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Killeen BD, Zhang H, Wang LJ, Liu Z, Kleinbeck C, Rosen M, Taylor RH, Osgood G, Unberath M. Stand in surgeon's shoes: virtual reality cross-training to enhance teamwork in surgery. Int J Comput Assist Radiol Surg 2024; 19:1213-1222. [PMID: 38642297 PMCID: PMC11178441 DOI: 10.1007/s11548-024-03138-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 03/28/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE Teamwork in surgery depends on a shared mental model of success, i.e., a common understanding of objectives in the operating room. A shared model leads to increased engagement among team members and is associated with fewer complications and overall better outcomes for patients. However, clinical training typically focuses on role-specific skills, leaving individuals to acquire a shared model indirectly through on-the-job experience. METHODS We investigate whether virtual reality (VR) cross-training, i.elet@tokeneonedotexposure to other roles, can enhance a shared mental model for non-surgeons more directly. Our study focuses on X-ray guided pelvic trauma surgery, a procedure where successful communication depends on the shared model between the surgeon and a C-arm technologist. We present a VR environment supporting both roles and evaluate a cross-training curriculum in which non-surgeons swap roles with the surgeon. RESULTS Exposure to the surgical task resulted in higher engagement with the C-arm technologist role in VR, as measured by the mental demand and effort expended by participants ( p < 0.001 ). It also has a significant effect on non-surgeon's mental model of the overall task; novice participants' estimation of the mental demand and effort required for the surgeon's task increases after training, while their perception of overall performance decreases ( p < 0.05 ), indicating a gap in understanding based solely on observation. This phenomenon was also present for a professional C-arm technologist. CONCLUSION Until now, VR applications for clinical training have focused on virtualizing existing curricula. We demonstrate how novel approaches which are not possible outside of a virtual environment, such as role swapping, may enhance the shared mental model of surgical teams by contextualizing each individual's role within the overall task in a time- and cost-efficient manner. As workflows grow increasingly sophisticated, we see VR curricula as being able to directly foster a shared model for success, ultimately benefiting patient outcomes through more effective teamwork in surgery.
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Affiliation(s)
| | - Han Zhang
- Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Liam J Wang
- Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Zixuan Liu
- Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Constantin Kleinbeck
- Johns Hopkins University, Baltimore, MD, 21218, USA
- Friedrich-Alexander-Universität, Erlangen, Germany
| | | | | | - Greg Osgood
- Department of Orthopaedic Surgery, Johns Hopkins Medicine, Baltimore, MD, 21218, USA
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Khilnani TK, Kesselman A, D'Angelo D, RoyChoudhury A, Lamparello NA. Implementation and Evaluation of a Comprehensive Simulation Curriculum for the IR/DR Integrated Residency. Acad Radiol 2023; 30:2067-2078. [PMID: 36849334 DOI: 10.1016/j.acra.2023.01.036] [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] [Received: 08/19/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 02/27/2023]
Abstract
RATIONALE AND OBJECTIVES Endovascular simulation is a validated training method, allowing residents to improve technical skills with interventional equipment in a risk-free environment. The purpose of this study was to assess the utility and efficacy of supplementing the IR/DR Integrated Residency training program with a dedicated 2-year endovascular simulation curriculum. MATERIALS AND METHODS Trainees participated in a 2-year curriculum that included the completion of 8 modules using a high-fidelity endovascular simulator (Mentice AB, Gothenberg, Sweden). Procedural modules included IVC filter placement, transarterial chemoembolization, trauma embolization, uterine artery embolization, prostate artery embolization, and peripheral arterial disease interventions. Each quarter, two trainees were filmed while completing an assigned module. Sessions led by IR faculty were held with film footage review and didactics on the assigned topic. Pre- and postcase surveys were collected to evaluate trainee comfort and confidence and assess the validity of the simulation. At the conclusion of the 2-year period, a postcurriculum survey was sent to all trainees to determine how residents viewed the utility of the simulation sessions. RESULTS Eight residents participated in the pre- and postcase surveys. The simulation curriculum significantly increased trainee confidence for these 8 residents. A separate postcurriculum survey was completed by all 16 IR/DR residents. All 16 residents felt that simulation was a helpful addition to their education. A total of 87.5% of all residents felt that the sessions improved their confidence in the IR procedure room. A total of 75% of all residents believe that the simulation curriculum should be incorporated into the IR residency program. CONCLUSION Adoption of a 2-year simulation curriculum can be considered for existing IR/DR training programs with access to high-fidelity endovascular simulators using the described approach.
