1
|
Nobis CP, Grottschreiber K, Olmos M, Moest T, Weber M, Kesting M, Lutz R. Development of a porcine training model for microvascular fasciocutaneous free flap reconstruction. Head Face Med 2024; 20:35. [PMID: 38831370 PMCID: PMC11145860 DOI: 10.1186/s13005-024-00435-z] [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: 01/26/2024] [Accepted: 05/26/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND In reconstructive surgery, improvements are needed in the effective teaching of free flap surgery. There is a need for easily accessible and widely available training without high financial costs or ethical concerns while still providing a realistic experience. Our aim was to develop an appropriate training model for microvascular flaps. METHODS We identified pig head halves as most appropriate regarding availability, cost, and realism. These accrue largely by the food industry, so no animals need to be sacrificed, making it more ethical from an animal welfare perspective. We evaluated the suitability as flap donor site and analyzed the vascular anatomy of 51 specimens. RESULTS Anatomical evaluation revealed a reliable and constant vascular anatomy, allowing the design of a flap model that can effectively illustrate the entire process of microvascular flap surgery. The process was divided into 6 key steps. The flap can be harvested after marking the vascular pedicle 5.3 cm from the lateral corner of the mouth. Skin island design and subsequent tissue dissection follow until a fasciocutaneous flap is raised, similar to a radial flap. Upon completion of flap harvesting, it can be freely transferred for defect reconstruction. Microvascular anastomosis can be performed on recipient vessels in the cervical region, and the difficulty can be individually adjusted. CONCLUSIONS The developed training model is a reasonable compromise in terms of surgical realism, availability, didactic value, and cost/time effectiveness. We believe it is a powerful and effective tool with high potential for improving surgical education and training.
Collapse
Affiliation(s)
- Christopher-Philipp Nobis
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glueckstrasse 11, D-91054, Erlangen, Germany.
| | - Katharina Grottschreiber
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glueckstrasse 11, D-91054, Erlangen, Germany
| | - Manuel Olmos
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glueckstrasse 11, D-91054, Erlangen, Germany
| | - Tobias Moest
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glueckstrasse 11, D-91054, Erlangen, Germany
| | - Manuel Weber
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glueckstrasse 11, D-91054, Erlangen, Germany
| | - Marco Kesting
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glueckstrasse 11, D-91054, Erlangen, Germany
| | - Rainer Lutz
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glueckstrasse 11, D-91054, Erlangen, Germany
| |
Collapse
|
2
|
Chen X, Liao P, Liu S, Zhu J, Abdullah AS, Xiao Y. Effect of virtual reality training to enhance laparoscopic assistance skills. BMC MEDICAL EDUCATION 2024; 24:29. [PMID: 38178100 PMCID: PMC10768454 DOI: 10.1186/s12909-023-05014-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 12/27/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND While laparoscopic assistance is often entrusted to less experienced individuals, such as residents, medical students, and operating room nurses, it is important to note that they typically receive little to no formal laparoscopic training. This deficiency can lead to poor visibility during minimally invasive surgery, thus increasing the risk of errors. Moreover, operating room nurses and medical students are currently not included as key users in structured laparoscopic training programs. OBJECTIVES The aim of this study is to evaluate the laparoscopic skills of OR nurses, clinical medical postgraduate students, and residents before and after undergoing virtual reality training. Additionally, it aimed to compare the differences in the laparoscopic skills among different groups (OR nurses/Students/Residents) both before and after virtual reality training. METHODS Operating room nurses, clinical medical postgraduate students and residents from a tertiary Grade A hospital in China in March 2022 were selected as participants. All participants were required to complete a laparoscopic simulation training course in 6 consecutive weeks. One task from each of the four training modules was selected as an evaluation indicator. A before-and-after self-control study was used to compare the basic laparoscopic skills of participants, and laparoscopic skill competency was compared between the groups of operating room nurses, clinical medical postgraduate students, and residents. RESULTS Twenty-seven operating room nurses, 31 clinical medical postgraduate students, and 16 residents were included. The training course scores for the navigation training module, task training module, coordination training module, and surgical skills training module between different groups (operating room nurses/clinical medical postgraduate/residents) before laparoscopic simulation training was statistically significant (p < 0.05). After laparoscopic simulation training, there was no statistically significant difference in the training course scores between the different groups. The surgical level scores before and after the training course were compared between the operating room nurses, clinical medical postgraduate students, and residents and showed significant increases (p < 0.05). CONCLUSION Our findings show a significant improvement in laparoscopic skills following virtual surgery simulation training across all participant groups. The integration of virtual surgery simulation technology in surgical training holds promise for bridging the gap in laparoscopic skill development among health care professionals.
Collapse
Affiliation(s)
- Xiuwen Chen
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Nursing, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Peng Liao
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, China
| | - Shiqing Liu
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China.
- International Joint Research Center of Minimally Invasive Endoscopic Technology Equipment & Standards, Xiangya Hospital, Central South University, Changsha, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
| | - Jianxi Zhu
- Hunan Key Laboratary of Aging Biology, Xiangya Hospital, Central South University, Changsha, 410008, China
- International Joint Research Center of Minimally Invasive Endoscopic Technology Equipment & Standards, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Abdullah Sultan Abdullah
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China
- International Joint Research Center of Minimally Invasive Endoscopic Technology Equipment & Standards, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yao Xiao
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China.
