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Venkateswaran S, Wang D, Potter AL, Jeffrey Yang CF. Safety and Optimizing Ergonomics for Cardiothoracic Surgeons. Thorac Surg Clin 2024; 34:197-205. [PMID: 38944446 DOI: 10.1016/j.thorsurg.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
Cardiothoracic surgery, demanding in nature, often results in surgeons suffering from musculoskeletal injuries, causing chronic pain and leading to premature retirement. A significant majority report experiencing pain, exacerbated by minimally invasive techniques such as video-assisted thoracoscopic surgery. Despite this, many surgeons delay seeking medical assistance. To mitigate these risks, preventative strategies such as strength exercises, stretching during operations, and taking brief breaks are crucial. However, the surgical community faces a shortage of institutional support and comprehensive ergonomic education. Advancements in technology, including artificial intelligence and virtual reality, could offer future solutions.
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Affiliation(s)
- Shivaek Venkateswaran
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Danny Wang
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Alexandra L Potter
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Chi-Fu Jeffrey Yang
- Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
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2
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Qi Z, Corr F, Grimm D, Nimsky C, Bopp MHA. Extended Reality-Based Head-Mounted Displays for Surgical Education: A Ten-Year Systematic Review. Bioengineering (Basel) 2024; 11:741. [PMID: 39199699 PMCID: PMC11351461 DOI: 10.3390/bioengineering11080741] [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: 07/01/2024] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 09/01/2024] Open
Abstract
Surgical education demands extensive knowledge and skill acquisition within limited time frames, often limited by reduced training opportunities and high-pressure environments. This review evaluates the effectiveness of extended reality-based head-mounted display (ExR-HMD) technology in surgical education, examining its impact on educational outcomes and exploring its strengths and limitations. Data from PubMed, Cochrane Library, Web of Science, ScienceDirect, Scopus, ACM Digital Library, IEEE Xplore, WorldCat, and Google Scholar (Year: 2014-2024) were synthesized. After screening, 32 studies comparing ExR-HMD and traditional surgical training methods for medical students or residents were identified. Quality and bias were assessed using the Medical Education Research Study Quality Instrument, Newcastle-Ottawa Scale-Education, and Cochrane Risk of Bias Tools. Results indicate that ExR-HMD offers benefits such as increased immersion, spatial awareness, and interaction and supports motor skill acquisition theory and constructivist educational theories. However, challenges such as system fidelity, operational inconvenience, and physical discomfort were noted. Nearly half the studies reported outcomes comparable or superior to traditional methods, emphasizing the importance of social interaction. Limitations include study heterogeneity and English-only publications. ExR-HMD shows promise but needs educational theory integration and social interaction. Future research should address technical and economic barriers to global accessibility.
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Affiliation(s)
- Ziyu Qi
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (F.C.); (D.G.); (C.N.)
- Department of Neurosurgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Felix Corr
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (F.C.); (D.G.); (C.N.)
| | - Dustin Grimm
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (F.C.); (D.G.); (C.N.)
| | - Christopher Nimsky
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (F.C.); (D.G.); (C.N.)
- Center for Mind, Brain and Behavior (CMBB), 35043 Marburg, Germany
| | - Miriam H. A. Bopp
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (F.C.); (D.G.); (C.N.)
- Center for Mind, Brain and Behavior (CMBB), 35043 Marburg, Germany
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3
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Zeigler SM, Starnes SL, Sade RM. Should a questionably competent resident be allowed to continue in the program? J Thorac Cardiovasc Surg 2024; 167:283-288. [PMID: 36357222 DOI: 10.1016/j.jtcvs.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/27/2022] [Accepted: 10/04/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Sanford M Zeigler
- Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC
| | - Sandra L Starnes
- Section of Cardiothoracic Surgery, Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Robert M Sade
- Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC.
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4
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Hamilton BC, Dairywala MI, Highet A, Nguyen TC, O'Sullivan P, Chern H, Soriano IS. Artificial intelligence based real-time video ergonomic assessment and training improves resident ergonomics. Am J Surg 2023; 226:741-746. [PMID: 37500299 DOI: 10.1016/j.amjsurg.2023.07.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 07/19/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Surgery demands long hours and intense exertion raising ergonomic concerns. We piloted a sensorless artificial intelligence (AI)-assisted ergonomics analysis app to determine its feasibility for use with residents. METHODS Surgery residents performed simulated laparoscopic tasks before and after a review of the SCORE ergonomics curriculum while filmed with a sensorless app from Kinetica Labs that calculates joint angles as a metric of ergonomics. A survey was completed before the session and a focus group was conducted after. RESULTS Thirteen surgical residents participated in the study. The brief intervention took little time and residents improved their ergonomic scores in neck and right shoulder angles. Residents expressed increased awareness of ergonomics based on the session content and AI information. All trainees desired more training in ergonomics. CONCLUSIONS Ergonomic assessment AI software can provide immediate feedback to surgical trainees to improve ergonomics. Additional studies using sensorless AI technology are needed.
