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Khan MTA, Patnaik R, Lee CS, Willson CM, Demario VK, Krell RW, Laverty RB. Systematic review of academic robotic surgery curricula. J Robot Surg 2022; 17:719-743. [DOI: 10.1007/s11701-022-01500-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022]
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Gabbott B, Tennent D, Snelgrove H. Effect of mental rehearsal on team performance and non-technical skills in surgical teams: systematic review. BJS Open 2020; 4:1062-1071. [PMID: 33128427 PMCID: PMC7709374 DOI: 10.1002/bjs5.50343] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 07/21/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Simulation-based training in medical education has become a common method to develop both technical and non-technical skills in teams. Mental rehearsal (MR) is the cognitive act of simulating a task in our heads to pre-experience tasks imaginatively. It has been used widely to improve individual and collective performance in fields outside healthcare, and offers potential for more efficient training in time-pressured surgical and medical team contexts. This study aimed to review the available literature to determine the impact of MR on team performance and non-technical skills in healthcare. METHODS MEDLINE, Embase, British Educational Index, CINAHL, Web of Science, PsycInfo and Cochrane databases were searched for the period 1994-2018. The primary outcome measure was improvement in team performance and non-technical skills. Study quality of RCTs was assessed using the Medical Education Research Quality Instrument. The reported impacts of MR in all included studies were mapped on to the Kirkpatrick framework for evaluation of educational interventions. RESULTS Eight studies with 268 participants were identified that met the inclusion criteria, of which there were six randomized trials, one prospective pragmatic trial and one qualitative study. Three studies found MR to be effective in improving team non-technical skills. MR practices were varied and often poorly defined. MR benefited team non-technical skills when it was specifically designed to do so, but was not an automatic consequence of technical MR alone. The majority of studies demonstrated benefits of MR for technical performance, but only three showed positive impacts on teamwork. Overall the studies were of low quality and lacked sufficient discriminatory focus to examine impacts on teamwork dynamics. CONCLUSION MR can improve technical performance, but the benefits on non-technical skills are less clear. Future research should look at longitudinal mixed-method evaluation designs and focus on real clinical teams.
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Affiliation(s)
| | | | - H. Snelgrove
- St George's Advanced Patient Simulation and Skills Centre, Department of Education and DevelopmentSt George's University Hospitals NHS Foundation TrustLondonUK
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Versteeg M, Hendriks RA, Thomas A, Ommering BWC, Steendijk P. Conceptualising spaced learning in health professions education: A scoping review. MEDICAL EDUCATION 2020; 54:205-216. [PMID: 31860936 PMCID: PMC7064953 DOI: 10.1111/medu.14025] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/05/2019] [Accepted: 10/21/2019] [Indexed: 05/10/2023]
Abstract
OBJECTIVES To investigate the definitions and applications of 'spaced learning' and to propose future directions for advancing its study and practice in health professions education. METHOD The authors searched five online databases for articles published on spaced learning in health professions education prior to February 2018. Two researchers independently screened articles for eligibility with set inclusion criteria. They extracted and analysed key data using both quantitative and qualitative methods. RESULTS Of the 2972 records retrieved, 120 articles were included in the review. More than 90% of these articles were published in the last 10 years. The definition of spaced learning varied widely and was often not theoretically grounded. Spaced learning was applied in distinct contexts, including online learning, simulation training and classroom settings. There was a large variety of spacing formats, ranging from dispersion of information or practice on a single day, to intervals lasting several months. Generally, spaced learning was implemented in practice or testing phases and rarely during teaching. CONCLUSIONS Spaced learning is infrequently and poorly defined in the health professions education literature. We propose a comprehensive definition of spaced learning and emphasise that detailed descriptions of spacing formats are needed in future research to facilitate the operationalisation of spaced learning research and practice in health professions education.
