1
|
Chen Y, Li M, Wu Y, Wang L, Cui Q. Design and fabrication of silicone cleft lip simulation model for personalized surgical training. J Plast Reconstr Aesthet Surg 2024; 93:254-260. [PMID: 38723511 DOI: 10.1016/j.bjps.2024.04.033] [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: 12/12/2023] [Revised: 03/02/2024] [Accepted: 04/05/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE OF THE STUDY To elucidate the design and fabrication methodologies employed in creating a personalized cleft lip simulation model, primarily intended for enhancing surgical training and diverse applications. The study further sought to assess the viability of integrating this simulation model into undergraduate oral experiments and instructional settings. STUDY DESIGN Facial data from individuals with cleft lip conditions were acquired using a scanner. Subsequent stages involved reverse engineering and the utilization of 3D printing technology to generate a cleft lip silicone simulation model. The molding process entailed injecting silicone into a polylactic acid mold. The study enrolled 53 undergraduate students majoring in dentistry, who were randomly assigned to either a control or experimental group. A dedicated instructor guided each group independently, employing a combination of multiple-choice tests and surveys to gauge real-time evaluations and discern inter-group disparities. RESULTS AND CONCLUSIONS We successfully designed and produced a personalized cleft lip simulation model, demonstrating notable efficacy in the context of cleft lip experimental teaching. Statistical analysis revealed a significant difference (P < 0.05) in the scores of the experimental group students on multiple-choice questions pertaining to cleft lip surgical procedures. Survey outcomes indicated that the experimental group students exhibited higher confidence levels in cleft lip surgery, as reflected from their responses to relevant questions, compared to the traditional group students. These differences were statistically significant (P < 0.05). The simulation model developed in this study emerges as a reliable and cost-effective training and teaching tool for cleft lip surgery.
Collapse
Affiliation(s)
- Yaqi Chen
- Department of Oral and Maxillofacial Surgery, Kunming Medical University School and Hospital of Stomatology, Kunming 650106, China; Yunnan Key Laboratory of Stomatology, Kunming 650106, China
| | - Ming Li
- Department of Oral and Maxillofacial Surgery, Kunming Medical University School and Hospital of Stomatology, Kunming 650106, China; Yunnan Key Laboratory of Stomatology, Kunming 650106, China
| | - Yong Wu
- Department of Oral and Maxillofacial Surgery, Kunming Medical University School and Hospital of Stomatology, Kunming 650106, China; Yunnan Key Laboratory of Stomatology, Kunming 650106, China
| | - Lidong Wang
- Department of Oral and Maxillofacial Surgery, Kunming Medical University School and Hospital of Stomatology, Kunming 650106, China; Yunnan Key Laboratory of Stomatology, Kunming 650106, China
| | - Qingying Cui
- Department of Oral and Maxillofacial Surgery, Kunming Medical University School and Hospital of Stomatology, Kunming 650106, China; Yunnan Key Laboratory of Stomatology, Kunming 650106, China.
| |
Collapse
|
2
|
Stanek K, Yao CA, Livingston KA, Weinstock PH, Rogers-Vizena CR. Teaching Unilateral Cleft lip Repair: Lessons from Simulation-Based Mining of Trainee Strengths and Performance Gaps. Cleft Palate Craniofac J 2024; 61:834-843. [PMID: 36529578 DOI: 10.1177/10556656221146736] [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: 02/17/2024] Open
Abstract
OBJECTIVE To identify specific areas for improvement in cleft lip repair teaching. DESIGN Secondary analysis of prospectively-collected, blinded data. SETTING Three residency programs rotating at a single academic children's hospital. PARTICIPANTS Plastic surgery residents, and craniofacial/pediatric plastic surgery fellows. MAIN OUTCOME MEASURES Mean scores for each skill in an 18-item Unilateral Cleft Lip Repair competency assessment tool (UCLR) (1-3 scale for each item) were rank ordered. Correlation between level of training (PGY) and performance on steps of the procedure was examined using Pearson R. RESULTS Simulation participants (n = 26) scored highest on skills in the "Marking" subscale (2.38-2.63 mean score). Procedural steps that scored lowest were: closing the nasal floor (2.00), repairing oral mucosa (2.15) and avoiding over/under-dissection (2.19). Interestingly, none of these skills correlated with PGY, suggesting they do not improve with training. CONCLUSIONS These results suggest that marking cleft lip repair is taught well in our current teaching environment, while steps like closing the nasal floor and repairing the oral mucosa are taught less well. Improved teaching of these steps could be achieved with deliberate instruction, video, digital simulation, and high fidelity simulation.
Collapse
Affiliation(s)
- Krystof Stanek
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Caroline A Yao
- Department of Plastic Surgery, Shriner's Hospital for Children, Los Angeles, CA, USA
- Operation Smile, Virginia Beach, Virginia, USA
| | | | - Peter H Weinstock
- Boston Children's Hospital Simulator Program (SIMPeds), Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Anesthesia and Critical Care, Boston Children's Hospital, Boston, MA, USA
| | - Carolyn R Rogers-Vizena
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
3
|
Leung R, Shi G. Building Your Future Holographic Mentor: Can We Use Mixed Reality Holograms for Visual Spatial Motor Skills Acquisition in Surgical Education? Surg Innov 2024; 31:82-91. [PMID: 37916497 PMCID: PMC10773164 DOI: 10.1177/15533506231211844] [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: 11/03/2023]
Abstract
Learning surgical skills require critical visual-spatial motor skills. Current learning methods employ costly and limited in-person teaching in addition to supplementation by videos, textbooks, and cadaveric labs. Increasingly limited healthcare resources and in-person training has led to growing concerns for skills acquisition of trainees. Recent Mixed Reality (MR) devices offer an attractive solution to these resource barriers by providing three-dimensional holographic representations of reality that mimic in-person experiences in a portable, individualized, and cost-effective form. We developed and evaluated two holographic MR models to explore the feasibility of visual-spatial motor skill acquisition from a technical development, learning, and usability perspective. In our first, a pair of holographic hands were created and projected in front of the trainee, and participants were evaluated on their ability to learn complex hand motions in comparison to traditional methods of video and apprenticeship-based learning. The second model displayed a 3D holographic model of the middle and inner ear with labeled anatomical structures which users could explore and user experience feedback was obtained. Our studies demonstrated that scores between MR and apprenticeship learning were comparable. All felt MR was an effective learning tool and most noted that the MR models were better than existing didactic methods of learning. Identified advantages of MR included the ability to provide true 3D spatial representation, improved visualization of smaller structures in detail by upscaling the models, and improved interactivity. Our results demonstrate that holographic learning is able to mimic in-person learning for visual-spatial motor skills and could be a new effective form of self-directed apprenticeship learning.
