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Papavasiliou T, Batten G, Bloom O, Chan JCY, Bain CJ, Uppal L. Utilising 3D-printed ex vivo biomimetics to improve open reduction and internal fixation (ORIF) simulation training for hand fractures. EUROPEAN JOURNAL OF PLASTIC SURGERY 2023; 46:1-7. [PMID: 37363690 PMCID: PMC10116095 DOI: 10.1007/s00238-023-02062-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/09/2023] [Indexed: 06/28/2023]
Abstract
Background Surgery for hand trauma accounts for a significant proportion of the plastic surgery training curriculum. The aim of this article is to create a standardised simulation training module for hand fracture fixation on open reduction and internal fixation (ORIF) techniques for residents in order to create a standardised hand-training framework that universally hones their skill and prepares them for their first encounter in a clinical setting. Methods A step-ladder approach training using three-dimensional (3D)-printed ex vivo hand biomimetics was employed on a cohort of 15 plastic surgery residents (n = 15). Assessment of skills using a score system (global rating scale) was performed in the beginning and the end of the module by hand experts in our unit. Results The overall average score of the cohort pre- and post-assessment were 22.08/50 (44.16%) and 41.54/50 (83.08%) respectively. Significant (p < 0.01) difference of improvement of skills was noted on all trainees. All trainees confirmed that the simulated models provided in this module were akin to the patient scenario and noted that it helped them improve their skills with regards to ORIF techniques including improvement of their understanding of the 3D bone topography. Conclusion We demonstrate a standardised simulation training framework that employs 3D-printed ex vivo hand biomimetics proven to improve the skills of residents and which paves the way to more universal, standardised and validated training across hand surgery. This is, to our knowledge, the first standardised method of simulated training on such hand-surgical cases.Level of Evidence: Not ratable.
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Affiliation(s)
- Theodora Papavasiliou
- Department of Plastic Surgery, Guy’s and St Thomas’ Hospitals, Westminster Bridge Rd, Lambeth, London, SE1 7EH UK
| | - Gemma Batten
- Department of Plastic Surgery, Guy’s and St Thomas’ Hospitals, Westminster Bridge Rd, Lambeth, London, SE1 7EH UK
| | - Oliver Bloom
- Department of Plastic Surgery, Guy’s and St Thomas’ Hospitals, Westminster Bridge Rd, Lambeth, London, SE1 7EH UK
| | - Jeffrey C. Y. Chan
- Department of Plastic Surgery, Guy’s and St Thomas’ Hospitals, Westminster Bridge Rd, Lambeth, London, SE1 7EH UK
| | - Charles J. Bain
- Department of Plastic Surgery, Guy’s and St Thomas’ Hospitals, Westminster Bridge Rd, Lambeth, London, SE1 7EH UK
| | - Lauren Uppal
- Department of Plastic Surgery, Guy’s and St Thomas’ Hospitals, Westminster Bridge Rd, Lambeth, London, SE1 7EH UK
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Sideris M, Nicolaides M, Jagiello J, Rallis KS, Emin E, Theodorou E, Hanrahan JG, Mallick R, Odejinmi F, Lymperopoulos N, Papalois A, Tsoulfas G. In vivo Simulation-Based Learning for Undergraduate Medical Students: Teaching and Assessment. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:995-1002. [PMID: 34512069 PMCID: PMC8416184 DOI: 10.2147/amep.s272185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 07/20/2021] [Indexed: 02/05/2023]
Abstract
An increasing emphasis on simulation has become evident in the last three decades following fundamental shifts in the medical profession. Simulation-based learning (SBL) is a wide term that encompasses several means for imitating a skill, attitude, or procedure to train personnel in a safe and adaptive environment. A classic example has been the use of live animal tissue, named in vivo SBL. We aimed to review all published evidence on in vivo SBL for undergraduate medical students; this includes both teaching concepts as well as focused assessment of students on those concepts. We performed a systematic review of published evidence on MEDLINE. We also incorporated evidence from a series of systematic reviews (eviCORE) focused on undergraduate education which have been outputs from our dedicated research network (eMERG). In vivo SBL has been shown to be valuable at undergraduate level and should be considered as a potential educational tool. Strict adherence to 3R (Reduce, Refine, Replace) principles in order to reduce animal tissue usage, should always be the basis of any curriculum. In vivo SBL could potentially grant an extra mile towards medical students' inspiration and aspiration to become safe surgeons; however, it should be optimised and supported by a well-designed curriculum which enhances learning via multi-level fidelity SBL.
