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Lucius C, Koch JBH, Jenssen C, Karlas T, Sänger SL, Dietrich CF. [State of the art: Simulation in US]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2024; 62:723-736. [PMID: 38417809 DOI: 10.1055/a-2183-1888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
Technical simulation of diagnostic and therapeutic procedures is of growing relevance for student education and advanced medical training and has already been introduced in the field of ultrasound. This review gives a broad overview on different levels of simulation for ultrasound diagnostics and highlights the technical background of the methodology. A critical review of the literature reveals recommendations for implementing simulation techniques in medical studies and professional ultrasound training. An analysis of strengths and weaknesses shows the advantages of simulation especially in the context of individual learning situations and COVID-19-related restrictions for personal interaction. However, simulation techniques cannot replace the experiences of complex clinical examinations with direct interaction to real patients. Therefore, future applications may focus on repetition and assessment of achieved competencies by using standardized feedback mechanisms in order to preserve the limited resources for practical medical training.
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Affiliation(s)
- Claudia Lucius
- CED-Zentrum Berlin-Nord, Poliklinik Gastroenterologie, HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - Jonas B H Koch
- Allgemeine Innere Medizin (DAIM) Kliniken Beau Site, Salem und Permanence, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
| | - Christian Jenssen
- Innere Medizin, Krankenhaus Märkisch Oderland GmbH, Strausberg, Germany
- Brandenburg Institute for Clinical Ultrasound at Medical University Brandenburg, Neuruppin, Germany
| | - Thomas Karlas
- Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | - Sophie Luise Sänger
- Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christoph F Dietrich
- Allgemeine Innere Medizin (DAIM) Kliniken Beau Site, Salem und Permanence, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
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Schlaepfer CH, Packiam VT, Tracy CR, Takacs EB, Steinberg RL. Current Utilization and Perceptions of Formal Education of Point-of-care Ultrasound in Urology. Urology 2024; 184:8-14. [PMID: 38065312 DOI: 10.1016/j.urology.2023.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/24/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To assess the extent of formal point-of-care ultrasound (POCUS) training, current utilization of POCUS, and contemporary perceptions of POCUS amongst urologists. METHODS A survey including questions regarding demographics, prior ultrasound education, current ultrasound utilization in practice/training, perceived optimal POCUS utilization, and the perception of formal ultrasound training was developed. The survey was disseminated to residency program directors (PDs) via the SAU and members of AUA subsection organizations. Data were collected via Redcap. RESULTS A total of 40 PDs and 159 other respondents completed the survey with approximately half (51%) in an academic practice and two-thirds (68%) with more than 10years in practice. PD response rate was 28%, and general response rate was 2%. Among all respondents, 95% (186/196) and 82% (160/194) agreed/strongly agreed formal POCUS training would be worthwhile during and after residency. Among urology residency PDs, 93% (37/40) agreed/strongly agreed that formal POCUS training is worthwhile in residency. The majority of respondents used some form of ultrasound in practice (77%, 154/199). However, only 37% (72/199) of all respondents had prior formal POCUS training, and 19% (5/26) of PDs reported formal training in their programs. Of respondents without formal training, 63% (80/127) reported interest in pursuing formal training. CONCLUSION POCUS is widely utilized in many practices. Yet, most urologists have not participated in formal POCUS training and most programs do not have curricula. Urologists have favorable opinions of the utility, safety, and efficacy of POCUS and desire training.
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Affiliation(s)
| | - Vignesh T Packiam
- University of Iowa Hospitals and Clinics, Department of Urology, Iowa City, IA
| | - Chad R Tracy
- University of Iowa Hospitals and Clinics, Department of Urology, Iowa City, IA
| | - Elizabeth B Takacs
- University of Iowa Hospitals and Clinics, Department of Urology, Iowa City, IA
| | - Ryan L Steinberg
- University of Iowa Hospitals and Clinics, Department of Urology, Iowa City, IA.
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Dietrich CF, Lucius C, Nielsen MB, Burmester E, Westerway SC, Chu CY, Condous G, Cui XW, Dong Y, Harrison G, Koch J, Kraus B, Nolsøe CP, Nayahangan LJ, Pedersen MRV, Saftoiu A, Savitsky E, Blaivas M. The ultrasound use of simulators, current view, and perspectives: Requirements and technical aspects (WFUMB state of the art paper). Endosc Ultrasound 2023; 12:38-49. [PMID: 36629173 PMCID: PMC10134935 DOI: 10.4103/eus-d-22-00197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/08/2022] [Indexed: 01/01/2023] Open
Abstract
Simulation has been shown to improve clinical learning outcomes, speed up the learning process and improve learner confidence, whilst initially taking pressure off busy clinical lists. The World Federation for Ultrasound in Medicine and Biology (WFUMB) state of the art paper on the use of simulators in ultrasound education introduces ultrasound simulation, its advantages and challenges. It describes different simulator types, including low and high-fidelity simulators, the requirements and technical aspects of simulators, followed by the clinical applications of ultrasound simulation. The paper discusses the role of ultrasound simulation in ultrasound clinical training, referencing established literature. Requirements for successful ultrasound simulation acceptance into educational structures are explored. Despite being in its infancy, ultrasound simulation already offers a wide range of training opportunities and likely holds the key to a broader point of care ultrasound education for medical students, practicing doctors, and other health care professionals. Despite the drawbacks of simulation, there are also many advantages, which are expanding rapidly as the technology evolves.