Collapse
Affiliation(s)
- Regina Leung
- Division of Plastic and Reconstructive Surgery, Western University, London, Canada
| | - Ge Shi
- Division of General Surgery, Western University, London, Canada
| |
Collapse
|
4
|
Elayah SA, Al-Watary MQ, Sakran KA, Chao Y, Jingtao L, Hanyao H, Li Y, Shi B. Two cleft palate simulators of Furlow double-opposing Z- palatoplasty: a comparative study. BMC Surg 2023; 23:302. [PMID: 37794436 PMCID: PMC10552431 DOI: 10.1186/s12893-023-02201-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/19/2023] [Indexed: 10/06/2023] Open
Abstract
PURPOSE This study aimed to evaluate the efficiency of the porcine tongue for palatoplasty simulation compared to 3D-printed simulators and their surgical education role. MATERIALS AND METHODS A total of 18 senior cleft surgeons participated in a palatoplasty simulation-based workshop conducted using porcine tongue simulators and 3D-printed simulators. This workshop consisted of a didactic session followed by a hands-on simulation session. Each participant independently used both simulators to perform Furlow double-opposing Z-plasty, which was assessed and scored by senior cleft surgeons using a scoring system including organizational flexibility and ductility, anatomical design simulation, proper incision, proper suturing, and convenience of operation. A paired t test was used for data statistical analysis and a P value < 0.05 was regarded as a statistically significant difference. RESULTS All senior cleft surgeons strongly agreed that the simulation-based workshop was a valuable learning experience, and both simulators were useful and easy to manipulate (P = 1.00). The results of this comparative study showed that a porcine tongue palatoplasty simulator had an effectively significant difference in terms of organizational flexibility and ductility (P = 0.04), and suturing was better than the 3D-printed palatoplasty simulator (P < 0.01). There were no significant differences between the simulators regarding anatomical design simulation (P = 0.76) and incision simulation (P = 0.65). CONCLUSION Both porcine tongue simulator and 3D-printed simulator have their unique strengths in surgical education for palatoplasty. Thus, the combined use of a porcine tongue and a 3D-printed cleft palate simulators are efficient as an educational model to practice Furlow double-opposing Z- palatoplasty. The porcine tongue simulators are superior in terms of organizational flexibility, ductility, and suturing simulators, while with the 3D-printed simulator, various palatoplasty techniques can be repeatedly practiced with better-simulated face and oral cavity.
Collapse
Affiliation(s)
- Sadam Ahmed Elayah
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral and Maxillofacial Surgery, Cleft Lip and Palate Center, Faculty of Dentistry, Jiblah University for Medical and Health Sciences, Ibb, Yemen
| | - Mohammed Qasem Al-Watary
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Karim Ahmed Sakran
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yang Chao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Li Jingtao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Huang Hanyao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yang Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Bing Shi
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| |
Collapse
|
5
|
Chaya BF, Laspro M, Verzella AN, Oliker A, Arnold A, Alcon A, Flores RL. Internet-based Digital Simulation for Cleft Surgery Education: A 10-year Assessment of Demographics, Usage, and Future Directions. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5300. [PMID: 37790141 PMCID: PMC10545349 DOI: 10.1097/gox.0000000000005300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/16/2023] [Indexed: 10/05/2023]
Abstract
Background In October 2012, an open-access, multimedia digital cleft simulator was released. Its purpose was to address global disparities in cleft surgery education, providing an easily accessible surgical atlas for trainees globally. The simulator platform includes a three-dimensional surgical simulation of cleft care procedures, intraoperative videos, and voiceover. This report aims to assess the simulator's demographics and usage in its tenth year since inception. Finally, we also aim to understand the traction of virtual reality in cleft surgical education. Methods Usage data of the simulator over 10 years were retrospectively collected and analyzed. Data parameters included the number of users, sessions, countries reached, and content access. An electronic survey was emailed to registered users to assess the benefits of the simulator. Results The total number of new and active simulator users reached 7687 and 12,042. The simulator was accessed an average of 172.9.0 ± 197.5 times per month. Low- to middle-income regions accounted for 43% of these sessions. The mean session duration was 11.4 ± 6.3 minutes, yielding a total screen time of 3022 hours. A total of 331 individuals responded to the survey, of whom 80.8% found the simulator to be very useful or extremely useful. Of those involved in education, 45.0% implemented the simulator as a teaching tool. Conclusions Global utilization of the simulator has been sustained after 10 years from inception with an increased presence in low- to middle-income nations. Future similar surgical simulators may provide sustainable training platforms to surgeons in low- and high-resource areas.
