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Martini ML, Shrivastava RK, Kellner CP, Morgenstern PF. Evaluation of a Role for Virtual Neurosurgical Education for Medical Students Over 2 Years of a Global Pandemic. World Neurosurg 2022; 166:e253-e262. [PMID: 35803566 DOI: 10.1016/j.wneu.2022.06.146] [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: 03/24/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Subinternships are critical experiences for medical students applying into neurosurgery to acquire knowledge of the field and network with colleagues. During the coronavirus disease 2019 pandemic, in-person rotations were suspended for 2020 and reduced for 2021. In 2020, our department developed a neurosurgical course to address this need. The course was continued in 2021, enabling assessment of student perceptions as the pandemic progresses. METHODS The virtual course consisted of weekly 1-hour seminars over a 3- to 4-month period. Prior to starting, participants were sent a comprehensive survey assessing their backgrounds, experiences, and confidences in core concepts across neurosurgical subdisciplines. Participants also completed postcourse surveys assessing the course's value and their confidence in the same topics. Responses from students completing both precourse and postcourse surveys were included, analyzed in pairwise fashion, and compared across course years. RESULTS Students shared similar baseline characteristics in terms of demographics, educational background, and exposure to neurosurgery prior to the course. In the 2020 and 2021 cohorts, quality ratings for presentations were favorable for all seminars, and participants reported significantly increased confidence in core topics across all neurosurgical disciplines after the course (2020: 3.36 ± 0.26, P < 0.0001; 2021: 3.56 ± 0.93, P = 0.005). Most participants felt the course would remain useful following the pandemic in both the 2020 (96.9%) and 2021 (100.0%) cohorts. CONCLUSIONS Survey results suggest that the course adds value for students seeking a basic didactic curriculum to supplement their education, and perhaps, an online curriculum for medical students would still be beneficial going forward as in-person rotations resume.
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Affiliation(s)
- Michael L Martini
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Raj K Shrivastava
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Christopher P Kellner
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Peter F Morgenstern
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York.
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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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Walker KG, Shah AP, Brennan PM, Blackhall VI, Nicol LG, Yalamarthi S, Vella M, Cleland J. Scotland's "Incentivised Laparoscopy Practice" programme: Engaging trainees with take-home laparoscopy simulation. Surgeon 2022; 21:190-197. [PMID: 35739002 DOI: 10.1016/j.surge.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The transfer validity of portable laparoscopy simulation is well established. However, attempts to integrate take-home simulation into surgical training have met with inconsistent engagement worldwide, as for example in our 2014-15 study of an Incentivised Laparoscopy Practice programme (ILPv1). Drawing on learning from our subsequent multi-centre study examining barriers and facilitators, we revised the programme for 2018 onwards. We now report on engagement with the 2018-2022 versions of this home-based simulation programme (ILP v2.1-2.3). METHODS In ILP v2.1-2.3, three consecutive year-groups of new-start Core Surgical Trainees (n = 48, 46 and 53) were loaned portable simulators. The 6-month education programme included induction, technical support, and intermittent feedback. Six tasks were prescribed, with video instruction and charting of metric scores. Video uploads were required and scored by faculty. A pass resulted in an eCertificate, expected at Annual Review (but not mandatory for progression). ILP was set within a wider reform, "Improving Surgical Training". RESULTS ILP v2.1-2.3 saw pass rates of 94%, 76% and 70% respectively (45/48, 35/46 and 37/53 trainees), compared with only 26% (7/27) in ILP v1, despite now including some trainees not intending careers in laparoscopic specialties. The ILP v2.2 group all reported their engagement with the whole simulation strategy was hampered by the COVID19 pandemic. CONCLUSIONS Simply providing take-home simulators, no matter how good, is not enough. To achieve trainee engagement, a whole programme is required, with motivated learners, individual and group practice, intermittent feedback, and clear goals and assessments. ILP is a complex intervention, best understood as a "reform within a reform, within a context."
