1
|
Chen PC, Yang PW, Kao YK, Chen CH, Tsai CJ, Chen YC, Song LC, Tsai KL, Wu RC, Chen CI. Laparoscopic training workshop to assess medical students' skill acquisition and interest in surgical careers. BMC MEDICAL EDUCATION 2024; 24:721. [PMID: 38961425 PMCID: PMC11223330 DOI: 10.1186/s12909-024-05708-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 06/25/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND With its minimally invasive approach, laparoscopic surgery has transformed the medical landscape. As the demand for these procedures escalates, there is a pressing need for adept surgeons trained in laparoscopic techniques. However, current training often falls short of catering to medical school education. This study evaluates the impact of a custom-designed laparoscopic training workshop on medical students' surgical skills and career aspirations. METHODS This prospective experimental study was conducted at the E-Da hospital in Kaohsiung City, Taiwan. Medical students from Taiwanese medical schools undergoing Clerk 5, Clerk 6, and Postgraduate Year 1 and 2 were invited to participate. Medical students (n = 44) underwent an endoscopic skill training workshop consisting of lectures, box training, and live tissue training. The trainees performed multiple tasks before and after training using our objective evaluation system. The primary outcome was assessed before and after training through a questionnaire assessing the influence of training on students' interest in surgery as a career. The secondary outcome measured improvement in skill acquisition, comparing the task completion time pre- and post-workshop. For the primary outcome, descriptive statistics were used to summarize the questionnaire responses, and paired t-tests were performed to determine significant changes in interest levels post-workshop. For the secondary outcome, paired t-tests were used to compare the time recorded pre- and post-training. RESULTS Post-training, participants exhibited significant proficiency gains, with task completion times reducing notably: 97 s (p = 0.0015) for Precision Beads Placement, 88.5 s (p < 0.0001) for Beads Transfer Exercise, 95 s (p < 0.0001) for Precision Balloon Cutting, and 137.8 s (p < 0.0001) for Intracorporeal Suture. The primary outcome showcased an increased mean score from 8.15 pre-workshop to 9.3 post-workshop, indicating a bolstered interest in surgery as a career. Additionally, post-training sentiment analysis underscored a predominant inclination toward surgery among 88% of participants. CONCLUSION The custom-designed laparoscopic workshop significantly improved technical skills and positively influenced students' career aspirations toward surgery. Such hands-on training workshops can play a crucial role in medical education, bridging the gap between theoretical knowledge and practical skills and potentially shaping the future of budding medical professionals.
Collapse
Affiliation(s)
- Pin-Chun Chen
- Division of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Po-Wen Yang
- Division of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Yi-Kai Kao
- Division of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chia-Hung Chen
- Division of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chih-Jong Tsai
- Division of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Yi-Chieh Chen
- Division of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Ling-Chiao Song
- Division of Colon and Rectal Surgery, Department of Surgery, E-DA Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Kai Lung Tsai
- Division of Colon and Rectal Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Richard C Wu
- Department of Urology, E-Da Hospital, Kaohsiung, Taiwan
- Department of Information Engineering, I-Shou University, Kaohsiung, Taiwan
- Department of Nursing, I-Shou University, Kaohsiung, Taiwan
| | - Chih-I Chen
- Division of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan.
- Division of Colon and Rectal Surgery, Department of Surgery, E-DA Cancer Hospital, I-Shou University, Kaohsiung, Taiwan.
- Executive Master of Business Administration, National Sun Yat-sen University, Kaohsiung, Taiwan.
- Division of General Surgery Medicine, Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
- School of Medicine, I-Shou University, Kaohsiung, Taiwan.