Collapse
Affiliation(s)
- Bachar F. Chaya
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, N.Y
| | - Matteo Laspro
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, N.Y
| | - Alexandra N. Verzella
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, N.Y
| | | | | | - Andre Alcon
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, N.Y
| | - Roberto L. Flores
- From the Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, N.Y
| |
Collapse
|
6
|
Wan T, Liu K, Li B, Wang X. Validity of an immersive virtual reality training system for orthognathic surgical education. Front Pediatr 2023; 11:1133456. [PMID: 37033170 PMCID: PMC10078956 DOI: 10.3389/fped.2023.1133456] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Virtual reality (VR) has been proven an important supplement for surgical education in medical students. However, studies on immersive VR (iVR) simulation in orthognathic surgical education are limited. This study aimed to assess the validity of the iVR surgical training system for orthognathic surgery. Participants completed questionnaires at the end of the course to assess the validity of the training system. The questionnaires included questions on the experience of using the iVR system and surgical authenticity. Seven experienced surgeons and seven inexperienced students were recruited in this study to use our self-developed iVR training system for orthognathic surgery. The participants showed strong agreement to the fidelity of our training system (4.35 out of 5), including the virtual environment, instruments, anatomy structures, and surgical procedures. The participants also strongly agreed that the iVR technique was essential in imparting surgical education. However, most of the participants experienced some degree of dizziness or fatigue after 1 h of using the system. The iVR training system is a new method for imparting education about orthognathic surgery. The iVR training system can act as a supplement and potential substitute of the traditional surgical training method.
Collapse
Affiliation(s)
- Teng Wan
- Department of Oral and Craniomaxillofacial Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Kai Liu
- Department of Oral and Craniomaxillofacial Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Biao Li
- Department of Oral and Craniomaxillofacial Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
- Correspondence: Xudong Wang Biao Li
| | - Xudong Wang
- Department of Oral and Craniomaxillofacial Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
- Correspondence: Xudong Wang Biao Li
| |
Collapse
|
7
|
Patel A, Massand S, Ingraham J. The state of remote learning in plastic surgery: A systematic review of modalities. SURGERY IN PRACTICE AND SCIENCE 2022. [DOI: 10.1016/j.sipas.2022.100102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
8
|
Yoshida S, Watanabe A, Sugahara K, Odaka K, Katakura A, Takano M. Osteotomy training for dental students using three-dimensional simulation software and maxillofacial three-dimensional-printed models. J Dent Educ 2022; 86:526-534. [PMID: 34978716 DOI: 10.1002/jdd.12860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/27/2021] [Accepted: 11/23/2021] [Indexed: 11/11/2022]
Abstract
PURPOSE/OBJECTIVES Simulated educational models of teeth, bones, and gums have been used for a long time in procedural skills training in dentistry. The advent of three-dimensional (3D) printing technologies and additive manufacturing has facilitated the production of more advanced 3D printed models that can be utilized for surgical and dental training together with other technologies (e.g., 3D scanners and image analysis software). METHODS We conducted training on osteotomy in the maxilla and mandible using maxillofacial simulation software (MSS) and a 3D-printed model for 5th-year undergraduate dental students (13 students in 2017 and 11 students in 2018 with more than half of their results). We compared the group (13 students) who performed osteotomy after participating in the simulation lecture with those (11 students) who performed osteotomy after performing self-simulation (they were instructed to bring their personal computers and install the MSS) using tests and questionnaires (pre- and post-curriculum). RESULTS The average test score was significantly higher in the group who performed osteotomy using the 3D-printed model after performing self-simulation; participants in this group had acquired a better understanding of the surgical procedure. Comparison using questionnaires showed a significant difference in the students' understanding of instruments and surgical techniques between both groups. CONCLUSION The MSS and 3D printed models are widely used clinically. Incorporating these in the curriculum will help accelerate student development. In addition, prompt education on the purpose and usefulness of these tools will not only facilitate simulation software and 3D-printed model-based treatment plan in the clinic but also promote further research.
Collapse
Affiliation(s)
- Shuji Yoshida
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Tokyo, Japan
| | - Akira Watanabe
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Tokyo, Japan
| | - Keisuke Sugahara
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Kento Odaka
- Department of Dental Radiology, Tokyo Dental College, Tokyo, Japan
| | - Akira Katakura
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Masayuki Takano
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Tokyo, Japan
| |
Collapse
|
9
|
Mehrotra D, Markus A. Emerging simulation technologies in global craniofacial surgical training. J Oral Biol Craniofac Res 2021; 11:486-499. [PMID: 34345584 PMCID: PMC8319526 DOI: 10.1016/j.jobcr.2021.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 06/22/2021] [Indexed: 12/14/2022] Open
Abstract
The last few decades have seen an exponential growth in the development and adoption of novel technologies in medical and surgical training of residents globally. Simulation is an active and innovative teaching method, and can be achieved via physical or digital models. Simulation allows the learners to repeatedly practice without the risk of causing any error in an actual patient and enhance their surgical skills and efficiency. Simulation may also allow the clinical instructor to objectively test the ability of the trainee to carry out the clinical procedure competently and independently prior to trainee's completion of the program. This review aims to explore the role of emerging simulation technologies globally in craniofacial training of students and residents in improving their surgical knowledge and skills. These technologies include 3D printed biomodels, virtual and augmented reality, use of google glass, hololens and haptic feedback, surgical boot camps, serious games and escape games and how they can be implemented in low and middle income countries. Craniofacial surgical training methods will probably go through a sea change in the coming years, with the integration of these new technologies in the surgical curriculum, allowing learning in a safe environment with a virtual patient, through repeated exercise. In future, it may also be used as an assessment tool to perform any specific procedure, without putting the actual patient on risk. Although these new technologies are being enthusiastically welcomed by the young surgeons, they should only be used as an addition to the actual curriculum and not as a replacement to the conventional tools, as the mentor-mentee relationship can never be replaced by any technology.
Collapse
Affiliation(s)
- Divya Mehrotra
- Department of Oral and Maxillofacial Surgery KGMU, Lucknow, India
| | - A.F. Markus
- Emeritus Consultant Maxillofacial Surgeon, Poole Hospital University of Bournemouth, University of Duisburg-Essen, Trinity College, Dublin, Ireland
| |
Collapse
|
10
|
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.