- International Joint Research Center of Minimally Invasive Endoscopic Technology Equipment & Standards, Xiangya Hospital, Central South University, Changsha, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
| |
Collapse
|
3
|
Li H, Zhao W, Li B, Li Y. Effects of the small private online course combined with simulation-based training in a patient safety education program among nursing students: A quasi-experimental study. Int J Nurs Sci 2023; 10:555-561. [PMID: 38020829 PMCID: PMC10667291 DOI: 10.1016/j.ijnss.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 09/05/2023] [Accepted: 09/20/2023] [Indexed: 12/01/2023] Open
Abstract
Objective This study aimed to explore the effects of the small private online course (SPOC) combined with simulation-based training in a patient safety education program among nursing students in China. Methods A quasi-experimental design was conducted. A total of 219 nursing students from four parallel classes were selected from the nursing department of a health vocational college in Zhengzhou, China, from November 2020 to June 2021 and allocated to the intervention group (n = 113) and control group (n = 106). Based on SPOC, nursing students in the intervention group implemented simulation teaching in small groups, with three class hours each time, a total of two times, divided into three stages: pre-class preparation, teaching implementation, and after-class reflection. The control group received theoretical patient safety education through SPOC, implemented on the DingDing platform for two class hours each time, four times. All participants were invited to complete a demographic questionnaire and the Chinese version of Patient Safety Competency Self-Evaluation (PSCSE) before and after the intervention. Results A total of 103 and 102 students from the intervention and control groups completed the study. The total scores of PSCSE in the post-test of the intervention group (176.24 ± 13.73 vs. 144.64 ± 13.75) and the control group (160.87 ± 14.88 vs. 142.57 ± 15.66) were higher than those in the pre-test (P < 0.01), and the total scores of PSCSE of the intervention group were higher than those of the control group (176.24 ± 13.73 vs. 160.87 ± 14.88, P < 0.01). After intervention, the scores of PSCSE in all dimensions were increased in the intervention group (P < 0.01); in the control group, the scores of patient safety competency in most dimensions were increased (P < 0.01), except for the dimensions of reporting and response to error and communication related to error (P> 0.05). Except for the dimensions of knowledge and attitude of error reporting and disclosing (P> 0.05), the scores of other dimensions in the intervention group were higher than those in the control group (P < 0.01). Conclusion The patient safety education program using the SPOC combined with simulation-based training can effectively improve the patient safety competency of nursing students in terms of attitude, skills, and knowledge.
Collapse
Affiliation(s)
- Hui Li
- Department of Nursing, Zhengzhou Health Vocational College, Zhengzhou, China
| | - Wenzhong Zhao
- Department of Nursing, Zhengzhou Health Vocational College, Zhengzhou, China
| | - Bo Li
- Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China
| | - Yanhong Li
- Department of Nursing, Zhengzhou Health Vocational College, Zhengzhou, China
| |
Collapse
|
4
|
de Araújo DP, Duarte JL, Araújo ES. Virtual Patients: Impact of Computer Simulation on Audiology Learning and Practice. Am J Audiol 2023; 32:604-613. [PMID: 37591217 DOI: 10.1044/2023_aja-22-00242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
PURPOSE The purpose of this study was to verify users' satisfaction with the interface of an audiometric simulator and self-perception of the computer simulation impact on practical acting in audiology, allowing the identification of problems and possibilities for improvement. METHOD A prospective, observational study was divided into two phases: The first is evaluating the student's satisfaction, using the simulator in the theoretical and practical learning of audiology, and the second one is assessing the self-perception of the simulator's impact on the practical performance of audiology. The sample comprised 35 students from two Speech-Language Pathology and Audiology courses, in Brazil, selected by convenience, who answered the questionnaire after completing the theoretical module, using Google Forms, without any identification. RESULTS In the first phase of the study, students positively evaluated the use of the simulator as an auxiliary tool for audiology learning, and in the second one, they also positively assessed the impact of training with the simulator in audiological practice. CONCLUSION The analyzed audiometric simulator proved to be an interactive system with high acceptability, level of satisfaction, and potential impact on practical performance in audiology. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23876325.
Collapse
Affiliation(s)
- Deuzimar Pires de Araújo
- Graduate Program in Speech, Language, and Hearing Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Josilene Luciene Duarte
- Department of Speech-Language Pathology and Audiology, Federal University of Sergipe, Lagarto, Brazil
| | - Eliene Silva Araújo
- Department of Speech-Language Pathology and Audiology, Natal, Rio Grande do Norte, Brazil
| |
Collapse
|
5
|
Kaplan N, Marques M, Scharf I, Yang K, Alkureishi L, Purnell C, Patel P, Zhao L. Virtual Reality and Augmented Reality in Plastic and Craniomaxillofacial Surgery: A Scoping Review. Bioengineering (Basel) 2023; 10:bioengineering10040480. [PMID: 37106667 PMCID: PMC10136227 DOI: 10.3390/bioengineering10040480] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Virtual reality (VR) and augmented reality (AR) have evolved since their introduction to medicine in the 1990s. More powerful software, the miniaturization of hardware, and greater accessibility and affordability enabled novel applications of such virtual tools in surgical practice. This scoping review aims to conduct a comprehensive analysis of the literature by including all articles between 2018 and 2021 pertaining to VR and AR and their use by plastic and craniofacial surgeons in a clinician-as-user, patient-specific manner. From the initial 1637 articles, 10 were eligible for final review. These discussed a variety of clinical applications: perforator flaps reconstruction, mastectomy reconstruction, lymphovenous anastomosis, metopic craniosynostosis, dermal filler injection, auricular reconstruction, facial vascularized composite allotransplantation, and facial artery mapping. More than half (60%) involved VR/AR use intraoperatively with the remainder (40%) examining preoperative use. The hardware used predominantly comprised HoloLens (40%) and smartphones (40%). In total, 9/10 Studies utilized an AR platform. This review found consensus that VR/AR in plastic and craniomaxillofacial surgery has been used to enhance surgeons' knowledge of patient-specific anatomy and potentially facilitated decreased intraoperative time via preoperative planning. However, further outcome-focused research is required to better establish the usability of this technology in everyday practice.
