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Massad N, Gingold J, Obanor O, Lerner V. Teaching principles of electrosurgery to OBGYN trainees via simulation: A hands-on approach. J Gynecol Obstet Hum Reprod 2024; 53:102753. [PMID: 38395411 DOI: 10.1016/j.jogoh.2024.102753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/27/2023] [Accepted: 02/20/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Surgeons use electrosurgery daily, though most of them are unfamiliar with its basic safety principles. METHOD We have designed a hands-on simulation session to teach OBGYN trainees principles of electrosurgery with practical implications for safety in the operating room. 15 participants completed post-session surveys. EXPERIENCE Our experience of serially refining teaching materials and electrosurgery demonstrations resulted in a comprehensive guide to electrosurgery in OBGYN. CONCLUSION This report will allow surgeon educators to implement simulation training in their institutions.
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Affiliation(s)
- Nicole Massad
- Department of Obstetrics and Gynecology, Montefiore Medical Center, Bronx, NY, United States
| | | | - Osaro Obanor
- Department of Obstetrics and Gynecology, Montefiore Medical Center, Bronx, NY, United States
| | - Veronica Lerner
- Department of Obstetrics & Gynecology, Lenox Hill Hospital, Northwell Health, 38 East 32nd Street, 9th floor, New York, NY 10016, United States.
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Kondo A, Tamate M, Nishihara Y, Watanabe Y. Hybrid Train-The-Trainer course for the Fundamental Use of Surgical Energy certificates improves self-confidence in knowledge of surgical energy and develops teaching skills: a feasibility study. Surg Endosc 2024; 38:368-376. [PMID: 37798531 DOI: 10.1007/s00464-023-10422-1] [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: 03/15/2023] [Accepted: 08/31/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Several well-trained expert instructors who completed the "Train-The-Trainer (TTT)" course are required to disseminate the safe use of surgical energy devices, which can be learned through the Fundamental Use of Surgical Energy (FUSE) program. This study aimed to explore whether the hybrid FUSE TTT course is feasible and effective, which can improve teaching skills of surgical energy. METHODS The hybrid TTT course, which was designed to train FUSE-certified personnel as instructors, comprised three virtual sessions spread over 5 h in total and a 1-day in-person training, followed by a 100-min FUSE electrosurgery hands-on workshop in practice as an instructor. The participants reported on self-confidence regarding knowledge of various energy devices or adverse events before, immediately after, and 6 months after the course. Participants and experienced FUSE instructors assessed the trainees' presentation skills at the beginning of the in-person training and after the hands-on workshop. The primary outcomes were the feasibility and completion rate of the entire course. RESULTS Seventeen participants completed the entire couse; most (94%) were satisfied with the course. Self-confidence in knowledge about various contents improved significantly: the fundamentals of electrosurgery (post, p < 0.001; 6 months, p = 0.01), mechanism and prevention of adverse events (post, p = 0.001; 6 months, p = 0.04), monopolar instruments (post, p = 0.002; 6 months, p = 0.01), bipolar instruments (post, p = 0.01; 6 months, p = 0.06), and integration with other medical devices (post, p = 0.006; 6 months, p = 0.02). The presentation skill index scores of self- and peer assessments improved after the in-person training (self-assessment [pre 44 vs. post 56, p < 0.001], peer assessment [pre 39 vs. post 68, p < 0.001]). CONCLUSIONS The hybrid TTT course can provide FUSE-certified personnel with an improved self-confidence concerning knowledge of surgical energy and improve their presentation skills with midterm retention. This can help build trainees' self-confidence as instructors.