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Affiliation(s)
- Tyler K Khilnani
- Department of Radiology, Division of Interventional Radiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York.
| | - Andrew Kesselman
- Department of Radiology, Division of Interventional Radiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York
| | - Debra D'Angelo
- Department of Population Health Sciences, Weill Cornell Medicine, 525 E 68th Street, New York City, NY 10021
| | - Arindam RoyChoudhury
- Department of Population Health Sciences, Weill Cornell Medicine, 525 E 68th Street, New York City, NY 10021
| | - Nicole A Lamparello
- Department of Radiology, Division of Interventional Radiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York
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Tsai CY, Tsai SCS, Shen GQ, Guo GLR, Tsui ZLG, Hsieh MY, Yuan C, Lin FCF. Simulation education utilizing phantom and angle reference guide in pulmonary nodule CT localization. Heliyon 2023; 9:e18329. [PMID: 37539172 PMCID: PMC10395521 DOI: 10.1016/j.heliyon.2023.e18329] [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: 11/16/2022] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023] Open
Abstract
Objective The incidence of sub-centimeter pulmonary nodules has been increasing along with the use of low-dose computed tomography (LDCT) as a screening tool for early lung cancer detection. In our institution, pulmonary nodule computed tomography-guided localization (PNCL) is performed preoperatively with the laser angle guided assembly (LAGA), an angle reference device. This study aims to investigate the efficacy of postgraduate education in a phantom simulation of PNCL, with or without LAGA. Setting design This prospective study was conducted in an academic hospital in Taiwan. Seven thoracic surgery residents and three experienced senior physicians were recruited to perform PNCL using a phantom simulation, with or without LAGA, for five nodules each and complete a questionnaire. Performance data were collected. χ2 tests, Mann-Whitney U test, univariate and multivariate linear regression were used for statistical analyses. Results The confidence level increased from median 7[range 1, 9] to 8, range [6,9] (p = 0.001) before and after the simulation education course. The scores of enhanced PNCL ability and course satisfaction were as high as 8 [5,9], and 9 [7,9]. LAGA enabled broader puncture angles (with 27.5° [0°,80°]; without 14° [0°, 80°], p = 0.003), a lower puncture frequency (with 1 [1,4]; without 2 [1,5], p < 0.001), and a smaller angle deviation (with 3°[ 0°,8°]; without 5°[ 0°,19°], p = 0.002). Pleural depth in millimeters was associated with increased puncture frequency (0.019[0,010,0.028]) and procedure time (0.071'[ 0.018,0.123']. The PNCL-experienced physicians performed the procedure in less time (-2.854'[-4.646',1.061']. The traverse direction toward the mediastinum diminished the frequency (toward 1[ 1,3]; away 1 [1,5], p = 0.003) and time (toward 7.5'[2',18]'; away 9'[ 3',31'], p = 0.027). The learning curve did not improve procedure performance after ten PNCL simulation rounds. Conclusions The phantom PNCL simulation education course increased the confidence level, enhanced residents' skill acquisition, and promoted learning satisfaction. The angle reference device helped improve the outcomes of the puncture frequency and reduced angle deviation.