Collapse
Affiliation(s)
- Nicolas Kaplan
- Division of Plastic, Reconstructive and Cosmetic Surgery, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Mitchell Marques
- Division of Plastic, Reconstructive and Cosmetic Surgery, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Isabel Scharf
- Division of Plastic, Reconstructive and Cosmetic Surgery, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Kevin Yang
- The Craniofacial Center, Division of Plastic, Reconstructive, and Cosmetic Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Lee Alkureishi
- The Craniofacial Center, Division of Plastic, Reconstructive, and Cosmetic Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA
- Shriners Children's Chicago Hospital, Chicago, IL 60707, USA
| | - Chad Purnell
- The Craniofacial Center, Division of Plastic, Reconstructive, and Cosmetic Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA
- Shriners Children's Chicago Hospital, Chicago, IL 60707, USA
| | - Pravin Patel
- The Craniofacial Center, Division of Plastic, Reconstructive, and Cosmetic Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA
- Shriners Children's Chicago Hospital, Chicago, IL 60707, USA
| | - Linping Zhao
- The Craniofacial Center, Division of Plastic, Reconstructive, and Cosmetic Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA
- Shriners Children's Chicago Hospital, Chicago, IL 60707, USA
| |
Collapse
|
6
|
Li JY, Tien CJ, Kassick M, Peters GW, Damast S. Implementing a simulation-based curriculum for hybrid intracavitary/interstitial brachytherapy using a new, commercially available, US/MR/CT-compatible gynecologic phantom. Brachytherapy 2023; 22:157-165. [PMID: 36528476 DOI: 10.1016/j.brachy.2022.11.006] [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: 08/21/2022] [Revised: 11/06/2022] [Accepted: 11/15/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE To establish a simulation-based workshop for teaching hybrid intracavitary/interstitial (IC/IS) brachytherapy skills using a new, commercially available US/CT/MRI-compatible gynecologic phantom prototype. METHODS AND MATERIALS The VIOMERSE gynecological trainer phantom consisted of tissue-like colloid material and was US, CT, and MRI-compatible. We designed a hands-on workshop incorporating the phantom prototype to teach skills for hybrid IC/IS brachytherapy including pre-implant planning, procedural steps of implant placement, and post-implant evaluation. The workshop impact was evaluated with pre- and post-workshop surveys and responses were analyzed with Wilcoxon matched-pairs signed-rank test. RESULTS Thirteen residents, divided into small groups, attended one of three separate 1-h workshop sessions held during the gynecologic education block. Workshop steps included IC applicator placement, tumor mapping and pre-planning desired location and depth of needles for hybrid IC/IS application, IS needle labelling and insertion, image review of needle placements, comparison of IC-alone versus IC/IS brachytherapy plans. Responses to questions ascertaining knowledge, confidence, and ability in planning and executing hybrid IC/IS procedures all demonstrated significant improvement from pre- to post-workshop. In response to whether the session was an effective learning experience, all residents rated the workshop with a score of 9 (n = 1) or 10 (n = 12) out of 10, with a score of 10 indicating "strongly agree." CONCLUSIONS Implementation of a hybrid IC/IS brachytherapy workshop utilizing a new, commercially-available phantom prototype was successful, with clear, subjective benefit for the residents in our program. This experience may inform continued efforts towards standardizing brachytherapy curricula across programs and increasing trainee exposure to interstitial procedures.
Collapse
Affiliation(s)
| | - Christopher J Tien
- Yale School of Medicine, Department of Therapeutic Radiology, New Haven, CT
| | - Megan Kassick
- Yale School of Medicine, Department of Therapeutic Radiology, New Haven, CT
| | - Gabrielle W Peters
- Yale School of Medicine, Department of Therapeutic Radiology, New Haven, CT
| | - Shari Damast
- Yale School of Medicine, Department of Therapeutic Radiology, New Haven, CT
| |
Collapse
|
7
|
de Lotbiniere-Bassett M, Volpato Batista A, Lai C, El Chemaly T, Dort J, Blevins N, Lui J. The user experience design of a novel microscope within SurgiSim, a virtual reality surgical simulator. Int J Comput Assist Radiol Surg 2023; 18:85-93. [PMID: 35933491 PMCID: PMC9358070 DOI: 10.1007/s11548-022-02727-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/28/2022] [Indexed: 02/01/2023]
Abstract
PURPOSE Virtual reality (VR) simulation has the potential to advance surgical education, procedural planning, and intraoperative guidance. "SurgiSim" is a VR platform developed for the rehearsal of complex procedures using patient-specific anatomy, high-fidelity stereoscopic graphics, and haptic feedback. SurgiSim is the first VR simulator to include a virtual operating room microscope. We describe the process of designing and refining the VR microscope user experience (UX) and user interaction (UI) to optimize surgical rehearsal and education. METHODS Human-centered VR design principles were applied in the design of the SurgiSim microscope to optimize the user's sense of presence. Throughout the UX's development, the team of developers met regularly with surgeons to gather end-user feedback. Supplemental testing was performed on four participants. RESULTS Through observation and participant feedback, we made iterative design upgrades to the SurgiSim platform. We identified the following key characteristics of the VR microscope UI: overall appearance, hand controller interface, and microscope movement. CONCLUSION Our design process identified challenges arising from the disparity between VR and physical environments that pertain to microscope education and deployment. These roadblocks were addressed using creative solutions. Future studies will investigate the efficacy of VR surgical microscope training on real-world microscope skills as assessed by validated performance metrics.
