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Ruggiero N, L'Huillier JC, Marine N, Burns O, Mawani F, Sanders LTM, Abbas A, Adams TM, Santos BF, Wirengard YR, Rosser JB. Perceptions of Competition-Based Learning After a Brief Experience at a National Surgical Meeting. Surg Innov 2023; 30:720-727. [PMID: 37831491 DOI: 10.1177/15533506231207438] [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: 10/14/2023]
Abstract
BACKGROUND Competition-based learning (CBL) facilitates learning through competitions. At the 2022 & 2023 Annual SAGES meetings, we evaluated a CBL experience (TOP GUN Shootout) developed from a modified version of the previously validated TOP GUN Laparoscopic Skills and Suturing Program. The project sought to evaluate the TOP GUN Shootout's (TGS) ability to enhance participant engagement in pursuit of laparoscopic surgical skills. METHODS Participants competed in the TGS. Their scores (time and errors) were recorded for: Fundamentals of Laparoscopic Surgery Peg Pass, Cup Drop Task, and Intracorporeal Suturing. All participants completed a 10-question satisfaction survey on a 7-point Likert scale, with questions assessing 3 domains: (1) capability/confidence in MIS skill performance prior to the competition; (2) applicability and satisfaction with TGS's capacity to develop MIS skills; and (3) interest in seeking additional MIS training and appropriateness of CBL in MIS training. Descriptive statistics were used to evaluate these areas. RESULTS Overall, 121 participants completed the TGS, of whom 84 (69%) completed the satisfaction survey. The average age was 32.9 years, 67% were males. On average (+/- SD), participant satisfaction was 5.04 (+/- 2.08) for Domain 1, 6.20 (+/- 1.28) for Domain 2, and 6.58 (+/- .95) for Domain 3. CONCLUSION Participants described an overall lack of confidence in their MIS skills prior to the 2022-2023 Annual SAGES conference. Participants felt that this brief CBL experience, aided in the development of their MIS skills. Furthermore, this brief CBL experience may inspire learners to seek out further training of their MIS skills.
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Affiliation(s)
- Nicco Ruggiero
- Department of Surgery, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Joseph C L'Huillier
- Department of Surgery, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Nigel Marine
- Department of Surgery, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Owen Burns
- Washington and Lee University, Lexington, VA, USA
| | - Farrah Mawani
- Department of Surgery, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | | | - Adam Abbas
- Department of Surgery, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Timothy M Adams
- Department of Surgery, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Byron F Santos
- Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
- White River Junction Veterans Affairs Medical Center, White River Junction, VT, USA
| | - Yana R Wirengard
- Department of Surgery, Contra Costa Health Services, Martinez, CA, USA
| | - James Butch Rosser
- Department of Surgery, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
- Department of Surgery, Gila Regional Medical Center, Silver City, NM, USA
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Measurement and Accreditation of Minimal Access Surgical Skills: Challenges and Solutions. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03319-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Zetner DB, Konge L, Fabrin A, Christensen JB, Thinggaard E. The Challenges of Dyad Practice in Simulation Training of Basic Open Surgical Skills-A Mixed-Method Study. Simul Healthc 2022; 17:e91-e97. [PMID: 34009912 DOI: 10.1097/sih.0000000000000560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Simulation training at home improves access to training, but motivation can be difficult to maintain. Dyad training could keep trainees motivated. This study aimed to examine the effect of self-regulated training of basic surgical skills in pairs versus individually. METHODS One hundred one medical doctors were included in this prospective, mixed-method, simulation-based study. Participants were randomized to train individually or in pairs during a 6-week course in open surgical skills, consisting of didactic instructions and self-directed training at home. Trainees kept a training log and filled in a questionnaire. Skills were tested before and after the course. Tests were rated by an expert using the Objective Structured Assessment of Technical Skills Global Rating Scale. RESULTS Ninety-seven doctors completed the study. We found no differences in test score between dyad and individual trainees. Dyad trainees compared with individual trainees improved by 7.23 points (intercept estimate) versus 6.94 points, respectively (P = 0.881). Dyad trainees trained less frequently [7.3 times (intercept estimate) vs. 12.1 times, P < 0.001, but for longer intervals compared with individual trainees (68 minutes vs. 38 minutes)]. Dyad trainees reported benefits such as having a sparring partner, receiving feedback, corrections, increased motivation, having fun, and more structured training sessions. However, the coordination of training sessions was difficult. CONCLUSIONS No differences were found between dyad trainees and individual trainees in improvement of surgical skills. Off-site dyad training led to fewer, but longer training sessions, which may have negatively impacted the effectiveness of training. Dyad trainees perceived dyad training beneficial.
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Affiliation(s)
- Diana B Zetner
- From the Copenhagen Academy for Medical Education and Simulation (D.B.Z., L.K., A.F., J.B.C., E.T.), Copenhagen Ø; University of Copenhagen, Faculty of Health and Medical Sciences (L.K.), Copenhagen N; Department of Thoracic, Cardiac and Vascular Surgery (A.F.), Odense University Hospital, Odense; and Department of Obstetrics and Gynaecology, Slagelse Sygehus (E.T.), Slagelse, Denmark
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Johnson G, Vergis A, Unger B, Park J, Gillman L. Design and Validity Evidence for a Unique Endoscopy Simulator Using a Commercial Video Game. Cureus 2021; 13:e18379. [PMID: 34725623 PMCID: PMC8553393 DOI: 10.7759/cureus.18379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 11/05/2022] Open
Abstract
Background Procedural simulation enhances early endoscopy training. Multiple commercial simulators are available; however, their application is limited by cost and poor user compliance. First-person "shooter" (FPS) video games are popular. In this study, we aimed to show that a novel in-house designed colonoscope controller used to play an FPS video game shares similar constructs with real-life endoscopy. Methodology Participants completed the first three levels on an FPS video game, Portal (Valve Corporation, Bellevue, WA), first using a conventional controller and then the modified endoscope controller. A total of 12 expert endoscopists and 12 surgical residents with minimal endoscopy experience were evaluated based on completion time, button presses, and hand motion analyses. Results Experts outperformed novices for completion time (expert: 944 seconds; novice: 1,515 seconds; p = 0.006) and hand movements (expert: 1,263.1; novice: 2,052.6; p = 0.004) in using the novel colonoscope controller. There was no difference in button presses or total path length traveled. Furthermore, performance did not differ using conventional game controls. Conclusions Experts outperformed novices using the endoscope but not the conventional controller with respect to the economy of movement and completion time. This result confirms that our endoscope-controlled video game shares similar paradigms with real-life endoscopy and serves as a first step toward creating a more enjoyable and cheaper alternative to commercially available endoscopy simulators.