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Affiliation(s)
- Barbara Cs Hamilton
- Department of Surgery, University of California, 505 Parnassus Avenue, San Francisco, CA, 94117, USA.
| | - Mohammed I Dairywala
- Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center, McGovern Medical School, 6400 Fannin St Suite 2850, Houston, TX, 77030, USA
| | - Alexandra Highet
- Department of Surgery, University of California, 505 Parnassus Avenue, San Francisco, CA, 94117, USA
| | - Tom C Nguyen
- Department of Surgery, University of California, 505 Parnassus Avenue, San Francisco, CA, 94117, USA
| | - Patricia O'Sullivan
- Department of Surgery, University of California, 505 Parnassus Avenue, San Francisco, CA, 94117, USA
| | - Hueylan Chern
- Department of Surgery, University of California, 505 Parnassus Avenue, San Francisco, CA, 94117, USA
| | - Ian S Soriano
- Department of Surgery, University of California, 505 Parnassus Avenue, San Francisco, CA, 94117, USA
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Siddiqui NA, Javed A, Pirzada A. A systematic review of simulation training for lower extremity bypass procedures. Vascular 2023:17085381231192689. [PMID: 37494569 DOI: 10.1177/17085381231192689] [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: 07/28/2023]
Abstract
OBJECTIVES Simulation is used across surgical specialties for skill enhancement. The choice and assessment method of a simulator varies across literature. In the age of endovascular approach, trainees have limited exposure to open lower limb bypass procedures which needs attention. This review aims to assess the utility of simulation training in lower limb bypass surgery using Kirkpatrick's model. METHODS Using PRISMA statement, we included all the studies done on simulators in lower limb bypass surgical procedures for this systematic review. The primary outcome was to assess the effectiveness of different types of simulation used for lower limb bypass surgery using the Kirkpatrick's model for training evaluation. RESULTS An initial search identified 295 articles out of which 7 articles were found to be eligible for this systematic review. A variety of simulators were used including cadavers and synthetic models. Most studies (n=5) found the use of simulation as an effective tool in achieving technical competence. All the five studies we found at level 2 on Kirpatrick's model evaluation. CONCLUSION Most of the existing studies are at level 2 of Kirkpatrick's model which reflects learning changes in trainees after simulation. Feedback mechanism needs to be evolved where the improvement after simulation training can be gauged by its replication in clinical practice and improved patient care practices corresponding to the highest level of Kirkpatrick's model.
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Affiliation(s)
| | - Aden Javed
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Ammar Pirzada
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
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Carlson ER, McGowan E. Faculty Development for the Twenty-First Century: Teaching the Teachers. Oral Maxillofac Surg Clin North Am 2022; 34:555-570. [PMID: 36224073 DOI: 10.1016/j.coms.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Faculty development is a poorly understood and incompletely executed initiative in undergraduate and graduate medical and dental education programs. Despite significant change in the delivery of health care over the past several decades, the education of students and residents has followed a legacy path of business as usual. Some faculty have incorrectly assumed that content expertise transfers to teaching expertise. The insistence for robust faculty development programs on the part of accrediting and other professional organizations has created a call to action, but much work has yet to be done. It is therefore essential that leaders in these programs develop a sense of urgency to teach the teachers lest our students and residents will replicate outdated methods, unsystematically teach themselves, and fall victim to an educational system that is grossly inadequate. It is the purpose of this article to enhance undergraduate and graduate medical and dental education by offering viable change options, specifically targeted to improving historical trends by emphasizing the importance of growth mindsets, emotional intelligence, the creation of holding environments, and stimulating enthusiasm for lifelong learning as part of twenty-first century strategies for faculty development.