Collapse
Affiliation(s)
- Madeleine de Lotbiniere-Bassett
- grid.168010.e0000000419368956Department of Mechanical Engineering, Stanford University, Stanford, CA USA ,grid.22072.350000 0004 1936 7697Department of Clinical Neurosciences, Division of Neurosurgery, University of Calgary, Calgary, AB Canada
| | - Arthur Volpato Batista
- grid.22072.350000 0004 1936 7697Department of Surgery, Division of Otolaryngology–Head & Neck Surgery, University of Calgary, Calgary, AB Canada
| | - Carolyn Lai
- grid.17063.330000 0001 2157 2938Department of Neurosurgery, University of Toronto, Toronto, ON Canada
| | - Trishia El Chemaly
- grid.168010.e0000000419368956Department of Bioengineering, Stanford University, Stanford, CA USA
| | - Joseph Dort
- grid.22072.350000 0004 1936 7697Department of Surgery, Division of Otolaryngology–Head & Neck Surgery, University of Calgary, Calgary, AB Canada
| | - Nikolas Blevins
- grid.168010.e0000000419368956Department of Otolaryngology, Stanford University, Stanford, CA USA
| | - Justin Lui
- grid.22072.350000 0004 1936 7697Department of Surgery, Division of Otolaryngology–Head & Neck Surgery, University of Calgary, Calgary, AB Canada
| |
Collapse
|
8
|
Zhou XY, Wang YF, Dou CX, Tian XY, Su J, Chen YY, Yan FX, Yang QH, Wang W. Evaluating the effects of simulated interprofessional teaching on the development of clinical core competence in nursing students: a mixed methods study. BMC Nurs 2022; 21:362. [PMID: 36536429 PMCID: PMC9762020 DOI: 10.1186/s12912-022-01108-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 11/14/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND While single-method studies have reported on the effectiveness of simulated interprofessional teaching, our understanding of its full effects remains incomplete. Teaching design also provides no relevant theoretical guidance, which reduces the scientific quality and rigor of research. The purpose of this work was to study the effects of the simulated interprofessional education (SIPE) teaching model based on the 3P theory on the course of "Clinical Critical Thinking Training" through a convergent mixed method, and to provide the basis for future teaching design. METHODS A convergent mixed-method design was used, which consisted of a survey and a semi-structured interview. Data collection took place from September 2021 to July 2022. A cluster sampling method was used to select 60 full-time nursing students from a school in China, and randomly divide them into a control group of 36 and an experimental group of 24. According to the principle of voluntary participation, 6 students majoring in clinical medicine and 6 students majoring in pharmacy were recruited to join the experimental group to form an interprofessional team. The students studied "Clinical Critical Thinking Training" together, in which the control group used traditional simulation teaching and the experimental group used SIPE. The CCTDI (California Critical Thinking Disposition Inventory) and AITCS-II Student (Assessment of Interprofessional Team Collaboration in Student Learning Scale) were used for quantitative evaluation before and after the course, and descriptive statistics and Mann-Whitney U test were used to compare the critical thinking and interprofessional collaboration skills of the two groups of students. Semi-structured interviews were used for qualitative evaluation. Thematic analysis was used to understand student development on the basis of inter-professional core competencies and learning experience. RESULTS The students' interprofessional cooperation abilities and critical thinking scores improved compared with the beginning of the course, but the scores of the experimental group were significantly higher than the control group (p < 0.05). Three themes emerged regarding simulated interprofessional teaching: clarifying team positioning, improving team efficiency, and optimizing the learning experience. CONCLUSION SIPE can build students' critical thinking, teamwork, and interprofessional core competencies, which makes it a useful teaching design.
Collapse
Affiliation(s)
- Xin-yi Zhou
- grid.258164.c0000 0004 1790 3548School of Nursing, Jinan University, Guangzhou, China
| | - Yan-feng Wang
- grid.258164.c0000 0004 1790 3548School of Nursing, Jinan University, Guangzhou, China
| | - Chun-xia Dou
- grid.258164.c0000 0004 1790 3548School of Nursing, Jinan University, Guangzhou, China
| | - Xiao-ying Tian
- grid.258164.c0000 0004 1790 3548School of Nursing, Jinan University, Guangzhou, China
| | - Jin Su
- grid.258164.c0000 0004 1790 3548School of Nursing, Jinan University, Guangzhou, China
| | - Yan-ya Chen
- grid.258164.c0000 0004 1790 3548School of Nursing, Jinan University, Guangzhou, China
| | - Feng-xia Yan
- grid.258164.c0000 0004 1790 3548School of Nursing, Jinan University, Guangzhou, China
| | - Qiao-hong Yang
- grid.258164.c0000 0004 1790 3548School of Nursing, Jinan University, Guangzhou, China
| | - Wenru Wang
- grid.4280.e0000 0001 2180 6431Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| |
Collapse
|
9
|
Kut C, Kao T, Morcos M, Kim Y, Boctor E, Viswanathan AN. 3D-printed Magnetic Resonance (MR)-based gynecological phantom for image-guided brachytherapy training. Brachytherapy 2022; 21:799-805. [PMID: 36050143 PMCID: PMC10810234 DOI: 10.1016/j.brachy.2022.07.005] [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: 02/15/2022] [Revised: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 01/16/2023]
Abstract
PURPOSE/OBJECTIVES There is a clinical need to develop anatomic phantoms for simulation-based learning in gynecological brachytherapy. Here, we provide a step-by-step approach to build a life-sized gynecological training phantom based on magnetic resonance imaging (MRI) of an individual patient. Our hypothesis is that this phantom can generate convincing ultrasound (US) images that are similar to patient scans. METHODS Organs-at-risk were manually segmented using patient scans (MRI). The gynecological phantom was constructed using positive molds from 3D printing and polyvinyl chloride (PVC) plastisol. Tissue texture/acoustic properties were simulated using different plastic softener/hardener ratios and microbead densities. Nine readers (residents) were asked to evaluate 10 cases (1 ultrasound image per case) and categorize each as a "patient" or "phantom" image. To evaluate whether the phantom and patient images were equivalent, we used a multireader, multicase equivalence study design with two composite null hypotheses with proportion (pr) at H01: pr ≤ 0.35 and H02: pr ≥ 0.65. Readers were also asked to review US videos and identify the insertion of an interstitial needle into the pelvic phantom. Computed Tomography (CT) and magnetic resonance (MR) images of the phantom were acquired for a feasibility study. RESULTS Readers correctly classified "patient" and "phantom" scans at pr = 53.3% ± 6.2% (p values 0.013 for H01 and 0.054 for H02, df = 5.96). Readers reviewed US videos and identified the interstitial needle 100% of the time in transabdominal view, and 78% in transrectal view. The phantom was CT and MR safe. CONCLUSIONS We have outlined a manufacturing process to create a life-sized, gynecological phantom that is compatible with multi-modality imaging and can be used to simulate clinical scenarios in image-guided brachytherapy procedures.