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Affiliation(s)
- Marjolein Versteeg
- Department of CardiologyLeiden University Medical CenterLeidenthe Netherlands
- Center for Innovation In Medical EducationLeiden University Medical CenterLeidenthe Netherlands
| | - Renée A. Hendriks
- Center for Innovation In Medical EducationLeiden University Medical CenterLeidenthe Netherlands
| | - Aliki Thomas
- School of Physical and Occupational TherapyMontrealQuébecCanada
- Faculty of MedicineInstitute for Health Sciences EducationMcGill UniversityMontrealQuébecCanada
- Centre for Interdisciplinary Research in RehabilitationMontrealQuébecCanada
| | - Belinda W. C. Ommering
- Center for Innovation In Medical EducationLeiden University Medical CenterLeidenthe Netherlands
| | - Paul Steendijk
- Department of CardiologyLeiden University Medical CenterLeidenthe Netherlands
- Center for Innovation In Medical EducationLeiden University Medical CenterLeidenthe Netherlands
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A Taxonomy Guide for Surgical Simulation. COMPREHENSIVE HEALTHCARE SIMULATION: SURGERY AND SURGICAL SUBSPECIALTIES 2019. [DOI: 10.1007/978-3-319-98276-2_3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Simulation as a surgical teaching model. Cir Esp 2017; 96:12-17. [PMID: 29054573 DOI: 10.1016/j.ciresp.2017.09.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/21/2017] [Accepted: 09/09/2017] [Indexed: 01/22/2023]
Abstract
Teaching of surgery has been affected by many factors over the last years, such as the reduction of working hours, the optimization of the use of the operating room or patient safety. Traditional teaching methodology fails to reduce the impact of these factors on surgeońs training. Simulation as a teaching model minimizes such impact, and is more effective than traditional teaching methods for integrating knowledge and clinical-surgical skills. Simulation complements clinical assistance with training, creating a safe learning environment where patient safety is not affected, and ethical or legal conflicts are avoided. Simulation uses learning methodologies that allow teaching individualization, adapting it to the learning needs of each student. It also allows training of all kinds of technical, cognitive or behavioural skills.
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White C, Rodger MWM, Tang T. Current understanding of learning psychomotor skills and the impact on teaching laparoscopic surgical skills. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/tog.12255] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Colette White
- Royal Jubilee Maternity Services; Belfast Health and Social Care Trust; 274 Grosvenor Road Belfast BT12 6BA UK
| | - Matthew WM Rodger
- Department of Psychology; Queen's University Belfast; Belfast BT9 5BN UK
| | - Thomas Tang
- Regional Fertility Centre; Royal Jubilee Maternity Services; Belfast Health and Social Care Trust; Belfast BT12 6BA UK
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Multimodal Perioperative Ultrasound Course for Interns Allows for Enhanced Acquisition and Retention of Skills and Knowledge. ACTA ACUST UNITED AC 2015; 5:119-23. [DOI: 10.1213/xaa.0000000000000200] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Abstract
Considerable progress has been made regarding the range of simulator technologies and simulation formats. Similarly, results from research in human learning and behavior have facilitated the development of best practices in simulation-based training (SBT) and surgical education. Today, SBT is a common curriculum component in surgical education that can significantly complement clinical learning, performance, and patient care experiences. Beginning with important considerations for selecting appropriate forms of simulation, several relevant educational theories of learning are described.
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Affiliation(s)
- Sheila W Chauvin
- Office of Medical Education Research and Development, Louisiana State University Health Sciences Center - New Orleans, School of Medicine, 2020 Gravier Street, Suite 657, New Orleans, LA 70112, USA.
