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Peng Y, Yang L, Qi A, Zhang L, Xiong R, Chen G. Simulation-Based Learning Combined with Case and Problem-Based Learning in the Clinical Education of Joint Surgery. JOURNAL OF SURGICAL EDUCATION 2023; 80:892-899. [PMID: 37032261 DOI: 10.1016/j.jsurg.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 01/25/2023] [Accepted: 03/14/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Traditional education of clinical training mainly relies on a single mode of lecture-based learning (LBL), in which the teacher lectures and the students listen, and the teaching effect is often unsatisfactory. This study aims to explore the effect of simulation-based learning (SBL) combined with case and problem-based learning (CPBL) teaching mode in the clinical education of joint surgery. DESIGN Through objective evaluation of joint surgery students' theoretical knowledge and clinical skills, and subjective evaluation of teaching quality by anonymous questionnaire, the teaching effects of LBL teaching mode, CPBL teaching mode and SBL combined with CPBL teaching mode in clinical teaching of joint surgery were compared. SETTING AND PARTICIPANTS Sixty students who participated in the standardized training of residents in the Center for Joint Surgery, Southwest Hospital, Army University, China from March 2020 to September 2021 were selected and randomly divided into groups A, B, and C, with 20 students in each group. Group A adopted traditional LBL mode, group B adopted CPBL mode, and group C adopted SBL combined with CPBL mode. RESULTS The scores of theoretical knowledge, clinical skills and total score of group C were (86.40 ± 9.76), (92.15 ± 4.49), (88.70 ± 5.75) points respectively, which were significantly higher than (78.80 ± 10.50), (86.60 ± 8.79), (81.92 ± 6.97) points in group B, and (80.50 ± 6.64), (85.35 ± 7.99), (82.44 ± 5.97) points in group A, the difference was statistically significant (p < 0.05). The scores of 5 self-evaluation items, i.e., learning interest, self-learning ability, problem-solving ability, clinical skills and comprehensive competency were (18.90 ± 1.22), (18.85 ± 1.01), (18.75 ± 1.13), (18.90 ± 1.22), (18.50 ± 1.02), (18.80 ± 0.81) points in group C, which were higher than (15.90 ± 1.41), (14.30 ± 2.47), (13.95 ± 2.01), (14.50 ± 1.63), (14.70 ± 1.38) points in group B, and (11.65 ± 2.90), (10.05 ± 1.69), (9.75 ± 1.67), (14.35 ± 1.90), (12.75 ± 2.12) points in group A, the difference was statistically significant (p <0.05). The satisfaction of students in group C (95.00%) was significantly better than that in group B (80.00%) and group A (65.00%), and the difference was statistically significant (p < 0.05). CONCLUSION SBL combined with CPBL teaching mode can effectively improve the theoretical knowledge and clinical skills of the students, which could improve self-assessment and teaching satisfaction rate, and is worthy of application and promotion in the clinical teaching of joint surgery.
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Affiliation(s)
- Yang Peng
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Liu Yang
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Aiping Qi
- Graduate School of Third Military Medical University (Army Military Medical University), Chongqing, China
| | - Lei Zhang
- Graduate School of Third Military Medical University (Army Military Medical University), Chongqing, China
| | - Ran Xiong
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Guangxing Chen
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
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Marquardt MD, Fischer F, Quatman-Yates C, Rutter C, Quatman CE. A Mixed-Methods Needs Assessment for a Longitudinal Surgical Preparation Course in Undergraduate Medical Education. JOURNAL OF SURGICAL EDUCATION 2023; 80:537-546. [PMID: 36697359 PMCID: PMC10401325 DOI: 10.1016/j.jsurg.2023.01.001] [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: 08/28/2022] [Revised: 11/15/2022] [Accepted: 01/02/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To assess the unmet needs associated with surgical education and skill development during the pre-clerkship years of medical school. DESIGN A mixed-methods design was employed that leveraged semi-structured interviews and quantitative surveys followed by qualitative analysis. SETTING A large midwestern academic medical center. PARTICIPANTS Eighteen participants were enrolled representing second year medical students with an interest in surgery, surgical residents, and attending surgeons from a diverse array of surgical specialties. RESULTS Unanimous support for the creation of a pre-clerkship surgical skills course emerged due to 2 main themes: (1) gaps in current surgical education offerings and (2) the value of early exposure to surgery and surgical skills followed by longitudinal practice. The components that participants deemed essential to a well-designed course were also revealed. Each stakeholder group (medical students, residents, surgeons) would benefit across all factors uncovered. CONCLUSIONS There is a significant unmet need across all stakeholder groups for the creation of a longitudinal surgical skills course for pre-clerkship medical students. Future studies should seek to design a curriculum based on these study results and assess a pilot version of the curriculum to understand its feasibility under application.
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Affiliation(s)
- Matthew D Marquardt
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Fielding Fischer
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | | | - Christopher Rutter
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Carmen E Quatman
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio.
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Deconstructing forearm casting task by videos with step-by-step simulation teaching improved performance of medical students: is making working student's memory work better similar to a process of artificial intelligence or just an improvement of the prefrontal cortex homunculus? INTERNATIONAL ORTHOPAEDICS 2023; 47:467-477. [PMID: 36370162 DOI: 10.1007/s00264-022-05626-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE To compare two teaching methods of a forearm cast in medical students through simulation, the traditional method (Trad) based on a continuous demonstration of the procedure and the task deconstruction method (Decon) with the procedure fragmenting into its constituent parts using videos. METHODS During simulation training of the below elbow casting technique, 64 medical students were randomized in two groups. Trad group demonstrated the entire procedure without pausing. Decon group received step-wise teaching with educational videos emphasizing key components of the procedure. Direct and video evaluations were performed immediately after training (day 0) and at six months. Performance in casting was assessed using a 25-item checklist, a seven item global rating scale (GRS Performance), and a one item GRS (GRS Final Product). RESULTS Fifty-two students (Trad n = 24; Decon n = 28) underwent both day zero and six month assessments. At day zero, the Decon group showed higher performance via video evaluation for OSATS (p = 0.035); GRS performance (p < 0.001); GRS final product (p < 0.001), and for GRS performance (p < 0.001) and GRS final product (p = 0.011) via direct evaluation. After six months, performance was decreased in both groups with ultimately no difference in performance between groups via both direct and video evaluation. Having done a rotation in orthopaedic surgery was the only independent factor associated to higher performance. CONCLUSIONS The modified video-based version simulation led to a higher performance than the traditional method immediately after the course and could be the preferred method for teaching complex skills.