Collapse
Affiliation(s)
- Carmen Kut
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | - Tracy Kao
- Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Champaign, IL
| | - Marc Morcos
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | - Younsu Kim
- Whiting School of Engineering, Johns Hopkins University, Baltimore, MD
| | - Emad Boctor
- Whiting School of Engineering, Johns Hopkins University, Baltimore, MD
| | - Akila N Viswanathan
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, MD.
| |
Collapse
|
10
|
van Schaagen F, van Steenis YP, Sadeghi AH, Bogers AJJC, Taverne YJHJ. Immersive 3D Virtual Reality-Based Clip Sizing for Thoracoscopic Left Atrial Appendage Closure. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2022; 17:304-309. [PMID: 35912487 PMCID: PMC9403374 DOI: 10.1177/15569845221114344] [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] [Indexed: 11/18/2022]
Abstract
Objective: Surgical left atrial appendage (LAA) closure using epicardial
clips has become popular in stroke prevention in patients with atrial fibrillation.
Optimal placement of the clip is essential to achieve complete LAA occlusion and to
prevent complications due to compression of the circumflex artery. We determine the added
value of immersive virtual reality (VR) in accurately assessing LAA base size and
selection of an appropriately sized clip. Methods: We studied the feasibility
of measuring the LAA base using VR and conventional computed tomography (CT). A
retrospective analysis was performed of LAA base measurements in 15 patients who had
undergone thoracoscopic LAA clipping. Subsequently, we compared the placed clip size with
imaging-acquired LAA base size to retrospectively evaluate intraprocedural sizing.
Results: We successfully applied a VR platform to measure LAA base size.
The median LAA base size measured in CT (23.8 mm, interquartile range [IQR] 22.3 to
26.4 mm) and intracardial virtual reality (23.4 mm, IQR 21.6 to 25.5 mm) did not differ
significantly (P = 0.416). VR measurements of the LAA base in surgeon's
view (25.7 mm, IQR 24.2 to 29.2) were significantly higher than those of 2-dimensional CT
(P = 0.037) and intracardial 3-dimensional (3D) VR
(P < 0.05) measurements. All measurements differed significantly with
placed clip sizes (P < 0.05). There were no clip
malpositioning-related events. Conclusions: Immersive VR is a feasible method
for obtaining anatomical information on LAA base size. In this retrospective analysis, CT
and VR-based measurements of LAA base size differed significantly from intraoperatively
placed LAA clips, indicating potential oversizing when measured intraoperatively. Using
intuitive 3D VR-based imaging might be a useful method to assist in accurate preprocedural
sizing of LAA base and can potentially prevent oversizing.
Collapse
Affiliation(s)
- Frank van Schaagen
- Department of Cardiothoracic Surgery, Thoraxcenter, 6993Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Yvar P van Steenis
- Department of Cardiothoracic Surgery, Thoraxcenter, 6993Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Amir H Sadeghi
- Department of Cardiothoracic Surgery, Thoraxcenter, 6993Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ad J J C Bogers
- Department of Cardiothoracic Surgery, Thoraxcenter, 6993Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Yannick J H J Taverne
- Department of Cardiothoracic Surgery, Thoraxcenter, 6993Erasmus University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
11
|
Deboever N, Antonoff MB. Commentary: Boot camps may improve skills, but how can they be further strengthened? JTCVS OPEN 2022; 10:296-297. [PMID: 36004233 PMCID: PMC9390635 DOI: 10.1016/j.xjon.2022.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 01/20/2022] [Accepted: 02/17/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Mara B. Antonoff
- Address for reprints: Mara B. Antonoff, MD, FACS, Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030.
| |
Collapse
|
12
|
Seifman MA, Young AB, Nestel D. Simulation in plastic and reconstructive surgery: a scoping review. Simul Healthc 2022. [DOI: 10.54531/hnpw7177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Since the origins of surgery, simulation has played an important role in surgical education, particularly in plastic and reconstructive surgery. This has greater relevance in contemporary settings of reduced clinical exposure resulting in limited work-based learning opportunities. With changing surgical curricula, it is prescient to examine the role of simulation in plastic and reconstructive surgery.
A scoping review protocol was used to identify relevant studies, with an iterative process identifying, reviewing and charting the data to derive reported outcomes and themes.