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Vaz-Guimaraes F, Rastelli MM, Fernandez-Miranda JC, Wang EW, Gardner PA, Snyderman CH. Impact of Dynamic Endoscopy and Bimanual-Binarial Dissection in Endoscopic Endonasal Surgery Training: A Laboratory Investigation. J Neurol Surg B Skull Base 2015; 76:365-71. [PMID: 26401478 DOI: 10.1055/s-0034-1544124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 11/25/2014] [Indexed: 12/11/2022] Open
Abstract
Objective The lack of a standard technique may be a relevant issue in teaching endoscopic endonasal surgery (EES) to novice surgeons. The objective of this article is to compare different endoscope positioning and microsurgical dissection techniques in EES training. Methods A comparative trial was designed to evaluate three techniques: group A, one surgeon performing binarial two-hands dissection using an endoscope holder (rigid endoscopy); group B, two surgeons performing a combined binarial two- and three-handed dissection with one surgeon guiding the endoscope (dynamic endoscopy); and group C, two surgeons performing a binarial two-hands dissection with one surgeon dedicated to endoscope positioning and the other dedicated to a two-handed dissection. Trainees were randomly assigned to these groups and oriented to complete surgical tasks in a validated training model for EES. A global rating scale, and a specific-task checklist for EES were used to assess surgical skills. Results The mean scores of the global rating scale and the specific-task checklist were higher (p = 0.001 and 0.002, respectively) for group C, reflecting the positive impact of dynamic endoscopy and bimanual dissection on training performance. Conclusions We found that dynamic endoscopic and bimanual-binarial microdissection techniques had a significant positive impact on EES training.
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Affiliation(s)
- Francisco Vaz-Guimaraes
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Milton M Rastelli
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Juan C Fernandez-Miranda
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Eric W Wang
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Paul A Gardner
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Carl H Snyderman
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States ; Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
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Brewin J, Tang J, Dasgupta P, Khan MS, Ahmed K, Bello F, Kneebone R, Jaye P. Full immersion simulation: validation of a distributed simulation environment for technical and non-technical skills training in Urology. BJU Int 2015; 116:156-62. [DOI: 10.1111/bju.12875] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- James Brewin
- Kings Health Partners; Guy's and St Thomas NHS Foundation Trust; London UK
| | | | - Prokar Dasgupta
- Kings Health Partners; Guy's and St Thomas NHS Foundation Trust; London UK
| | - Muhammad S. Khan
- Kings Health Partners; Guy's and St Thomas NHS Foundation Trust; London UK
| | - Kamran Ahmed
- Kings Health Partners; Guy's and St Thomas NHS Foundation Trust; London UK
| | | | | | - Peter Jaye
- Kings Health Partners; Guy's and St Thomas NHS Foundation Trust; London UK
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Saurin TA, Wachs P, Righi AW, Henriqson E. The design of scenario-based training from the resilience engineering perspective: a study with grid electricians. ACCIDENT; ANALYSIS AND PREVENTION 2014; 68:30-41. [PMID: 23835132 DOI: 10.1016/j.aap.2013.05.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Revised: 05/13/2013] [Accepted: 05/28/2013] [Indexed: 06/02/2023]
Abstract
Although scenario-based training (SBT) can be an effective means to help workers develop resilience skills, it has not yet been analyzed from the resilience engineering (RE) perspective. This study introduces a five-stage method for designing SBT from the RE view: (a) identification of resilience skills, work constraints and actions for re-designing the socio-technical system; (b) design of template scenarios, allowing the simulation of the work constraints and the use of resilience skills; (c) design of the simulation protocol, which includes briefing, simulation and debriefing; (d) implementation of both scenarios and simulation protocol; and (e) evaluation of the scenarios and simulation protocol. It is reported how the method was applied in an electricity distribution company, in order to train grid electricians. The study was framed as an application of design science research, and five research outputs are discussed: method, constructs, model of the relationships among constructs, instantiations of the method, and theory building. Concerning the last output, the operationalization of the RE perspective on three elements of SBT is presented: identification of training objectives; scenario design; and debriefing.
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Affiliation(s)
| | - Priscila Wachs
- Industrial Engineering and Transportation Department (DEPROT), Federal University of Rio Grande do Sul (UFRGS), Av. Osvaldo Aranha, 99, 5 andar, CEP 90035-190 Porto Alegre, RS, Brazil.
| | | | - Eder Henriqson
- PUCRS (Pontifícia Universidade Católica do Rio, Grande do Sul), Porto Alegre, RS, Brazil.