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Affiliation(s)
- Michail Sideris
- Women’s Health Research Unit, Queen Mary University of London, London, UK
| | - Marios Nicolaides
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Kathrine S Rallis
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Elif Emin
- Women’s Health Research Unit, Queen Mary University of London, London, UK
| | - Efthymia Theodorou
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Rebecca Mallick
- Princess Royal Hospital, Brighton and Sussex University Hospitals NHS Trust, Haywards Heath, UK
| | - Funlayo Odejinmi
- Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
| | | | - Apostolos Papalois
- Special Unit for Biomedical Research and Education, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Tsoulfas
- Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
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3
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Sideris M, Nicolaides M, Theodoulou I, Emin EI, Hanrahan JG, Dedeilia A, Theodorou E, Paparoidamis G, Abdullah Z, Papoutsos C, Pittaras T, Odejinmi F, Papalois A. Student Views on a Novel Holistic Surgical Education Curriculum (iG4): A Multi-national Survey in a Changing Landscape. In Vivo 2021; 34:1063-1069. [PMID: 32354893 DOI: 10.21873/invivo.11876] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 11/10/2022]
Abstract
AIM Essential Skills in the Management of Surgical Cases (ESMSC Marathon Course™) Integrated Generation 4 (iG4) is the first reported multifaceted undergraduate surgical course aiming to provide holistic surgical teaching. In this prospective observational study, we explored students' views on the iG4 curriculum, and identified how it can potentially address modern challenges in surgical training. MATERIAL AND METHODS Medical students were invited to apply to the course online and were screened against pre-defined criteria. A multi-national structured questionnaire incorporating five domains related to the course curriculum and our dedicated research network, was designed and distributed to participants after successful completion of the course. RESULTS Forty-one students from European and Asian medical schools completed the course and filled in the survey. The median overall evaluation score of the course was 4.73 out of 5 (interquartile range=4.21-4.72) and all students found that iG4 served the vision of holistic surgical education. ESMSC had a positive motivational effect towards following a career in surgery (p=0.012) and 92.7% of students declared that it should be an essential part of a future medical school curriculum. There was no statistically significant difference (p>0.05) in results between participants of different countries of study, year of studies or age group. CONCLUSION The ESMSC Marathon Course™ is perceived as a unique course model, with an established educational value and a positive motivational effect towards surgery. It might potentially be implemented in future medical school curricula as an essential element of undergraduate surgical education. The iG4 curriculum has opened a new exciting horizon of opportunities for advancing undergraduate holistic surgical education.
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Affiliation(s)
- Michail Sideris
- Women's Health Research Unit, Queen Mary University of London, London, U.K.