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Affiliation(s)
- Eric R Carlson
- Department of Oral and Maxillofacial Surgery, University of Tennessee Graduate School of Medicine, 1930 Alcoa Highway Suite 335, Knoxville, TN 37920, USA.
| | - Eileen McGowan
- Harvard Graduate School of Education, 1165 N Pennsylvania Street, Denver, CO 80203, USA
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Dairywala MI, Gupta S, Salna M, Nguyen TC. Surgeon Strength: Ergonomics and Strength Training in Cardiothoracic Surgery. Semin Thorac Cardiovasc Surg 2021; 34:1220-1229. [PMID: 34597795 DOI: 10.1053/j.semtcvs.2021.09.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 09/22/2021] [Indexed: 01/09/2023]
Abstract
With the high prevalence of musculoskeletal pain in surgeons and interventionalists, it is critical to analyze the impact of ergonomics on cardiothoracic surgeon health. Here, we review the existing literature and propose recommendations to improve physical preparedness for surgery both in and outside the operating room. For decades, cardiothoracic surgeons have suffered from musculoskeletal pain, most commonly in the neck, and back due to a lack of proper ergonomics during surgery. A lack of dedicated ergonomics curriculum during training may leave surgeons at a high predisposition for work-related musculoskeletal disorders. We searched PubMed, Google Scholar, and other sources for studies relevant to surgical ergonomics and prevalence of musculoskeletal disease among surgeons and interventionalists. Whenever possible, data from quantitative studies, and meta-analyses are presented. We also contacted experts and propose an exercise routine to improve physical preparedness for demands of surgery. To date, many studies have reported astonishingly high rates of work-related pain in surgeons with rates as high as 87% in minimally-invasive surgeons. Several optimizations regarding correct table height, monitor positioning, and loupe angles have been discussed. Lastly, implementation of ergonomics training at some programs have been effective at reducing the rates of musculoskeletal pain among surgeons. Surgical work-related stress injuries are more common than we think. Many factors including smaller incisions and technological advancements have led to this plight. Ultimately, work-related injuries are underreported and understudied and the field of surgical ergonomics remains open for investigative study.
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Affiliation(s)
- Mohammed I Dairywala
- Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center Houston, McGovern Medical School, Houston, Texas
| | - Saurabh Gupta
- Division of Cardiac Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Michael Salna
- Division of Cardiac, Thoracic, and Vascular Surgery, Department of Surgery, Columbia University Irving Medical Center, New York, New York
| | - Tom C Nguyen
- Division of Adult Cardiothoracic Surgery, Department of Surgery, UCSF Health, San Francisco, California.
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Pugh CM. The Experienced Surgeon and New Tricks-It's Time for Full Adoption and Support of Automated Performance Metrics and Databases. JAMA Surg 2021; 156:1109-1110. [PMID: 34524403 DOI: 10.1001/jamasurg.2021.4531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Carla M Pugh
- Department of Surgery, Stanford University, Stanford, California
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9
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Hancı E, Ruijten PAM, Lacroix J, IJsselsteijn WA. The Impact of Mindset on Self-Tracking Experience. Front Digit Health 2021; 3:676742. [PMID: 34713146 PMCID: PMC8521810 DOI: 10.3389/fdgth.2021.676742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/22/2021] [Indexed: 11/13/2022] Open
Abstract
Self-tracking technologies aim to offer a better understanding of ourselves through data, create self-awareness, and facilitate healthy behavior change. Despite such promising objectives, very little is known about whether the implicit beliefs users may have about the changeability of their own behavior influence the way they experience self-tracking. These implicit beliefs about the permanence of the abilities are called mindsets; someone with a fixed mindset typically perceives human qualities (e.g., intelligence) as fixed, while someone with a growth mindset perceives them as amenable to change and improvement through learning. This paper investigates the concept of mindset in the context of self-tracking and uses online survey data from individuals wearing a self-tracking device (n = 290) to explore the ways in which users with different mindsets experience self-tracking. A combination of qualitative and quantitative approaches indicates that implicit beliefs about the changeability of behavior influence the extent to which users are self-determined toward self-tracking use. Moreover, differences were found in how users perceive and respond to failure, and how self-judgmental vs. self-compassionate they are toward their own mistakes. Overall, considering that how users respond to the self-tracking data is one of the core dimensions of self-tracking, our results suggest that mindset is one of the important determinants in shaping the self-tracking experience. This paper concludes by presenting design considerations and directions for future research.