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Affiliation(s)
- Chiao-Yun Tsai
- Department of Thoracic Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Stella Chin-Shaw Tsai
- Superintendents' Office, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
- Department of Postbaccalaureate Medicine, School of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Guang-Qian Shen
- Department of Mechanical and Computer-Aided Engineering, Feng Chia University, Taichung, Taiwan
| | - Guan-Liang Robert Guo
- Department of Mechanical and Computer-Aided Engineering, Feng Chia University, Taichung, Taiwan
| | - Zhe-Luen Gerald Tsui
- Department of Mechanical and Computer-Aided Engineering, Feng Chia University, Taichung, Taiwan
| | - Ming-Yu Hsieh
- Department of Pediatric Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Cadmus Yuan
- Department of Mechanical and Computer-Aided Engineering, Feng Chia University, Taichung, Taiwan
| | - Frank Cheau-Feng Lin
- Department of Thoracic Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Alexander LF, McComb BL, Bowman AW, Bonnett SL, Ghazanfari SM, Caserta MP. Ultrasound Simulation Training for Radiology Residents-Curriculum Design and Implementation. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:777-790. [PMID: 36106721 DOI: 10.1002/jum.16098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/16/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
Medical simulation training can be used to improve clinician performance, teach communication and professionalism skills, and enhance team training. Radiology residents can benefit from simulation training in diagnostic ultrasound, procedural ultrasound, and communication skills prior to direct patient care experiences. This paper details a weeklong ultrasound simulation training curriculum for radiology residents during the PGY-1 clinical internship. The organization of established teaching methods into a dedicated course early in radiology residency training with the benefit of a multi-disciplinary approach makes this method unique. This framework can be adapted to fit learners at different skill levels or with specific procedural needs.
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Affiliation(s)
- Lauren F Alexander
- Department of Radiology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | - Barbara L McComb
- Department of Radiology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | - Andrew W Bowman
- Division Chair of Hospital & Emergency Imaging | Department of Radiology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | | | | | - Melanie P Caserta
- Division Chair of Sonography | Department of Radiology, Mayo Clinic Florida, Jacksonville, Florida, USA
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Haridass S, Keshava SN, Kalva SP. Simulation in Interventional Radiology. JOURNAL OF CLINICAL INTERVENTIONAL RADIOLOGY ISVIR 2023. [DOI: 10.1055/s-0042-1760441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Shoban Haridass
- Division of Clinical Radiology, Department of Interventional Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Shymakumar N. Keshava
- Division of Clinical Radiology, Department of Interventional Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sanjeeva P. Kalva
- Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, United States
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3D Printed Percutaneous Transhepatic Cholangiography and Drainage (PTCD) Simulator for Interventional Radiology. Cardiovasc Intervent Radiol 2023; 46:500-507. [PMID: 36635370 DOI: 10.1007/s00270-022-03347-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 12/17/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE Learning how to perform percutaneous transhepatic bile duct drainage (PTCD) is challenging for interventional radiology (IR) trainees. Therefore, simulators are crucial for IR training and are being increasingly demanded in the evolving healthcare environment of value-based care. To facilitate interventional training, we tried to evaluate our newly developed liver phantom for further use in IR training. METHODS We developed a liver phantom with a flexible hollow biliary tree, hydrogel-based liver parenchyma, plastic ribs, and silicone skin. The phantom was evaluated by 20 radiology residents from two hospitals. After an introduction, all participants tried to obtain biliary access by fluoroscopic guidance within 25 min. Puncture time, fluoroscopy time, and kerma area product were measured. After 7 days, the participants repeated the procedure on an altered and more difficult model. Additionally, a survey was handed out to every participant (20 residents, 5 experts, and 5 IR fellows) to evaluate the phantom in terms of accuracy and haptic feedback, as well as general questions regarding simulation. RESULTS The residents performed significantly faster and were more self-confident on Day 7 than on Day 1, significantly decreasing puncture time, fluoroscopy time, and kerma area product (p ≤ 0.0001). The participants were very satisfied with their simulation experience and would trust themselves more in real-life scenarios. CONCLUSION We were able to develop a phantom with high anatomical accuracy for fluoroscopy and ultrasound-guided interventions. The phantom successfully helped residents learn and improve their PTCD performance.