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Lu EL, Harris MK, Gao TZ, Good L, Harris DP, Renton D. Near-Peer Teaching in Conjunction with Flipped Classroom to Teach First-Year Medical Students Basic Surgical Skills. MEDICAL SCIENCE EDUCATOR 2022; 32:1015-1022. [PMID: 35936650 PMCID: PMC9340706 DOI: 10.1007/s40670-022-01602-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND There is increasing evidence that students are completing medical school with insufficient surgical education. Near-peer tutoring and flipped classroom formatting may be used to enhance learning while simultaneously relieving faculty burden of teaching. Here, we qualitatively evaluate a 3-month course that integrates the use of near-peer teaching and flipped classroom formatting, with the goal of increasing first-year medical students' self-perceived confidence in performing basic sutures and knot-ties as well as interest in surgery. METHODS Twenty-one first-year medical students participated in a suturing and knot-tying course led by senior medical students. The course consisted of 2-h sessions held every 2 weeks for a total of five sessions. Students were sent publicly available videos prior to each session by which to learn the upcoming techniques and received live feedback from instructors during sessions. Questionnaires were completed pre-course and post-course. RESULTS Compared to pre-course ratings, post-course ratings of self-perceived confidence to perform various knot-ties and sutures all increased significantly (p < 0.05). All students stated that the course strengthened their desire to pursue a career in surgery. Student feedback of the course was overall positive. CONCLUSIONS Near-peer teaching can be used in conjunction with flipped classroom to increase first-year medical students' self-perceived confidence in surgical suturing and knot-tying as well as interest in surgery. This curriculum may serve as an outline for student-led courses at other institutions.
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Affiliation(s)
- Emily L. Lu
- The Ohio State University College of Medicine, Columbus, OH USA
| | - Micah K. Harris
- The Ohio State University College of Medicine, Columbus, OH USA
| | - Thomas Z. Gao
- The Ohio State University College of Medicine, Columbus, OH USA
| | - Logan Good
- The Ohio State University College of Medicine, Columbus, OH USA
| | - Daniel P. Harris
- Case Western Reserve University School of Medicine, Cleveland, OH USA
| | - David Renton
- Department of General Surgery, The Ohio State University Wexner Medical Center, Columbus, OH USA
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Wilson CA, Davidson J, Chahine S, Chan EP, Stringer L, Quantz MA, Saklofske DH, Wang PZT. What is Transferred and How Much is Retained? A Simulation Study of Complex Surgical Skills. J Surg Res 2022; 280:411-420. [PMID: 36041341 DOI: 10.1016/j.jss.2022.07.040] [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: 10/14/2021] [Revised: 06/29/2022] [Accepted: 07/29/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Studies indicate that learning surgical skills on low-fidelity models is equally beneficial to learning on high-fidelity models in terms of skills retention and transfer. However, it is unclear how low-fidelity simulation training impacts retention and transfer in novice learners, particularly on complex surgical tasks that incorporate multiple challenging skills. This study explores the capacity of complete novices to learn and transfer complex surgical skills from a low-fidelity model to a high-fidelity simulation after a delay. METHODS Task-naïve medical and nonmedical undergraduate students (n = 62) participated in a three-phase prospective double-arm randomized (2:1) experimental study. Participants completed two skills training sessions (end-to-side anastomosis) on a low-fidelity bench model. After a 4-week delay, participants completed the task again either using the low-fidelity model or a high-fidelity model (cadaver) and were assessed using a validated checklist. RESULTS There was a significant time × fidelity group interaction (P = 0.004). Simple effects analysis indicated the high-fidelity group (Mdiff = 4.18, P < 0.001) performed significantly worse (P = 0.003) in phase 3 relative to phase 2 compared to the low-fidelity group (Mdiff = 0.75, P = 0.39). Post hoc logistic regression analysis indicated that radial suturing technique and economy of motion skills were less likely to be completed correctly for those in the high-fidelity group. CONCLUSIONS These findings suggest that for novice populations, relying on low-fidelity simulation training as a source of teaching complex skills may not provide a reliable transfer to high-fidelity models and in turn clinical settings.
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Affiliation(s)
- Claire A Wilson
- Division of Pediatric Surgery, London Health Sciences Centre, London, Ontario, Canada
| | - Jacob Davidson
- Division of Pediatric Surgery, London Health Sciences Centre, London, Ontario, Canada
| | - Saad Chahine
- Faculty of Education, Queen's University, Kingston, Ontario, Canada
| | | | - Leandra Stringer
- Department of Surgery, Western University, London, Ontario, Canada
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Distance Education for Basic Surgical Skills Using Homemade Tools—DIY Methods for Emergency Situations. SUSTAINABILITY 2022. [DOI: 10.3390/su14148639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The aim of our research was to establish a reproducible curriculum that offers the possibility to gain basic surgical skills (knot tying, suturing, laparoscopy basics) through distance education in emergency situations by using tools available in the household. Forty-six volunteering third- and fourth-year medical students were involved in the study. The distance education system was set up using homemade or easily obtainable tools (an empty can, shoe box, sponge, etc.) to teach surgical knotting, suturing, and basic laparoscopic skills. The reachable learning objectives were contrasted with the original course plan. Feedback from the students has been collected. The students’ results were compared to the regular course of the previous years. Seventy-nine percent of the original learning objectives could be reached completely, and 15% partially. The necessary tools were available for 82% of the students. The students evaluated the course for 4.26 in general and 4.86 considering the circumstances (on a 5-level-scale). The homemade trainers were assessed over four as an acceptable substitution. Students’ exam results decreased only by 7% compared to the previous two years. Basic surgical skills can be educated with acceptable efficiency and student satisfaction using distance teaching and homemade tools. This is the first study where not only the simulators but the surgical instruments were replaced with household tools and evaluated by a reproducible curriculum.