Collapse
Affiliation(s)
- V Fuertes Bielsa
- Plastic Surgery Department University Hospital Miguel Servet Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain.
| |
Collapse
|
11
|
Videoscope-Assisted Cleft Palate Surgery: Rationale, Experience, and Technical Implementation. Plast Reconstr Surg 2020; 146:1129-1132. [DOI: 10.1097/prs.0000000000007291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
12
|
Three-Dimensional Affordable Stone Models for Cleft Lip Markings: A Prospective Study of Learner Satisfaction. Ann Plast Surg 2020; 83:340-343. [PMID: 31008789 DOI: 10.1097/sap.0000000000001813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Knowledge of surgical markings for unilateral cleft lip (UCL) repair is critical for surgical competency. However, few appropriate models are accessible to residents and affordable and accurately reproduce this 3-dimensional (3D) deformity. We propose that cleft care units have the capability of creating affordable 3D stone models to teach UCL markings. METHODS Polyvinyl siloxane and SnapStone were used to create UCL stone models. Thirteen plastic surgery residents were prospectively recruited, provided with a textbook chapter and online module for studying surgical markings for UCL repair, and then asked to perform the markings on a UCL stone model and standardized patient photograph. Learner satisfaction was evaluated using a modified survey based on the Student Evaluation of Educational Quality survey. RESULTS The production time of each model was 10 minutes, whereas the cost was $1.84. Participants reported that the stone model was more stimulating (4.77 ± 0.44 vs 3.92 ± 0.86; U = 38.0; P = 0.008), increased their interest more (4.70 ± 0.48 vs 3.53 ± 1.20; U = 33.5; P = 0.005), allowed better learning (4.61 ± 0.51 vs 3.08 ± 0.86; U = 10.0; P < 0.001), was clearer (4.62 ± 0.51 vs 3.15 ± 0.90; U = 12.5; P < 0.001), and was more effective for learning cleft lip markings (4.77 ± 0.44 vs 3.08 ± 1.04; U = 9.0; P < 0.001). They were also more likely to recommend it (4.85 ± 0.38 vs 3.15 ± 1.07; U = 7.0; P < 0.001). CONCLUSIONS Plastic surgery residents report that 3D cleft lip stone models are superior training tools to learn cleft lip markings compared with patient photographs. These educational tools have the potential to overcome significant financial, logistic, and time constraints in teaching cleft lip surgery markings.
Collapse
|
13
|
Misky AT, Sadr AH, Nikkhah D. Response to "Re "Impact of MSLT-II on lymph node clearance surgery in a tertiary plastic surgery centre"". J Plast Reconstr Aesthet Surg 2020; 73:2239-2260. [PMID: 33039303 DOI: 10.1016/j.bjps.2020.08.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Adam T Misky
- Department of Plastic Surgery, Royal Free Hospital, Royal Free London NHS Foundation Trust, Pond Street, NW3 2QG London, UK
| | - Amir H Sadr
- Department of Plastic Surgery, Royal Free Hospital, Royal Free London NHS Foundation Trust, Pond Street, NW3 2QG London, UK
| | - Dariush Nikkhah
- Department of Plastic Surgery, Royal Free Hospital, Royal Free London NHS Foundation Trust, Pond Street, NW3 2QG London, UK.
| |
Collapse
|
14
|
Tatum SA. The Art of Teaching, Training, and Putting the Scalpel in Residents' Hands. Facial Plast Surg Clin North Am 2020; 28:469-475. [PMID: 33010865 DOI: 10.1016/j.fsc.2020.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Surgical education is under tremendous pressure due to ever-increasing medical knowledge and demands on trainees' time. They must continually learn more in less time due to work hour limitations, regulations, and electronic medical record demands. Surgical training must become more efficient. There is an unprecedented array of education and training opportunities for resident preparation. The preparation for each case has to be maximal. Preoperative, intraoperative, and postoperative simulation and discussions improve the educational benefit of the trainee experience. For the teaching surgeon, putting a scalpel in residents' hands requires patience, knowledge, judgment, and a leap of faith in the resident.
Collapse
Affiliation(s)
- Sherard Austin Tatum
- Department of Otolaryngology, Cleft and Craniofacial Center, Division of Facial Plastic and Reconstructive Surgery, Upstate Medical University, State University of New York, 750 East Adams Street, CWB, Syracuse, NY 13210, USA.
| |
Collapse
|
15
|
Kantar RS, Breugem CC, Keith K, Kassam S, Vijayakumar C, Bow M, Alfonso AR, Chahine EM, Ghotmi LH, Patel KG, Shetye PR, Santiago PE, Losee JE, Steinbacher DM, Rossell-Perry P, Garib DG, Alonso N, Mann RJ, Prada-Madrid JR, Esenlik E, Pamplona MDC, Collares MVM, Bennun RD, Kummer A, Giugliano C, Padwa BL, Raposo-Amaral CE, Tse R, Sommerlad B, Flores RL, Hamdan US. Simulation-Based Comprehensive Cleft Care Workshops: A Reproducible Model for Sustainable Education. Cleft Palate Craniofac J 2020; 57:1238-1246. [PMID: 32729337 DOI: 10.1177/1055665620944781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Evaluate simulation-based comprehensive cleft care workshops as a reproducible model for education with sustained impact. DESIGN Cross-sectional survey-based evaluation. SETTING Simulation-based comprehensive cleft care workshop. PARTICIPANTS Total of 180 participants. INTERVENTIONS Three-day simulation-based comprehensive cleft care workshop. MAIN OUTCOME MEASURES Number of workshop participants stratified by specialty, satisfaction with the workshop, satisfaction with simulation-based workshops as educational tools, impact on cleft surgery procedural confidence, short-term impact on clinical practice, medium-term impact on clinical practice. RESULTS The workshop included 180 participants from 5 continents. The response rate was 54.5%, with participants reporting high satisfaction with all aspects of the workshop and with simulation-based workshops as educational tools. Participants reported a significant improvement in cleft lip (33.3 ± 5.7 vs 25.7 ± 7.6; P < .001) and palate (32.4 ± 7.1 vs 23.7 ± 6.6; P < .001) surgery procedural confidence following the simulation sessions. Participants also reported a positive short-term and medium-term impact on their clinical practices. CONCLUSION Simulation-based comprehensive cleft care workshops are well received by participants, lead to improved cleft surgery procedural confidence, and have a sustained positive impact on participants' clinical practices. Future efforts should focus on evaluating and quantifying this perceived positive impact, as well reproducing these efforts in other areas of need.