| |
Collapse
|
2
|
Alarfaj AA, Al-Nasser S. Evaluating Gaps in Otolaryngology Training: An In-Depth Needs Assessment in Saudi Arabia. Healthcare (Basel) 2023; 11:2741. [PMID: 37893815 PMCID: PMC10606914 DOI: 10.3390/healthcare11202741] [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: 09/02/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The landscape of otolaryngology training in Saudi Arabia is undergoing transformation due to the expansion of medical colleges and increased overseas medical scholarships. However, concerns persist regarding the satisfaction and adequacy of surgical education. This study aims to assess gaps in otolaryngology training through an in-depth needs assessment. METHODS A cross-sectional study was conducted among 85 otolaryngology-head and neck surgery residency graduates in Saudi Arabia between 2019 and 2021. Participants completed a validated questionnaire assessing deficiencies, importance, and competence in different subspecialty areas. Data were analyzed using descriptive statistics, median comparisons, and Kruskal-Wallis tests. RESULTS Participants identified deficiencies in training across domains, with significant variations in specific subspecialties among different regions. Dissatisfaction with clinical discussions, research training, access to simulation labs, and training in emerging subspecialties was evident. CONCLUSION The study highlights challenges within otolaryngology training, emphasizing the need for continuous evaluation and adaptation to ensure high-quality and comprehensive training. Addressing these gaps is essential to produce well-rounded otolaryngologists capable of meeting the evolving demands of modern healthcare.
Collapse
Affiliation(s)
- Abdullah A. Alarfaj
- Otorhinolaryngology Unit, Department of Surgery, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Sami Al-Nasser
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh 11481, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh 11481, Saudi Arabia
| |
Collapse
|
3
|
Weinstein A, MacPherson P, Schmidt S, Van Opstal E, Chou E, Pogemiller M, Gibbs K, Held M. Needs assessment for enhancing pediatric clerkship readiness. BMC MEDICAL EDUCATION 2023; 23:188. [PMID: 36978085 PMCID: PMC10044806 DOI: 10.1186/s12909-023-04167-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Many students report feeling inadequately prepared for their clinical experiences in pediatrics. There is striking variability on how pediatric clinical skills are taught in pre-clerkship curricula. METHODS We asked students who completed their clerkships in pediatrics, family medicine, surgery, obstetrics-gynecology and internal medicine to rate their pre-clinical training in preparing them for each clerkship, specifically asking about medical knowledge, communication, and physical exam skills. Based on these results, we surveyed pediatric clerkship and clinical skills course directors at North American medical schools to describe the competence students should have in the pediatric physical exam prior to their pediatric clerkship. RESULTS Close to 1/3 of students reported not feeling adequately prepared for their pediatrics, obstetrics-gynecology, or surgery clerkship. Students felt less prepared to perform pediatric physical exam skills compared to physical exam skills in all other clerkships. Pediatric clerkship directors and clinical skills course directors felt students should have knowledge of and some ability to perform a wide spectrum of physical exam skills on children. There were no differences between the two groups except that clinical skills educators identified a slightly higher expected competence for development assessment skills compared to pediatric clerkship directors. CONCLUSIONS As medical schools undergo cycles of curricular reform, it may be beneficial to integrate more pre-clerkship exposure to pediatric topics and skills. Further exploration and collaboration establishing how and when to incorporate this learning could serve as a starting point for curricular improvements, with evaluation of effects on student experience and performance. A challenge is identifying infants and children for physical exam skills practice.
Collapse
Affiliation(s)
- Adam Weinstein
- Frank H. Netter MD School of Medicine, North Haven, CT, USA.
| | | | - Suzanne Schmidt
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Erica Chou
- Medical College of Wisconsin, Milwaukee, WI, USA
| | | | | | - Melissa Held
- University of Connecticut School of Medicine, Farmington, CT, USA
| |
Collapse
|
4
|
Khondker A, Lee MHY, Kangasjarvi E, Simpson JS. Educational exposures associated with preclinical medical student interest in pursuing surgical residency: Longitudinal mixed-methods study with narrative evaluation. Surg Open Sci 2023; 12:43-47. [PMID: 36936451 PMCID: PMC10017410 DOI: 10.1016/j.sopen.2023.03.002] [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: 02/25/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Pre-clerkship medical students rely on various educational experiences to decide on the residency they would like to pursue. We conducted a longitudinal mixed-methods study to identify educational experiences in pre-clerkship that are associated with an interest in pursuing surgery. Methods Pre-clerkship medical students were invited to complete an initial survey regarding their interest in surgery and educational exposures. After 10 months, a follow-up survey was sent to identify changes in their interest and the role of educational experiences they may have had in the interim. Univariate regression was used to determine associations, and thematic analysis was done. Results Data from 218 pre-clerkship students showed that shadowing (OR = 2.7), participation in technical workshops (OR = 5.1), having a mentor (OR = 4.6) and conducting surgical research (OR = 4.6) were associated with an interest in pursuing surgery. From the students with follow-up data, thematic analysis showed that 94 %, 89 %, and 81 % of students found shadowing, research, and mentorship, respectively, as influential in the decision of pursuing a surgical specialty, respectively. Conclusions Shadowing and mentorship were important factors for students in the decision-making process in pursuing surgery. Identifying high-yield educational experiences-for students to determine if one wants to pursue a surgical specialty is important for educators in curriculum design for resource allocation. Key message We describe a longitudinal mixed-methods study to determine the role of early educational exposures which influence a medical student's decision to pursue a surgical specialty. Shadowing, technical skills workshops, surgical mentorship, involvement in surgical research, play an important role for student decisions.