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Preparatory surgical bootcamp: an effective form of training with a positive impact on self-confidence and procedural skills of the residents. SURGERY IN PRACTICE AND SCIENCE 2022. [DOI: 10.1016/j.sipas.2022.100095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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The Surgical Skills and Technology Elective Program and Medical Student Career Choice. J Surg Res 2022; 273:127-131. [DOI: 10.1016/j.jss.2021.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 10/21/2021] [Accepted: 12/14/2021] [Indexed: 11/20/2022]
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Hayden EM, Petrusa E, Sherman A, Feinstein DM, Khoury K, Krupat E, Pawlowski J, Oriol NE, Smithedajkul PY, Venkatan SK, Gordon JA. Association of Simulation Participation With Diagnostic Reasoning Scores in Preclinical Students. Simul Healthc 2022; 17:35-41. [PMID: 34120136 DOI: 10.1097/sih.0000000000000589] [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: 11/25/2022]
Abstract
PURPOSE The aim of the study was to evaluate for an association between the number of voluntary mannequin simulation sessions completed during the school year with scores on a year-end diagnostic reasoning assessment among second-year medical students. METHOD This is retrospective analysis of participation in 0 to 8 extracurricular mannequin simulation sessions on diagnostic reasoning assessed among 129 second-year medical students in an end-of-year evaluation. For the final skills assessment, 2 physicians measured students' ability to reason through a standardized case encounter using the Diagnostic Justification (DXJ) instrument (4 categories each scored 0-3 by raters reviewing students' postencounter written summaries). Rater scores were averaged for a total DXJ score (0-12). To provide additional baseline comparison, zero participation students were divided into 2 groups based on intent to participate: those who signed up for extracurricular sessions but never attended versus those who never expressed interest. Scores across the attendance groups were compared with an analysis of variance and trend analysis. RESULTS The class DXJ mean equaled 7.56, with a standard deviation of 2.78 and range of 0 to 12. Post hoc analysis after a significant analysis of variance (F = 4.91, df = 8, 128, P < 0.001) showed those participating in 1 or more extracurricular sessions had significantly higher DXJ scores than those not participating. Students doing 7 extracurricular sessions had significantly higher DXJ scores than those doing 0 and 2 (P < 0.05). Zero attendance groups were not different. A significant linear trend (R = 0.48, F = 38.0, df = 1, 127, P < 0.001) was found with 9 groups. A significant quadratic effect, like a dose-response pattern, was found (F = 18.1, df = 2, 125, P < 0.001) in an analysis including both zero attendance groups, a low (1-4 extracurricular sessions) group and a high (5-8) group. CONCLUSIONS Higher year-end diagnostic reasoning scores were associated with increased voluntary participation in extracurricular mannequin-based simulation exercises in an approximate dose-response pattern.
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Affiliation(s)
- Emily M Hayden
- From the Gilbert Program in Medical Simulation, Harvard Medical School; MGH Learning Laboratory, Departments of Emergency Medicine and Surgery, Massachusetts General Hospital; Departments of Medicine and Anesthesia, Beth Israel Deaconess Medical Center; and Department of Medicine, Brigham and Women's Hospital, Boston, MA
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Mullens CL, Battin A, Grabo DJ, Borgstrom DC, Thomay AA. The PASS Course: Practical Anatomy and Surgical Skills Course as a Pragmatic Primer for Senior Medical Students Pursuing Surgical Residency. Am Surg 2021:31348211054551. [PMID: 34766513 DOI: 10.1177/00031348211054551] [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: 11/16/2022]
Abstract
The senior year of undergraduate medical education has been scrutinized for lacking emphasis from educators and value for students. Surgical residency program directors and medical students have reported different sets of perceived weaknesses as surgical trainees enter residency. With this in mind, we developed a novel rotation for senior medical students pursuing surgical residency. The rotation incorporates practical didactics, robust skill and simulation training, and an enriching anatomy experience that entails dissections and operations on embalmed and fresh tissue cadavers. To our knowledge, this is the first reported formal training experience for medical students that involves working with fresh tissue cadavers, which have been described as effective models for live human tissue in the operating room. We describe our multifaceted curriculum in detail, discuss its organization, and elaborate on its potential value. We also provide detailed explanations of the curriculum components so that other surgical educators may consider adopting them.
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Affiliation(s)
| | - Alexander Battin
- 12355West Virginia University School of Medicine, Morgantown, WV, USA
| | - Daniel J Grabo
- Department of Surgery, Division of Trauma and Surgical Critical Care, 5631West Virginia University School of Medicine, Morgantown, WV, USA
| | - David C Borgstrom
- Department of Surgery, Division of General Surgery, 5631West Virginia University School of Medicine, Morgantown, WV, USA
| | - Alan A Thomay
- Department of Surgery, Division of Surgical Oncology12355West Virginia University School of Medicine, Morgantown, WV, USA
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The Next SSTEP: The "Surgical Skills and Technology Elective Program" Decreases Cognitive Load During Suturing Tasks in 2nd Year Medical Students. J Surg Res 2021; 267:598-604. [PMID: 34271266 DOI: 10.1016/j.jss.2021.06.006] [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: 04/03/2021] [Revised: 05/17/2021] [Accepted: 06/08/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The Surgical Skills and Technology Elective Program (SSTEP) is a one-week, simulation-based procedural skills bootcamp for preclinical medical students. Using cognitive load (CL) as a useful framework for understanding simulation in medical education, our aims were to (1) examine the ability of SSTEP to decrease medical students' CL during procedural skills training and (2) determine the impact of SSTEP on secondary learning. METHODS In this prospective cohort study, twenty SSTEP participants and twenty controls were recruited. CL was assessed during a simple suturing task and a clinical vignette multitasking activity, where participants were required to suture and concurrently listen to a clinical vignette. CL was measured using the validated Subjective Rating of Mental Effort (SRME) and its impact on working memory was assessed using a knowledge test about the clinical vignette. RESULTS Participants reported lower SRME scores while suturing following SSTEP, which persisted at 3 months (p = 0.002) and were significantly lower than controls (p = 0.031). Participants also reported lower SRME scores during the clinical vignette multitasking activity (p = 0.011), despite no improvement among controls (p = 0.63). Participants significantly outperformed controls on the clinical vignette knowledge test (p = 0.02). CONCLUSIONS Surgical skills training through SSTEP was associated with lower reports of mental effort and increased performance on secondary learning tasks. Procedural skills bootcamps may better prepare students for the complex learning environments encountered during clinical clerkship.
