliation(s)
- Ryan R Sun
- Department of Surgery, University of Manitoba, Winnipeg, Canada.
| | - Yushi Wang
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Andrew Fast
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Chris Dutka
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Kianna Cadogan
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Lauren Burton
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Cole Kubay
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
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11
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Kalun P, Dunn K, Wagner N, Pulakunta T, Sonnadara R. Recent evidence on visual-spatial ability in surgical education: A scoping review. CANADIAN MEDICAL EDUCATION JOURNAL 2020; 11:e111-e127. [PMID: 33349760 PMCID: PMC7749687 DOI: 10.36834/cmej.69051] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Understanding the relationships between structures is critical for surgical trainees. However, the heterogeneity of the literature on visual-spatial ability (VSA) in surgery makes it challenging for educators to make informed decisions on incorporating VSA into their programs. We conducted a scoping review of the literature on VSA in surgery to provide a map of the literature and identify where gaps still exist for future research. METHODS We searched databases until December 2019 using keywords related to VSA and surgery. The resulting articles were independently screened by two researchers for inclusion in our review. RESULTS We included 117 articles in the final review. Fifty-nine articles reported significant correlations between VSA tests and surgical performance, and this association is supported by neuroimaging studies. However, it remains unclear whether VSA should be incorporated into trainee selection and whether there is a benefit of three-dimensional (3D) over two-dimensional (2D) training. CONCLUSIONS It appears that VSA correlates with surgical performance in the simulated environment, particularly for novice learners. Based on our findings, we make suggestions for how surgical educators may use VSA to support novice learners. Further research should determine whether VSA remains correlated to surgical performance when trainees move into the operative environment.
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Affiliation(s)
- Portia Kalun
- Department of Surgery, McMaster University, Ontario, Canada
| | - Krista Dunn
- Faculty of Medicine, Dalhousie University, Nova Scotia, Canada
| | - Natalie Wagner
- Department of Surgery, McMaster University, Ontario, Canada
- Office of Professional Development & Educational Scholarship, Faculty of Health Sciences, Queen’s University, Ontario, Canada
| | | | - Ranil Sonnadara
- Department of Surgery, McMaster University, Ontario, Canada
- Department of Surgery, University of Toronto, Ontario, Canada
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Bechtolsheim F, Oehme F, Weitz J, Oppermann N, Reissfelder C, Mees ST, Yang C. The Hunger Games: Laparoscopic Performance in Novice Surgeons is Not Altered by Food Deprivation but Influenced by the Degree of Appetite - A Randomized Controlled Trial. JOURNAL OF SURGICAL EDUCATION 2020; 77:1236-1243. [PMID: 32532700 DOI: 10.1016/j.jsurg.2020.03.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 02/27/2020] [Accepted: 03/31/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Food deprivation is a common condition for visceral surgeons and especially laparoscopic approaches require high levels of concentration. The current literature does not provide adequate answers whether intraoperative breaks, especially food intake, might influence the quality of the surgical skills. Thus, the primary aim of this trial was to analyze the influence of food deprivation on the laparoscopic performance. DESIGN SETTING AND PARTICIPANTS 37 laparoscopic novices participated from 10/2017 to 04/2018 in this single center, prospective-randomized trial and were trained during laparoscopic training sessions until they reached a predefined level of proficiency. Subsequently, participants were randomized into 3 different groups: food deprivation of 8 hours, 4 hours, or carbohydrate loading directly prior to the laparoscopic exam. The exam comprised PEG-transfer, precise cutting, gallbladder resection and surgical knot. MAIN FINDINGS Completion time for PEG-transfer, precise cutting, gallbladder resection and surgical knot was 63s, 139s, 192s and 272s respectively. Participants starving for 8 hours performed 3 of 4 tasks more slowly whilst participants starving for 4 hours performed 3 of 4 tasks faster than the average. Analyzing self-reported level of appetite revealed: Students with an intermediate level were significantly faster (p <0.05) during complex procedures compared to participants that reported hunger prior to performing these tasks (192s vs. 307s). Additionally, hungry students had been more inaccurate during the surgical knot (p <0.05) whilst students with intermediate appetite level tend to be most accurate (p - value 0.012). CONCLUSIONS The subjective level of appetite rather than the absolute number of fasting hours influences the laparoscopic performance most. Thus, any extreme level of appetite may be avoided and surgeons may achieve the best performance when they have an intermediate level of appetite. In consequence, heavy meals may be omitted immediately prior to demanding laparoscopic procedures and surgeons may have access to mini-breaks and refreshers during major procedures.
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Affiliation(s)
- Felix Bechtolsheim
- Department for Visceral, Thoracic and Vascular Surgery, University Hospital Dresden, Dresden, Germany
| | - Florian Oehme
- Department for Visceral, Thoracic and Vascular Surgery, University Hospital Dresden, Dresden, Germany
| | - Juergen Weitz
- Department for Visceral, Thoracic and Vascular Surgery, University Hospital Dresden, Dresden, Germany
| | - Nadine Oppermann
- Department for Visceral, Thoracic and Vascular Surgery, University Hospital Dresden, Dresden, Germany
| | - Christoph Reissfelder
- Department for Visceral, Thoracic and Vascular Surgery, University Hospital Dresden, Dresden, Germany; Department of Surgery, University Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Soeren T Mees
- Department for Visceral, Thoracic and Vascular Surgery, University Hospital Dresden, Dresden, Germany; Department of General, Visceral, and Thoracic Surgery, Municipal Hospital Dresden-Friedrichstadt, Dresden, Germany
| | - Cui Yang
- Department for Visceral, Thoracic and Vascular Surgery, University Hospital Dresden, Dresden, Germany; Department of Surgery, University Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
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