Collapse
Affiliation(s)
- Adree Khondker
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael Ho-Yan Lee
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Emilia Kangasjarvi
- Li Ka Shing Knowledge Institute, Applied Education Research Operatives, Faculty of Medicine, University of Toronto at St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Jory S. Simpson
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, St. Michael's Hospital, Toronto, Ontario, Canada
- Corresponding author at: Department of Surgery, St. Michael's Hospital, 30 Bond Street, Donnelly Wing, Room 3-005, Toronto, ON M5B 1W8, Canada.
| |
Collapse
|
5
|
Schwill S, Krug K, Poppleton A, Reith D, Senft JD, Szecsenyi J, Stengel S. How can competencies in minor surgery in general practice be increased? Assessing the effect of a compact intervention in postgraduate training: a mixed-methods study. BMJ Open 2022; 12:e060991. [PMID: 35902194 PMCID: PMC9341175 DOI: 10.1136/bmjopen-2022-060991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 07/20/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We aimed to assess general practice (GP) trainees' self-perception of surgical competencies and to explore longitudinal effects of a compact intervention. DESIGN We performed a mixed-methods study including a before and after comparison in the intervention group (IG), a comparison of attendees and non-attendees (control group (CG)) and a qualitative evaluation of the intervention. Competencies were self-assessed through surveys. Semi-structured interviews were performed after 9 months. SETTING In 2019, a 2-day voluntary seminar focussing on minor surgery/injuries was offered on 13 occasions by educators from KWBW Verbundweiterbildungplus (Competence Centre for Postgraduate Medical Education Baden-Württemberg). PARTICIPANTS All enrolled GP trainees were offered participation. GP trainees who did not attend a seminar (non-attendees) were recruited for CG after the 13th intervention. INTERVENTION Attendees took part in an interactive, GP-oriented short course incorporating 270 min of focused minor surgery/injuries training (compact intervention) on the second day of the 2-day seminar. RESULTS 326 GP trainees (IG: n=257; CG: n=69) participated in the study. 17 attendees were interviewed. CG had more often experienced a surgical rotation (p=0.03) and reported higher interest in performing minor surgery in future practice (p=0.03). GP trainees self-rated their all-round competency in minor surgery as average (IG: 3.0±1.0, CG: 3.2±0.9, IG:CG p=0.06). After the intervention, attendees felt that surgical skills should be a core component of GP vocational training (p=0.05). After 9 months, attendees remembered a variety of content and valued the interactive, case-oriented, peer-to-peer approach in a mixed learning group. Some attendees reported they had started to overcome competency gaps in minor surgery. CONCLUSIONS A compact intervention in minor surgery provides an 'intense' stimulus which could foster positive attitudes towards minor surgery and promote longitudinal personal development of related competencies in GP trainees, including those with little interest in surgery. Such measures appear crucial to support individual progress of GP trainees to provide comprehensive primary care.