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Mitchell JD, Mahmood F, Bose R, Hess PE, Wong V, Matyal R. Novel, Multimodal Approach for Basic Transesophageal Echocardiographic Teaching. J Cardiothorac Vasc Anesth 2014; 28:800-9. [DOI: 10.1053/j.jvca.2014.01.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Indexed: 01/06/2023]
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Denadai R, Saad-Hossne R, Todelo AP, Kirylko L, Souto LRM. Low-fidelity bench models for basic surgical skills training during undergraduate medical education. Rev Col Bras Cir 2014; 41:137-45. [PMID: 24918729 DOI: 10.1590/s0100-69912014000200012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 01/15/2013] [Indexed: 02/08/2023] Open
Abstract
It is remarkable the reduction in the number of medical students choosing general surgery as a career. In this context, new possibilities in the field of surgical education should be developed to combat this lack of interest. In this study, a program of surgical training based on learning with models of low-fidelity bench is designed as a complementary alternative to the various methodologies in the teaching of basic surgical skills during medical education, and to develop personal interests in career choice.
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Affiliation(s)
- Rafael Denadai
- Institute of Craniofacial Plastic Surgery; Dr. Mario Gatti County Hospital, Brazil
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Virtual reality simulation training in Otolaryngology. Int J Surg 2014; 12:87-94. [DOI: 10.1016/j.ijsu.2013.11.007] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Accepted: 11/14/2013] [Indexed: 11/20/2022]
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15
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An update and review of simulation in urological training. Int J Surg 2013; 12:103-8. [PMID: 24316286 DOI: 10.1016/j.ijsu.2013.11.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 10/11/2013] [Accepted: 11/13/2013] [Indexed: 12/26/2022]
Abstract
Simulation, if appropriately integrated into surgical training, may provide a time efficient, cost effective and safe method of training. The use of simulation in urology training is supported by a growing evidence base for its use, leading many authors to call for it to be integrated into the curriculum. There is growing evidence for the utilisation of part task (technical skills) simulators to shorten the learning curve in an environment that does not compromise patient safety. There is also evidence that non-technical skills affect patient outcomes in the operating room and that high fidelity team based simulation training can improve non-technical skills and surgical team performance. This evidence has strengthened the argument of surgical educators who feel that simulation should be formally incorporated into the urology training curriculum to develop both technical and non-technical skills with the aim of optimising performance and patient safety.
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Lamont S, Brunero S. ‘eSimulation’ Part 1: Development of an interactive multimedia mental health education program for generalist nurses. Collegian 2013; 20:239-47. [DOI: 10.1016/j.colegn.2012.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Sohmer B, Hudson C, Hudson J, Posner GD, Naik V. Transesophageal echocardiography simulation is an effective tool in teaching psychomotor skills to novice echocardiographers. Can J Anaesth 2013; 61:235-41. [PMID: 24271567 DOI: 10.1007/s12630-013-0081-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 11/05/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Performance of transesophageal echocardiography (TEE) requires the psychomotor ability to obtain interpretable echocardiographic images. The purpose of this study was to determine the effectiveness of a simulation-based curriculum in which a TEE simulator is used to teach the psychomotor skills to novice echocardiographers and to compare instructor-guided with self-directed online delivery of the curriculum. METHODS After institutional review board approval, subjects inexperienced in TEE completed an online review of TEE material prior to a baseline pre-test of TEE psychomotor skills using the simulator. Subjects were randomized to two groups. The first group received an instructor-guided lesson of TEE psychomotor skills with the simulator. The second group received a self-directed slide presentation of TEE psychomotor skills with the simulator. Both lessons delivered identical information. Following their respective training sessions, all subjects performed a post-test of their TEE psychomotor skills using the simulator. Two assessors rated the TEE performances using a validated scoring system for acquisition of images. RESULTS Pre-test TEE simulator scores were similar between the two instruction groups (9.0 vs 5.0; P = 0.28). The scores in both groups improved significantly following training, regardless of the method of instruction (P < 0.0001). The improvement in scores (post-test scores minus pre-test scores) did not differ significantly between instruction groups (12.5 vs 14.5; P = 0.55). There was strong inter-rater reliability between assessors (α = 0.98; 95% confidence interval [CI]: 0.97 to 0.99). CONCLUSIONS High-fidelity TEE simulators are an effective training adjunct for the acquisition of basic TEE psychomotor skills. There was no difference in improvement between the different modalities of instruction. Further research will examine the need for a faculty resource for a curriculum in which a simulator is used as an adjunct.