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Atli K, Selman W, Ray A. A Comprehensive Multicomponent Neurosurgical Course with use of Virtual Reality: Modernizing the Medical Classroom. JOURNAL OF SURGICAL EDUCATION 2021; 78:1350-1356. [PMID: 33221253 DOI: 10.1016/j.jsurg.2020.11.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Surgical education has constantly evolved and has been recently severely impacted by the COVID-19 pandemic. While virtual reality (VR) has been utilized for resident training and neuroanatomy education, application of VR has been limited for neurosurgical education in medical school. This is the first report of a comprehensive, multicomponent teaching model with VR as a primary component to neurosurgical and neuroanatomy education for pre-clerkship medical students. DESIGN Twelve second-year medical students were included in this prospective survey study that was conducted to evaluate a year-long neurosurgery elective course with an interactive VR platform as a primary teaching tool for neuroanatomy and neurosurgical procedures. The course had 4 components: (1) didactic/lecture-based learning, (2) problem-based learning, (3) hands-on skills lab, and (4) VR-based learning through Surgical Theater's Precision VR visualization platform. Outcome measures were based on confidence levels measured on pre- and post-course competency confidence surveys in students' ability to identify neuroanatomical structures, interpret neuroradiological imaging, and analyze neurosurgical cases, and student feedback on their experience with VR on a postcourse survey. SETTING The survey study was conducted in the neurosurgery library and conference room at University Hospitals Cleveland Medical Center in Cleveland, Ohio, USA. PARTICIPANTS All 12 second-year medical students who enrolled in the neurosurgery zero-credit hour course completed the course. RESULTS At course conclusion, 100% of students reported significantly higher competency confidence levels on all topics, and 100% agreed utilizing VR helped them gain a deeper understanding of neuroanatomy/neurosurgery. 92% agreed that using VR helped them better retain the anatomical/functional details of the brain/spine, and 69% better understand neurosurgical skills taught, respectively. 100% of students found the course to be a valuable learning experience and VR a useful learning tool. CONCLUSION A comprehensive multi-component neurosurgery elective course using VR as a primary teaching tool may improve neurosurgical education in medical school.
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Affiliation(s)
- Karam Atli
- University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Warren Selman
- University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Abhishek Ray
- University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.
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Objective Structured Assessment of technical skill (OSATS) in the Surgical Skills and Technology Elective Program (SSTEP): Comparison of peer and expert raters. Am J Surg 2021; 223:276-279. [PMID: 33838866 DOI: 10.1016/j.amjsurg.2021.03.064] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 02/26/2021] [Accepted: 03/20/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND A major challenge with Competency Based Medical Education (CBME) is that of increased assessment burden on faculty. To reduce this burden, the accuracy and reliability of peer-assessment for surgical skills requires further exploration. METHODS Forty-two second year medical students were video recorded while performing a simple interrupted suture and an instrument tie. Four novice raters underwent a short training session on the use of the Objective Structured Assessment of Technical Skills (OSATS) checklists. Videos of the suturing task were then independently assessed by the four novice raters and two expert raters on two occasions. Agreement between novice and expert rater scores was calculated using the intraclass correlation coefficient (ICC). RESULTS For both simple interrupted suturing (ICC = 0.78, CI = 0.66-0.86, p < 0.001) and instrument ties (ICC = 0.87, CI = 0.80-0.92, p < 0.001), there was good agreement between novice and expert raters. CONCLUSIONS Novice raters can be taught to use the OSATS checklists to assess peers on simple suturing and instrument tying tasks.
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MacNevin W, Poon E, Skinner TA. Technology readiness of medical students and the association of technology readiness with specialty interest. CANADIAN MEDICAL EDUCATION JOURNAL 2021; 12:e31-e41. [PMID: 33995718 PMCID: PMC8105587 DOI: 10.36834/cmej.70624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Technology readiness (TR) is a construct which characterizes an individual's propensity to utilize new technology. Despite increased technology use in healthcare, limited data exists on medical student TR and the relation of TR with specialty interest. This study assesses the TR of 2nd year medical students and its association with specialty interest. METHODS Respondents completed a survey assessing their most preferred specialty, specialty interests, and technology readiness using a 5-point Likert scale. Using Chi-square analysis, we examined the relation between demographics, TR, and specialty interest. RESULTS This study obtained a 45.7% (n = 53/116) response rate demonstrating that 79.2% (n = 42/53) of students were "technology ready." Male students were more likely to be technology ready (95.2%, n = 20/21, vs 68.8%, n = 22/32, p = 0.02) when compared to female students. Technology ready students were associated with being more interested in "Technology-Focused" specialties compared to students who were not technology ready (88.5%, n = 23/26 vs 70.4%, n = 19/27, p = 0.104). CONCLUSIONS As a cohort, most medical students were technology ready. It is inconclusive if technology ready students are more likely to be interested in technology-focused specialties due to the limited sample size of this study, although with an increased sample size, an improved understanding on technology readiness and its potential impact on student specialty interest may be obtained. Furthermore, knowledge of TR may aid in developing targeted technology-based education programs and in improving remedial approaches for students who are less comfortable with new technology.