Of the 554 studies identified, 52 studies were included in this review. The themes identified included simulator modalities, curriculum elements targeted and relevant surgical competencies. There was a predominance of synthetically based simulators, targeting technical skills largely associated with microsurgery, paediatric surgery and craniomaxillofacial surgery.
Existing simulators largely address high-complexity procedures. There are multiple under-represented areas, including low-complexity procedures and simulation activities addressing communication, collaboration, management and leadership. There are many opportunities for simulation in surgical education, which requires a contextual appreciation of educational theory. Simulation may be used both as a learning method and as an assessment tool.
This review describes the literature relating to simulation in plastic and reconstructive surgery and proposes opportunities for incorporating simulation in a broader sense, in the surgical curriculum.
Collapse
Affiliation(s)
- Marc A Seifman
- 1Plastic, Reconstructive and Hand Surgery Unit, Peninsula Health, Frankston, Australia
| | - Abby B Young
- 1Plastic, Reconstructive and Hand Surgery Unit, Peninsula Health, Frankston, Australia
| | - Debra Nestel
- 2Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
13
|
Rabenstein AP, Khomutova A, Shroyer ALW, Scriven R, McLarty A, Tannous H, Balaguer JM. Cardiac surgical simulation program during general surgery residency increases resident physician exposure to cardiac surgery and technical expertise. JTCVS OPEN 2022; 9:179-184. [PMID: 36003448 PMCID: PMC9390549 DOI: 10.1016/j.xjon.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 01/12/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Andrew P. Rabenstein
- Department of Thoracic and Cardiovascular Surgery, Allegheny General Hospital, AHN Cardiovascular Institute, Pittsburgh, Pa
| | - Alisa Khomutova
- Department of Surgery, General Surgery Residency Program, Stony Brook University Hospital, Stony Brook, NY
| | - A. Laurie W. Shroyer
- Division of Cardiothoracic Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY
| | - Richard Scriven
- Department of Surgery, General Surgery Residency Program, Stony Brook University Hospital, Stony Brook, NY
| | - Allison McLarty
- Division of Cardiothoracic Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY
| | - Henry Tannous
- Division of Cardiothoracic Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY
| | - Jorge M. Balaguer
- Division of Cardiothoracic Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY
- Address for reprints: Jorge M. Balaguer, MD, Division of Cardiothoracic Surgery, Department of Surgery, Health Sciences Center T19-080, Stony Brook, NY 11794-8191.
| |
Collapse
|
14
|
Singh M, Park C, Roche ET. Decellularization Following Fixation of Explanted Aortic Valves as a Strategy for Preserving Native Mechanical Properties and Function. Front Bioeng Biotechnol 2022; 9:803183. [PMID: 35071211 PMCID: PMC8770733 DOI: 10.3389/fbioe.2021.803183] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022] Open
Abstract
Mechanical or biological aortic valves are incorporated in physical cardiac simulators for surgical training, educational purposes, and device testing. They suffer from limitations including either a lack of anatomical and biomechanical accuracy or a short lifespan, hence limiting the authentic hands-on learning experience. Medical schools utilize hearts from human cadavers for teaching and research, but these formaldehyde-fixed aortic valves contort and stiffen relative to native valves. Here, we compare a panel of different chemical treatment methods on explanted porcine aortic valves and evaluate the microscopic and macroscopic features of each treatment with a primary focus on mechanical function. A surfactant-based decellularization method after formaldehyde fixation is shown to have mechanical properties close to those of the native aortic valve. Valves treated in this method were integrated into a custom-built left heart cardiac simulator to test their hemodynamic performance. This decellularization, post-fixation technique produced aortic valves which have ultimate stress and elastic modulus in the range of the native leaflets. Decellularization of fixed valves reduced the valvular regurgitation by 60% compared to formaldehyde-fixed valves. This fixation method has implications for scenarios where the dynamic function of preserved valves is required, such as in surgical trainers or device test rigs.
Collapse
Affiliation(s)
- Manisha Singh
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Clara Park
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Ellen T Roche
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States
| |
Collapse
|
15
|
O’Dwyer M, Fleming CA, Ahern S, Barrett S, Raftery NB, Ní Dhonnchú T, Doddakula K. OUP accepted manuscript. BJS Open 2022; 6:6526458. [PMID: 35143631 PMCID: PMC8830760 DOI: 10.1093/bjsopen/zrab147] [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: 10/07/2021] [Accepted: 12/16/2021] [Indexed: 11/25/2022] Open
Abstract
Background Coronary artery anastomosis training and assessment are vital for patient safety and for conferring a prognostic benefit. A systematic review and meta-analysis were performed to analyse the impact of simulation on coronary anastomosis proficiency in terms of time taken and skill score. Methods This review was conducted in accordance with PRISMA guidelines, searching PubMed, Embase and Cochrane databases on 10 October 2020, using the terms ‘Coronary anastomosis simulation’ or ‘vascular anastomosis simulation’ and ‘anastomosis simulation’. Studies included had objective measurement of scores of before and after simulation. Meta-analysis was performed using RevMan, version 5.4 (Cochrane Library). Results From a pool of 1687 articles, 12 articles evaluating the use of simulation in teaching coronary anastomosis were identified, with objective scores at baseline and after simulation. The 12 papers included 274 subjects. Data on 223 subjects could be extracted for analysis in performing coronary anastomosis in a simulated environment. Eight trials evaluated improvement in time and 12 trials evaluated performance using an objective evaluation score. In comparison with no formal simulation training, simulation was associated with improved skill in a five-point scale (standardized mean difference 1.68 (95 per cent c.i. 1.23 to 2.13; P < 0.001)) and time (mean difference 205.9 s (95 per cent c.i. 133.62 to 278.18; P < 0.001)) in trials included in the meta-analysis. Furthermore, novice cardiothoracic surgeons benefited more from simulation as regards time improvement compared with senior cardiothoracic surgeons (293 versus 120 s improvement; P = 0.003). Fidelity of simulator did not have a significant effect on rates of improvement. Conclusion Simulation-based training in coronary anastomosis is associated with improved time efficiency and overall performance in comparison with no intervention. Further studies are necessary to determine the optimum timing of trainees progressing from simulation training to live operating.