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Affiliation(s)
- Benjamin Sohmer
- Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, 40 Ruskin Street, Suite H2410, Ottawa, ON, K1Y 4W7, Canada,
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Xiao D, Albayrak A, Jakimowicz JJ, Goossens RHM. A newly designed portable ergonomic laparoscopic skills Ergo-Lap simulator. MINIM INVASIV THER 2013; 22:337-45. [PMID: 23992382 DOI: 10.3109/13645706.2013.821997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The cost of laparoscopic simulators restricts the wide use of simulation for training of basic psychomotor skills. This paper describes the scientifically-based development of an inexpensive and portable Ergonomic Laparoscopic Skills (Ergo-Lap) simulator with multiple tasks. MATERIAL AND METHODS The design of this Ergo-Lap simulator and related training task panel was based on scientific research regarding the representative skills and the ergonomic guidelines for laparoscopic surgery. A user-centred design approach was followed. Fifty-three surgical participants with variable laparoscopic experience (14 medical students, 27 surgeons in training, and 12 experienced laparoscopic surgeons) performed several tasks on the prototype and gave their feedback by filling out a 5-point scale Likert scale questionnaire. RESULTS The results of the usability evaluation showed that the participants regarded the Ergo-Lap simulator as a useful device to practice the basic and advanced skills effectively. Forty-three of the 53 participants indicated they would like to purchase this simulator since it is easy to use and challenges their laparoscopic skills. CONCLUSIONS For laparoscopic skills training, this inexpensive Ergo-Lap simulator with diverse task choices offers a simple training opportunity for trainees who want to practice laparoscopic skills at home or at the office.
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Affiliation(s)
- Dongjuan Xiao
- Faculty of Industrial Design Engineering, Delft University of Technology , Delft , The Netherlands
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Denadai R, Saad-Hossne R, Martinhão Souto LR. Simulation-based cutaneous surgical-skill training on a chicken-skin bench model in a medical undergraduate program. Indian J Dermatol 2013; 58:200-7. [PMID: 23723471 PMCID: PMC3667283 DOI: 10.4103/0019-5154.110829] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Because of ethical and medico-legal aspects involved in the training of cutaneous surgical skills on living patients, human cadavers and living animals, it is necessary the search for alternative and effective forms of training simulation. AIMS To propose and describe an alternative methodology for teaching and learning the principles of cutaneous surgery in a medical undergraduate program by using a chicken-skin bench model. MATERIALS AND METHODS One instructor for every four students, teaching materials on cutaneous surgical skills, chicken trunks, wings, or thighs, a rigid platform support, needled threads, needle holders, surgical blades with scalpel handles, rat-tooth tweezers, scissors, and marking pens were necessary for training simulation. RESULTS A proposal for simulation-based training on incision, suture, biopsy, and on reconstruction techniques using a chicken-skin bench model distributed in several sessions and with increasing levels of difficultywas structured. Both feedback and objective evaluations always directed to individual students were also outlined. CONCLUSION The teaching of a methodology for the principles of cutaneous surgery using a chicken-skin bench model versatile, portable, easy to assemble, and inexpensive is an alternative and complementary option to the armamentarium of methods based on other bench models described.
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Affiliation(s)
- Rafael Denadai
- Institute of Plastic and Craniofacial Surgery, Brazilian Society of Research and Assistance to Craniofacial Rehabilitation Hospital (SOBRAPAR), Campinas Brazil ; Department of Surgery, Botucatu Medical School, University of the State of São Paulo (UNESP), Botucatu, Brazil ; Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medical Sciences, Marilia University (UNIMAR), Marilia, SP, Brazil
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Acquisition of suture skills during medical graduation by instructor-directed training: a randomized controlled study comparing senior medical students and faculty surgeons. Updates Surg 2013; 65:131-40. [PMID: 23404432 DOI: 10.1007/s13304-013-0199-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 01/16/2013] [Indexed: 02/08/2023]
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Denadai R, Toledo AP, Martinhão Souto LR. Basic Plastic Surgery Skills Training Program on Inanimate Bench Models during Medical Graduation. PLASTIC SURGERY INTERNATIONAL 2012; 2012:651863. [PMID: 23326659 PMCID: PMC3544258 DOI: 10.1155/2012/651863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 11/12/2012] [Accepted: 11/19/2012] [Indexed: 02/05/2023]
Abstract
Due to ethical and medical-legal drawbacks, high costs, and difficulties of accessibility that are inherent to the practice of basic surgical skills on living patients, fresh human cadaver, and live animals, the search for alternative forms of training is needed. In this study, the teaching and learning process of basic surgical skills pertinent to plastic surgery during medical education on different inanimate bench models as a form of alternative and complementary training to the teaching programs already established is proposed.