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Affiliation(s)
- Wyatt MacNevin
- Faculty of Medicine, Dalhousie University, Nova Scotia, Canada
| | - Eric Poon
- Faculty of Medicine, Dalhousie University, Nova Scotia, Canada
| | - Thomas A Skinner
- Faculty of Medicine, Dalhousie University, Nova Scotia, Canada
- Department of Urology, Queen Elizabeth II Health Sciences Centre, Nova Scotia, Canada
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Hon NWL, Hussein N, Honjo O, Yoo SJ. Evaluating the Impact of Medical Student Inclusion Into Hands-On Surgical Simulation in Congenital Heart Surgery. JOURNAL OF SURGICAL EDUCATION 2021; 78:207-213. [PMID: 32646811 DOI: 10.1016/j.jsurg.2020.06.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/19/2020] [Accepted: 06/20/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Over the last decade medical students' interest in pursuing surgery as a career has declined. This is more apparent in high-specialized specialities such as congenital heart surgery (CHS). Early hands-on simulation has shown to have a positive impact on medical students' interest in pursuing surgery, however, its incorporation into medical school curricula is lacking. This study aimed to evaluate the impact of incorporating medical students as surgical assistants during the Hands On Surgical Training course in CHS. METHODS Local preclinical medical students were invited to participate as surgical assistants during the 5th annual Hands On Surgical Training course in CHS. Among those who responded to the invitation, students were randomly selected and allocated to assist a congenital heart surgeon. All selected students attended an assistants' session prior to the course to familiarize themselves with assisting and to practice basic surgical skills. At the end of both courses students completed a questionnaire based on Likert 5-point scale to evaluate the courses' usefulness. RESULTS Fifteen medical students completed the questionnaires. All reported a beginner level of understanding of congenital heart disease. All students were highly satisfied with using 3D-printed models to help their understanding of congenital heart disease (4.80 ± 0.41) and agreed that the sessions improved their assisting skills (4.93 ± 0.26). All expressed a desire to attend similar sessions in the future and agreed that surgical simulation inclusion into medical school curricula would enhance learning (5.00 ± 0.00). Interest in pursuing a career in CHS increased from 33% (5) to 87% (13) by the end of the course. CONCLUSIONS Integration of preclinical medical students into surgical simulation increases interest in pursuing highly specialised surgical specialities such as CHS. Early exposure and the incorporation of such simulation programs into medical school curricula will likely improve surgical skill acquisition and may enable students to be better informed when selecting future career choices.
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Affiliation(s)
- Nicole Wing Lam Hon
- The Center for Image Guided Innovation and Therapeutic Intervention, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nabil Hussein
- Division of Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Division of Cardiovascular Surgery, Department of Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Osami Honjo
- Division of Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Division of Cardiovascular Surgery, Department of Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Shi-Joon Yoo
- Department of Diagnostic Imaging, Division of Cardiology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
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16
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Huo B, MacNevin W, Smyth M, Miller SG. Medical Student Comfort With Procedural Skills Performance Based on Elective Experience and Career Interest. Cureus 2020; 12:e12374. [PMID: 33527055 PMCID: PMC7842240 DOI: 10.7759/cureus.12374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction Despite increased efforts, studies suggest that exposure to procedural skills in undergraduate medical training is insufficient. As medical students have low self-reported competence in many skills, a significant concern is that medical students are underprepared for a clerkship. Furthermore, pre-clerkship electives selected based on student career interests can provide students with additional skills learning opportunities. The impact of career interest and elective choice on student comfort with procedural skills is unclear. This study examines the relationship between student procedural skills comfort, career interest, and elective choices. Materials and methods An evidence-based questionnaire was synthesized following a literature search using PubMed, Embase, and Google Scholar. Surveys were completed by second-year medical students. A Likert scale was used to evaluate students’ exposure, comfort, and motivation to learn common procedural skills. Descriptive, Pearson’s chi-square and Spearman’s rho correlation coefficient analyses were performed to evaluate the relationship between career interests, elective exposure, and procedural skills. Results Medical students (>60%) reported poor comfort levels for most skills, despite >80% of students displaying high motivation to learn. Elective choice impacted student comfort levels as students who completed electives in anesthesiology were more comfortable with performing intubation (23% vs 10%, p = 0.026) and IV insertion (38% vs 13%, p = 0.002). Those with surgical career interests were less comfortable performing Foley catheter insertion in males (7% vs 5%, p = 0.033) and in females (7% vs 5%, p = 0.008). Conclusions This study supports that medical students feel low levels of comfort with performing procedural skills despite high motivation for learning. Comfort was influenced by both career interest and elective experience. Programs aiming to increase students’ comfort levels in performing procedural skills should adapt curricula toward increasing early exposure to these skills.
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Recruiting trainees to surgery in the United States and Canadian system - What strategies are effective? Am J Surg 2020; 221:410-423. [PMID: 33317811 DOI: 10.1016/j.amjsurg.2020.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 11/05/2020] [Accepted: 12/02/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND There has been increasing concerns regarding the declining number of medical students entering surgical residencies. The aim of this study is to analyze strategies and outcomes to enhance recruitment to the surgical specialties. METHODS A systematic literature PRISMA-based search was performed. Study quality and bias were assessed. Meta-analysis was performed using DerSimonian Laird method. RESULTS Of 3288 unique titles identified, 73 studies met inclusion criteria. Median study unique sample size was 84 participants (range 15-910). Subjective interest was reported in 59 studies, while objective match rate was reported by only 21 studies. The cumulative odds of students interested in the studied specialty was 1.98 (95% CI 1.47-2.67, I2 = 0%) and in any surgical specialty was 1.40 (95% 1.01-1.95, I2 = 37%) after an intervention compared to baseline. CONCLUSION While studies show increased odds of "interested in" a surgical specialty, the results may be subject to high selective and confounding biases.
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Valdez TA, Kudaravalli S, Kavanagh KR. Combined web and haptic simulation system: A pilot study. Int J Pediatr Otorhinolaryngol 2020; 138:110371. [PMID: 33152964 DOI: 10.1016/j.ijporl.2020.110371] [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: 07/25/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Simulation education is increasingly used in otolaryngology training. The objective of this pilot study is to describe a mixed web-based and haptic modular platform for pediatric airway conditions. METHODS A web-based modular case presentation and evaluation system were developed to correspond to a pediatric laryngeal condition represented on the haptic models created using 3D printing and silicone elastomer. The haptic microlaryngoscopy simulation training and web module were evaluated by participants using a Likert scale. The mixed modular apparatus systematized the open web platform and haptic simulator, videos, text, questions, and evaluation to provide a more comprehensive simulation experience. RESULTS Seventeen otolaryngology trainees participated, each completing a post-simulation survey. All participants responded 4 or higher (agree or strongly agree) on the Likert scale that the virtual training and case presentations improved their understanding of the pediatric laryngeal conditions presented. CONCLUSION A modular system constitutes a variety of web-based cases for evaluating, diagnosing, and performing procedures on a haptic surgical simulator taking the physician in training from diagnosis to treatment thereby expanding our current use of haptic simulators in surgical education to include case based learning and decision making.