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Affiliation(s)
| | | | - Bertram Unger
- Internal Medicine, University of Manitoba, Winnipeg, CAN
| | - Jason Park
- Surgery, University of Manitoba, Winnipeg, CAN
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Bielsa VF. Virtual reality simulation in plastic surgery training. Literature review. J Plast Reconstr Aesthet Surg 2021; 74:2372-2378. [PMID: 33972199 DOI: 10.1016/j.bjps.2021.03.066] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 11/07/2020] [Accepted: 03/13/2021] [Indexed: 11/19/2022]
Abstract
Major changes have occurred in the medical environment leading to an evolution from the traditional residency programmes to competency-based ones. Virtual reality (VR) represents a promising simulation resource for surgical training. Several types of VR simulators can be considered, depending on the level of immersion they offer. The goal of the article is to review the progress of VR simulation in plastic surgery (PS) training. A systematic search of the literature was performed on PUBMED/MEDLINE with the following key words: (Simulation OR Virtual Reality) AND (Education OR Training) AND Plastic Surgery from January 1998 to September 2019. A total of 244 results were found, and 80 of them were selected for abstract review. Sixty-four articles were selected for complete reading. Several attempts have been made to create VR simulators and most of them are non-immersive or partially immersive. The main conclusions of them are summarized. VR simulation has been proven to have a role in PS training, offering many advantages. Furthermore, VR simulation can be used for safety training, team interaction and decision-making education. Validation is a key point for acceptance of simulators. Further efforts are required to include simulation in PS curricula.
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Affiliation(s)
- V Fuertes Bielsa
- Plastic Surgery Department University Hospital Miguel Servet Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain.
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Sloth SB, Jensen RD, Seyer-Hansen M, Christensen MK, De Win G. Remote training in laparoscopy: a randomized trial comparing home-based self-regulated training to centralized instructor-regulated training. Surg Endosc 2021; 36:1444-1455. [PMID: 33742271 PMCID: PMC7978167 DOI: 10.1007/s00464-021-08429-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/03/2021] [Indexed: 01/16/2023]
Abstract
Background Simulation-based surgical training (SBST) is key to securing future surgical expertise. Proficiency-based training (PBT) in laparoscopy has shown promising results on skills transfer. However, time constraints and limited possibilities for distributed training constitute barriers to effective PBT. Home-based training may provide a solution to these barriers and may be a feasible alternative to centralized training in times of assembly constraints. Methods We randomly assigned first-year trainees in abdominal surgery, gynecology, and urology to either centralized instructor-regulated training (CIRT) or home-based self-regulated training (HSRT) in laparoscopy. All participants trained on portable box trainers providing feedback on metrics and possibility for video reviewing. Training in both groups was structured as PBT with graded proficiency exercises adopted from the Fundamentals of Laparoscopic Surgery (FLS). The HSRT group trained at home guided by online learning materials, while the CIRT group attended two training sessions in the simulation center with feedback from experienced instructors. Performance tests consisted of hand–eye and bimanual coordination, suture and knot-tying, and FLS exercises. We analyzed passing rates, training time and distribution, and test performances. Results Passing rates were 87% and 96% in the CIRT and HSRT group, respectively. HSRT facilitated distributed training and resulted in greater variation in training times. Task times for hand–eye and bimanual coordination were significantly reduced between pretest and posttest in both groups. Trainees maintained their posttest performances at the 6-month retention test. Our analyses revealed no significant inter-group differences in performances at pretest, posttest, or retention test. Performance improvements in the two groups followed similar patterns. Conclusion CIRT and HSRT in laparoscopy result in comparable performance improvements. HSRT in laparoscopy is a feasible and effective alternative to CIRT when offered inside a supportive instructional design. Further research is needed to clarify trainees’ preferences and explore facilitators and barriers to HSRT.