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Affiliation(s)
- Akihiro Kondo
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Takamatsu, Kagawa, Japan
| | - Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Yuichi Nishihara
- Department of Surgery, Sassa General Hospital, Nishitokyo, Tokyo, Japan
| | - Yusuke Watanabe
- Clinical Research and Medical Innovation Center, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Kita 14 Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
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Birido N, Brown KM, Olmo Ferrer D, Friedland R, Bailey SKT, Wawersik D, Charnetski M, Nair B, Kutzin JM, Gross IT, Palaganas JC. Health Care Simulation in Person and at a Distance: A Systematic Review. Simul Healthc 2024; 19:S65-S74. [PMID: 38240620 DOI: 10.1097/sih.0000000000000763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
ABSTRACT Distance simulation is a method of health care training in which the learners and facilitators are in different physical locations. Although methods of distance simulation have existed in health care for decades, this approach to education became much more prevalent during the COVID-19 pandemic. This systematic review studies a subset of distance simulation that includes combined in-person and distance simulation elements, identified here as "mixed- distance simulation." A review of the distance simulation literature identified 10,929 articles. Screened by inclusion and exclusion criteria, 34 articles were ultimately included in this review. The findings of this review present positive and negative aspects of mixed-distance simulation formats, a description of the most frequent configurations related to delivery, terminology challenges, as well as future directions including the need for faculty development, methodological rigor, and reporting details.
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Affiliation(s)
- Nuha Birido
- From the Royal College of Surgeons in Ireland-Medical University of Bahrain (N.B., B.N.), Busaiteen, Bahrain; Johns Hopkins University School of Nursing (K.M.B.), Baltimore, MD; Norfolk and Norwich University (D.O.-F.), Norfolk, UK; University of South Florida (S.K.T.B.), Tampa, FL; Nova Southeastern University (D.W.), Fort Lauderdale, FL; Dartmouth Health (M.C.), Lebanon, NH; The Mount Sinai Hospital (J.M.K.). New York, NY; Yale University School of Medicine (I.T.G.), New Haven, CT; and MGH Institute of Health Professions (J.C.P.), Boston, MA
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Elkin R, Duff JP, LaForest ML, Stapleton S, Ramachandra G, Palaganas JC, Gross IT. Distance simulation in the health professions: a scoping review. Adv Simul (Lond) 2023; 8:27. [PMID: 37978416 PMCID: PMC10656877 DOI: 10.1186/s41077-023-00266-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 10/13/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Distance simulation is defined as simulation experiences in which participants and/or facilitators are separated from each other by geographic distance and/or time. The use of distance simulation as an education technique expanded rapidly with the recent COVID-19 pandemic, with a concomitant increase in scholarly work. METHODS A scoping review was performed to review and characterize the distance simulation literature. With the assistance of an informationist, the literature was systematically searched. Each abstract was reviewed by two researchers and disagreements were addressed by consensus. Risk of bias of the included studies was evaluated using the Risk of Bias 2 (RoB 2) and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tools. RESULTS Six thousand nine hundred sixty-nine abstracts were screened, ultimately leading to 124 papers in the final dataset for extraction. A variety of simulation modalities, contexts, and distance simulation technologies were identified, with activities covering a range of content areas. Only 72 papers presented outcomes and sufficient detail to be analyzed for risk of bias. Most studies had moderate to high risk of bias, most commonly related to confounding factors, intervention classification, or measurement of outcomes. CONCLUSIONS Most of the papers reviewed during the more than 20-year time period captured in this study presented early work or low-level outcomes. More standardization around reporting is needed to facilitate a clear and shared understanding of future distance simulation research. As the broader simulation community gains more experience with distance simulation, more studies are needed to inform when and how it should be used.
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Affiliation(s)
- Rachel Elkin
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
| | - Jonathan P Duff
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Marian L LaForest
- Augustus Long Health Sciences Library, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Geethanjali Ramachandra
- Department of Pediatric Intensive Care, Krishna Institute of Medical Science, Secunderabad, India
| | - Janice C Palaganas
- Department of Health Professions Education, MGH Institute of Health Professions, Boston, MA, USA
| | - Isabel T Gross
- Section of Pediatric Emergency Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
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Park JO, Lee-Jayaram J, Sato E, Eto Y, Kahili-Heede M, Hirayama K, Berg BW. A scoping review of remote facilitation during simulation-based healthcare education. BMC MEDICAL EDUCATION 2023; 23:592. [PMID: 37605196 PMCID: PMC10464104 DOI: 10.1186/s12909-023-04551-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 07/29/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Remote facilitation is a synchronous distance education method where instructors facilitate a lesson, in real-time, in physically separate conditions. In this scoping review, we aimed to describe types of remote facilitation used in a healthcare simulation, the influences on learner outcomes, and related factors. METHODS We accessed PubMed, EMBASE, CINAHL, ERIC, and Web of Science using our search strategies. Five reviewers performed the review using the Preferred Reporting Items for Systematic Reviews and Meta Analysis extension for Scoping Reviews (PRISMA-ScR) framework, and the Johanna Briggs Institute (JBI) guidelines. RESULTS We included a total of 29 articles presenting 28 simulation studies. The most common tool was videoconferencing (n = 26, 89.7%). Knowledge improvement was the most frequently measured outcome. There was no significant difference in learning outcomes between the two teaching modes. There were differences in learners' preferences and satisfaction with remote facilitators before and after COVID-19. CONCLUSIONS Our scoping review indicates that remote facilitation has been widely accepted in many healthcare professions using various types of simulation modalities. Remote facilitation can be used to overcome logistical problems of synchronous multi-location education, and to improve learner knowledge, skills, and confidence measured by instructor evaluation or self-assessment.