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Affiliation(s)
- Tulio A Valdez
- Stanford University, 801 Welch Road Palo Alto, CA, 94304, United States.
| | | | - Katherine R Kavanagh
- Connecticut Children's, 282 Washington Street 2L, Hartford, Connecticut, 06119, United States
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Market M, Battaglia F, Langlois E, Shin J, Seabrook C, Brandys T. Using Self-Reported Measures of Confidence and Anxiety to Determine the Efficacy of the Surgical Exploration And Discovery (SEAD) Program in Reducing Anxiety and Increasing Confidence in Performing Procedural Skills. JOURNAL OF SURGICAL EDUCATION 2020; 77:1154-1160. [PMID: 32446770 DOI: 10.1016/j.jsurg.2020.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 02/14/2020] [Accepted: 03/22/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Clerkship students feel increased anxiety and lack of confidence when it comes to surgery. This study assessed whether participation in Surgical Exploration And Discovery (SEAD), a 2-week intensive surgical program that includes career information, simulation workshops, and operating room observerships, would help decrease anxiety, increase confidence, and foster interest in a surgical career. SETTING This study took place at The Ottawa Hospital in Ottawa, Ontario, Canada. DESIGN Thirty first year medical students were randomly selected for the SEAD program and 32 were only given the program's instruction manual during the duration of the program serving as the control. At baseline and after the completion of SEAD, both groups were given a survey containing the State Trait Anxiety Inventory that measures self-reported anxiety levels with an adjunct that gauges confidence and interest in a surgical career. RESULTS Students who participated in the program showed significant improvements in self-perceived knowledge and confidence for each surgical skill: scrubbing (p-value < 0.001, p-value < 0.001), maintaining sterility (p-value < 0.001, p-value < 0.001), and surgical assisting (p-value < 0.001, p-value < 0.001). However, there was no difference in the average state anxiety with procedural skills (p-value = 0.190) between students who participated in SEAD and those who did not. Students who completed SEAD had a notable increase in their interest in pursuing a career in surgery compared with their pretest (p-value = 0.020) and compared with the control group (p-value = 0.600). CONCLUSIONS The SEAD program may increase medical students' confidence and interest in pursuing a surgical career. These results encourage offering medical students with similar opportunities that provide exposure to surgery in preclerkship.
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Affiliation(s)
| | | | | | - John Shin
- University of Ottawa, Ottawa, Ontario, Canada.
| | - Christine Seabrook
- The Ottawa Hospital, Department of Surgery, Division of Vascular Surgery, Ottawa, Ontario, Canada
| | - Tim Brandys
- The Ottawa Hospital, Department of Surgery, Division of Vascular Surgery, Ottawa, Ontario, Canada
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Savage T, Wang JZ, Vo TX, Ko G, Karmali RJ, Siu J, Spano S, You D, Kolar M, Winthrop A, Mann S. A technical skills elective program for pre-clerkship medical students reduces levels of high anxiety for performing technical skills. Am J Surg 2020; 220:90-94. [DOI: 10.1016/j.amjsurg.2019.10.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 10/13/2019] [Indexed: 11/25/2022]
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Kachare SD, Kapsalis C, Yun A, Kachare MD, Davis J, Weeks D, Jhang J, Wilhelmi BJ, Kasdan ML. Students teaching students: A survey of a medical student led surgical skills workshop - A prospective cohort study. Ann Med Surg (Lond) 2020; 56:43-47. [PMID: 32577230 PMCID: PMC7303916 DOI: 10.1016/j.amsu.2020.05.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 12/02/2022] Open
Abstract
Background Surgical skills training is a recognized vital component of medical education, yet a standardized curriculum does not exist. Early opportunities for skills development and mentorship may increase student interest in pursuing surgery. We evaluated the effects of a student-led, faculty-supervised suture clinic on student comfort level with basic surgical skills and interest in surgery. Methods A cohort survey study of 103 second-year medical students participating in a surgical skills course was performed between the years 2016–2018. Upon completion of the course, we assessed their comfort level with performing six basic skills as well as their interest in pursuing surgery based on pre- and post-course surveys. Results Mean age was 25 years and 50.5% were female. Most students (61.2%) had no prior suturing experience. Upon completion of the course, there was a significant improvement (p = < 0.0001) in comfort level for each of the six skills. Most students (81%) reported an increased interest in surgery. Conclusions Early implementation of a basic skills workshop can augment student comfort level and promote an interest in surgery. Peer student mentors can effectively lead the workshop and minimize the time commitment needed by surgical faculty. This can serve as a new direction in medical education and an avenue for further studies to analyze the longitudinal effects of the curriculum on career choice and success in surgical residency. Learning suture skills early in medical school leads to future operative confidence. Early suture skills teaching can significantly increase skill level among junior medical students. Suture clinics can provide students opportunities for mentorship and encourage interest in pursuing surgical specialties. Medical Students appropriately trained can lead a suture clinic, minimizing demand on faculty support.
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Affiliation(s)
- Swapnil D Kachare
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, KY, United States
| | - Christina Kapsalis
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC, United States
| | - Angelica Yun
- University of Louisville School of Medicine, Louisville, KY, United States
| | - Milind D Kachare
- Department of Surgery, Robert Wood Johnson Medical School, New Brunswick, NJ, Canada
| | - Jared Davis
- Division of Plastic and Reconstructive Surgery, Department of Surgery, The University of Mississippi, Jackson, MS, United States
| | - Dexter Weeks
- Division of Plastic and Reconstructive Surgery, Department of Surgery, The University of Texas Medical Branch, Galveston, TX, United States
| | - Joyce Jhang
- Department of Surgery, East Carolina University, Greenville, NC, United States
| | - Bradon J Wilhelmi
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, KY, United States
| | - Morton L Kasdan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, KY, United States
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Lee KS, Priest S, Wellington JJ, Owoso T, Osei Atiemo L, Mardanpour A, Craft Z, Blencowe N, Hinchliffe RJ. Surgical Skills Day: Bridging the Gap. Cureus 2020; 12:e8131. [PMID: 32550051 PMCID: PMC7294894 DOI: 10.7759/cureus.8131] [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] [Indexed: 11/23/2022] Open
Abstract
Background The General Medical Council (GMC) requires all newly qualified doctors to be competent in certain surgical skills, including the provision of basic wound closure. Yet there is a profound lack of undergraduate competence in, and exposure to, basic surgical skills such as wound closure. The Surgical Skills Day (SSD) aimed to provide medical students with additional skills training. Methods Student self-assessment and instructors’ assessment forms were completed prior to and following a workshop on basic wound closure skills. Paired t-tests was used to statistically compare the two pre and post-instruction data sets. Results A total of 46 students attended the SSD; 29 consented to the skills assessment. 100% (n = 29) self-reported improved competency in at least one of the skills following tuition (p < 0.001). Instructors’ assessment agreed that 100% (n = 29) of students improved in at least one of the skills assessed (p < 0.001). 100% of the attendees agreed that additional practical surgical skills should be incorporated into the undergraduate curriculum. 64% (n = 21) of students also confirmed that they were more likely to pursue a career in surgery following the SSD. Conclusion Current clinical teaching in basic suturing is unsuitable for long term retention. SSDs can improve skills acquisition and elevate student confidence. This data builds on our previous work by documenting the high efficacy in skills acquisition as a result of SSD tuition. We recommend that SSDs be integrated into medical school curricula in order to address shortcomings in current undergraduate programmes.