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Affiliation(s)
| | - Rune Dall Jensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Corporate HR MidtSim, Central Denmark Region, Aarhus, Denmark
| | - Mikkel Seyer-Hansen
- Department of Obstetrics & Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Gunter De Win
- Antwerp Surgical Training, Anatomy and Research Center (ASTARC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Urology, University Hospital Antwerp, Edegem, Belgium
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IJgosse WM, van Goor H, Rosman C, Luursema JM. The Fun Factor: Does Serious Gaming Affect the Volume of Voluntary Laparoscopic Skills Training? World J Surg 2020; 45:66-71. [PMID: 32989581 PMCID: PMC7752875 DOI: 10.1007/s00268-020-05800-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2020] [Indexed: 01/22/2023]
Abstract
Background The availability of validated laparoscopic simulators has not resulted in sustainable high-volume training. We investigated whether the validated laparoscopic serious game Underground would increase voluntary training by residents. We hypothesized that by removing intrinsic barriers and extrinsic barriers, residents would spend more time on voluntary training with Underground compared to voluntary training with traditional simulators. Methods After 1 year, we compared amount of voluntary time spent on playing Underground to time spent on all other laparoscopic training modalities and to time spent on performing laparoscopic procedures in the OR for all surgical residents. These data were compared to resident’ time spent on laparoscopic activities over the prior year before the introduction of Underground. Results From March 2016 until March 2017, 63 residents spent on average 20 min on voluntary serious gaming, 17 min on voluntary simulator training, 2 h and 44 min on mandatory laparoscopic training courses, and 14 h and 49 min on laparoscopic procedures in the OR. Voluntary activities represented 3% of laparoscopic training activities which was similar in the prior year wherein fifty residents spent on average 33 min on voluntary simulator training, 3 h and 28 min on mandatory laparoscopic training courses, and 11 h and 19 min on laparoscopic procedures. Conclusion Serious gaming has not increased total voluntary training volume. Underground did not mitigate intrinsic and extrinsic barriers to voluntary training. Mandatory, scheduled training courses remain needed. Serious gaming is flexible and affordable and could be an important part of such training courses.
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Affiliation(s)
- Wouter Martijn IJgosse
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands. .,Radboud University Medical Center, PO Box 9101 (960), 6500 HB, Nijmegen, The Netherlands.
| | - Harry van Goor
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Camiel Rosman
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Jan-Maarten Luursema
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
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Assessment of training and selected factors on speed and quality of performing different tasks on the endoscopic simulator. Wideochir Inne Tech Maloinwazyjne 2020; 16:110-116. [PMID: 33786123 PMCID: PMC7991932 DOI: 10.5114/wiitm.2020.97364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/09/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction One of the most significant challenges nowadays is to educate and predict the predispositions of young surgeons taking into consideration that every ability has its own learning curve. Aim To determine the influence of selected factors and examine the shape and the length of the learning curve in performing simple tasks on an endoscopic simulator. Material and methods Twenty students took part in 4 training sessions with a one-week break between sessions. They were training 12 min and performed three tasks at every session on the endoscopic simulator. To identify whether selected factors influence the time of completing tasks, the participants were asked to fill in questionnaires. All participants also completed the Minnesota Manual Dexterity Test (MMDT) to assess hand-eye coordination. Results Our research reveals that regardless of activities performed in free time, the shape of the learning curve was logarithmic. Improvement after the fourth session ranged from 50% to 75%. Performing specific activities in the free time did not influence the results achieved on the simulator. No statistically significant correlation between MMDT results and the time to accomplish each task was found. Conclusions This study has shown that the length of the learning curve of performing simple tasks is quite short and the shape is logarithmic. It suggests that more complex exercises should be included in the training programme.
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Abstract
Resources are available for remote laparoscopic and basic surgical training, including core skills, psychomotor, visual–spatial, and cognitive, to improve gaps in surgical training during the coronavirus disease 2019 (COVID-19) pandemic. The coronavirus disease 2019 (COVID-19) pandemic has created a unique educational circumstance in which medical students, residents, and fellows find themselves with a gap in their surgical training. We reviewed the literature, and nine categories of resources were identified that may benefit trainees in preventing skill decay: laparoscopic box trainers, virtual reality trainers, homemade simulation models, video games, online surgical simulations, webinars, surgical videos, smartphone applications, and hobbies including mental imagery. We report data regarding effectiveness, limitations, skills incorporated, cost, accessibility, and feasibility. Although the cost and accessibility of these resources vary, they all may be considered in the design of remote surgical training curricula during this unprecedented time of the COVID-19 pandemic.
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Establishment and evaluation of a training course in advanced laparoscopic surgery based on human body donors embalmed by ethanol-glycerol-lysoformin fixation. Surg Endosc 2020; 35:1385-1394. [PMID: 32444969 PMCID: PMC7886762 DOI: 10.1007/s00464-020-07523-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 03/26/2020] [Indexed: 02/05/2023]
Abstract
Background Education of clinical anatomy and training of surgical skills are essential prerequisites for any surgical intervention in patients. Here, we evaluated a structured training program for advanced gynecologic laparoscopy based on human body donors and its impact on clinical practice. Methods The three-step training course included: (1) anatomical and surgical lectures, (2) demonstration and hands-on study of pre-dissected anatomical specimens, and (3) surgical training of a broad spectrum of gynecological laparoscopic procedures on human body donors embalmed by ethanol-glycerin-lysoformin. Two standardized questionnaires (after the course and 6 months later) evaluated the effectiveness of each of the training modules and the benefits to surgical practice. Results Eighty participants took part in 6 training courses using a total number of 24 body donors (3 trainees/body donor). Based on a 91.3% (73/80) response rate, participants rated high or very high the tissue and organ properties of the body donors (n = 72, 98.6%), the technical feasibility to perform laparoscopic surgery (n = 70, 95.9%), and the overall learning success (n = 72, 98.6%). Based on a 67.5% (54/80) response rate at 6 months, participants rated the benefit of the course to their daily routine as very high (mean 80.94 ± 24.61%, n = 53), and this correlated strongly with the use of body donors (r = 0.74) and the ability to train laparoscopic dissections (r = 0.77). Conclusions This study demonstrates the technical feasibility and didactic effectiveness of laparoscopic training courses in a professional and true-to-life setting by using ethanol-glycerol-lysoformin embalmed body donors. This cost-efficient fixation method offers the option to integrate advanced surgical training courses into structured postgraduate educational curricula to meet both the technical demands of minimal invasive surgery and the ethical concerns regarding patients´ safety.