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Affiliation(s)
- Christoph F. Dietrich
- Department of Internal Medicine (DAIM), Hirslanden Private Hospital Bern, Beau Site, Salem und Permanence, Bern, Switzerland
| | - Claudia Lucius
- Department of Gastroenterology, IBD Centre, Poliklinik Helios Klinikum Buch, Berlin, Germany
| | | | - Eike Burmester
- Department of Internal Medicine (DAIM), Sana Hospital, Luebeck, Germany
| | - Susan Campbell Westerway
- Department of Internal Medicine (DAIM), Faculty of Science and Health, Charles Sturt University, NSW, Australia
| | - Chit Yan Chu
- Department of Internal Medicine (DAIM), Acute Gynaecology, Early Pregnancy and Advanced Endosurgery Unit, Sydney Medical School Nepean, University of Sydney, Nepean Hospital, Sydney, NSW, Australia
| | - George Condous
- Department of Internal Medicine (DAIM), Acute Gynaecology, Early Pregnancy and Advanced Endosurgery Unit, Sydney Medical School Nepean, University of Sydney, Nepean Hospital, Sydney, NSW, Australia
| | - Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | | | - Jonas Koch
- Department of Internal Medicine (DAIM), Hirslanden Private Hospital Bern, Beau Site, Salem und Permanence, Bern, Switzerland
| | - Barbara Kraus
- Department of Internal Medicine (DAIM), University of Applied Sciences FH Campus Wien, Health Sciences, Radiological Technology, Sonography, Vienna, Austria
| | - Christian Pállson Nolsøe
- Department of Surgery, Centre for Surgical Ultrasound, Zealand University Hospital, Køge, Denmark
- Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark
| | | | | | - Adrian Saftoiu
- Department of Gastroenterology and Hepatology, Elias Emergency University Hospital, University of Medicine and Pharmacy “Carol Davila” Bucharest, Romania
| | - Eric Savitsky
- Ronald Reagan UCLA Medical Center, UCLA Emergency Medicine Residency Program, Los Angeles, California, USA
| | - Michael Blaivas
- Department of Medicine, University of South Carolina School of Medicine, Columbia, South Carolina, USA
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Fulgham PF, Clark AR. A template for conducting a post-graduate hands-on, urologic ultrasound course. World J Urol 2022; 41:627-634. [PMID: 35438314 DOI: 10.1007/s00345-022-04011-5] [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: 02/06/2022] [Accepted: 04/01/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To describe a program for post-graduate education of urologists providing urologic ultrasound services. METHODS A detailed description of the evolution of an educational program developed by the American Urological Association (AUA) Office of Education for providing the knowledge and fundamental skills necessary for urologists to provide high-quality, medically appropriate urologic ultrasound examinations. The structure of the program, as well as the training of instructors and certification of attainment of the goals and skills set forth in the program, is highlighted. Specific recommendations for providing didactic instruction and managing the logistics of the hands-on training are given. RESULTS Approximately 1700 urologists have received post-graduation instruction in the performance of urologic ultrasound in some form under the auspices of the AUA Office of Education since 1993. The hands-on training course has continued to evolve in response to feedback from the attendees and the ongoing emergence of new clinical indications for urologist-performed ultrasound. A post graduate course, including didactic instruction and hands-on skill training, continues to be in demand and fully subscribed and attended. CONCLUSION Instruction in the performance of diagnostic ultrasound examinations is not a formal component of many urologic residencies in the United States. Since many ultrasound procedures are being performed by practicing urologists, there is an ongoing need for post-graduate training in urologic ultrasound.
