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Ron I, Kyin C, Zari DS, Peskin B, Ghrayeb N, Norman D, Shapira J. COVID-19 Resulted in Reduction Trainee Bedside Experience, But No Reduction in Surgical Experience. Arthrosc Sports Med Rehabil 2024; 6:100856. [PMID: 38260822 PMCID: PMC10801223 DOI: 10.1016/j.asmr.2023.100856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/28/2023] [Indexed: 01/24/2024] Open
Abstract
Purpose Because of the concerns regarding residency process during the pandemic, this study aimed to investigate the volume of clinical interactions of orthopaedic residents at a tertiary hospital by reporting the number of patients treated in the outpatient clinic, inpatient ward, and operating room. Methods This retrospective chart study evaluated variables such as volume of clinical interactions of orthopaedic residents at a tertiary hospital by reporting the number of patients treated in the outpatient clinic, inpatient ward, and operating room, from an orthopaedic department in a tertiary trauma center throughout the COVID-19 pandemic era. Comparing these measures was an indirect evaluation tool for measuring the amount of work completed and clinical exposure gained by the residents. Results Occupancy percentage, hospitalization days, admissions to the department, and attendance of the outpatient clinic were all decreased during the pandemic. No significant changes were evident in the total number of surgeries nor the number of elective surgeries during the pandemic. Conclusions Overall, a reduction in overall hospitalization days, admissions to the department, total number of visits in the outpatient clinic, and occupancy percentage of the ward was observed during COVID-19. However, there was no difference in the average number of monthly surgeries between the pre-COVID-19 and COVID-19 timeframes. Level of Evidence Level III, retrospective comparative review.
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Affiliation(s)
- Itay Ron
- Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Cynthia Kyin
- University of Central Florida College of Medicine, Orlando, Florida, U.S.A
| | - David Shaked Zari
- Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Bezalel Peskin
- Orthopedic Department, Rambam Medical Center, Haifa, Israel
| | - Nabil Ghrayeb
- Orthopedic Department, Rambam Medical Center, Haifa, Israel
| | - Doron Norman
- Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
- Orthopedic Department, Rambam Medical Center, Haifa, Israel
| | - Jacob Shapira
- Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
- Orthopedic Department, Rambam Medical Center, Haifa, Israel
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Lawaetz J, Soenens G, Eiberg J, Van Herzeele I, Konge L, Nesbitt C, Gentile F, Stavroulakis K, Weiss S, Nayahangan LJ. Facilitators and Barriers to Implementation of Simulation Based Education in Vascular Surgery in Europe. Eur J Vasc Endovasc Surg 2023; 66:428-436. [PMID: 37330202 DOI: 10.1016/j.ejvs.2023.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/27/2023] [Accepted: 06/07/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE This study explored the status and availability of simulation based education (SBE) for learning vascular surgical procedures identified in the 2019 General Needs Assessment in vascular surgery in Europe (GNA-2019) and identified facilitators and barriers to SBE implementation in vascular surgery. METHODS A three round iterative survey was distributed via the European Society for Vascular Surgery and the Union Européenne des Médecins Spécialistes. Members from leading committees and organisations within the European vascular surgical community were invited to participate as key opinion leaders (KOLs). Three online survey rounds explored demographics, SBE availability, and facilitators and barriers to SBE implementation. RESULTS Overall, 147 KOLs (target population 338) accepted invitation to round 1, representing 30 European countries. The dropout rates for rounds 2 and 3 were 29% and 40%, respectively. Most respondents (88%) were senior, consultant level or higher. No mandatory SBE training was required in their department before training on patients, according to 84% of the KOLs. There was high consensus on the need for structured SBE (87%) and mandatory SBE (81%). SBE is available for the top three prioritised procedures in GNA-2019 (basic open skills, basic endovascular skills, and vascular imaging interpretation) in 24, 23, and 20 of the 30 represented European countries, respectively. The highest ranking facilitators were structured SBE programmes, availability of simulation equipment locally and regionally, good quality simulators, and having a dedicated person running the SBE. The highest ranked barriers were lack of structured SBE curriculum, equipment costs, lack of SBE culture, no or limited dedicated time for faculty to teach in SBE, and clinical work overload. CONCLUSION Based largely on the opinions of KOLs in vascular surgery in Europe, this study revealed that SBE is needed in vascular surgery training and that systematic and structured programmes are required to ensure successful implementation.
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Affiliation(s)
- Jonathan Lawaetz
- Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark; Copenhagen Academy for Medical Education and Simulation (CAMES), Centre for Human Resources and Education, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.