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Force-based learning curve tracking in fundamental laparoscopic skills training. Surg Endosc 2018; 32:3609-3621. [PMID: 29423553 PMCID: PMC6061061 DOI: 10.1007/s00464-018-6090-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 02/01/2018] [Indexed: 10/26/2022]
Abstract
BACKGROUND Within minimally invasive surgery (MIS), structural implementation of courses and structured assessment of skills are challenged by availability of trainers, time, and money. We aimed to establish and validate an objective measurement tool for preclinical skills acquisition in a basic laparoscopic at-home training program. METHODS A mobile laparoscopic simulator was equipped with a state-of-the-art force, motion, and time tracking system (ForceSense, MediShield B.V., Delft, the Netherlands). These performance parameters respectively representing tissue manipulation and instrument handling were continuously tracked during every trial. Proficiency levels were set by clinical experts for six different training tasks. Resident's acquisition and development of fundamental skills were evaluated by comparing pre- and post-course assessment measurements and OSATS forms. A questionnaire was distributed to determine face and content validity. RESULTS Out of 1842 captured attempts by novices, 1594 successful trials were evaluated. A decrease in maximum exerted absolute force was shown in comparison of four training tasks (p ≤ 0.023). Three of the six comparisons also showed lower mean forces during tissue manipulation (p ≤ 0.024). Lower instrument handling outcomes (i.e., time and motion parameters) were observed in five tasks (resp. (p ≤ 0.019) and (p ≤ 0.025)). Simultaneously, all OSATS scores increased (p ≤ 0.028). Proficiency levels for all tasks can be reached in 2 weeks of at home training. CONCLUSIONS Monitoring force, motion, and time parameters during training showed to be effective in determining acquisition and development of basic laparoscopic tissue manipulation and instrument handling skills. Therefore, we were able to gain insight into the amount of training needed to reach certain levels of competence. Skills improved after sufficient amount of training at home. Questionnaire outcomes indicated that skills and self-confidence improved and that this training should therefore be part of the regular residency training program.
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Lee GI, Lee MR. Can a virtual reality surgical simulation training provide a self-driven and mentor-free skills learning? Investigation of the practical influence of the performance metrics from the virtual reality robotic surgery simulator on the skill learning and associated cognitive workloads. Surg Endosc 2017. [DOI: 10.1007/s00464-017-5634-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Validation of a Cognitive Task Simulation and Rehearsal Tool for Open Carpal Tunnel Release. Arch Plast Surg 2017; 44:223-227. [PMID: 28573097 PMCID: PMC5447532 DOI: 10.5999/aps.2017.44.3.223] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 08/01/2016] [Accepted: 08/17/2016] [Indexed: 11/08/2022] Open
Abstract
Background Carpal tunnel release is one of the most common surgical procedures performed by hand surgeons. The authors created a surgical simulation of open carpal tunnel release utilizing a mobile and rehearsal platform app. This study was performed in order to validate the simulator as an effective training platform for carpal tunnel release. Methods The simulator was evaluated using a number of metrics: construct validity (the ability to identify variability in skill levels), face validity (the perceived ability of the simulator to teach the intended material), content validity (that the simulator was an accurate representation of the intended operation), and acceptability validity (willingness of the desired user group to adopt this method of training). Novices and experts were recruited. Each group was tested, and all participants were assigned an objective score, which served as construct validation. A Likert-scale questionnaire was administered to gauge face, content, and acceptability validity. Results Twenty novices and 10 experts were recruited for this study. The objective performance scores from the expert group were significantly higher than those of the novice group, with surgeons scoring a median of 74% and medical students scoring a median of 45%. The questionnaire responses indicated face, content, and acceptability validation. Conclusions This mobile-based surgical simulation platform provides step-by-step instruction for a variety of surgical procedures. The findings of this study help to demonstrate its utility as a learning tool, as we confirmed construct, face, content, and acceptability validity for carpal tunnel release. This easy-to-use educational tool may help bring surgical education to a new—and highly mobile—level.
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Seewoonarain S, Barrett M. The technological evolution in surgical skills. CLINICAL TEACHER 2017; 14:370-371. [DOI: 10.1111/tct.12643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Michael Barrett
- Trauma and Orthopaedics Department; Ipswich NHS Hospital Trust; UK
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Gostlow H, Marlow N, Babidge W, Maddern G. Systematic Review of Voluntary Participation in Simulation-Based Laparoscopic Skills Training: Motivators and Barriers for Surgical Trainee Attendance. JOURNAL OF SURGICAL EDUCATION 2017; 74:306-318. [PMID: 27836238 DOI: 10.1016/j.jsurg.2016.10.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/06/2016] [Accepted: 10/06/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To examine and report on evidence relating to surgical trainees' voluntary participation in simulation-based laparoscopic skills training. Specifically, the underlying motivators, enablers, and barriers faced by surgical trainees with regard to attending training sessions on a regular basis. DESIGN A systematic search of the literature (PubMed; CINAHL; EMBASE; Cochrane Collaboration) was conducted between May and July 2015. Studies were included on whether they reported on surgical trainee attendance at voluntary, simulation-based laparoscopic skills training sessions, in addition to qualitative data regarding participant's perceived barriers and motivators influencing their decision to attend such training. Factors affecting a trainee's motivation were categorized as either intrinsic (internal) or extrinsic (external). RESULTS Two randomised control trials and 7 case series' met our inclusion criteria. Included studies were small and generally poor quality. Overall, voluntary simulation-based laparoscopic skills training was not well attended. Intrinsic motivators included clearly defined personal performance goals and relevance to clinical practice. Extrinsic motivators included clinical responsibilities and available free time, simulator location close to clinical training, and setting obligatory assessments or mandated training sessions. The effect of each of these factors was variable, and largely dependent on the individual trainee. The greatest reported barrier to attending voluntary training was the lack of available free time. CONCLUSION Although data quality is limited, it can be seen that providing unrestricted access to simulator equipment is not effective in motivating surgical trainees to voluntarily participate in simulation-based laparoscopic skills training. To successfully encourage participation, consideration needs to be given to the factors influencing motivation to attend training. Further research, including better designed randomised control trials and large-scale surveys, is required to provide more definitive answers to the degree in which various incentives influence trainees' motivations and actual attendance rates.