| | - Marios Nicolaides
- Barts Cancer Institute, Queen Mary University of London, London, U.K
| | - Iakovos Theodoulou
- Faculty of Life Sciences and Medicine, King's College London, London, U.K
| | - Elif Iliria Emin
- Faculty of Life Sciences and Medicine, King's College London, London, U.K
| | | | - Aikaterini Dedeilia
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Efthymia Theodorou
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
| | | | - Ziena Abdullah
- Barking, Havering and Redbridge Hospitals NHS Trust, London, U.K
| | - Constantinos Papoutsos
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
| | - Theodoros Pittaras
- Hematology Laboratory-Blood Bank, Aretaieion Hospital, University of Athens School of Medicine, Athens, Greece
| | | | - Apostolos Papalois
- Experimental, Educational and Research Centre ELPEN, Athens, Greece.,School of Medicine, European University of Cyprus, Nicosia, Cyprus
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4
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Hanrahan J, Sideris M, Pasha T, Tsitsopoulos PP, Theodoulou I, Nicolaides M, Georgopoulou EM, Kombogiorgas D, Bimpis A, Papalois A. Hands train the brain-what is the role of hand tremor and anxiety in undergraduate microsurgical skills? Acta Neurochir (Wien) 2018; 160:1673-1679. [PMID: 29968093 PMCID: PMC6105223 DOI: 10.1007/s00701-018-3609-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 06/25/2018] [Indexed: 01/28/2023]
Abstract
Introduction Physiological hand tremor occurs naturally, due to oscillations of the upper extremities. Tremor can be exacerbated by stress and anxiety, interfering with fine motor tasks and potentially impact on surgical performance, particularly in microsurgery. We investigated the link between tremor, anxiety and performance in a neurosurgical module as part of an international surgical course. Methods Essential Skills in the Management of Surgical Cases (ESMSC) course recruits medical students from European Union (EU) medical schools. Students are asked to suture the dura mater in an ex vivo swine model, of which the first suture completed was assessed. Questionnaires were distributed before and after the module, eliciting tremor risk factors, self-perception of tremor and anxiety. Johnson O’Connor dexterity pad was used to objectively measure dexterity. Direct Observation of Procedural Skills (DOPS) was used to assess skills-based performance. Anxiety was assessed using the Westside Test Anxiety Scale (WTAS). Tremor was evaluated by four qualified neurosurgeons. Results Forty delegates participated in the study. Overall performance decreased with greater subjective perception of anxiety (p = 0.032, rho = − 0.392). Although increasing scores for tremor at rest and overall WTAS score were associated with decreased performance, this was not statistically significant (p > 0.05). Tremor at rest did not affect dexterity (p = 0.876, rho = − 0.027). Conclusions Physiological tremor did not affect student performance and microsurgical dexterity in a simulation-based environment. Self-perception of anxiety affected performance in this module, suggesting that more confident students perform better in a simulated neurosurgical setting.
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Affiliation(s)
- John Hanrahan
- Faculty of Life Sciences and Medicine, King's College London, Strand, London, WC2R 2LS, UK.
| | - Michail Sideris
- Women's Health Research Unit, Queen Mary University of London, Mile End Rd, London, E1 4NS, UK
| | - Terouz Pasha
- Faculty of Life Sciences and Medicine, King's College London, Strand, London, WC2R 2LS, UK
| | - Parmenion P Tsitsopoulos
- Section of Neurosurgery, Department of Neuroscience, Uppsala University, 752 36, Uppsala, Sweden
| | - Iakovos Theodoulou
- Faculty of Life Sciences and Medicine, King's College London, Strand, London, WC2R 2LS, UK
| | - Marios Nicolaides
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Mile End Rd, London, E1 4NS, UK
| | | | | | - Alexios Bimpis
- Department of Neurosurgery, General Hospital of Tripoli, Erythrou Stavrou str., 22100, Tripoli, Greece
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Hanrahan J, Sideris M, Tsitsopoulos PP, Bimpis A, Pasha T, Whitfield PC, Papalois AE. Increasing motivation and engagement in neurosurgery for medical students through practical simulation-based learning. Ann Med Surg (Lond) 2018; 34:75-79. [PMID: 30271592 PMCID: PMC6160393 DOI: 10.1016/j.amsu.2018.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 07/03/2018] [Accepted: 08/12/2018] [Indexed: 11/02/2022] Open
Abstract
Background Simulation-based learning (SBL) is an essential adjunct to modern surgical education. Our study aimed to evaluate the educational benefit and motivational impact of a pilot practical neurosurgical module. Materials and methods 38 clinical medical students from several EU Medical Schools attended an international surgical course focused on teaching and learning basic surgical skills. We designed a pilot neurosurgical workshop instructing students to insert an intracranial pressure bolt using an ex vivo pig model. Each delegate was assessed by two consultant neurosurgeons using a validated assessment tool. Structured questionnaires were distributed on completion of the module. Results Delegate performance increased (p < 0.001) with no difference in performance improvement across year of study (p = 0.676) or medical school (p = 0.647). All delegates perceived this workshop as a potential addition to their education (median 5/5, IQR = 0), and indicated that the course provided motivational value towards a neurosurgical career (median 4/5, IQR = 1), with no difference seen between year of study or medical school (p > 0.05). Conclusion Our pilot neurosurgical workshop demonstrated the educational value of practical SBL learning for motivating students towards a surgical career. Homogeneous views across year of study and medical school underline the value of developing a unified strategy to develop and standardise undergraduate surgical teaching with a practical focus.