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Weiss D, Wilms LM, Ivan VL, Vach M, Loberg C, Ziayee F, Kirchner J, Schimmöller L, Antoch G, Minko P. Complication Management and Prevention in Vascular and non-vascular Interventions. ROFO-FORTSCHR RONTG 2022; 194:1140-1146. [PMID: 35977554 DOI: 10.1055/a-1829-6055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
PURPOSE This overview summarizes key points of complication management in vascular and non-vascular interventions, particularly focusing on complication prevention and practiced safety culture. Flowcharts for intervention planning and implementation are outlined, and recording systems and conferences are explained in the context of failure analysis. In addition, troubleshooting by interventionalists on patient cases is presented. MATERIAL AND METHODS The patient cases presented are derived from our institute. Literature was researched on PubMed. RESULTS Checklists, structured intervention planning, standard operating procedures, and opportunities for error and complication discussion are important elements of complication management and essential for a practiced safety culture. CONCLUSION A systematic troubleshooting and a practiced safety culture contribute significantly to patient safety. Primarily, a rational and thorough error analysis is important for quality improvement. KEY POINTS · Establishing a safety culture is essential for high-quality interventions with few complications.. · A rational and careful troubleshooting is essential to increase quality of interventions.. · Checklists and SOPs can structure and optimize the procedure of interventions.. CITATION FORMAT · Weiss D, Wilms LM, Ivan VL et al. Complication Management and Prevention in Vascular and non-vascular Interventions. Fortschr Röntgenstr 2022; DOI: 10.1055/a-1829-6055.
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Affiliation(s)
- Daniel Weiss
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf 40225, Germany
| | - Lena Marie Wilms
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf 40225, Germany
| | - Vivien Lorena Ivan
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf 40225, Germany
| | - Marius Vach
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf 40225, Germany
| | - Christina Loberg
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf 40225, Germany
| | - Farid Ziayee
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf 40225, Germany
| | - Julian Kirchner
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf 40225, Germany
| | - Lars Schimmöller
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf 40225, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf 40225, Germany
| | - Peter Minko
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf 40225, Germany
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Kaufmann R, Zech CJ, Deutschmann M, Scharinger B, Hecht S, Hergan K, Rezar R, Hitzl W, Meissnitzer M. Endovascular embolization techniques in acute thoracic and abdominal bleedings can be technically reproduced and trained in a standardized simulation setting using SLA 3D printing: a 1-year single-center study. Insights Imaging 2022; 13:72. [PMID: 35397043 PMCID: PMC8994805 DOI: 10.1186/s13244-022-01206-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/13/2022] [Indexed: 12/29/2022] Open
Abstract
Background Endovascular embolization techniques are nowadays well established in the management of acute arterial bleedings. However, the education and training of the next generation of interventionalists are still based on the traditional apprenticeship model, where the trainee learns and practices directly at the patient, which potentially affects the patient’s safety. The objective of this study was to design and develop a standardized endovascular simulation concept for the training of acute bleeding embolizations, based on real-life cases. Results An adaptable and cost-effective endovascular simulator was developed using an in-house 3D print laboratory. All thoracic and abdominal acute bleeding embolizations over more than a year with appropriate pre-interventional computed tomography scans were included to manufacture 3D printed vascular models. A peristaltic pump was used to generate pulsatile flow curves. Forty embolization cases were engaged in this study, and 27 cases were fully reproduced in the simulation setting (69.23%). The simulation success was significantly lower in pulmonary embolizations (p = 0.031) and significantly higher in soft tissue (p = 0.032) and coil embolizations (p = 0.045). The overall simulation success was 7.8 out of 10 available points. Conclusions Using stereolithography 3D printing in a standardized simulation concept, endovascular embolization techniques for treating acute internal hemorrhages in the chest and abdomen can be simulated and trained based on the patient-specific anatomy in a majority of the cases and at a broad spectrum of different causes. Supplementary Information The online version contains supplementary material available at 10.1186/s13244-022-01206-7.