Collapse
Affiliation(s)
- Rami S Kantar
- Global Smile Foundation, Norwood, MA, USA
- Department of Surgery, The University of Maryland Medical System, Baltimore, MD, USA
| | - Corstiaan C Breugem
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | | | - Serena Kassam
- Global Smile Foundation, Norwood, MA, USA
- Department of Pediatric Dentistry, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Charanya Vijayakumar
- Cleft and Craniofacial Center, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
| | | | - Allyson R Alfonso
- Global Smile Foundation, Norwood, MA, USA
- The Hansjörg Department of Plastic Surgery, New York University Langone Health, New York City, NY, USA
| | | | | | - Krishna G Patel
- Global Smile Foundation, Norwood, MA, USA
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Pradip R Shetye
- The Hansjörg Department of Plastic Surgery, New York University Langone Health, New York City, NY, USA
| | | | - Joseph E Losee
- Department of Plastic Surgery, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, PA, USA
| | - Derek M Steinbacher
- Division of Plastic Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Percy Rossell-Perry
- Edgardo Rebagliati Hospital ESSALUD and San Martin de Porres University, Lima, Peru
| | - Daniela G Garib
- Department of Orthodontics, Bauru Dental School and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Nivaldo Alonso
- Department of Plastic Surgery, University of São Paulo, São Paulo, Brazil
| | - Robert J Mann
- Division of Pediatric Plastic Surgery, Spectrum Health Medical Group, Michigan State College of Human Medicine, Grand Rapids, MI, USA
| | - Jose Rolando Prada-Madrid
- Department of Plastic and Reconstructive Surgery, Hospital Infantil Universitario de San José, Bogotá, Colombia
| | - Elçin Esenlik
- Department of Orthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - María Del Carmen Pamplona
- Hablarte e Integrarte, AC, Cleft Palate Clinic, Hospital Gea Gonzalez and Universidad San Sebastián, Mexico City, Mexico
| | - Marcus Vinícius Martins Collares
- Plastic and Craniomaxillofacial Surgery Division, School of Medicine, Rio Grande do Sul Federal University, Porto Alegre, Brazil
| | - Ricardo D Bennun
- Asociacion PIEL and School of Medicine, National University of Buenos Aires, Buenos Aires, Argentina
| | - Ann Kummer
- Division of Speech-Language Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Carlos Giugliano
- Plastic Surgery Unit, Alfredo Gantz Mann Foundation, and Clínica Alemana, Santiago, Chile
| | - Bonnie L Padwa
- Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Raymond Tse
- University of Washington and Seattle Children's Hospital, Seattle, WA, USA
| | - Brian Sommerlad
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Roberto L Flores
- The Hansjörg Department of Plastic Surgery, New York University Langone Health, New York City, NY, USA
| | - Usama S Hamdan
- Global Smile Foundation, Norwood, MA, USA
- Otology and Laryngology, Harvard Medical School, Boston, MA, USA
- Otolaryngology, Tufts University School of Medicine, Boston, MA, USA
- Otolaryngology, Boston University School of Medicine, MA, USA
| |
Collapse
|
16
|
Online Resources in Plastic Surgery Education: A Toolbox for Modern Trainees and Plastic Surgeons. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2894. [PMID: 32802637 PMCID: PMC7413800 DOI: 10.1097/gox.0000000000002894] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/09/2020] [Indexed: 11/25/2022]
Abstract
Plastic surgery is a rapidly evolving field that requires novel approaches in providing continuous and dynamic educational resources to address the increasing time and skill demands from residents. Online resources in their various forms, such as books, journals, simulators, and applications, are increasingly used by residents, notably over traditional print and in-person counterparts. In this digital era, it is imperative to understand the scope and utility of online resources that have the potential to revolutionize plastic surgery education. In this review article, we first discuss the current model of plastic surgery education and the challenges of meeting its goals and then suggest reasons by which online resources close this gap. We also offer an exposition on the benefits of distinct types of resources and current trends regarding their use. Our goal is to create a framework within which learners and educators are able to organize online resources in plastic surgery.
Collapse
|
17
|
Agrawal N, Turner A, Grome L, Abu-Ghname A, Davis MJ, Reece EM, Buchanan EP, Winocour S. Use of Simulation in Plastic Surgery Training. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2896. [PMID: 32802639 PMCID: PMC7413819 DOI: 10.1097/gox.0000000000002896] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/14/2020] [Indexed: 12/18/2022]
Abstract
The nationwide focus on patient safety and the health of residents has increased the demand for educational tools outside the operating room. Simulation is a valuable tool for assessing and developing surgical skills in a controlled and safe environment. The use of simulation as a formal component of training has been increasing in various surgical subspecialties. In general surgery, simulation examinations such as the Fundamentals of Laparoscopic Surgery and Fundamentals of Endoscopic Surgery have become a prerequisite to board certification. Although formal simulation examinations in plastic surgery are not universal, there has been an increase in the use of simulation to increase resident competency in the operating room. For now, we will review the current state of simulation in craniofacial, hand, microvascular, and esthetic surgery and discuss applications for the future. We will also discuss the evolving role of artificial intelligence, virtual reality, and augmented reality in plastic surgery training and testing.