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Affiliation(s)
- Hannah Gostlow
- Division of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia; Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S), Royal Australasian College of Surgeons, North Adelaide, South Australia, Australia
| | - Nicholas Marlow
- Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S), Royal Australasian College of Surgeons, North Adelaide, South Australia, Australia
| | - Wendy Babidge
- Division of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia; Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S), Royal Australasian College of Surgeons, North Adelaide, South Australia, Australia
| | - Guy Maddern
- Division of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia; Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S), Royal Australasian College of Surgeons, North Adelaide, South Australia, Australia.
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Nicol LG, Walker KG, Cleland J, Partridge R, Moug SJ. Incentivising practice with take-home laparoscopic simulators in two UK Core Surgical Training programmes. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2016; 2:112-117. [DOI: 10.1136/bmjstel-2016-000117] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/29/2016] [Indexed: 11/04/2022]
Abstract
IntroductionPractice using simulators has been validated as a mean for surgical trainees to improve basic laparoscopic skills and free their attention for higher cognitive functions. However, mere provision of equipment does not result in frequent practice. This study assesses one approach to incentivising practice within core surgical training programmes and leads to further recommendations.Methods30 core surgical trainees (CST) starting laparoscopic-based specialties were recruited from East and West of Scotland CST programmes and given take-home laparoscopic simulators, with six training modules. Attainment of target metric scores generated an eCertificate, to be rewarded by progression in the live theatre. Questionnaires assessed confounding variables and explored CSTs’ anxieties about laparoscopy.Results27 trainees (90%) agreed to participate (mean age 28 years, range 24–25; 17 males). 13 CSTs (48%) were in the first year of surgical training. 11 (41%) had no previous simulation experience and 7 (32%) CSTs played video games >3 hours/week. 12 of 27 trainees (44%) completed ≥1 task and 7 completed all (26%).Performances improved in some participants, but overall engagement with the programme was poor. Reasons given included poor internet connectivity, busy rotations and examinations. CSTs who engaged in the study significantly reduced their anxiety (mean 4.96 vs 3.56, p<0.05).ConclusionsThe provision of take-home laparoscopic simulators with accompanying targets did not successfully incentivise CSTs to practise. However, the subgroup who did engage with the project reported performance improvements and significantly reduced anxiety. Proposals to overcome barriers to practising in simulation, including obligatory simulation-based assessments, are discussed.
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Thinggaard E, Konge L, Bjerrum F, Strandbygaard J, Gögenur I, Spanager L. Take-home training in a simulation-based laparoscopy course. Surg Endosc 2016; 31:1738-1745. [PMID: 27515838 DOI: 10.1007/s00464-016-5166-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 07/30/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND Simulation training can prepare trainees for clinical practice in laparoscopic surgery. Training on box trainers allows for simulation training at home, which studies have shown to be a feasible method of training. However, little research has been conducted into how to make it a more efficient method of training. Our aim was to investigate how box trainers are used in take-home training to help guide the design of take-home training courses. METHODS This study was designed using a mixed methods approach. Junior doctors participating in a laparoscopy curriculum, which included practising at home on box trainers, were invited. Quantitative data on training patterns was collected from logbooks. Qualitative data on the use of box trainers was retrieved from focus groups and individual interviews. RESULTS From logbooks, we found that 14 out of 18 junior doctors mixed their training modalities, and four practised first on box trainers then on virtual reality simulators. Twelve practised only at home, while five practised at both places and one practised solely at the simulation centre. After a delayed start, most practised for some time, then had a period without training and then started training again towards the end of the course. We found that the themes of the interviews were: training method, training pattern, feedback and self-regulation. Participants identified the lack of feedback as challenging but described how self-rating provided direction during unsupervised training. Mandatory training elements affected when and how much participants practised. CONCLUSIONS When participants practised at home, they took an individualised approach to training. They mixed their training at home with training at the simulation centre. Participants practised at the beginning and towards the end of the course. Self-rating helped to guide unsupervised training where feedback was not accessible. Curricular requirements and testing determined when and how much participants practised.
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Affiliation(s)
- Ebbe Thinggaard
- Copenhagen Academy for Medical Education and Simulation, Capital Region Denmark, Copenhagen, Denmark.
- Department of Surgery, Zealand University Hospital, Lykkebaekvej 1, 4600, Koege, Denmark.
| | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation, Capital Region Denmark, Copenhagen, Denmark
| | - Flemming Bjerrum
- Department of Surgery, Zealand University Hospital, Lykkebaekvej 1, 4600, Koege, Denmark
| | | | - Ismail Gögenur
- Department of Surgery, Zealand University Hospital, Lykkebaekvej 1, 4600, Koege, Denmark
| | - Lene Spanager
- Department of Surgery, Nordsjaellands Hospital, Hilleroed, Denmark
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Optimizing the Timing of Expert Feedback During Simulation-Based Spaced Practice of Endourologic Skills. ACTA ACUST UNITED AC 2016; 11:257-63. [DOI: 10.1097/sih.0000000000000165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Thinggaard E, Kleif J, Bjerrum F, Strandbygaard J, Gögenur I, Matthew Ritter E, Konge L. Off-site training of laparoscopic skills, a scoping review using a thematic analysis. Surg Endosc 2016; 30:4733-4741. [DOI: 10.1007/s00464-016-4834-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 02/15/2016] [Indexed: 01/22/2023]
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Sugand K, Mawkin M, Gupte C. Training effect of using Touch Surgery for intramedullary femoral nailing. Injury 2016; 47:448-52. [PMID: 26596416 DOI: 10.1016/j.injury.2015.09.036] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 08/11/2015] [Accepted: 09/28/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Simulation in orthopaedic training is becoming increasingly popular and has been widely used in formal curricula. However, these resources are expensive and not easily accessible to every trainee. Other means of disseminating surgical education through virtual reality (VR) multimedia can act as useful adjunct to traditional methods of teaching. One validated VR platform is Touch Surgery, a cognitive task simulation and rehearsal app. OBJECTIVES The primary objective of this study was to identify the training effect of Touch Surgery intramedullary femoral nailing (IFN) modules using objective performance metrics over six consecutive attempts. Secondary objectives consisted of validated multiple choice questions (MCQ) testing before the first (pre) and after the sixth (post) attempts. METHODS 27 medical undergraduates were recruited to complete the decision-making process six consecutive times for four modules on the procedural steps of IFN. The modules consisted of (i) preparing the patient and equipment, (ii) femoral canal preparation, (iii) nail insertion and proximal locking, and (iv) distal locking and closure. Real-time objective performance metrics were obtained, stored electronically and analysed using the median and Bonett-Price 95% confidence intervals from the participants' attempts to assess training effect. Significance was calculated using the Mann-Whitney U test for independent data whilst the Wilcoxon signed ranked test was used for paired data. Significance was set as 2-tailed p-value <0.05. RESULTS Median performance scores per attempt for all four modules demonstrated a significant improvement ranging from 58 to 115%. Scoring variability and distribution was reduced and more predictable per attempt. Logarithmic learning curves elicited strong positive correlations between the number of attempts and scoring. Mean scores for pre and post-study MCQs tests significantly improved from 83 to 94% in all modules. CONCLUSION IFN modules on Touch Surgery app demonstrated a significant training effect with practice. Novices demonstrated cognitive competencies to ensure patient safety prior to operating. The app is an effective adjunct to traditional learning methods and has the potential for curricular implementation.
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Affiliation(s)
- Kapil Sugand
- MSk Lab, Imperial College London, Level 7 East, Charing Cross Hospital, Fulham, London W6 8RF, UK.
| | - Mala Mawkin
- MSk Lab, Imperial College London, Level 7 East, Charing Cross Hospital, Fulham, London W6 8RF, UK.
| | - Chinmay Gupte
- MSk Lab, Imperial College London, Level 7 East, Charing Cross Hospital, Fulham, London W6 8RF, UK.
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van der Aa JE, Schreuder HWR. Training Laparoscopic Skills at Home: Residents' Opinion of a New Portable Tablet Box Trainer. Surg Innov 2015; 23:196-200. [PMID: 26464469 DOI: 10.1177/1553350615610654] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine residents' opinion about a new portable box trainer, to see if they would be interested in using this for training at home, and to give an overview of the box trainers that could be used at home. METHODS An expert opinion study was performed among 27 gynecology residents to determine the value of the portable box trainer in training their laparoscopic skills and the value of using it at home. Their opinions were scored on a 5-point Likert scale. RESULTS Gynecology residents very much appreciated the portable box trainer in its design, size, visualization, light source, ability to record, and instruments (all median 4). They felt that the portable box trainer would be effective in training laparoscopic skills in general; in training hand-eye coordination, 3D perception, and tying knots (all median 4); and especially in training basic skills (median 5). Almost all residents would use the portable box trainer if they had one at home (median 5). The literature supports the hypothesis that training laparoscopic skills at home using a box trainer may be effective in acquiring and maintaining laparoscopic skills. CONCLUSIONS Training laparoscopic skills at home using a portable box trainer may be of added value in the laparoscopic training of surgical residents. Residents feel positive about using the new portable box trainer that is presented and appreciate the possibility of training at home.
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Aslam A, Nason GJ, Giri SK. Homemade laparoscopic surgical simulator: a cost-effective solution to the challenge of acquiring laparoscopic skills? Ir J Med Sci 2015; 185:791-796. [DOI: 10.1007/s11845-015-1357-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 09/05/2015] [Indexed: 11/29/2022]
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Castillo R, Buckel E, León F, Varas J, Alvarado J, Achurra P, Aggarwal R, Jarufe N, Boza C. Effectiveness of learning advanced laparoscopic skills in a brief intensive laparoscopy training program. JOURNAL OF SURGICAL EDUCATION 2015; 72:648-653. [PMID: 26073475 DOI: 10.1016/j.jsurg.2015.01.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 01/15/2015] [Accepted: 01/23/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Intensive training programs arose from limitations in access to simulation centers. The aim of this study is to evaluate the effect and associated factors involved in an intensive course for learning advanced laparoscopic skills, which include validated teaching techniques. METHODS General surgeons and final-year residents were analyzed after completing an intensive 5-session advanced laparoscopy course. Initial (IA) and final assessment (FA) consisted in performing a jejunojejunal anastomosis in a live porcine model, measured using objective structured assessment of technical skill (OSATS) (GRS and SRS, that is, global rating scale and specific rating scale, respectively) and operative time (OT). The 3-session training was structured in a bench model with an ex vivo bowel. For the demographic analysis, 3 groups were defined according to the presentation of relevant changes in OSATS and in OT between IA and FA: group A, no changes; group B, change in 1 variable; and group C, change in both variables. RESULTS After the course, all 114 participants presented a significant improvement in OT (37 vs 24.6min, p < 0.001) and in OSATS; global rating scale (10.5 vs 16 points; p < 0.001) and Specific Rating Scale (8.5 vs 12.7 points; p < 0.001). In the IA, 70 (61%) participants completed the jejunojejunal anastomosis and 105(92%) in the FA (p < 0.01). In the FA, 56% of participants presented relevant changes in both variables (group C). This group was significantly younger (34 vs 45 vs 40y old; p < 0.001), had fewer years of surgical experience (2 vs 9 vs 5y; p < 0.001), and had a proportionally higher concentration of residents (p = 0.01). CONCLUSIONS This intensive course is set out as a viable alternative to teach basic skills in advanced laparoscopy in a short period of time, which is ideal for surgeons with difficult access to training centers. It remains necessary to establish the participant profile for which this type of course is most beneficial.