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Affiliation(s)
- Reinhard Kaufmann
- Department of Radiology, University Hospital Salzburg, Paracelsus Medical University, Müllner Hauptstraße 48, 5020, Salzburg, Austria. .,Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, 4031, Basel, Switzerland.
| | - Christoph J Zech
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, 4031, Basel, Switzerland
| | - Michael Deutschmann
- Department of Radiology, University Hospital Salzburg, Paracelsus Medical University, Müllner Hauptstraße 48, 5020, Salzburg, Austria
| | - Bernhard Scharinger
- Department of Radiology, University Hospital Salzburg, Paracelsus Medical University, Müllner Hauptstraße 48, 5020, Salzburg, Austria
| | - Stefan Hecht
- Department of Radiology, University Hospital Salzburg, Paracelsus Medical University, Müllner Hauptstraße 48, 5020, Salzburg, Austria
| | - Klaus Hergan
- Department of Radiology, University Hospital Salzburg, Paracelsus Medical University, Müllner Hauptstraße 48, 5020, Salzburg, Austria
| | - Richard Rezar
- Clinic of Internal Medicine II, Department of Cardiology and Internal Intensive Care Medicine, University Hospital Salzburg, Paracelsus Medical University, 5020, Salzburg, Austria
| | - Wolfgang Hitzl
- Research Office (Biostatistics), Paracelsus Medical University of Salzburg, 5020, Salzburg, Austria
| | - Matthias Meissnitzer
- Department of Radiology, University Hospital Salzburg, Paracelsus Medical University, Müllner Hauptstraße 48, 5020, Salzburg, Austria
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Mathern N, Sandmann J, Sichtermann T, Ridwan H, Riabikin A, Stockero A, Nikoubashman O, Wiesmann M. Can training on ex-vivo models increase neurointerventionalists’ subjective self-confidence in the operating room? PLoS One 2022; 17:e0264180. [PMID: 35192670 PMCID: PMC8863251 DOI: 10.1371/journal.pone.0264180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 02/04/2022] [Indexed: 11/19/2022] Open
Abstract
In a changing learning environment where young neurointerventionalists spend less time in the operating room, computer simulators have been established as a new training model. Our aim was the comparison of silicone models and computer simulators, and the evaluation of their influence on subjective self-confidence of operators. Pre- and postquestionnaires of 27 participants and 9 tutors were evaluated after the participation in a three-days interventional stroke course using silicone models and computer simulators. Training on computer simulators was considered as more realistic and important before patient contact than training on silicone models. Participants rated their own abilities as significantly better after participation in the course and felt significantly better prepared for patient care. Training on computer simulators can increase the subjective self-confidence of trainees. We suggest a stepwise training program, comprising both ex-vivo and the porcine in-vivo model, finished by conventional operating room teaching, to prepare neuroradiologists for optimal patient care when performing interventions.
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Affiliation(s)
- Nathalie Mathern
- Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany
- * E-mail:
| | - Johanna Sandmann
- Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Thorsten Sichtermann
- Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Hani Ridwan
- Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Alexander Riabikin
- Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Andrea Stockero
- Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Omid Nikoubashman
- Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Martin Wiesmann
- Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany
| | - German Stroke School Group
- Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany
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Lopez Benítez R, Reyes Del Castillo T, Benz D, Fechner C, Szabo L, Kara L, Monnard E, Kostrzewa M, Roos JE. Percutaneous transhepatic biliary puncture simulator: a cord network prototype. Adv Simul (Lond) 2021; 6:27. [PMID: 34362469 PMCID: PMC8343814 DOI: 10.1186/s41077-021-00178-w] [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: 02/22/2021] [Accepted: 07/14/2021] [Indexed: 11/30/2022] Open
Abstract