Collapse
Affiliation(s)
- Nikhil Agrawal
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
| | - Acara Turner
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
| | - Luke Grome
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
| | - Amjed Abu-Ghname
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
- Division of Plastic Surgery, Department of Surgery, Texas Children’s Hospital, Houston, Tex
| | - Matthew J. Davis
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
- Division of Plastic Surgery, Department of Surgery, Texas Children’s Hospital, Houston, Tex
| | - Edward M. Reece
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
- Division of Plastic Surgery, Department of Surgery, Texas Children’s Hospital, Houston, Tex
| | - Edward P. Buchanan
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
- Division of Plastic Surgery, Department of Surgery, Texas Children’s Hospital, Houston, Tex
| | - Sebastian Winocour
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
| |
Collapse
|
18
|
O’Neill R, Raj S, Davis MJ, Abu-Ghname A, Reece EM, Winocour J, Buchanan EP, Winocour S. Aesthetic Training in Plastic Surgery Residency. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2895. [PMID: 32802638 PMCID: PMC7413815 DOI: 10.1097/gox.0000000000002895] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/09/2020] [Indexed: 01/18/2023]
Abstract
Training in aesthetic surgery is a core element in a plastic surgery residency program. Nevertheless, in the past, many studies have shown the lack of resident confidence in aesthetic procedures upon graduation. In recent years, a number of efforts have been made to address this concern, including increasing the required residency aesthetic case requirements and the integration of resident aesthetic clinics to increase exposure and independence in this aspect of training. Numerous studies have been conducted to evaluate the efficacy of these resident-run clinics and have substantiated their value as an important educational tool in residency training and validated their safety in patient care. In fact, survey studies have shown that though residents today show a markedly increased confidence in their training when compared with the past, they still feel there is room for improvement in areas such as facial and minimally invasive surgeries, along with procedures that require higher patient volume to refine. In this article, we review the current state of aesthetic surgery training during plastic surgery residency and discuss future directions in the field.
Collapse
Affiliation(s)
- Rebecca O’Neill
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
| | - Sarth Raj
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
| | - Matthew J. Davis
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
- Division of Plastic Surgery, Department of Surgery, Texas Children’s Hospital, Houston, Tex
| | - Amjed Abu-Ghname
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
- Division of Plastic Surgery, Department of Surgery, Texas Children’s Hospital, Houston, Tex
| | - Edward M. Reece
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
- Division of Plastic Surgery, Department of Surgery, Texas Children’s Hospital, Houston, Tex
| | - Julian Winocour
- Department of Plastic Surgery, Vanderbilt University, Nashville, Tenn
| | - Edward P. Buchanan
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
- Division of Plastic Surgery, Department of Surgery, Texas Children’s Hospital, Houston, Tex
| | - Sebastian Winocour
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
| |
Collapse
|
19
|
|
20
|
Knowledge and Skills Acquisition by Plastic Surgery Residents through Digital Simulation Training. Plast Reconstr Surg 2020; 145:184e-192e. [DOI: 10.1097/prs.0000000000006375] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
21
|
Kantar RS, Plana NM, Diaz-Siso JR, Flores RL. Reply: Simulation-Based Cleft Surgery Education: From Theory to Real-Time Application. Plast Reconstr Surg 2019; 144:717e-718e. [PMID: 31568339 DOI: 10.1097/prs.0000000000006054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Rami S Kantar
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, N.Y
| | | | | | | |
Collapse
|
22
|
Kantar RS, Alfonso AR, Ramly EP, Diaz-Siso JR, Breugem CC, Flores RL. Simulation in Cleft Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2438. [PMID: 31942398 PMCID: PMC6908384 DOI: 10.1097/gox.0000000000002438] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 07/12/2019] [Indexed: 11/25/2022]
Abstract
A number of digital and haptic simulators have been developed to address challenges facing cleft surgery education. However, to date, a comprehensive review of available simulators has yet to be performed. Our goal is to appraise cleft surgery simulators that have been described to date, their role within a simulation-based educational strategy, the costs associated with their use, and data supporting or refuting their utility.
Collapse
Affiliation(s)
- Rami S Kantar
- The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Allyson R Alfonso
- The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Elie P Ramly
- The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - J Rodrigo Diaz-Siso
- The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Corstiaan C Breugem
- Department of Plastic and Reconstructive Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Roberto L Flores
- The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| |
Collapse
|
23
|
Bilateral Sagittal Split Osteotomy: Description of Surgical Technique to Complement the Procedural Cognition Simulation in the Craniofacial Interactive Virtual Assistant-Professional Edition. J Craniofac Surg 2019; 30:2324-2327. [PMID: 31261323 DOI: 10.1097/scs.0000000000005705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Operative experience for the contemporary trainee has become exceedingly more challenging in the setting of more stringent hospital regulations. Surgical training is thus shifting toward more self-directed, independent learning to maximize operative opportunities as they become available; yet, this can prove difficult for complex surgeries like craniofacial procedures. The intricate anatomy and fine reconstructive techniques employed cannot be readily depicted onto a two-dimensional page. To address this educational gap, the Craniofacial Interactive Virtual Assistant-Pro Edition (CIVA-Pro) was developed as a web-based surgical simulator to aid learners with conceptualizing the surgical principles utilized in these cases. The current work reviews the Bilateral Sagittal Split Osteotomy module of CIVA-Pro, providing detailed narratives for each chapter with expert commentary on broadened indications and future directions.