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Affiliation(s)
- Keng Siang Lee
- Medicine, Bristol Medical School, University of Bristol, Bristol, GBR
| | - Sebastian Priest
- Medicine, Bristol Medical School, University of Bristol, Bristol, GBR
| | | | - Toluwaniyin Owoso
- Medicine, Bristol Medical School, University of Bristol, Bristol, GBR
| | - Leyln Osei Atiemo
- Medicine, Bristol Medical School, University of Bristol, Bristol, GBR
| | - Ameen Mardanpour
- Medicine, Bristol Medical School, University of Bristol, Bristol, GBR
| | - Zachary Craft
- Medicine, Bristol Medical School, University of Bristol, Bristol, GBR
| | - Natalie Blencowe
- Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, GBR
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Vaidya A, Aydin A, Ridgley J, Raison N, Dasgupta P, Ahmed K. Current Status of Technical Skills Assessment Tools in Surgery: A Systematic Review. J Surg Res 2020; 246:342-378. [DOI: 10.1016/j.jss.2019.09.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 08/29/2019] [Accepted: 09/11/2019] [Indexed: 12/18/2022]
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Head LK, Greene B, Gawad N, Hamstra SJ, Brandys T. Harvesting the 'SEAD': Long-Term Follow-Up of the Surgical Exploration and Discovery Program. JOURNAL OF SURGICAL EDUCATION 2020; 77:96-103. [PMID: 31439433 DOI: 10.1016/j.jsurg.2019.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 06/09/2019] [Accepted: 07/17/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The Surgical Exploration and Discovery (SEAD) program was established to facilitate career decision-making by providing preclerkship students with comprehensive exposure to surgical specialties. Our short-term findings demonstrated that, compared to a control group, SEAD participants showed significantly greater career-related learning. The purpose of this study was to understand the long-term impact of the SEAD program. DESIGN This was a prospective cohort study. One group of students participated in a 2-week surgical curriculum (SEAD group) while another group read only the program manual (Manual group). Students were surveyed following their residency selection 3 years later. The outcome measures were final specialty preference (medical or surgical), program utility, and program satisfaction. SETTING Undergraduate Medical Education, Faculty of Medicine, at the University of Ottawa in Ottawa, Ontario, Canada. PARTICIPANTS A total of 18 medical students in the SEAD group, and 18 in the Manual group. RESULTS Survey response rate was 100%. There was no significant difference in the number of students who pursued surgical careers in the SEAD and Manual groups. All students who pursued a surgical residency were 'very interested' in surgery prior to SEAD-initial interest in surgery had a significant influence on final residency preference. Ninety-four percent (n = 17) of SEAD participants described the SEAD program as valuable to facilitating their career decision-making. CONCLUSIONS Although SEAD does not generate sustained new interest in surgical disciplines, graduating students believe the program is valuable in facilitating career decision-making and perceive the program as a worthwhile time investment. These findings were true for students who selected both surgical and medical specialties, suggesting that early, multifaceted, exposure to surgery is a valuable addition to career exploration even for students who ultimately don't pursue surgical specialties. Going forward, integrating a longitudinal mentorship program may further improve the value of SEAD.
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Affiliation(s)
- Linden K Head
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada; Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
| | - Brittany Greene
- Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Department of Surgery, University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada
| | - Nada Gawad
- Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Department of Surgery, University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada
| | - Stanley J Hamstra
- Accreditation Council for Graduate Medical Education, Chicago, Illinois; Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Tim Brandys
- Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Skills and Simulation Centre (uOSSC), Faculty of Medicine, Ottawa, Ontario, Canada
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Sparks D, Kavanagh KR, Vargas JA, Valdez TA. 3D printed myringotomy and tube simulation as an introduction to otolaryngology for medical students. Int J Pediatr Otorhinolaryngol 2020; 128:109730. [PMID: 31634651 DOI: 10.1016/j.ijporl.2019.109730] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 10/12/2019] [Accepted: 10/12/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Surgical simulation models have been shown to improve surgical skill and confidence for surgical residents before real life procedures. Surgical simulators can be similarly applied in undergraduate medical education as a tool to introduce students to the field of otolaryngology. METHODS Ear models were created using 3D printing and high-performance silicone. Twenty medical students participated in a slide presentation and a myringotomy tube simulation station, each completing a pre- and post-survey using a 5-point Likert scale. RESULTS A previously validated 3D myringotomy simulator was used. Twenty medical student volunteers participated in the simulation including 14 first-year and 6 s-year medical students. None of the participating students reported observing myringotomy and placement of tympanostomy tubes before the session. Medical student participants rated their knowledge of the steps of the procedure and where to insert the tympanostomy tube at 2 (2 = disagree) or below with a mean of 1.35 SD = 0.47 and 1.2 SD = 0.41 respectively. At the completion of the educational session, the medical students rated their knowledge of the steps of the procedure as significantly improved at 4.45 SD = 0.6 (p = 0.00001). DISCUSSION We found that medical students with no prior exposure to ear anatomy or surgical training were able to use the simulator as an introduction to the specialty. There was a perceived improvement in their medical knowledge and basics of a procedural skill. CONCLUSION Medical schools can provide an inexpensive, safe, procedural practice tool using 3D printing as an introduction for students interested in surgical procedures.
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Affiliation(s)
- Devika Sparks
- University of Connecticut Health Center, Farmington, CT, USA
| | | | | | - Tulio A Valdez
- Stanford University Department of Otolaryngology, Palo Alto, CA, USA.