Background The aim of this study was to present a percutaneous transhepatic biliary puncture simulator that can be used without radiation exposure and that reflects the conventional anatomy of the biliary ducts and its vicinity structures. Methods An anatomically based model of the biliary tree was developed using a cord network fixed to a wooden frame. The skin, ribs, intercostal muscles, and right lower lobe pleura were simulated using foam sponge, plastic tubes, a polystyrene foam panel, and an air pad, respectively. For the puncture, we used a 20-G Chiba needle and a wire with distal double arches; these were used to troll a cord, simulating the successful puncture of a bile duct. A camera was also placed above the model to allow the trainees to train eye-hand coordination while viewing the image on a monitor in real time. The simulator was tested with 60 radiology residents to evaluate the confidence and skills transferability of the training model. Results After receiving an introduction of the system and 5 min of training under tutor surveillance, all participants were able to troll a cord of the biliary simulator by themselves in less than 4 min. Only one participant punctured the simulated pleura. The participants’ evaluations showed positive results, with increased user confidence and skills transferability after the training session. Conclusions This proposed simulator can be an effective tool to improve a trainee’s confidence and competence while achieving procedural and non-procedural interventional radiology skills related to the liver. Trial registration Retrospectively registered
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Affiliation(s)
- Rubén Lopez Benítez
- Department of Radiology and Nuclear Medicine, Luzerner Kantonsspital, 6000, Lucerne, Switzerland
| | - Tomás Reyes Del Castillo
- Department of Radiology and Nuclear Medicine, Luzerner Kantonsspital, 6000, Lucerne, Switzerland.
| | - David Benz
- Department of Radiology and Nuclear Medicine, Luzerner Kantonsspital, 6000, Lucerne, Switzerland
| | - Carsten Fechner
- Department of Radiology and Nuclear Medicine, Luzerner Kantonsspital, 6000, Lucerne, Switzerland
| | - Lorant Szabo
- Department of Radiology and Nuclear Medicine, Luzerner Kantonsspital, 6000, Lucerne, Switzerland
| | - Levent Kara
- Institute of Radiology and Nuclear Medicine, Stadtspital Triemli Zürich, 8063, Zurich, Switzerland
| | - Etienne Monnard
- Department of Radiology, Fribourg Hopital Cantonal, 1752, Fribourg, Switzerland
| | - Michael Kostrzewa
- Institute of Radiology, Kantosspital Baden, 5404, Baden, Switzerland
| | - Justus E Roos
- Department of Radiology and Nuclear Medicine, Luzerner Kantonsspital, 6000, Lucerne, Switzerland
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Tenewitz C, Le RT, Hernandez M, Baig S, Meyer TE. Systematic review of three-dimensional printing for simulation training of interventional radiology trainees. 3D Print Med 2021; 7:10. [PMID: 33881672 PMCID: PMC8059217 DOI: 10.1186/s41205-021-00102-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/08/2021] [Indexed: 12/13/2022] Open
Abstract
RATIONALE AND OBJECTIVES Three-dimensional (3D) printing has been utilized as a means of producing high-quality simulation models for trainees in procedure-intensive or surgical subspecialties. However, less is known about its role for trainee education within interventional radiology (IR). Thus, the purpose of this review was to assess the state of current literature regarding the use of 3D printed simulation models in IR procedural simulation experiences. MATERIALS AND METHODS A literature query was conducted through April 2020 for articles discussing three-dimensional printing for simulations in PubMed, Embase, CINAHL, Web of Science, and the Cochrane library databases using key terms relating to 3D printing, radiology, simulation, training, and interventional radiology. RESULTS We identified a scarcity of published sources, 4 total articles, that appraised the use of three-dimensional printing for simulation training in IR. While trainee feedback is generally supportive of the use of three-dimensional printing within the field, current applications utilizing 3D printed models are heterogeneous, reflecting a lack of best practices standards in the realm of medical education. CONCLUSIONS Presently available literature endorses the use of three-dimensional printing within interventional radiology as a teaching tool. Literature documenting the benefits of 3D printed models for IR simulation has the potential to expand within the field, as it offers a straightforward, sustainable, and reproducible means for hands-on training that ought to be standardized.