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Affiliation(s)
- Kenneth G Walker
- Scottish Surgical Simulation Collaborative, Royal College of Surgeons of Edinburgh and Royal College of Physicians and Surgeons of Glasgow, Scotland, UK; NHS Education for Scotland, Edinburgh, Scotland, UK; Raigmore Hospital (NHS Highland) and Centre for Health Science, Inverness, Scotland, UK.
| | - Adarsh P Shah
- Scottish Surgical Simulation Collaborative, Royal College of Surgeons of Edinburgh and Royal College of Physicians and Surgeons of Glasgow, Scotland, UK; Centre for Healthcare Education Research and Innovation, University of Aberdeen, Scotland, UK
| | - Paul M Brennan
- Centre for Clinical Brain Sciences, University of Edinburgh, Scotland, UK
| | - Vivienne I Blackhall
- Scottish Surgical Simulation Collaborative, Royal College of Surgeons of Edinburgh and Royal College of Physicians and Surgeons of Glasgow, Scotland, UK; Centre for Healthcare Education Research and Innovation, University of Aberdeen, Scotland, UK; Queen Elizabeth University Hospital (NHS Greater Glasgow & Clyde), Glasgow, Scotland, UK
| | - Laura G Nicol
- Scottish Surgical Simulation Collaborative, Royal College of Surgeons of Edinburgh and Royal College of Physicians and Surgeons of Glasgow, Scotland, UK; Dr Gray's Hospital Elgin (NHS Grampian), Scotland, UK
| | - Satheesh Yalamarthi
- Scottish Surgical Simulation Collaborative, Royal College of Surgeons of Edinburgh and Royal College of Physicians and Surgeons of Glasgow, Scotland, UK; NHS Education for Scotland, Edinburgh, Scotland, UK; Victoria Hospital (NHS Fife), Kirkaldy, Scotland, UK
| | - Mark Vella
- Scottish Surgical Simulation Collaborative, Royal College of Surgeons of Edinburgh and Royal College of Physicians and Surgeons of Glasgow, Scotland, UK; NHS Education for Scotland, Edinburgh, Scotland, UK; Royal Alexandra Hospital (NHS Greater Glasgow & Clyde), Paisley, Scotland, UK
| | - Jennifer Cleland
- Scottish Surgical Simulation Collaborative, Royal College of Surgeons of Edinburgh and Royal College of Physicians and Surgeons of Glasgow, Scotland, UK; Centre for Healthcare Education Research and Innovation, University of Aberdeen, Scotland, UK; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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Bedada AG, Hsiao M, Chilisa U, Yarranton B, Chinyepi N, Azzie G. Surgical Simulation Training for Medical Students: Strategies and Implications in Botswana. World J Surg 2022; 46:1637-1642. [PMID: 35347389 DOI: 10.1007/s00268-022-06529-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The role of simulation in teaching technical skills to medical students is not yet well defined. Strategies for its use may be especially relevant where teachers, time, and resources are limited, especially in low-middle-income countries. METHODS Sixty-seven third-year and 67 fifth-year medical students at the University of Botswana were taught surgical skills by a trained peer medical student, a medical officer with no specialty training or a staff surgeon. Pre- and post-intervention performance of two basic tasks (simple interrupted suture (SIS) and laparoscopic peg transfer (LPT)) and one complex task (laparoscopic intracorporeal suture (LIS)) were assessed. Subjective measures of self-perceived performance, preparedness for internship, and interest in surgery were also measured. RESULTS The simulation program decreased the time to complete the two basic tasks and improved the objective score for the complex task. Performance of the basic skills improved regardless of the seniority of the instructor while performance of the advanced skill improved more when taught by a staff surgeon. All students had similar improvements in their self-reported confidence to perform the skills, preparedness to assist in an operation and preparedness for internship, regardless of the seniority of their instructor. Students taught by a staff surgeon felt better prepared to assist in laparoscopic procedures. CONCLUSION Simulation-based teaching of defined surgical skills can be effectively conducted by peers and near-peers. The implications are widespread and may be most relevant where time and resources are limited, and where experienced teachers are scarce.
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Affiliation(s)
- Alemayehu Ginbo Bedada
- Department of Surgery, Faculty of Medicine, University of Botswana, Corner of Notwane and Mobuto Road, Pvt Bag UB, 00713, Gaborone, Botswana. .,Princess Marina Hospital, Gaborone, Botswana.
| | - Marvin Hsiao
- Division of General Surgery, Royal Columbian Hospital, Vancouver, BC, Canada
| | - Unami Chilisa
- Department of Surgery, Faculty of Medicine, University of Botswana, Corner of Notwane and Mobuto Road, Pvt Bag UB, 00713, Gaborone, Botswana.,Princess Marina Hospital, Gaborone, Botswana
| | - Brianne Yarranton
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nkhabe Chinyepi
- Department of Surgery, Faculty of Medicine, University of Botswana, Corner of Notwane and Mobuto Road, Pvt Bag UB, 00713, Gaborone, Botswana.,Princess Marina Hospital, Gaborone, Botswana
| | - Georges Azzie
- Division of General and Thoracic Surgery, Hospital for Sick Children, Toronto, Canada
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