Collapse
Affiliation(s)
- Marliza O’Dwyer
- Department of Cardiothoracic Surgery, Cork University Hospital, Cork, Ireland
- Correspondence to: Marliza O'Dwyer, Department of Cardiothoracic Surgery, Cork University Hospital, Wilton, Cork, Ireland (e-mail: )
| | | | - Shane Ahern
- Department of Cardiothoracic Surgery, Cork University Hospital, Cork, Ireland
| | - Sean Barrett
- Department of Cardiothoracic Surgery, Cork University Hospital, Cork, Ireland
| | - Nicola B. Raftery
- Department of Breast Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Tara Ní Dhonnchú
- Department of Cardiothoracic Surgery, Cork University Hospital, Cork, Ireland
| | - Kishore Doddakula
- Department of Cardiothoracic Surgery, Cork University Hospital, Cork, Ireland
| |
Collapse
|
16
|
Sharma VJ, Barton C, Page S, Ganesh JS, Patel N, Pirone F, Lin Z, Kejriwal NK, El Gamel A, McCormack DJ, Meikle F. Cardiac surgery simulation: A low-cost feasible option in an Australasian setting. ANZ J Surg 2021; 91:2042-2046. [PMID: 34291538 DOI: 10.1111/ans.17077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 06/22/2021] [Accepted: 07/06/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Simulation training is a useful adjunct to surgical training and education (SET) in Cardiothoracic Surgery yet training opportunities outside the Royal Australasian College of Surgery or industry-sponsored workshops are rare due to high cost and limited training faculty, time, assessment tools or structured curricula. We describe our experience in establishing a low-cost cardiac simulation programme. METHODS We created low-cost models using hospital facilities, hardware stores, abattoirs and donations from industry. Three workshops were conducted on coronary anastomoses, aortic and mitral valve replacement. RESULTS Whole porcine hearts were sourced from local farms. Industry donations of obsolete stock were used for suture and valve material-stations constructed using ironing-board, 2-L buckets and kebab-skewers. Suture ring holders were fashioned from recycled cardboard or donated. All participants were asked to complete pre and post simulation self-assessment forms. Across three workshops, 45 participants (57.8% female) with a median age 27 (interquartile range 24-31) attended. Training level consisted of nurses (8, 17.8%), medical students (17, 37.8%), residents/house officers (6, 13.3%) and registrars (14, 31.1%). There were improvements in knowledge of anatomy (mean difference 18%; 95% confidence interval 12%-24%), imaging (16%; 10%-22%) and procedural components (34%; 28%-42%); and practical ability to describe steps (30%; 24%-38%), partially (32%; 26%-38%) or fully complete (32%; 28%-38%) the procedure. CONCLUSIONS Simulation-based training in cardiac surgery is feasible in a hospital setting with low overhead costs. It can benefit participants at all training levels and has the potential to be implemented in training hospitals as an adjunct to the SET programme.
Collapse
Affiliation(s)
- Varun J Sharma
- Department of Cardiothoracic Surgery, Waikato Cardiothoracic Surgery Unit, Hamilton, New Zealand.,Waikato Institute of Surgical Education and Research, Hamilton, New Zealand
| | - Calum Barton
- Department of Cardiothoracic Surgery, Waikato Cardiothoracic Surgery Unit, Hamilton, New Zealand
| | - Sarah Page
- Department of Cardiothoracic Surgery, Waikato Cardiothoracic Surgery Unit, Hamilton, New Zealand
| | | | - Nishith Patel
- Department of Cardiothoracic Surgery, Waikato Cardiothoracic Surgery Unit, Hamilton, New Zealand.,Waikato Institute of Surgical Education and Research, Hamilton, New Zealand.,Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand
| | - Francesco Pirone
- Department of Cardiothoracic Surgery, Waikato Cardiothoracic Surgery Unit, Hamilton, New Zealand
| | - Zaw Lin
- Department of Cardiothoracic Surgery, Waikato Cardiothoracic Surgery Unit, Hamilton, New Zealand
| | - Nand K Kejriwal
- Department of Cardiothoracic Surgery, Waikato Cardiothoracic Surgery Unit, Hamilton, New Zealand
| | - Adam El Gamel
- Department of Cardiothoracic Surgery, Waikato Cardiothoracic Surgery Unit, Hamilton, New Zealand.,Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand
| | - David J McCormack
- Department of Cardiothoracic Surgery, Waikato Cardiothoracic Surgery Unit, Hamilton, New Zealand.,Waikato Institute of Surgical Education and Research, Hamilton, New Zealand.,Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand
| | - Felicity Meikle
- Department of Cardiothoracic Surgery, Waikato Cardiothoracic Surgery Unit, Hamilton, New Zealand
| |
Collapse
|
17
|
Simulation-based learning for enhanced gynecologic brachytherapy training among radiation oncology residents. Brachytherapy 2020; 20:128-135. [PMID: 33158776 DOI: 10.1016/j.brachy.2020.08.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/31/2020] [Accepted: 08/31/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Brachytherapy is an irreplaceable component of gynecologic cancer treatment. Resident training has declined, and procedural exposure is variable. We evaluated whether simulation-based gynecologic brachytherapy training among radiation oncology residents could improve knowledge, confidence, and interest. METHODS AND MATERIALS Before a brachytherapy workshop, radiation oncology residents without prior gynecologic brachytherapy experience completed a survey on brachytherapy knowledge, procedural confidence, plan evaluation, and quality/safety. Residents then participated in a gynecologic brachytherapy workshop. Lectures covered brachytherapy imaging and physics principles/quality assurance, followed by hands-on and individualized feedback regarding applicator selection and placement, target segmentation, and physics quality assurance. Afterward, preworkshop questions were recollected. Descriptive statistics and Fisher's exact tests were used for data analysis. RESULTS After the workshop, resident responses regarding the learning environment and baseline knowledge questions improved overall. There was a 30% improvement in favorable responses to the learning environment statement "My residency has a formal process/curriculum to teach brachytherapy" and for baseline knowledge the greatest improvement was seen for "I am familiar with the anatomy and placement of the applicators in relation to the anatomy". "Lack of didactic or procedural training exposure" was identified as the main reason for declining brachytherapy use. Initially, 1/8 residents correctly completed the knowledge questions, and after the workshop, 6/7 (p < 0.001) residents correctly completed the questions. CONCLUSIONS Domain-specific knowledge, procedural confidence, and brachytherapy interest improved after a gynecologic brachytherapy workshop. Integrated didactic and simulation-based brachytherapy training may serve as a valuable learning tool to augment resident knowledge, introduce practical skills, and spark resident interest in brachytherapy.