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Affiliation(s)
- Rafael Denadai
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Avenue Adolpho Lutz 100, Caixa Postal 6028, 13084-880 Campinas, SP, Brazil
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medical Sciences, University of Marίlia (UNIMAR), 17525-902 Marίlia, SP, Brazil
| | - Andréia Padilha Toledo
- School of Medical Sciences, University São Francisco (USF), 12916-900 Bragança Paulista, SP, Brazil
| | - Luis Ricardo Martinhão Souto
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medical Sciences, University of Marίlia (UNIMAR), 17525-902 Marίlia, SP, Brazil
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Dulan G, Rege RV, Hogg DC, Gilberg-Fisher KM, Arain NA, Tesfay ST, Scott DJ. Developing a comprehensive, proficiency-based training program for robotic surgery. Surgery 2012; 152:477-88. [PMID: 22938907 DOI: 10.1016/j.surg.2012.07.028] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2011] [Accepted: 07/23/2012] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Robotically assisted surgery has become very popular for numerous surgical disciplines, yet training practices remain variable with little to no validation. The purpose of this study was to develop a comprehensive, proficiency-based robotic training program. METHODS A skill deconstruction list was generated by observation of robotic operations and interviews with experts. Available resources were used, and other components were developed as needed to develop a comprehensive, proficiency-based curriculum to teach all deconstructed skills. Preliminary construct and content validity and curriculum feasibility were evaluated. RESULTS The skill deconstruction list contained 23 items. Curricular components included an online tutorial, a half-day interactive session, and 9 inanimate exercises with objective metrics. Novice (546 ± 26) and expert (923 ± 60) inanimate composite scores were different (P < .001), supporting construct validity, and substantial pre-test to post-test improvement was noted after successful training completion. All 23 deconstructed skills were rated as highly relevant (4.9 ± 0.5; 5-point scale), and no skills were absent from the curriculum, supporting content validity. CONCLUSION These data suggest that this proficiency-based training curriculum comprehensively addresses the skills necessary to perform robotic operations with early construct and content validity and feasibility demonstrated. Further validation is encouraged.
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Affiliation(s)
- Genevieve Dulan
- University of Texas Southwestern Medical Center, Dallas, TX 75390-9156, USA
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Development and evaluation of a decision-based simulation for assessment of team skills. Surgery 2012; 152:152-7. [DOI: 10.1016/j.surg.2012.02.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2011] [Accepted: 02/13/2012] [Indexed: 11/21/2022]
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Snodgrass SJ, Odelli RA. Objective concurrent feedback on force parameters improves performance of lumbar mobilisation, but skill retention declines rapidly. Physiotherapy 2012; 98:47-56. [DOI: 10.1016/j.physio.2011.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Accepted: 02/20/2011] [Indexed: 12/16/2022]
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Wiet GJ, Stredney D, Kerwin T, Hittle B, Fernandez SA, Abdel-Rasoul M, Welling DB. Virtual temporal bone dissection system: OSU virtual temporal bone system: development and testing. Laryngoscope 2012; 122 Suppl 1:S1-12. [PMID: 22294268 DOI: 10.1002/lary.22499] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 11/21/2011] [Indexed: 12/22/2022]
Abstract
OBJECTIVES/HYPOTHESIS The objective of this project was to develop a virtual temporal bone dissection system that would provide an enhanced educational experience for the training of otologic surgeons. STUDY DESIGN A randomized, controlled, multi-institutional, single-blinded validation study. METHODS The project encompassed four areas of emphasis: structural data acquisition, integration of the system, dissemination of the system, and validation. RESULTS Structural acquisition was performed on multiple imaging platforms. Integration achieved a cost-effective system. Dissemination was achieved on different levels including casual interest, downloading of software, and full involvement in development and validation studies. A validation study was performed at eight different training institutions across the country using a two-arm randomized trial where study subjects were randomized to a 2-week practice session using either the virtual temporal bone or standard cadaveric temporal bones. Eighty subjects were enrolled and randomized to one of the two treatment arms; 65 completed the study. There was no difference between the two groups using a blinded rating tool to assess performance after training. CONCLUSIONS A virtual temporal bone dissection system has been developed and compared to cadaveric temporal bones for practice using a multicenter trial. There was no statistical difference between practice on the current simulator compared to practice on human cadaveric temporal bones. Further refinements in structural acquisition and interface design have been identified, which can be implemented prior to full incorporation into training programs and used for objective skills assessment.