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Affiliation(s)
- Elçin Hancı
- Department of Industrial Engineering & Innovation Sciences, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Peter A. M. Ruijten
- Department of Industrial Engineering & Innovation Sciences, Eindhoven University of Technology, Eindhoven, Netherlands
| | | | - Wijnand A. IJsselsteijn
- Department of Industrial Engineering & Innovation Sciences, Eindhoven University of Technology, Eindhoven, Netherlands
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10
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Beattie KL, Hill A, Horswill MS, Grove PM, Stevenson ARL. Laparoscopic skills training: the effects of viewing mode (2D vs. 3D) on skill acquisition and transfer. Surg Endosc 2021; 35:4332-4344. [PMID: 32876737 PMCID: PMC8263422 DOI: 10.1007/s00464-020-07923-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/17/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Three-dimensional (3D) visual displays have been suggested to aid laparoscopic skills training by providing the depth cues not present in traditional two-dimensional (2D) displays. However, few studies have robustly investigated the impact of viewing mode (2D vs. 3D) on learning outcomes. PURPOSE To examine how viewing mode (2D vs. 3D) impacts the acquisition and transferability of basic laparoscopic skills by comparing performance between transfer and control groups on a complete proficiency-based training program. METHOD A counterbalanced between-subjects design was employed. Each participant was randomly allocated to one of four groups, comprising two transfer groups (trained in one viewing mode and tested in the alternate mode: the 2D → 3D and 3D → 2D groups) and two control groups (trained and tested in one viewing mode: the 2D → 2D and 3D → 3D groups). Participants completed proficiency-based training in six laparoscopic training tasks. Testing included two further repetitions of all tasks under test conditions. Objective performance measures included the total number of repetitions to reach proficiency, and total performance scores (i.e. time + error penalties across all repetitions) in training and testing. RESULTS The groups trained in 3D demonstrated superior training performance (i.e. less time + errors) and took fewer repetitions to reach proficiency than the groups trained in 2D. The groups tested in 3D also demonstrated superior test performance compared to those tested in 2D. However, training mode did not yield significant test differences between the groups tested in 2D (i.e. 2D → 2D vs. 3D → 2D), or between the groups tested in 3D (i.e. 3D → 3D vs. 2D → 3D). CONCLUSION Novices demonstrate superior performance in laparoscopic skills training using a 3D viewing mode compared to 2D. However, this does not necessarily translate to superior performance in subsequent testing or enhanced learning overall. Rather, test performance appears to be dictated by the viewing mode used during testing, not that of prior training.
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Affiliation(s)
- Kirsty L Beattie
- School of Psychology, The University of Queensland, St Lucia, Brisbane, 4072, Australia.
| | - Andrew Hill
- School of Psychology, The University of Queensland, St Lucia, Brisbane, 4072, Australia
- Clinical Skills Development Service, Metro North Hospital and Health Service, Brisbane, Australia
- Minerals Industry Safety and Health Centre, Sustainable Minerals Institute, The University of Queensland, Brisbane, Australia
| | - Mark S Horswill
- School of Psychology, The University of Queensland, St Lucia, Brisbane, 4072, Australia
| | - Philip M Grove
- School of Psychology, The University of Queensland, St Lucia, Brisbane, 4072, Australia
| | - Andrew R L Stevenson
- School of Medicine, The University of Queensland, Brisbane, Australia
- Department of Colon and Rectal Surgery, Royal Brisbane and Women's Hospital, Brisbane, Australia
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Shalkow-Klincovstein J, Porras-Hernandez JD, Villalpando R, Olaya-Vargas A, Esparza-Aguilar M. Academic paediatric surgery and work-life balance: Insights from Mexico. Semin Pediatr Surg 2021; 30:151023. [PMID: 33648707 DOI: 10.1016/j.sempedsurg.2021.151023] [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: 10/22/2022]
Abstract
Academic pediatric surgery in Mexico has many challenges and opportunities. Work life balance, health service delivery and committements to our many students and residents must be tailored to goals and aspirations respecting talent at every opportunity when we encounter it. This article offers a perspective on the landscape and how we can shape the future in our nation to embrace new leadership in academic pediatric surgery.