Collapse
|
18
|
Preoperative tracheal resection and reconstruction simulations with patient-specific three-dimensional models. Gen Thorac Cardiovasc Surg 2020; 69:593-596. [PMID: 33123845 DOI: 10.1007/s11748-020-01531-y] [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: 04/27/2020] [Accepted: 10/16/2020] [Indexed: 10/23/2022]
Abstract
Three-dimensional (3D) printers are increasingly being used for a variety of applications. In the surgical field, patient-specific organ models are increasingly being used as preoperative simulators for complicated surgeries. In this study, we describe the use of patient-specific 3D models for tracheal resection. We performed preoperative simulations for two patients diagnosed with tracheal ganglioneuroma and adenoid cystic carcinoma; the mimic operations suggested the necessity of a short cuff intubation tube across the surgical field, indicating the recommended amount of dissection around the trachea and bilateral hilum prior to tracheal reconstruction. The postoperative courses were free from any anastomotic or pulmonary complications. We described the availability of preoperative simulations for complicated tracheal resection and reconstruction using patient-specific 3D printed models. Mimic operations using the 3D printed models allowed accurate preparation and confidence in selection of the optimal surgical strategy.
Collapse
|
19
|
Luthra S, Leiva-Juarez MM, Ismail AH, Tsang GM, Barlow CW, Velissaris T, Miskolczi S, Ohri SK. Is Resident Training Safe in Cardiac Surgery? Ann Thorac Surg 2020; 110:1404-1411. [DOI: 10.1016/j.athoracsur.2020.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/21/2020] [Accepted: 02/04/2020] [Indexed: 01/18/2023]
|
20
|
Saracoglu KT, Yilmaz M, Turan AZ, Kus A, Colak T, Saracoglu A. Pecha Kucha with Part-Task Training Improves Airway Management in Fresh Frozen Cadavers: A Case-Control Observational Study. Med Princ Pract 2020; 29:532-537. [PMID: 32069469 PMCID: PMC7768097 DOI: 10.1159/000506597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 02/16/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The objective of this study was to ascertain whether the addition of part-task training as a step in Pecha Kucha for fiberoptic tracheal intubation increases the success rate and reduces the complication rate. SUBJECTS AND METHODS The residents of the Department of Anesthesiology were initially included in an orientation program. We used the Pecha Kucha method for the presentation of teaching fiberoptic intubation skills. Afterwards the participants were trained in Laerdal® airway management and each participant performed tracheal intubation using the Aintree catheter. The participants were divided into two groups. Group 1 (n = 9) received part-task training and group 2 (n = 9) received whole-task training. The tracheal intubation performances of participants were evaluated on fresh frozen cadavers. The number of interventions, incidence of complications, success rate, and optimization maneuver requirements were recorded. RESULTS Eighteen residents aged between 27 and 33 years were included. All were junior residents with less than 2 years of experience. There was no significant difference in terms of duration of tracheal intubation, complication rates, and optimization maneuvers between the study groups. Six participants could not place the tracheal tube in the last section. The success rates for the part-task group during Aintree and tracheal tube placement were 100 and 66.7%, respectively, whereas the rates were 55.6 and 44.4%, respectively, in whole-task group (p < 0.05). CONCLUSION In addition to the Pecha Kucha method in fiberoptic intubation training, simulation-based part-task training appears to increase the success rate and to reduce the complication rate on fresh frozen cadavers.
Collapse
Affiliation(s)
- Kemal Tolga Saracoglu
- Department of Anesthesiology and Intensive Care, Health Sciences University Medical School, Istanbul, Turkey,
| | - Mehmet Yilmaz
- Department of Anesthesiology and Intensive Care, Health Sciences University Medical School, Kocaeli, Turkey
| | - Ayse Zeynep Turan
- Department of Anesthesiology and Intensive Care, Health Sciences University Medical School, Kocaeli, Turkey
| | - Alparslan Kus
- Department of Anesthesiology and Intensive Care, Kocaeli University Medical School, Kocaeli, Turkey
| | - Tuncay Colak
- Department of Anatomy, Kocaeli University Medical School, Kocaeli, Turkey
| | - Ayten Saracoglu
- Department of Anesthesiology and Intensive Care, Marmara University Medical School, Istanbul, Turkey
| |
Collapse
|