Collapse
|
24
|
Fronto-Orbital Advancement: Description of Surgical Technique to Complement the Procedural Cognition Simulation in the Craniofacial Interactive Virtual Assistant-Professional Edition. J Craniofac Surg 2019; 30:473-477. [PMID: 30676451 DOI: 10.1097/scs.0000000000005141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The surgical treatment of nonsyndromic craniosynostosis is one of the most common procedures performed by craniofacial surgeons. However, for residents and fellows, the high degree of difficulty and complex anatomy may result in slow progress along a steep learning curve. This is particularly important in the context of contemporary academic practice, where work-hour limits and other factors restrict operative exposure and opportunities for trainees to learn. These issues have prompted the development of surgical simulation modalities that, while prevalent in other surgical specialties, have not been fully adopted in reconstructive surgery.Among these resources is the Craniofacial Interactive Virtual Assistant - Professional Edition (CIVA-Pro), a procedural cognition simulator that is free of charge. By integrating 3-dimensional virtual animation, voice over, and high-definition intraoperative video, CIVA-Pro describes cardinal craniofacial surgery procedures in an engaging platform. In this study, a detailed, step-by-step description of the fronto-orbital advancement surgical technique to complement the corresponding CIVA-Pro module was presented. This synergistic combination of multimedia educational resources provides a unique didactic option for current trainees to prepare for surgery.
Collapse
|
25
|
A Prospective, Randomized, Blinded Trial Comparing Digital Simulation to Textbook for Cleft Surgery Education. Plast Reconstr Surg 2019; 143:202-209. [DOI: 10.1097/prs.0000000000005093] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
26
|
Kantar RS, Ramly EP, Almas F, Patel KG, Rogers-Vizena CR, Roche NA, Zgheib E, Munoz-Pareja JC, Nader MK, Kummer AW, Flores RL, Van Aalst JA, Hamdan US. Sustainable Cleft Care Through Education: The First Simulation-Based Comprehensive Workshop in the Middle East and North Africa Region. Cleft Palate Craniofac J 2018; 56:735-743. [DOI: 10.1177/1055665618810574] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Rami S. Kantar
- The Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, NY, USA
- Global Smile Foundation, Norwood, MA, USA
| | - Elie P. Ramly
- The Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, NY, USA
- Global Smile Foundation, Norwood, MA, USA
| | - Fernando Almas
- Global Smile Foundation, Norwood, MA, USA
- Cirurgião BucoMaxiloFacial, Hospital Geral de Goiânia, Goiânia, Brazil
| | - Krishna G. Patel
- Global Smile Foundation, Norwood, MA, USA
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Carolyn R. Rogers-Vizena
- Global Smile Foundation, Norwood, MA, USA
- Department of Plastic and Oral Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Nathalie A. Roche
- Department of Plastic and Reconstructive Surgery, Ghent University Hospital, Ghent, Belgium
| | | | - Jennifer C. Munoz-Pareja
- Global Smile Foundation, Norwood, MA, USA
- Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, USA
| | - Marie K. Nader
- Global Smile Foundation, Norwood, MA, USA
- Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, USA
| | - Ann W. Kummer
- Division of Speech-Language Pathology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Roberto L. Flores
- The Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, NY, USA
| | - John A. Van Aalst
- Division of Plastic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Usama S. Hamdan
- Global Smile Foundation, Norwood, MA, USA
- Otology and Laryngology, Harvard Medical School, Boston, MA, USA
- Otolaryngology, Tufts University School of Medicine, Boston, MA, USA
- Otolaryngology, Boston University School of Medicine, Boston, MA, USA
| |
Collapse
|
27
|
David JA, Rifkin WJ, Saadeh PB, Sinno S. Assessing the Value of a Multimedia-Based Aesthetic Curriculum in Plastic Surgery Residency: A Single-Center Pilot Study. Aesthet Surg J 2018; 38:NP216-NP224. [PMID: 29733345 DOI: 10.1093/asj/sjy110] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although global demand for cosmetic surgery continues to rise, plastic surgery residents feel that current models of aesthetic training are inadequate in preparing them for future practice. Digital learning resources offer promising educational possibilities, yet there are no formal studies investigating the integration of these technologies into the aesthetic curriculum. OBJECTIVES Here, we review the current state of aesthetic training for plastic surgery residents and present a pilot study investigating the value of a dedicated multimedia-based aesthetic curriculum at a single, large academic program. METHODS Twenty plastic surgery residents participated in an 8-week curriculum consisting of weekly multimedia-based modules covering a specific aesthetic topic. Participants completed pre- and post-intervention surveys at 0 and 10 weeks, respectively. Surveys evaluated resident perspectives of the current state of aesthetic training, confidence in performing surgical and non-surgical aesthetic procedures, perceived efficacy of multimedia interventions for learning, and preferences for inclusion of such approaches in future curricula. RESULTS 16.7% of participants planned on entering an aesthetic fellowship following residency. The mean number of months of dedicated cosmetic surgery rotations was 1.65 months. Resident confidence level in performing a particular aesthetic procedure significantly increased in 6/14 modules. More than 90% of residents were interested in incorporating the modules into residency. CONCLUSIONS Technology-based aesthetic training is critical for producing the finest future practitioners and leaders of this specialty. Here, we show that plastic surgery residents can benefit from a multimedia-based aesthetic curriculum, even if they do not plan on pursuing a career devoted to cosmetic surgery.