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Affiliation(s)
- Jaime Shalkow-Klincovstein
- Department of Surgical Oncology, National Institute of Paediatrics and ABC Cancer Centre, Associated Researcher, Anahuac University, Mexico.
| | | | - Ricardo Villalpando
- Paediatric Surgeon, Former President: Mexican Board of Paediatric Surgery, Mexico
| | - Alberto Olaya-Vargas
- Paediatric Oncologist, Director, Stem Cell Transplantation and Cellular Therapy, National Institute of Paediatrics and ABC Cancer Centre, Mexico
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12
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Reaching for Peak Performance During Surgical Training: The Value in Assessment Tools and Critical Performance Measures. J Am Acad Orthop Surg 2020; 28:e744-e751. [PMID: 32433426 DOI: 10.5435/jaaos-d-20-00172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Peak performance is the ability to achieve optimal outcomes or performance of a given task in a consistent manner. Commonly studied in athletes and musicians, this topic is less often studied in medicine and rarely broached for trainees. However, residency is a crucial period of training where foundations for future success are sewn into habit and daily practice. As educators, we should aim to equip trainees with the tools necessary to achieve peak performance. Studies in athletes and musicians focus on achieving peak performance by setting goals, mastering skills through deliberate practice, perseverance, grit, and discipline. Mentorship is also an important element to streamline efforts for the trainee and help them to focus. In the following article, we review the current literature on applying these principles to surgical trainees to achieve peak performance.
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Stephens EH, Dearani JA. On Becoming a Master Surgeon: Role Models, Mentorship, Coaching, and Apprenticeship. Ann Thorac Surg 2020; 111:1746-1753. [PMID: 32861640 DOI: 10.1016/j.athoracsur.2020.06.061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 06/07/2020] [Indexed: 11/15/2022]
Abstract
Cardiothoracic surgery is a high risk, high reward specialty demanding exceptional performance for desired outcomes. Whereas the demand for technical excellence, critical thinking skills, judgment, and overall experience is clear, the pathway to optimize performance improvement after training is completed is less clear. "Role modeling," "mentorship," "coaching," and "apprenticeship" are all buzz words that have flooded the proverbial air of our specialty in recent years. The goal of this article is to describe strategies, including career development relationships, continuing medical education, and professional societal involvement, that are key to continuing to improve one's craft and identify career phases when such elements are most applicable.
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Affiliation(s)
| | - Joseph A Dearani
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
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14
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Smood B, Nguyen SN, Kelly JJ, Han JJ. Integrated cardiothoracic surgery: Developing a successful residency application. J Thorac Cardiovasc Surg 2020; 160:167-174. [DOI: 10.1016/j.jtcvs.2019.09.161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/09/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
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15
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Bisco SE, Price DL, Olsen KD, Boes CJ, Carlson ML. "Filler-ins" to Physicians: History of the Otolaryngology Training Program at Mayo Clinic. Mayo Clin Proc Innov Qual Outcomes 2020; 4:76-89. [PMID: 32055773 PMCID: PMC7010977 DOI: 10.1016/j.mayocpiqo.2019.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 09/16/2019] [Indexed: 11/22/2022] Open
Abstract
The first officially recognized otolaryngology resident at Mayo Clinic started training in 1908. In the following years, the residency program evolved through emerging national standards and regulations for medical education, declining and resurgent interest in the specialty, and radical changes in otolaryngology as a practice. This article details the growth of the Mayo Clinic otolaryngology residency program, often in the words of the pioneering physicians involved in the process, from "filler-ins" for the staff to today's nationally recognized program.
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Affiliation(s)
- Susan E. Bisco
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN
| | - Daniel L. Price
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN
| | - Kerry D. Olsen
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN
| | | | - Matthew L. Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN
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Hermsen JL, Mokadam NA, Verrier ED. Flipping the Classroom: How to Optimize Learning in the Didactic Setting. Thorac Surg Clin 2019; 29:279-284. [PMID: 31235296 DOI: 10.1016/j.thorsurg.2019.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Classic classroom education emphasizes the teacher imparting knowledge, experience, or wisdom (pedagogy). Adult educational theory indicates learning is optimized in an experiential setting, where the learner prepares, the session is case based, and the responsibility of the educator is to teach what the learner does not know. This is referred to as "flipping the classroom." Flipping the classroom is not simple, as the historical educational culture often changes; and, at least early in the transition process, different expectations, preparation, or training are essential for both the learner and educator for this approach to be effective.