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Affiliation(s)
- John Hanrahan
- Faculty of Life Sciences and Medicine, King's College London, Great Maze Pond, London, SE1 9RT, United Kingdom
| | - Michail Sideris
- Women's Health Research Unit, Queen Mary University of London, United Kingdom, Mile End Rd, London, E1 4NS, United Kingdom
| | - Parmenion P Tsitsopoulos
- Section of Neurosurgery, Department of Neuroscience, Uppsala University, Sweden, 751 05, Uppsala, Sweden
| | - Alexios Bimpis
- Department of Neurosurgery, General Hospital of Tripoli, Greece, Erythrou Stavrou Odos, Tripoli, 22100, Greece
| | - Terouz Pasha
- Faculty of Life Sciences and Medicine, King's College London, Great Maze Pond, London, SE1 9RT, United Kingdom
| | - Peter C Whitfield
- Southwest Neurosurgical Centre, Plymouth Hospitals NHS Trust, Plymouth, PL6 8DH, UK
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6
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Sideris M, Hanrahan J, Staikoglou N, Pantelidis P, Pidgeon C, Psychalakis N, Andersen N, Pittaras T, Athanasiou T, Tsoulfas G, Papalois A. Optimizing engagement of undergraduate students in medical education research: The eMERG training network. Ann Med Surg (Lond) 2018; 31:6-10. [PMID: 29922460 PMCID: PMC6004769 DOI: 10.1016/j.amsu.2018.05.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 05/16/2018] [Accepted: 05/23/2018] [Indexed: 02/08/2023] Open
Abstract
Background The practice of evidence-based medicine and critical appraisal are essential for the modern doctor. Early engagement of medical students in research methodology is considered as a rising need for most medical school curricula; however, few peer-reviewed initiatives have been reported so far. We developed a Medical Education Research Group (eMERG) as part of a novel undergraduate surgical masterclass, which aimed to train undergraduate students on basic research methodology, as well as to motivate them to pursue a clinical and academic career in surgical specialties. Methods: eMERG consists of an international structured network of senior academics, consultant-level clinicians, senior and junior trainees who support undergraduate trainees. Students are selected from a competitive pool of applicants. Several small prospective studies in skills-based education, as well as systematic reviews on similar topics, have run under the umbrella of this framework, in the form of scholarship awards. Structured feedback questionnaires were distributed to evaluate the experience of the first three years. Results 12 students have participated in this pilot initiative. 11 manuscripts have been submitted for publication and 8 were accepted following peer-review in MEDLINE-indexed journals. Delegates perceived this experience as an excellent training opportunity which improved their research productivity. Delegates also stated engagement in research developed interest in the relevant surgical speciality, impacting their career aspirations. Conclusions eMERG is one of the first reported European educational research networks for undergraduates. Research outcomes and students' perceptions conclude that eMERG enhances engagement with research methodology and motivation towards a career in surgery. eMERG is a pilot international research training network where medical students receive support to conduct research in Medical Education. eMERG structure can serve as a novel model to convey research experience from one generation to another, and in the same time, motivate and aspire students to develop leadership skills. eMERG was developed in a financial crisis environment with promising research outputs and positive students' feedback.