Collapse
Affiliation(s)
- Joshua A David
- Chief of Plastic Surgery Service, Bellevue Hospital Center New York University Langone Health, New York, NY
- Director of the Plastic Surgery Residency Program, New York University Langone Health, New York, NY Hansjörg Wyss Department of Plastic and Reconstructive Surgery, New York University Langone Health, New York, NY
| | - William J Rifkin
- Chief of Plastic Surgery Service, Bellevue Hospital Center New York University Langone Health, New York, NY
- Director of the Plastic Surgery Residency Program, New York University Langone Health, New York, NY Hansjörg Wyss Department of Plastic and Reconstructive Surgery, New York University Langone Health, New York, NY
| | - Pierre B Saadeh
- Chief of Plastic Surgery Service, Bellevue Hospital Center New York University Langone Health, New York, NY
- Director of the Plastic Surgery Residency Program, New York University Langone Health, New York, NY Hansjörg Wyss Department of Plastic and Reconstructive Surgery, New York University Langone Health, New York, NY
| | - Sammy Sinno
- Plastic surgeon in private practice in Chicago, IL
| |
Collapse
|
28
|
Maliha SG, Diaz-Siso JR, Plana NM, Torroni A, Flores RL. Haptic, Physical, and Web-Based Simulators: Are They Underused in Maxillofacial Surgery Training? J Oral Maxillofac Surg 2018; 76:2424.e1-2424.e11. [PMID: 30081008 DOI: 10.1016/j.joms.2018.06.177] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/30/2018] [Accepted: 06/19/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Surgical residencies have increasingly incorporated both digital and mannequin simulation into their training programs. The aim of our review was to identify all digital and mannequin maxillofacial simulators available for education and training, highlight their benefit, and critically assess the evidence in support of these educational resources. MATERIALS AND METHODS We performed a comprehensive literature review of all peer-reviewed publications of digital and mannequin simulators that met the inclusion criteria, defined as any simulator used in education or training. All simulators used in surgical planning were excluded. Before the query, it was hypothesized that most studies would be descriptive in nature and supported by low levels of evidence. Literature search strategies included the use of multiple combinations of key search terms, review of titles and abstracts, and precise identification of the use of the simulator described. All statistics were descriptive. RESULTS The primary search yielded 259 results, from which 22 total simulators published on from 2001 to 2016 were identified using the inclusion and exclusion criteria: 10 virtual reality haptic-based simulators, 6 physical model simulators, and 6 Web-based simulators used for a variety of procedures such as dental skills, instrument handling, orthognathic surgery (Le Fort I osteotomy, vertical ramus osteotomy, bilateral sagittal split ramus osteotomy), genioplasty, bone grafting, sinus surgery, cleft lip repair, orbital floor repair, and oral biopsy. Only 9 formalized studies were completed; these were classified as low-level evidence-based cohort studies (Levels IV and V). All other simulator reports were descriptive in nature. There were no studies with high levels of evidence completed (Level I to III). CONCLUSIONS The results of this review suggest that, although seemingly beneficial to the trainee in maxillofacial surgery, simulation in education in this field is an underused commodity because of the significant lack of scientific and validated study designs reported on in the literature thus far. The maxillofacial and simulation communities would benefit from studies on utility and efficacy with higher levels of evidence.
Collapse
Affiliation(s)
- Samantha G Maliha
- Medical Student and Research Fellow, Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, and New York University School of Medicine, New York, NY.
| | - J Rodrigo Diaz-Siso
- Research Fellow, Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY
| | - Natalie M Plana
- Medical Student and Research Fellow, Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, and New York University School of Medicine, New York, NY
| | - Andrea Torroni
- Associate Professor, New York University School of Medicine, New York, NY, and Department of Oral and Maxillofacial Surgery, College of Dentistry, New York University, New York, NY
| | - Roberto L Flores
- Joseph G. McCarthy Associate Professor of Reconstructive Plastic Surgery, Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY
| |
Collapse
|
29
|
Kantar RS, Plana NM, Cutting CB, Diaz-Siso JR, Flores RL. Internet-Based Digital Simulation for Cleft Surgery Education: A 5-Year Assessment of Demographics, Usage, and Global Effect. JOURNAL OF SURGICAL EDUCATION 2018; 75:1120-1126. [PMID: 29396278 DOI: 10.1016/j.jsurg.2017.12.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/17/2017] [Accepted: 12/10/2017] [Indexed: 05/24/2023]
Abstract
BACKGROUND In October 2012, a freely available, internet-based cleft simulator was created in partnership between academic, nonprofit, and industry sectors. The purpose of this educational resource was to address global disparities in cleft surgery education. This report assesses demographics, usage, and global effect of our simulator, in its fifth year since inception. OBJECTIVE Evaluate the global effect, usage, and demographics of an internet-based educational digital simulation cleft surgery software. SETTING AND PARTICIPANTS Simulator modules, available in five languages demonstrate surgical anatomy, markings, detailed procedures, and intraoperative footage to supplement digital animation. Available data regarding number of users, sessions, countries reached, and content access were recorded. Surveys evaluating the demographic characteristics of registered users and simulator use were collected by direct e-mail. RESULTS The total number of simulator new and active users reached 2865 and 4086 in June 2017, respectively. By June 2017, users from 136 countries had accessed the simulator. From 2015 to 2017, the number of sessions was 11,176 with a monthly average of 399.0 ± 190.0. Developing countries accounted for 35% of sessions and the average session duration was 9.0 ± 7.3 minutes. This yields a total simulator screen time of 100,584 minutes (1676 hours). Most survey respondents were surgeons or trainees (87%) specializing in plastic, maxillofacial, or general surgery (89%). Most users found the simulator to be useful (88%), at least equivalent or more useful than other resources (83%), and used it for teaching (58%). CONCLUSIONS Our internet-based interactive cleft surgery platform reaches its intended target audience, is not restricted by socioeconomic barriers to access, and is judged to be useful by surgeons. More than 4000 active users have been reached since inception. The total screen time over approximately 2 years exceeded 1600 hours. This suggests that future surgical simulators of this kind may be sustainable by stakeholders interested in reaching this target audience.
Collapse
Affiliation(s)
- Rami S Kantar
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, New York
| | - Natalie M Plana
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, New York
| | - Court B Cutting
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, New York
| | - Jesus Rodrigo Diaz-Siso
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, New York
| | - Roberto L Flores
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, New York.
| |
Collapse
|
30
|
|