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Hudson A, Mclaughlin R, Miller S, Holland J, Blake K. Canadian medical schools' preclerkship paediatric clinical skills curricula: How can we improve? Paediatr Child Health 2019; 25:505-510. [PMID: 33354259 DOI: 10.1093/pch/pxz106] [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: 09/11/2018] [Accepted: 01/08/2019] [Indexed: 11/13/2022] Open
Abstract
Background Little is known about how Canadian medical schools teach paediatric clinical skills (history and physical exam) to preclerkship students, or its cost to the institutions. Methods Clinical skills program directors from all 17 Canadian medical schools were contacted to complete a questionnaire focused on teaching methods, and barriers/strengths of their Preclerkship Paediatric Clinical Skills program. Results Seventeen schools (100% response rate) participated. Seven schools (41%) do not introduce paediatric clinical skills until the second year of medicine. Half of the schools (53%) dedicate <10 total hours to preclerkship paediatric clinical skills. Fifty-nine per cent have ≤6 total hours of hands-on paediatric patient interaction (real or simulated). Medical students were least likely to be exposed to the infant age group (age 1 to 24 months). Twelve schools (71%) used simulated parent/child dyads. The most significant barriers identified by programs were limited time for sessions and patient availability. We describe one sample medical school's simulated parent/paediatric patient program where every student has hands-on learning with paediatric patients of all ages (program cost $938/student). Discussion This study is the first to summarize Canadian preclerkship paediatric clinical skills programs, among which there is great variability and commonly experienced barriers. Many students are not being exposed to all age groups of paediatric patients before their clerkship years. Medical schools can use this information to strengthen this important and challenging aspect of the curriculum, while being mindful of its fiscal implications.
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Affiliation(s)
- Alexandra Hudson
- Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Robyn Mclaughlin
- Department of Pediatrics, IWK Health Centre, Halifax, Nova Scotia.,Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia
| | - Stephen Miller
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia.,Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia
| | - Joanna Holland
- Department of Pediatrics, IWK Health Centre, Halifax, Nova Scotia.,Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia
| | - Kim Blake
- Department of Pediatrics, IWK Health Centre, Halifax, Nova Scotia.,Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia
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Nakazato T, Callahan Z, Kuchta K, Linn JG, Joehl RJ, Ujiki MB. A 1-day simulation-based boot camp for incoming general surgery residents improves confidence and technical skills. Surgery 2019; 166:572-579. [DOI: 10.1016/j.surg.2019.05.051] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/19/2019] [Accepted: 05/19/2019] [Indexed: 10/26/2022]
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Hakim MA, Dominguez ED, Priest S, Lee KS, Mardanpour A, Tandle S, Al-Khalil M, Slade G, Gujral S. Surgical Skills Workshops Should Be a Part of the United Kingdom Undergraduate Medical Curriculum. Cureus 2019; 11:e4642. [PMID: 31312568 PMCID: PMC6624155 DOI: 10.7759/cureus.4642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction: Medical students across the United Kingdom (UK) report poor satisfaction with surgical teaching. The Surgical Skills Day (SSD) begins to address this by exposing medical students to surgery through an easily accessible one-day practical workshop. This study shows how the SSD encourages undergraduate engagement in surgery. Method: Feedback forms were emailed to attendees of the SSD and their anonymised responses were used to evaluate the SSD. Results: A total of 144 students attended the SSD across three years and the feedback response rate was 74% (n = 107). Key findings were that 100% of respondents (n = 107) would like the SSD to be an annual event, 79% (n = 83) were more inclined to pursue a surgical career following the event, and 97% (n = 103) would like to see practical surgical skills incorporated into the curriculum. The SSD was able to engage undergraduates with surgery through mentorship, practical skills, specialty exposure, and teaching of the General Medical Council (GMC) mandated skills. Conclusions: Undergraduate surgical teaching in the UK is insufficient. The student-led annual SSD showed improved engagement in practical surgical skills and increased enthusiasm for a surgical career. In light of this, the authors feel the SSD or similar event should be integrated into the UK medical school curriculum.
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Affiliation(s)
- Muhammad A Hakim
- Health Sciences, University of Bristol Medical School, Bristol, GBR
| | | | - Sebastian Priest
- Health Sciences, University of Bristol Medical School, Bristol, GBR
| | - Keng Siang Lee
- Health Sciences, University of Bristol Medical School, Bristol, GBR
| | - Ameen Mardanpour
- Health Sciences, University of Bristol Medical School, Bristol, GBR
| | - Sankalp Tandle
- Health Sciences, University of Bristol Medical School, Bristol, GBR
| | - Majid Al-Khalil
- Health Sciences, University of Bristol Medical School, Bristol, GBR
| | - George Slade
- Health Sciences, University of Bristol Medical School, Bristol, GBR
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Lerner V, Higgins EE, Winkel A. Re-boot: Simulation Elective for Medical Students as Preparation Bootcamp for Obstetrics and Gynecology Residency. Cureus 2018; 10:e2811. [PMID: 30116684 PMCID: PMC6092190 DOI: 10.7759/cureus.2811] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 06/14/2018] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To evaluate the impact of a simulation-based elective on medical student preparedness for obstetrics and gynecology (OB/GYN) residency. METHODS A two-week, simulation-based elective course for post-clerkship medical students was developed, and 10 students participated at a single academic institution in 2016 and 2017. Using standardized patients and team-based training, students practiced procedural and surgical skills, as well as the diagnosis, management, and work-up of commonly seen problems. Close coaching with a low student-faculty ratio was employed for each session, allowing for individualized feedback in real time. Prior to and after completing the elective, student knowledge was evaluated using the Preparation for Residency Knowledge Assessment tool (PrepForRes). Written course evaluations were also completed by students at the end of the course. RESULTS Mean scores on the PrepForRes exam increased from 63.6% to 75.3% (p=0.0136). Notably, the average post-course score improved to a passing level, and all but one student achieved a passing score on the post-course test. Course evaluations and student feedback showed high satisfaction rates with the course. CONCLUSIONS This study demonstrates that a simulation-based elective course is an effective tool for helping medical students transition to OB/GYN residency. As medical schools work to facilitate the transition from undergraduate to graduate medical education, simulation can bridge gaps during this transition in order for students to meet entry-level residency requirements.
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