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Affiliation(s)
- Ju Ok Park
- Department of Emergency Medicine, Hallym University College of Medicine, Dongtan Sacred Heart Hospital, Hwaseong-si, South Korea.
| | - Jannet Lee-Jayaram
- SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawaii at Manoa, , Honolulu Hawaii, USA
| | - Eri Sato
- SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawaii at Manoa, , Honolulu Hawaii, USA
| | - Yuka Eto
- SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawaii at Manoa, , Honolulu Hawaii, USA
| | - Melissa Kahili-Heede
- Health Science Library, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu Hawaii, USA
| | - Krystal Hirayama
- SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawaii at Manoa, , Honolulu Hawaii, USA
| | - Benjamin W Berg
- SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawaii at Manoa, , Honolulu Hawaii, USA
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Vyacheslavovich NT, Mikhailovich LK, Romanovich CE, Evgenievich TA, Vyacheslavovich SA. Surgeons know that they don't know about the safe use of surgical energy: an international study reveals that the knowledge gap persists. Surg Endosc 2023:10.1007/s00464-023-09936-5. [PMID: 36879166 DOI: 10.1007/s00464-023-09936-5] [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: 12/06/2022] [Accepted: 02/05/2023] [Indexed: 03/08/2023]
Abstract
INTRODUCTION The rate of electrosurgery complications is 0.1-2.1%. More than 10 years ago, SAGES pioneered a well-structured educational program (FUSE) aimed to teach about the safe use of electrosurgery. This inspired the development of similar training programs around the globe. Still, the knowledge gap persists among surgeons, possibly due to the lack of judgment. AIM To investigate factors affecting the level of expertise in electrosurgical safety and their correlation with self-assessment scores among surgeons and surgical residents. MATERIALS AND METHODS We conducted an online survey consisting of 15 questions that could be thematically broken down into 5 blocks. We analyzed how the objective scores were correlated with the self-assessment scores, professional experience, past participation in training programs, and work at a teaching hospital. RESULTS A total of 145 specialists took part in the survey, including 111 general surgeons and 34 s-year surgical residents from Russia, Belarus, Ukraine, and Kirgizia. Only 9 (8.1%) surgeons scored "excellent," 32 (28.8%) scored "good," and 56 (50.4%) scored "fair." Of all surgical residents participating in the study, only 1 (2.9%) scored "excellent," 9 (26.5%) scored "good," and 11 (32.4%) scored "fair." The test was failed by 14 surgeons (12.6%) and 13 (38.2%) residents. The difference between the trainees and the surgeons was statistically significant. Our multivariate logistic model identified 3 significant factors predisposing to successful performance on the test: past training in the safe use of electrosurgery, professional experience, and work at a teaching hospital. Of all study participants, those with no past training in the safe use of electrosurgery, and non-teaching surgeons were the most realistic about their competencies. CONCLUSION We have identified alarming gaps in the knowledge of electrosurgical safety among surgeons. Faculty staff and experienced surgeons scored higher, but past training was the most influential factor in improving knowledge of electrosurgical safety.