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Affiliation(s)
- Michail Sideris
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Queen Mary University of London, Yvonne Carter Building, London E1 2AB, United Kingdom
| | - John Hanrahan
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,King's College London, Faculty of Life Sciences and Medicine, Strand, London WC2R 2LS, United Kingdom
| | - Nikolaos Staikoglou
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Aristotle University of Thessaloniki, Thessaloniki 541 24, Greece
| | - Panteleimon Pantelidis
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Aristotle University of Thessaloniki, Thessaloniki 541 24, Greece
| | - Connie Pidgeon
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Royal London Hospital, Bartshealth NHS Trust, United Kingdom
| | - Nikolaos Psychalakis
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Experimental Research Centre ELPEN, Athens, Greece
| | - Nikolai Andersen
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,PPA-International Medical, Denmark
| | - Theodore Pittaras
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,National and Kapodistrian University of Athens, Athens, 115 27, Greece
| | - Thanos Athanasiou
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Imperial College London, London SW7 2AZ, United Kingdom
| | - Georgios Tsoulfas
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Aristotle University of Thessaloniki, Thessaloniki 541 24, Greece
| | - Apostolos Papalois
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Experimental Research Centre ELPEN, Athens, Greece
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Sideris M, Hanrahan J, Tsoulfas G, Theodoulou I, Dhaif F, Papalois V, Papagrigoriadis S, Velmahos G, Turner P, Papalois A. Developing a novel international undergraduate surgical masterclass during a financial crisis: our 4-year experience. Postgrad Med J 2018. [PMID: 29519810 DOI: 10.1136/postgradmedj-2017-135479] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Essential Skills in the Management of Surgical Cases (ESMSC) is a novel 3-day international undergraduate surgical masterclass. Its current curriculum (Cores integrated for Research-Ci4R) is built on a tetracore, multiclustered architecture combining high-fidelity and low-fidelity simulation-based learning (SBL), with applied and basic science case-based workshops, and non-technical skills modules. We aimed to report our experience in setting up ESMSC during the global financial crisis. METHODS We report the evolution of our curriculum's methodology and summarised the research outcomes related to the objective performance improvement of delegates, the educational environment of the course and the use of mixed-fidelity SBL. Feedback from the last three series of the course was prospectively collected and analysed using univariate statistics on IBM SPSS V.23. RESULTS 311 medical students across the European Union (EU) were selected from a competitive pool of 1280 applicants during seven series of the course between 2014 and 2017. During this period, curriculum 14 s evolved to the final Ci4R version, which integrates a tetracore structure combining 32 stations of in vivo, ex vivo and dry lab SBL with small group teaching workshops. Ci4R was positively perceived across different educational background students (p>0.05 for any comparison). CONCLUSIONS ESMSC is considered an innovative and effective multidisciplinary teaching model by delegates, where it improves delegates objective performance in basic surgical skills. Our experience demonstrates provision of high-quality and free surgical education during a financial crisis, which evolved through a dynamic feedback mechanism. The prospective recording and subsequent analysis of curriculum evolution provides a blueprint to direct development of effective surgical education courses that can be adapted to local needs.