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Affiliation(s)
- Pat F Fulgham
- Texas Health Presbyterian Dallas, 8230 Walnut Hill Lane, Suite 700, Dallas, TX, 75231, USA.
| | - Angela R Clark
- Urology Research and Education Foundation, 8210 Walnut Hill Lane, Suite 014, Dallas, TX, 75231, USA
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Gómez Rivas J, Toribio Vázquez C, Ballesteros Ruiz C, Taratkin M, Marenco JL, Cacciamani GE, Checcucci E, Okhunov Z, Enikeev D, Esperto F, Grossmann R, Somani B, Veneziano D. Artificial intelligence and simulation in urology. Actas Urol Esp 2021; 45:524-529. [PMID: 34526254 DOI: 10.1016/j.acuroe.2021.07.001] [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: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 10/20/2022]
Abstract
INTRODUCTION AND OBJECTIVE Artificial intelligence (AI) is in full development and its implementation in medicine has led to an improvement in clinical and surgical practice. One of its multiple applications is surgical training, with the creation of programs that allow avoiding complications and risks for the patient. The aim of this article is to analyze the advantages of AI applied to surgical training in urology. MATERIAL AND METHODS A literary research is carried out to identify articles published in English regarding AI applied to medicine, especially in surgery and the acquisition of surgical skills. RESULTS Surgical training has evolved over time thanks to AI. A model for surgical learning where skills are acquired in a progressive way while avoiding complications to the patient, has been created. The use of simulators allows a progressive learning, providing trainees with procedures that increase in number and complexity. On the other hand, AI is used in imaging tests for surgical or treatment planning. CONCLUSION Currently, the use of AI in daily clinical practice has led to progress in medicine, specifically in surgical training.
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Affiliation(s)
- J Gómez Rivas
- Departamento de Urología, Hospital Clínico San Carlos, Madrid, Spain; Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, The Netherlands.
| | - C Toribio Vázquez
- Departamento de Urología, Hospital Universitario La Paz, Madrid, Spain
| | | | - M Taratkin
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, The Netherlands; Institute for Urology and Reproductive Health, Sechenov University, Moscú, Russia
| | - J L Marenco
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, The Netherlands; Departamento de Urología, Instituto Valenciano de Oncología, Valencia, Spain
| | - G E Cacciamani
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, The Netherlands; Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - E Checcucci
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, The Netherlands; Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Z Okhunov
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, The Netherlands; Department of Urology, University of California, Irvine, CA, United States
| | - D Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscú, Russia
| | - F Esperto
- Department of Urology, Campus Biomedico, University of Rome, Roma, Italy
| | - R Grossmann
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, The Netherlands; Eastern Maine Medical Center, Bangor, ME, United States
| | - B Somani
- Department of Urology, University Hospital Southhampton, Southampton, United Kingdom
| | - D Veneziano
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, The Netherlands; Department of Urology and Kidney Transplant, Grande Ospedale Metropolitano, Reggio Calabria, Italy
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6
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Gómez Rivas J, Toribio Vázquez C, Ballesteros Ruiz C, Taratkin M, Marenco JL, Cacciamani GE, Checcucci E, Okhunov Z, Enikeev D, Esperto F, Grossmann R, Somani B, Veneziano D. Artificial intelligence and simulation in urology. Actas Urol Esp 2021; 45:S0210-4806(21)00088-7. [PMID: 34127285 DOI: 10.1016/j.acuro.2020.10.012] [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: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND OBJECTIVE Artificial intelligence (AI) is in full development and its implementation in medicine has led to an improvement in clinical and surgical practice. One of its multiple applications is surgical training, with the creation of programs that allow avoiding complications and risks for the patient. The aim of this article is to analyze the advantages of AI applied to surgical training in urology. MATERIAL AND METHODS A literary research is carried out to identify articles published in English regarding AI applied to medicine, especially in surgery and the acquisition of surgical skills. RESULTS Surgical training has evolved over time thanks to AI. A model for surgical learning where skills are acquired in a progressive way while avoiding complications to the patient, has been created. The use of simulators allows a progressive learning, providing trainees with procedures that increase in number and complexity. On the other hand, AI is used in imaging tests for surgical or treatment planning. CONCLUSION Currently, the use of AI in daily clinical practice has led to progress in medicine, specifically in surgical training.
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Affiliation(s)
- J Gómez Rivas
- Departamento de Urología, Hospital Clínico San Carlos, Madrid, España; Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, Países Bajos.
| | - C Toribio Vázquez
- Departamento de Urología, Hospital Universitario La Paz, Madrid, España
| | | | - M Taratkin
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, Países Bajos; Institute for Urology and Reproductive Health, Sechenov University, Moscú, Rusia
| | - J L Marenco
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, Países Bajos; Departamento de Urología, Instituto Valenciano de Oncología, Valencia, España
| | - G E Cacciamani
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, Países Bajos; Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California, Estados Unidos
| | - E Checcucci
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, Países Bajos; Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italia
| | - Z Okhunov
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, Países Bajos; Department of Urology, University of California, Irvine, California, Estados Unidos
| | - D Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscú, Rusia
| | - F Esperto
- Department of Urology, Campus Biomedico, University of Rome, Roma, Italia
| | - R Grossmann
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, Países Bajos; Eastern Maine Medical Center, Bangor, Maine, Estados Unidos
| | - B Somani
- Department of Urology, University Hospital Southhampton, Southampton, Reino Unido
| | - D Veneziano
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, Países Bajos; Department of Urology and Kidney Transplant, Grande Ospedale Metropolitano, Reggio Calabria, Italia
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