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Sazhin AV, Nechay TV, Tyagunov AE, Yuldashev AG, Zhulina YS, Loban KM, Chechin ER, Ilichev AA, Elgina NY. [Safety in electrosurgery: results of the All-Russian survey]. Khirurgiia (Mosk) 2023:5-12. [PMID: 36583488 DOI: 10.17116/hirurgia20230115] [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: 12/31/2022]
Abstract
OBJECTIVE To assess the level of knowledge in electrosurgical safety among specialists in the Russian Federation. MATERIAL AND METHODS An Internet survey was devoted to the issues of electrosurgical safety. The questionnaire consisted of 15 questions in 5 items. Data were collected for 2 months. Data analysis included final assessment of respondents, correlation of results with their own assessment of knowledge and parameters of surgical experience, the fact of training and belonging to the department. Question design, survey and presentation of results were performed in accordance with the CHERRIES (Check list of Reporting Results of Internet E-Surveys) criteria for Internet surveys. RESULTS Survey enrolled 231 specialists. Excellent rating was given to 13 (5.6%) respondents, good - 66 (28.3%), satisfactory - 105 (45.1%) respondents. Forty-nine (21.03%) respondents did not overcome the passing score (7) and showed unsatisfactory knowledge of electrosurgical safety. Mean score among all participants was 8.6±2.6 (median 8 points, interquartile range [7-11]) or 53.3% of maximum value (15). In multivariate logistic model, significant factors were the completed course in electrosurgical safety (OR 2.26, 95% CI 1.30-3.97; p=0.004), experience of work (OR 1.03, 95% CI 1.01-1.05; p=0.011) and work in the department (OR 1.74, 95% CI 1.03-2.95; p=0.038). Respondents who did not take the course (positive significant correlation r=0.1629, p=0.02674) and non-departmental employees (r=0.1655, p=0.031) assess the level of knowledge more adequately with respect to real results. Respondents with completed course (r=0.1078, p=0.4659) and departmental staff (r=0.1411, p=0.2699) are prone to overestimate self-assessment (positive insignificant correlation of their own assessment and received points). CONCLUSION We found significant knowledge gaps in electrosurgical safety among various practitioners. The main causes are no mandatory specialized courses on electrosurgical safety and insufficient motivation of specialists for self-education due to false ideas about their own level of knowledge.
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Affiliation(s)
- A V Sazhin
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - T V Nechay
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A E Tyagunov
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A G Yuldashev
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - Yu S Zhulina
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - K M Loban
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - E R Chechin
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A A Ilichev
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - N Yu Elgina
- Pirogov Russian National Research Medical University, Moscow, Russia
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Rashidian N, Giglio MC, Van Herzeele I, Smeets P, Morise Z, Alseidi A, Troisi RI, Willaert W. Effectiveness of an immersive virtual reality environment on curricular training for complex cognitive skills in liver surgery: a multicentric crossover randomized trial. HPB (Oxford) 2022; 24:2086-2095. [PMID: 35961933 DOI: 10.1016/j.hpb.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/26/2022] [Accepted: 07/13/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Virtual reality (VR) is increasingly used in surgical education, but evidence of its benefits in complex cognitive training compared to conventional 3-dimensional (3D) visualization methods is lacking. The objective of this study is to assess the impact of 3D liver models rendered visible by VR or desktop interfaces (DIs) on residents' performance in clinical decision-making. METHOD From September 2020 to April 2021, a single-blinded, crossover randomized educational intervention trial was conducted at two university hospitals in Belgium and Italy. A proficiency-based stepwise curriculum for preoperative liver surgery planning was developed for general surgery residents. After completing the training, residents were randomized in one of two assessment sequences to evaluate ten real clinical scenarios. RESULTS Among the 50 participants, 46 (23 juniors/23 seniors) completed the training and were randomized. Forty residents (86.96%) achieved proficiency in decision-making. The accuracy of virtual surgical planning using VR was higher than that using DI in both groups A (8.43 ± 1.03 vs 6.86 ± 1.79, p < 0.001) and B (8.08 ± 0.9 vs 6.52 ± 1.37, p < 0.001). CONCLUSION Proficiency-based curricular training for liver surgery planning successfully resulted in the acquisition of complex cognitive skills. VR was superior to DI visualization of 3D models in decision-making. CLINICALTRIALS GOV ID NCT04959630.