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Affiliation(s)
- Gregory J Wiet
- Department of Otolaryngology, The Ohio State University, Columbus, Ohio 43205, USA.
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Denadai R, Souto LRM. Organic bench model to complement the teaching and learning on basic surgical skills. Acta Cir Bras 2012; 27:88-94. [PMID: 22159445 DOI: 10.1590/s0102-86502012000100015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 11/16/2011] [Indexed: 02/08/2023] Open
Abstract
PURPOSE: To propose an organic bench model made with fruits/vegetables as an alternative to complement the arsenal of simulators used in the teaching and learning of basic surgical skills during medical graduation and education. METHODS: They were described the training strategies, through the use of fruits (or vegetables) to the learning of different techniques of incision, sutures, biopsies and basic principles of reconstruction. The preparation of bench model, the processes of skill acquisition, feedback and evaluation were also delineated. RESULTS: A proposal for teaching based on an organic model with training delivered in multiple sessions, with increasing levels of difficulty, and with feedback and evaluation during all the process was structured. CONCLUSION: The organic model, being simple, versatile, portable, reproducible, readily available, and having low cost, is another option to complement the existing simulators for teaching and learning of basic surgical skills.
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Cendan JC, Johnson TR. Enhancing learning through optimal sequencing of web-based and manikin simulators to teach shock physiology in the medical curriculum. ADVANCES IN PHYSIOLOGY EDUCATION 2011; 35:402-407. [PMID: 22139778 DOI: 10.1152/advan.00061.2011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The Association of American Medical Colleges has encouraged educators to investigate proper linkage of simulation experiences with medical curricula. The authors aimed to determine if student knowledge and satisfaction differ between participation in web-based and manikin simulations for learning shock physiology and treatment and to determine if a specific training sequencing had a differential effect on learning. All 40 second-year medical students participated in a randomized, counterbalanced study with two interventions: group 1 (n = 20) participated in a web-based simulation followed by a manikin simulation and group 2 (n = 20) participated in reverse order. Knowledge and attitudes were documented. Mixed-model ANOVA indicated a significant main effect of time (F(1,38) = 18.6, P < 0.001, η(p)(2) = 0.33). Group 1 scored significantly higher on quiz 2 (81.5%) than on quiz 1 (74.3%, t(19) = 3.9, P = 0.001), for an observed difference of 7.2% (95% confidence interval: 3.3, 11.0). Mean quiz scores of group 2 did not differ significantly (quiz 1: 77.0% and quiz 2: 79.7%). There was no significant main effect of group or a group by time interaction effect. Students rated the simulations as equally effective in teaching shock physiology (P = 0.88); however, the manikin simulation was regarded as more effective in teaching shock treatment (P < 0.001). Most students (73.7%) preferred the manikin simulation. The two simulations may be of similar efficacy for educating students on the physiology of shock; however, the data suggest improved learning when web-based simulation precedes manikin use. This finding warrants further study.
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Affiliation(s)
- Juan C Cendan
- Department of Medical Education, Office of Assessment, College of Medicine, University of Central Florida, Orlando, 32827, USA.
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