| | - Gilles Soenens
- Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium
| | - Jonas Eiberg
- Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark; Copenhagen Academy for Medical Education and Simulation (CAMES), Centre for Human Resources and Education, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Isabelle Van Herzeele
- Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium
| | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation (CAMES), Centre for Human Resources and Education, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Craig Nesbitt
- Northern Vascular Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, United Kingdom
| | | | | | - Salome Weiss
- Department of Vascular Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Leizl Joy Nayahangan
- Copenhagen Academy for Medical Education and Simulation (CAMES), Centre for Human Resources and Education, Copenhagen, Denmark
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Cate G, Barnes J, Cherney S, Stambough J, Bumpass D, Barnes CL, Dickinson KJ. Current status of virtual reality simulation education for orthopedic residents: the need for a change in focus. GLOBAL SURGICAL EDUCATION : JOURNAL OF THE ASSOCIATION FOR SURGICAL EDUCATION 2023; 2:46. [PMID: 38013875 PMCID: PMC10032253 DOI: 10.1007/s44186-023-00120-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 02/23/2023] [Accepted: 03/06/2023] [Indexed: 03/24/2023]
Abstract
Introduction Advances in technology are changing surgical education. Simulation provides an important adjunct to operative experience. This pedagogy has arguably become more important in light of the COVID-19 pandemic, with resultant reduction in operative exposure for trainees. Virtual reality (VR) simulators may provide significant contribution to experiential learning; however, much of the investigative focus to date has, correctly, been on establishing validity evidence for these constructs. The aim of this work was to perform a scoping review to assess the current status of VR simulation education to determine curricular development efforts for orthopedic residents. Methods With a trained medical librarian, searches of PubMed, EMBASE, and Web of Science were conducted for all articles in the last 10 years (September 2011-September 2021). Controlled vocabulary Medical Subject Headings (MeSH) terms and natural language developed with subject matter experts describing virtual reality or VR simulation and orthopedic training were used. Two trained reviewers evaluated all abstracts for inclusion. Exclusion criteria were all articles that did not assess VR simulation education involving orthopedic residents. Data were extracted from the included full-text articles including: study design, type of participants, type of VR simulation, simulated orthopedic skill, type of educational event, learner assessment including Kirkpatrick's level, assessment of quality using the Medical Education Research Study Quality Instrument (MERSQI), and level of effectiveness (LoE). Results Initial search identified 1,394 articles, of which 61 were included in the final qualitative synthesis. The majority (54%) were published in 2019- 2021, 49% in Europe. The commonest VR simulator was ArthroS (23%) and the commonest simulated skill was knee arthroscopy (33%). The majority of studies (70%) focused on simulator validation. Twenty-three studies described an educational module or curriculum, and of the 21 (34%) educational modules, 43% were one-off events. Most modules (18/21, 86%) assessed learners at Kirkpatrick level 2. With regard to methodological quality, 44% of studies had MERSQI 11.5-15 and 89% of studies had LoE of 2. Two studies had LoE of 3. Conclusion Current literature pertaining to VR training for orthopedic residents is focused on establishing validity and rarely forms part of a curriculum. Where the focus is education, the majority are discrete educational modules and do not teach a comprehensive amalgam of orthopedic skills. This suggests focus is needed to embed VR simulation training within formal curricula efforts guided by the work of Kern, and assess the efficacy of these against patient outcomes.
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Affiliation(s)
- Graham Cate
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Jack Barnes
- Department of Orthopedics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Steven Cherney
- Department of Orthopedics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Jeffrey Stambough
- Department of Orthopedics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - David Bumpass
- Department of Orthopedics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - C. Lowry Barnes
- Department of Orthopedics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Karen J. Dickinson
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR USA
- Office of Interprofessional Education, University of Arkansas for Medical Sciences, Little Rock, USA
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Haiser A, Aydin A, Kunduzi B, Ahmed K, Dasgupta P. A Systematic Review of Simulation-Based Training in Vascular Surgery. J Surg Res 2022; 279:409-419. [PMID: 35839575 PMCID: PMC9483723 DOI: 10.1016/j.jss.2022.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/20/2022] [Accepted: 05/22/2022] [Indexed: 11/25/2022]
Abstract
Introduction Recent advancements in surgical technology, reduced working hours, and training opportunities exacerbated by the COVID-19 pandemic have led to an increase in simulation-based training. Furthermore, a rise in endovascular procedures has led to a requirement for high-fidelity simulators that offer comprehensive feedback. This review aims to identify vascular surgery simulation models and assess their validity and levels of effectiveness (LoE) for each model in order to successfully implement them into current training curricula. Methods PubMed and EMBASE were searched on January 1, 2021, for full-text English studies on vascular surgery simulators. Eligible articles were given validity ratings based on Messick’s modern concept of validity alongside an LoE score according to McGaghie’s translational outcomes. Results Overall 76 eligible articles validated 34 vascular surgery simulators and training courses for open and endovascular procedures. High validity ratings were achieved across studies for: content (35), response processes (12), the internal structure (5), relations to other variables (57), and consequences (2). Only seven studies achieved an LoE greater than 3/5. Overall, ANGIO Mentor was the most highly validated and effective simulator and was the only simulator to achieve an LoE of 5/5. Conclusions Simulation-based training in vascular surgery is a continuously developing field with exciting future prospects, demonstrated by the vast number of models and training courses. To effectively integrate simulation models into current vascular surgery curricula and assessments, there is a need for studies to look at trainee skill retention over a longer period of time. A more detailed discussion on cost-effectiveness is also needed.
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Affiliation(s)
- Alexander Haiser
- Guy's, King's and St Thomas' School of Medical Education, King's College London, London, UK
| | - Abdullatif Aydin
- MRC Centre for Transplantation, Guy's Hospital, King's College London, London, UK.
| | - Basir Kunduzi
- Department of Transplant Surgery, Guy's and St. Thomas' NHS Foundation Trust, London, London, UK
| | - Kamran Ahmed
- MRC Centre for Transplantation, Guy's Hospital, King's College London, London, UK
| | - Prokar Dasgupta
- MRC Centre for Transplantation, Guy's Hospital, King's College London, London, UK
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Current status of simulation-based training tools in general surgery: A systematic review. INTERNATIONAL JOURNAL OF SURGERY OPEN 2022. [DOI: 10.1016/j.ijso.2021.100427] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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