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Affiliation(s)
- Nikdokht Rashidian
- Department of Human Structure and Repair, Ghent University Faculty of Medicine, Belgium.
| | - Mariano C Giglio
- Division of HPB, Minimally Invasive and Robotic Surgery, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy
| | | | - Peter Smeets
- Department of Radiology, Ghent University Hospital, Belgium
| | - Zenichi Morise
- Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan
| | - Adnan Alseidi
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Roberto I Troisi
- Department of Human Structure and Repair, Ghent University Faculty of Medicine, Belgium; Division of HPB, Minimally Invasive and Robotic Surgery, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy
| | - Wouter Willaert
- Department of Human Structure and Repair, Ghent University Faculty of Medicine, Belgium
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Kiriyama K, Poudel S, Kurashima Y, Watanabe Y, Murakami Y, Miyazaki K, Kawarada Y, Hirano S. Development of a systematic telesimulation curriculum for laparoscopic inguinal hernia repair. GLOBAL SURGICAL EDUCATION : JOURNAL OF THE ASSOCIATION FOR SURGICAL EDUCATION 2022; 1:52. [PMID: 38013710 PMCID: PMC9582386 DOI: 10.1007/s44186-022-00059-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/12/2022] [Accepted: 10/09/2022] [Indexed: 12/04/2022]
Abstract
Purpose Telesimulation, whereby learners telecommunicate and use simulator resources to receive education at an off-site location, has been used to educate surgical trainees about how to perform basic surgical procedures. However, it has not yet been used for advanced surgical procedures. We aimed to develop a telesimulation curriculum to teach a common laparoscopic procedure called transabdominal preperitoneal (TAPP) repair and to explore the feasibility of its use. Methods Learning objectives were created to develop a telesimulation curriculum that included didactic telelecture and telesimulation training. Pre-tests and post-tests to assess the didactic materials were developed and assessed among surgeons with various experiences. We assessed the feasibility of the telelecture and telesimulation separately. Pre-tests, post-tests, and questionnaires were used to assess the telelectures. We created a TAPP repair telesimulation system and checked for problems during training. Trainees were assessed to determine their skill improvement using previously published assessment tools and questionnaires. Results A didactic telelecture was developed based on the learning objectives using an expert consensus and pilot-tested among five participants. After the lecture, their test scores improved and they expressed positive opinions about the usefulness of telelectures. The TAPP repair telesimulation training was pilot-tested among three trainees. No technical problems occurred during training. All trainees improved their skills after the telesimulation training and agreed that the training was useful for learning the TAPP repair procedure. Conclusions We systematically developed a telesimulation curriculum for the TAPP repair procedure and demonstrated its feasibility among learners.
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Affiliation(s)
- Kotoe Kiriyama
- Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Japan
| | - Saseem Poudel
- Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Japan
- Department of Surgery and Gastroenterological Surgery, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Yo Kurashima
- Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Japan
| | - Yusuke Watanabe
- Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Japan
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Japan
| | - Yoshihiro Murakami
- Department of Surgery and Gastroenterological Surgery, Asahikawa City Hospital, Asahikawa, Japan
| | | | - Yo Kawarada
- Department of Surgery and Gastroenterological Surgery, Tonan Hospital, Sapporo, Japan
| | - Satoshi Hirano
- Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Japan
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Dickinson KJ, Hill T, Johnson S, Orfanos M, Casavechia J, Glasgow M, Neill KK. Simulated patient perceptions of telesimulation education. Simul Healthc 2022. [DOI: 10.54531/tymu3872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Perspectives of simulated participants (SPs) as stakeholders in simulation education are under-represented. With rapid increase in virtual education and anticipation of post-pandemic continuation it is important to establish best practices. This work aims to determine SP perceptions of telesimulation.
In-depth semi-structured interviews determined SP opinions of participation in telesimulation. Thematic analysis utilizing an inductive and semantic iterative coding process was performed. SPs completed a survey of their demographics, experience and prior SP training, both virtual and in-person.
Data sufficiency occurred after 16 interviews (10 females/6 males; 15 White/1 Black/African American). Median age was 56 years (range 37–72). Median number of in-person simulation experiences was 100 (range 6–300) and 27 telesimulations (range 3–100). Thematic analysis identified five themes: (1) students behave differently (distracted, less professional, less prepared for ‘real life’, less nervous), (2) my performance – some things are easier and some harder (increased cognitive load, coming out of role more, difficulties with non-verbal aspect, more standardized performance), (3) it’s harder to connect with learners (different cues, less of a personal connection), (4) safety for all in telesimulation (as psychologically safe as in-person, appreciate opportunity to continue to educate/work, personal safety), (5) future applications of telesimulation (telehealth training, better access to education for learners).