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Affiliation(s)
- Michail Sideris
- Women's Health Research Unit, Queen Mary University of London, London, UK
| | - John Hanrahan
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Georgios Tsoulfas
- Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Iakovos Theodoulou
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Fatema Dhaif
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | | | - George Velmahos
- Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical Care, Harvard Medical School, Boston, Maryland, USA
| | - Patricia Turner
- American College of Surgeons, Chicago, Illinois, USA.,Department of Surgery, Section of General Surgery, The University of Chicago, Chicago, Illinois, USA
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Dhaif F, Paparoidamis G, Sideris M, Hanrahan J, Georgopoulou EM, Tsagkaraki I, Staikoglou N, Saeed F, Michail T, Tzavelas A, Kenanidis E, Potoupnis M, Tsiridis E, Papalois A. The Role of Anxiety in Simulation-Based Dexterity and Overall Performance: Does It Really Matter? J INVEST SURG 2017; 32:164-169. [PMID: 29286827 DOI: 10.1080/08941939.2017.1387624] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Essential Skills in the Management of Surgical Cases (ESMSC) is an international undergraduate surgical masterclass which combines ex vivo, dry lab and high fidelity in vivo simulation-based learning (SBL). It consists of 32 stations of skills-based learning, including open reduction internal fixation (ORIF) of fractures. Current literature suggests early involvement in skills-based learning at the undergraduate level is vital. AIMS To compare students' dexterity and skills-based performance with demographic and educational background parameters. METHODS 112 medical students from European Union countries including the United Kingdom, Germany, Greece, Cyprus, Germany, and Bulgaria were selected from a competitive pool of candidates to attend the course. Students undertook ORIF in an ex vivo swine model, and in a simulated fracture on a bamboo rod. Skills-based performance was assessed by two consultant surgeons with validated direct observation of procedural skills (DOPS) forms. Anxiety was self-assessed using the Westside Anxiety Scale prior to the ORIF stations. Dexterity was measured with the O'Connor tweezer dexterity test. RESULTS Female students had significantly higher dexterity scores (median difference 7, p =.003). Right-handed students achieved higher dexterity than left-handed students (median difference 7, p =.043). There was no difference in students' performance across different medical schools, and across year groups (p <.05 for any correlation). Self-reported anxiety was not correlated with high fidelity skills-based performance (r = 0.032, p =.74). CONCLUSION Anxiety does not seem to play a significant role in Simulation Skills-Based learning. Undergraduate surgical curricula should incorporate SBL-based modules to enhance practical skills learning and motivate future orthopedic surgeons.
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Affiliation(s)
| | | | | | | | | | | | | | - Ferha Saeed
- e Newham University Hospital, Bartshealth NHS Trust , London , UK
| | | | | | | | | | | | - Apostolos Papalois
- e Newham University Hospital, Bartshealth NHS Trust , London , UK.,f Experimental Research Centre ELPEN , Athens , Greece
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9
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Pantelidis P, Sideris M, Tsoulfas G, Georgopoulou EM, Tsagkaraki I, Staikoglou N, Stagias G, Psychalakis N, Tsitsopoulos P, Athanasiou T, Zografos G, Papalois A. Is In-Vivo laparoscopic simulation learning a step forward in the Undergraduate Surgical Education? Ann Med Surg (Lond) 2017; 16:52-56. [PMID: 28413632 PMCID: PMC5385388 DOI: 10.1016/j.amsu.2017.01.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 01/31/2017] [Accepted: 01/31/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Essentials Skills in the Management of Surgical Cases - ESMSC is an International Combined Applied Surgical Science and Wet Lab course addressed at the Undergraduate level. Laparoscopic Skills is a fundamental element of Surgical Education and various Simulation-Based Learning (SBL) models have been endorsed. This study aims to explore if there is any significant difference in delegates' performance depending on whether they completed In Vivo module prior to the equivalent in the laparoscopic simulator. MATERIALS AND METHODS 37 Medical Students from various EU countries were divided in 2 groups, and both completed the "Fundamentals in Laparoscopic Surgery" module in the Dry-lab Laparoscopic Simulator as well as the same module "In Vivo" on a swine model. Group A (18 students, 48.6%) completed the "Fundamentals in Laparoscopic Surgery - FLS" module prior to the "In Vivo", whereas group B completed the "In Vivo" module first. Direct Observation of Procedural Skills (DOPS) were used to assess delegates' performance. RESULTS The mean DOPS scores for the "FLS" and "In Vivo" models were 2.27 ± 0.902 and 2.03 ± 0.833, respectively, and the delegates' performance was not statistically significantly different between them (p = 0.128). There was no statistically significant difference in the scores among different gender, year of study, school and handedness groups. The alteration in the sequence between Dry-lab "FLS" and "In Vivo" modules did not affect the performance in neither the "FLS" nor the "In Vivo" models. CONCLUSIONS The inexpensive, but low-fidelity "FLS" model could serve an equal alternative Simulation-Based Learning model for the early undergraduate training. Our study demonstrated that high fidelity In Vivo simulation for laparoscopic skills does not affect significantly the improvement in the delegates' performance at the undergraduate level. Further studies should be conducted to identify at which stage of training should high fidelity simulation be introduced.
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