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Affiliation(s)
- Chase Tenewitz
- Mercer University School of Medicine, Savannah, GA, USA.
| | - Rebecca T Le
- University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | | | - Saif Baig
- UF Health Jacksonville, Jacksonville, FL, USA
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Solomon AJ, England RW, Kolarich AR, Liddell RP. Disrupting the Education Paradigm: An Opportunity to Advance Simulation Training in Radiology- Radiology In Training. Radiology 2021; 298:292-294. [PMID: 33258747 DOI: 10.1148/radiol.2020203534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Alex J Solomon
- From the Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, Johns Hopkins School of Medicine, 1800 Orleans St, Zayed 7203, Baltimore, MD 21287
| | - Ryan W England
- From the Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, Johns Hopkins School of Medicine, 1800 Orleans St, Zayed 7203, Baltimore, MD 21287
| | - Andrew R Kolarich
- From the Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, Johns Hopkins School of Medicine, 1800 Orleans St, Zayed 7203, Baltimore, MD 21287
| | - Robert P Liddell
- From the Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, Johns Hopkins School of Medicine, 1800 Orleans St, Zayed 7203, Baltimore, MD 21287
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Teaching brain imaging through a drawing method may improve learning in medical students. Eur Radiol 2020; 31:4195-4202. [PMID: 33201281 DOI: 10.1007/s00330-020-07484-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/13/2020] [Accepted: 11/06/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Brain imaging is particularly difficult to learn and to teach. This study aimed to evaluate the performance of teaching brain imaging through drawing method in medical faculty students. METHODS We conducted a prospective, interventional, randomized, single-blind study in third-year voluntary medical students between December 2016 and June 2019. Eighty medical students received a theoretical training on brain imaging interpretation and were subsequently randomized into two groups ("teaching through drawing" and "standard teaching"). An initial evaluation was carried out to assess the students' basic level. Three teaching and training sessions were spread over 2 months in each group. One month after the third teaching session, students were evaluated by an examiner who was blind to the student's group. The same comprehensive evaluation grid has been used for the initial and final students' evaluations to give an objective score out of 20 points. Students' scores were compared between groups using the t test and effect sizes were measured using Cohen's d. RESULTS Students' mean age was 21.1 years old. In total, 61.3% were female. Regarding initial evaluation, scores did not differ significantly between both groups (10.1 ± 2.0 versus 9.9 ± 1.9, p = 0.65), thus confirming the homogeneity of the students' basic level. The scores obtained from the final evaluation were significantly higher for the "teaching through drawing" students than for the "standard teaching" students (14.7 ± 2.7 vs 13.2 ± 2.0, p = 0.009, Cohen's d = 0.62). CONCLUSIONS This study provides class II evidence that the method of drawing alone can improve brain imaging comprehension and analysis in medical faculty students. KEY POINTS • The method of drawing can improve brain imaging analysis in medical faculty students. • A large majority of students were satisfied by the method of brain imaging teaching through drawing.
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ESR statement on new approaches to undergraduate teaching in Radiology. Insights Imaging 2019; 10:109. [PMID: 31745669 PMCID: PMC6863988 DOI: 10.1186/s13244-019-0804-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 10/10/2019] [Indexed: 01/25/2023] Open
Abstract
Medical education is evolving and electronic learning (e-Learning) strategies have now become an essential asset in radiology education. Radiology education is a significant part of the undergraduate medical curriculum and the use of e-Learning in radiology teaching in medical schools is on the rise. If coupled with clinical decision support systems, e-Learning can be a practical way of teaching students clinical decision making, such as selecting the diagnostic imaging tests that are best suited in certain clinical scenarios.The innovative concept of flipped classroom learning encourages students to work independently and maximises the application of learnt contents in interactive classroom sessions.For integrated curricula with their student-centred, problem-based, and community-based design, an approach to systematically integrate radiology may be to define diagnostic reasoning as one of the core goals. Radiologists as teachers and scholars may understand themselves as experts in diagnostic reasoning and in mentoring how to make medical decisions.Computer programs simulating the routine work are available and can be used to teach the recognition of anatomical structures and pathological patterns, and also to teach ultrasonography and interventional radiology, maximising patient safety.
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