SP perceptions of telesimulation education revealed appreciation of the educational modality and identified potential benefit in telehealth education. SPs were concerned about learner participation, professionalism and resultant preparation for clinical practice. Incorporating SP feedback into telesimulation education may be important to ensure high quality.
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Affiliation(s)
- Karen J Dickinson
- 1Department of Surgery, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Travis Hill
- 3UAMS Centers for Simulation Education, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Sherry Johnson
- 3UAMS Centers for Simulation Education, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Michae Orfanos
- 3UAMS Centers for Simulation Education, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Judith Casavechia
- 3UAMS Centers for Simulation Education, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Margaret Glasgow
- 3UAMS Centers for Simulation Education, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Kathryn K Neill
- 2Office of Interprofessional Education, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
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Evidence-based Guidelines on the Use of Virtual Surgical Education Pertaining to the Domains of Cognition and Curriculum, Psychomotor Skills Training, and Faculty Development and Mentorship. Ann Surg 2022; 276:e6-e15. [PMID: 34171862 DOI: 10.1097/sla.0000000000005014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To identify, categorize, and evaluate the quality of literature, and to provide evidence-based guidelines on virtual surgical education within the cognitive and curricula, psychomotor, and faculty development and mentorship domains. SUMMARY OF BACKGROUND DATA During the coronavirus disease 2019 pandemic, utilizing virtual learning modalities is expanding rapidly. Although the innovative methods must be considered to bridge the surgical education gap, a framework is needed to avoid expansion of virtual education without proper supporting evidence in some areas. METHODS The Association for Surgical Education formed an ad-hoc research group to evaluate the quality and methodology of the current literature on virtual education and to build evidence-based guidelines by utilizing the SiGN methodology. We identified patient/problem-intervention-comparison-outcome-style questions, conducted systematic literature reviews using PubMed, EMBASE, and Education Resources information Center databases. Then we formulated evidence-based recommendations, assessed the quality of evidence using Grading of Recommendations, Assessment, Development, and Evaluation, Newcastle-Ottawa Scale for Education, and Kirkpatrick ratings, and conducted Delphi consensus to validate the recommendations. RESULTS Eleven patient/problem-intervention-comparison-outcome-style questions were designed by the expert committees. After screening 4723 articles by the review committee, 241 articles met inclusion criteria for full article reviews, and 166 studies were included and categorized into 3 domains: cognition and curricula (n = 92), psychomotor, (n = 119), and faculty development and mentorship (n = 119). Sixteen evidence-based recommendations were formulated and validated by an external expert panel. CONCLUSION The evidence-based guidelines developed using SiGN methodology, provide a set of recommendations for surgical training societies, training programs, and educators on utilizing virtual surgical education and highlights the area of needs for further investigation.
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Mulita F, Verras GI, Anagnostopoulos CN, Kotis K. A Smarter Health through the Internet of Surgical Things. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22124577. [PMID: 35746359 PMCID: PMC9231158 DOI: 10.3390/s22124577] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 05/14/2023]
Abstract
(1) Background: In the last few years, technological developments in the surgical field have been rapid and are continuously evolving. One of the most revolutionizing breakthroughs was the introduction of the IoT concept within surgical practice. Our systematic review aims to summarize the most important studies evaluating the IoT concept within surgical practice, focusing on Telesurgery and surgical Telementoring. (2) Methods: We conducted a systematic review of the current literature, focusing on the Internet of Surgical Things in Telesurgery and Telementoring. Forty-eight (48) studies were included in this review. As secondary research questions, we also included brief overviews of the use of IoT in image-guided surgery, and patient Telemonitoring, by systematically analyzing fourteen (14) and nineteen (19) studies, respectively. (3) Results: Data from 219 patients and 757 healthcare professionals were quantitively analyzed. Study designs were primarily observational or based on model development. Palpable advantages from the IoT incorporation mainly include less surgical hours, accessibility to high quality treatment, and safer and more effective surgical education. Despite the described technological advances, and proposed benefits of the systems presented, there are still identifiable gaps in the literature that need to be further explored in a systematic manner. (4) Conclusions: The use of the IoT concept within the surgery domain is a widely incorporated but less investigated concept. Advantages have become palpable over the past decade, yet further research is warranted.