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Affiliation(s)
- Joshua L Hermsen
- University of Wisconsin Hospital and Clinics, 600 Highland Avenue, Clinical Sciences Center, H4/352, Madison, WI 53792-7375, USA.
| | - Nahush A Mokadam
- Division of Cardiac Surgery, Ohio State University, N-825 Doan Hall, 410 West 10th Avenue, Columbus, OH 43210, USA
| | - Edward D Verrier
- Division of Cardiothoracic Surgery, Department of Surgery, University of Washington, 1959 NE Pacific Street, Seattle WA 98195, USA
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17
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A Foundational Framework for Andragogy in Oral and Maxillofacial Surgery V: Moving Forward. J Oral Maxillofac Surg 2019; 77:1739-1740. [DOI: 10.1016/j.joms.2019.01.055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 01/27/2019] [Indexed: 11/20/2022]
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18
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Rowse PG, Dearani JA. Deliberate Practice and the Emerging Roles of Simulation in Thoracic Surgery. Thorac Surg Clin 2019; 29:303-309. [DOI: 10.1016/j.thorsurg.2019.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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20
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Verrier ED. Commentary: Another exercise in the educational gymnasium. J Thorac Cardiovasc Surg 2019; 159:1445-1446. [PMID: 31301897 DOI: 10.1016/j.jtcvs.2019.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 06/03/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Edward D Verrier
- Department of Cardiovascular Surgery, University of Washington, Seattle, Wash.
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21
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2019 Oriens Lecture: The yin and yang of life as a surgeon. J Trauma Acute Care Surg 2019; 87:254-258. [PMID: 31033890 DOI: 10.1097/ta.0000000000002326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Verrier ED. Easier said than done. J Thorac Cardiovasc Surg 2019; 157:678-679. [DOI: 10.1016/j.jtcvs.2018.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 08/10/2018] [Indexed: 10/28/2022]
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Han JJ, Patrick WL. See one-practice-do one-practice-teach one-practice: The importance of practicing outside of the operating room in surgical training. J Thorac Cardiovasc Surg 2018; 157:671-677. [PMID: 30528442 DOI: 10.1016/j.jtcvs.2018.07.108] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/18/2018] [Accepted: 07/28/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Jason J Han
- Division of Cardiovascular Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa.
| | - William L Patrick
- Division of Cardiovascular Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
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Pulijala Y, Ma M, Pears M, Peebles D, Ayoub A. Effectiveness of Immersive Virtual Reality in Surgical Training-A Randomized Control Trial. J Oral Maxillofac Surg 2017; 76:1065-1072. [PMID: 29104028 DOI: 10.1016/j.joms.2017.10.002] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 10/03/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Surgical training methods are evolving with the technological advancements, including the application of virtual reality (VR) and augmented reality. However, 28 to 40% of novice residents are not confident in performing a major surgical procedure. VR surgery, an immersive VR (iVR) experience, was developed using Oculus Rift and Leap Motion devices (Leap Motion, Inc, San Francisco, CA) to address this challenge. Our iVR is a multisensory, holistic surgical training application that demonstrates a maxillofacial surgical technique, the Le Fort I osteotomy. The main objective of the present study was to evaluate the effect of using VR surgery on the self-confidence and knowledge of surgical residents. MATERIALS AND METHODS A multisite, single-blind, parallel, randomized controlled trial (RCT) was performed. The participants were novice surgical residents with limited experience in performing the Le Fort I osteotomy. The primary outcome measures were the self-assessment scores of trainee confidence using a Likert scale and an objective assessment of the cognitive skills. Ninety-five residents from 7 dental schools were included in the RCT. The participants were randomly divided into a study group of 51 residents and a control group of 44. Participants in the study group used the VR surgery application on an Oculus Rift with Leap Motion device. The control group participants used similar content in a standard PowerPoint presentation on a laptop. Repeated measures multivariate analysis of variance was applied to the data to assess the overall effect of the intervention on the confidence of the residents. RESULTS The study group participants showed significantly greater perceived self-confidence levels compared with those in the control group (P = .034; α = 0.05). Novices in the first year of their training showed the greatest improvement in their confidence compared with those in their second and third year. CONCLUSIONS iVR experiences improve the knowledge and self-confidence of the surgical residents.
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Affiliation(s)
- Yeshwanth Pulijala
- Doctoral Researcher, School of Art, Design and Architecture, University of Huddersfield, Huddersfield, United Kingdom.
| | - Minhua Ma
- Professor, Computer Games Technology, School of Computing and Digital Technologies, Staffordshire University, Stoke-on-Trent, United Kingdom
| | - Matthew Pears
- Doctoral Researcher, Department of Psychology, School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
| | - David Peebles
- Reader in Cognitive Science, Department of Psychology, School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
| | - Ashraf Ayoub
- Professor, Department of Oral and Maxillofacial Surgery, School of Medicine, Dentistry and Nursing, Glasgow University Dental School, Glasgow, United Kingdom
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