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Affiliation(s)
- Richard Castillo
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Erwin Buckel
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Felipe León
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Julián Varas
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan Alvarado
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Achurra
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rajesh Aggarwal
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Department of Surgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Arnold and Blema Steinberg Medical Simulation Centre, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Nicolás Jarufe
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Camilo Boza
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Laparoscopic suturing learning curve in an open versus closed box trainer. Surg Endosc 2015; 30:315-22. [PMID: 25939742 PMCID: PMC4710670 DOI: 10.1007/s00464-015-4211-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 04/08/2015] [Indexed: 01/22/2023]
Abstract
Background The aim of this study was to examine the influence of training under direct vision prior to training with indirect vision on the learning curve of the laparoscopic suture task. Methods Novices were randomized in two groups. Group 1 performed three suturing tasks in a transparent laparoscopic box trainer under direct vision followed by three suturing tasks in a standard non-transparent laparoscopic box trainer equipped with a 0° laparoscope. Group 2 performed six suturing tasks in a standard laparoscopic box trainer. Performance time, motion analysis parameters (economy of movements) and interaction force parameters (tissue handling) were measured. Participants completed a questionnaire assessing: self-perceived dexterity before and after the training, their experienced frustration and the difficulty of the training. Results A total of 34 participants were included, one was excluded because of incomplete training. Group 1 used significantly less time to complete the total of six tasks (27 %). At the end of the training, there were no differences in motion or force parameters between the two groups. Group 2 rated their self-perceived dexterity after the training significantly lower than before the training and also reported significantly higher levels of frustration compared to group 1. Both groups rated the difficulty of the training similar. Conclusion Novices benefit from starting their training of difficult basic laparoscopic skills, e.g., suturing, in a transparent box trainer without camera. It takes less time to complete the tasks, and they get less frustrated by the training with the same results on their economy of movements and tissue handling skills.
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Wong IH, Denkers MR, Urquhart NA, Farrokhyar F. Systematic instruction of arthroscopic knot tying with the ArK Trainer: an objective evaluation tool. Knee Surg Sports Traumatol Arthrosc 2015; 23:912-8. [PMID: 23807030 DOI: 10.1007/s00167-013-2567-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Accepted: 06/10/2013] [Indexed: 12/26/2022]
Abstract
PURPOSE A Proficiency Formula was introduced as an objective self-evaluation method for evaluating basic arthroscopic knot tying in a laboratory setting. The correlation between the Proficiency Formula and gold standard pass/fail dichotomy was demonstrated, as well as with other popular evaluation tools--task-specific checklist (TSC) and global rating scale (GRS). METHOD A step-by-step video tutorial was used to instruct 35 medical students on how to tie an arthroscopic Samsung Medical Center (SMC) knot secured by three half hitches. Participants were video recorded performing arthroscopic knot tying and assessed on their success tying an SMC knot, pass or fail, and through three outcome tools: the Proficiency Formula, GRS and the TSC. Independent samples t test was used to compare the GRS, TSC and Proficiency Formula scores, between those who were passed or failed by the evaluators. Correlation between the measurement scales was tested using Spearman's rho correlation coefficient. RESULTS Participants received a mean proficiency score of 195 (140-249). The mean Proficiency score for those that passed was 323 (95 % CI 272-374), for those that failed, 87 (95 % CI 26-148, p < 0.001). We found strong linear correlation between the Proficiency Formula and GRS and TSE (0.83 and 0.78, respectively). CONCLUSION The Proficiency Formula has high correlation with gold standard GRS and TSC measurements when used to assess arthroscopic knot tying skills on a model. It has the added advantage of being able to be self-assessed.
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Affiliation(s)
- Ivan H Wong
- , 2nd Floor Rm 2106, QEII Camp Hill Veteran's Memorial Building, 5655 Veterans' Memorial Building, Halifax, NS, B3H 2E1, Canada,
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Zapf MAC, Ujiki MB. Surgical resident evaluations of portable laparoscopic box trainers incorporated into a simulation-based minimally invasive surgery curriculum. Surg Innov 2014; 22:83-7. [PMID: 24925895 DOI: 10.1177/1553350614535858] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Box trainers have been shown to be an effective tool for teaching laparoscopic skills; however, residents are challenged to find practice time. Portable trainers theoretically allow for extended hands on practice out of the hospital. We aimed to report resident experience with laparoscopic home box trainers. METHODS Over 2 years, all residents rotating through a minimally invasive service were given a portable trainer and access to a surgical simulation lab for practice. Each trainer contained a collapsible frame, a webcam with USB port, trocars, and laparoscopic instruments (needle driver, shears, Maryland and straight dissecting graspers) as well as Fundamentals of Laparoscopic Surgery skills testing materials. Residents were asked to log hours, usages, and their experience anonymously. RESULTS Twenty-three residents received a portable trainer. Fifty percent of the participants found the trainer useful or very useful, 25% said it was not useful, and 25% did not access the trainer. Those that used the trainer during their rotation did so 3.1 ± 3.0 times for 2.9 ± 3.0 hours/week. After completing their rotation, 5 of 12 residents used their trainer for an average of 10.2 ± 9.4 hours. Forty-two percent of the responders liked the accessibility of the home box trainers, while 25% criticized the camera-computer interface. CONCLUSIONS Portable box trainers are useful and can effectively supplement a laboratory-based surgical simulation curriculum; however, personal possession of a portable simulator does not result in voluntarily long-term practice.