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Affiliation(s)
- Francesk Mulita
- Intelligent Systems Lab, Department of Cultural Technology and Communication, University of the Aegean, 81100 Mytilene, Greece;
- Department of Surgery, General University Hospital of Patras, 26504 Rio, Greece;
- Correspondence: (F.M.); (K.K.); Tel.: +30-6974822712 (K.K.)
| | | | | | - Konstantinos Kotis
- Intelligent Systems Lab, Department of Cultural Technology and Communication, University of the Aegean, 81100 Mytilene, Greece;
- Correspondence: (F.M.); (K.K.); Tel.: +30-6974822712 (K.K.)
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Raborn LN, Janis JE. Overcoming the Impact of COVID-19 on Surgical Mentorship: A Scoping Review of Long-distance Mentorship in Surgery. JOURNAL OF SURGICAL EDUCATION 2021; 78:1948-1964. [PMID: 34059480 PMCID: PMC8894132 DOI: 10.1016/j.jsurg.2021.05.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/05/2021] [Accepted: 05/02/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND Mentorship in the surgical field has been increasingly recognized as a crucial component of career success. Distance mentorship models may be utilized to overcome geographic limitations, increase mentorship access, and strengthen mentoring relationships in surgery. OBJECTIVE This review aimed to identify the scope of literature on distance mentoring in surgery, the range of its application, its effectiveness, and any gaps in the literature that should be addressed in order to enhance mentorship in the surgical field. DESIGN A comprehensive PubMed review was performed in January 2021 on distance mentorship of students, trainees, and surgeons in the surgical field. Reviews, replies, and non-English articles were excluded. Data was extracted regarding publication year, author's country, specialty, subjects, aim of mentorship model, and efficacy. RESULTS 134 total studies met inclusion and exclusion criteria. Most studies were published in 2020, written by authors in the United States, from general surgery, and featured an expert surgeon paired with a more junior fully trained surgeon. In all, 93.3% of studies utilized distance mentorship to enhance surgical skill through telementoring and only 4.5% were focused on mentorship to enhance careers through professional development. The remaining studies utilized distance mentorship models to increase surgical research (0.7%) and clinical knowledge (1.5%). CONCLUSION The results of this review suggest successful implementation of distance mentoring in surgery through telementoring, but a lack of professionally aimed distance mentorship programs. Amidst COVID-19, distance mentorship is particularly important because of decreased face-to-face opportunity. Future studies in the surgical field should investigate distance mentoring as a means of increasing mentorship for professional development.
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Affiliation(s)
- Layne N Raborn
- Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Jeffrey E Janis
- Department of Plastic and Reconstructive Surgery, Ohio State University, Wexner Medical Center Columbus, Columbus, Ohio.
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Rosser JB, Nitsche L, Yee G, Alam H. The evolution of surgical virtual education and telementoring: One surgeon's journey. J Surg Oncol 2021; 124:162-173. [PMID: 34245579 DOI: 10.1002/jso.26563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 11/12/2022]
Abstract
The first era of the global proliferation of surgical advancements involved surgical infection rate and technique breakthroughs by Lister, Halsted, and others. This was propagated by letters, academic papers, and international visits. While success was achieved, it was at a suboptimal pace. In the current era of minimally invasive surgical approaches, these methods are inadequate. This paper chronicles the development and application of virtual learning and telementoring as force multipliers to speed procedural adoption and proliferation.
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Affiliation(s)
- James Butch Rosser
- School of Medicine and Biomedical Sciences, University at Buffalo Jacobs, Buffalo, New York, USA
| | - Lindsay Nitsche
- School of Medicine and Biomedical Sciences, University at Buffalo Jacobs, Buffalo, New York, USA
| | - Gabrielle Yee
- School of Medicine and Biomedical Sciences, University at Buffalo Jacobs, Buffalo, New York, USA
| | - Harris Alam
- University of Central Florida, Orlando, Florida, USA
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