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Affiliation(s)
| | - Michael B Ujiki
- NorthShore University HealthSystem, Evanston, IL, USA University of Chicago, Chicago, IL, USA
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Dehabadi M, Fernando B, Berlingieri P. The use of simulation in the acquisition of laparoscopic suturing skills. Int J Surg 2014; 12:258-68. [DOI: 10.1016/j.ijsu.2014.01.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Accepted: 01/25/2014] [Indexed: 01/19/2023]
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Strandbygaard J, Bjerrum F, Maagaard M, Rifbjerg Larsen C, Ottesen B, Sorensen JL. A structured four-step curriculum in basic laparoscopy: development and validation. Acta Obstet Gynecol Scand 2014; 93:359-66. [PMID: 24392777 DOI: 10.1111/aogs.12330] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 12/30/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The objective of this study was to develop a four-step curriculum in basic laparoscopy consisting of validated modules integrating a cognitive component, a practical component and a procedural component. DESIGN A four-step curriculum was developed. The methodology was different for each step. Step 1: A 1-day course in basic laparoscopy developed on the background of a regional needs analysis. Step 2: A multiple-choice test, developed and validated through interviews with experts in laparoscopy and subsequently through a Delphi audit involving regional chief physicians. Step 3: A procedural training task (a salpingectomy) on a validated virtual reality simulator. Step 4: An operation on a patient (a salpingectomy) with following formative assessment based on a validated assessment scale. SETTING University hospital, Copenhagen, Denmark. POPULATION Fifty-two first-year residents in obstetrics and gynecology from 2009 to 2011. METHOD Observational cohort study. MAIN OUTCOME MEASURE Completion rate. RESULTS All participants completed step 1 and improved post-course test scores compared with pre-course test scores, p = 0.001. Step 2 was completed by 75% (37/52); all improved test scores after 6 months, p = 0.001. Step 3 was completed by 75%. Participants used 238 min (range 75-599) and 38 repetitions (range 8-99) to reach proficiency level on a virtual reality simulator. Step 4 was completed by 55%. There was no correlation between test scores and simulator training time. Protected training time was correlated with increasing completion rate. CONCLUSION A four-step curriculum in basic laparoscopy is applicable in residency training. Protected training time correlated with increasing completion rate.
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Affiliation(s)
- Jeanett Strandbygaard
- Department of Obstetrics and Gynecology, Juliane Marie Center, Center for Children, Women and Reproduction, Rigshospitalet University Hospital, Copenhagen, Denmark
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Burden C, Appleyard TL, Angouri J, Draycott TJ, McDermott L, Fox R. Implementation of laparoscopic virtual-reality simulation training in gynaecology: a mixed-methods design. Eur J Obstet Gynecol Reprod Biol 2013; 170:474-9. [PMID: 23932183 DOI: 10.1016/j.ejogrb.2013.07.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 04/10/2013] [Accepted: 07/01/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Virtual-reality (VR) training has been demonstrated to improve laparoscopic surgical skills in the operating theatre. The incorporation of laparoscopic VR simulation into surgical training in gynaecology remains a significant educational challenge. We undertook a pilot study to assess the feasibility of the implementation of a laparoscopic VR simulation programme into a single unit. STUDY DESIGN An observational study with qualitative analysis of semi-structured group interviews. Trainees in gynaecology (n=9) were scheduled to undertake a pre-validated structured training programme on a laparoscopic VR simulator (LapSim(®)) over six months. The main outcome measure was the trainees' progress through the training modules in six months. Trainees' perceptions of the feasibility and barriers to the implementation of laparoscopic VR training were assessed in focus groups after training. RESULTS Sixty-six percent of participants completed six of ten modules. Overall, feedback from the focus groups was positive; trainees felt training improved their dexterity, hand-eye co-ordination and confidence in theatre. Negative aspects included lack of haptic feedback, and facility for laparoscopic port placement training. Time restriction emerged as the main barrier to training. CONCLUSIONS Despite positive perceptions of training, no trainee completed more than two-thirds of the modules of a self-directed laparoscopic VR training programme. Suggested improvements to the integration of future laparoscopic VR training include an additional theoretical component with a fuller understanding of benefits of VR training, and scheduled supervision. Ultimately, the success of a laparoscopic VR simulation training programme might only be improved if it is a mandatory component of the curriculum, together with dedicated time for training. Future multi-centred implementation studies of validated laparoscopic VR curricula are required.
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Affiliation(s)
- Christy Burden
- The Womens' Centre, Gloucestershire Hospital, Great Western Road, Gloucestershire GL1 3NN, UK; Research into Safety and Quality (RiSQ), Southmead Hospital, Westbury on Trym, Bristol BS10 5NB, UK.
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Learning curve on the TrEndo laparoscopic simulator compared to an expert level. Surg Endosc 2013; 27:2934-9. [DOI: 10.1007/s00464-013-2859-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Accepted: 01/28/2013] [Indexed: 12/17/2022]
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Current world literature. Curr Opin Anaesthesiol 2012; 25:743-8. [PMID: 23147670 DOI: 10.1097/aco.0b013e32835b8a43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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