Collapse
Affiliation(s)
- Simon Schwill
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Katja Krug
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Dorothee Reith
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Jonas D Senft
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Sandra Stengel
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| |
Collapse
|
6
|
Use of the Fundamentals of Arthroscopic Surgical Training Workstation for Immediate Objective Feedback During Training Improves Hand-Tied Surgical Knot Proficiency: A Randomized Controlled Study. Simul Healthc 2021; 16:311-317. [PMID: 32701865 DOI: 10.1097/sih.0000000000000494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION In a prior study, we validated the FAST workstation as an objective evaluator of hand-tied surgical knots. The goal of this study was to determine whether guided practice with the FAST workstation could lead to objective improvement in hand-tied surgical knot performance. METHODS Sixty participants were randomized into 1 of 2 groups: a control group, with access to only the knot-tying station, and a test group, with access to the knot-tying station plus the knot testing station. The study was divided into 3 phases: prepractice, practice, and postpractice. Using the FAST workstation, participants hand-tied 5 knots, 15 knots, and 5 knots using 0 Vicryl suture in the prepractice, practice, and postpractice phases, respectively. Knots for each participant from the prepractice and postpractice phases were collected, tested, and compared. RESULTS Within the control group, the average number of prepractice knot successes was 2.63, and the average number of postpractice knot successes was 3.40, which resulted in an improvement of average knot successes of 0.77 (P < 0.01). Within the test group, the average number of prepractice knot successes was 2.40, and the average number of postpractice knot successes was 4.10, which resulted in an improvement of average knot successes of 1.70 (P < 0.01). The difference in average improvement of knot-tying successes (0.93 knots) between the 2 groups was statistically significant (P < 0.01). DISCUSSION A knot-tying trainer that provides objective feedback on knot performance may better improve hand-tied surgical knot proficiency compared with one without objective feedback.
Collapse
|
7
|
Schaffer S, O’Neill P, Hassan S, Pearson M, Subramaniam M. Validating the Use of Peer-Assisted Learning Laparoscopic Simulation Training for Medical Students. MEDICAL SCIENCE EDUCATOR 2021; 31:359-363. [PMID: 34457893 PMCID: PMC8368588 DOI: 10.1007/s40670-020-01199-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/22/2020] [Indexed: 06/13/2023]
Abstract
Medical students are often passive observers in laparoscopic theatres due to their lack of basic laparoscopic skill competence, which negatively impacts their education. This study aims to (1) validate the use of peer-assisted learning (PAL) to teach medical students basic laparoscopic skills on low-cost simulators and (2) compare the efficacy of PAL training between pre-clinical and clinical medical students to ascertain when this training should be introduced. Our results demonstrate significant training efficacy at both levels, suggesting that PAL simulation may be implemented at either stage of training, but may garner better retention of confidence and knowledge in the clinical medical students.
Collapse
Affiliation(s)
- Sierra Schaffer
- St George’s, University of London, Cranmer Terrace, Tooting, London, SW17 0RE UK
| | - Parker O’Neill
- St George’s, University of London, Cranmer Terrace, Tooting, London, SW17 0RE UK
| | - Shamira Hassan
- St George’s, University of London, Cranmer Terrace, Tooting, London, SW17 0RE UK
| | - Marina Pearson
- St George’s, University of London, Cranmer Terrace, Tooting, London, SW17 0RE UK
| | - Malvika Subramaniam
- St George’s, University of London, Cranmer Terrace, Tooting, London, SW17 0RE UK
| |
Collapse
|
8
|
Validation of an in vivo porcine simulation model of pedicled latissimus dorsi myocutaneous flap elevation. EUROPEAN JOURNAL OF PLASTIC SURGERY 2021. [DOI: 10.1007/s00238-020-01734-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Abstract
Background
In vivo and ex vivo simulation training workshops can contribute to surgical skill acquisition but require validation before becoming incorporated within curricula. Ideally, that validation should include the following: face, content, construct, concurrent, and predictive validity.
Methods
During two in vivo porcine surgical training workshops, 27 participants completed questionnaires relating to face and content validity of porcine in vivo flap elevation. Six participants’ performances raising a pedicled myocutaneous latissimus dorsi (LD) flap in the pig (2 experts and 4 trainees) were sequentially and objectively assessed for construct validity with hand motion analysis (HMA), a performance checklist, a blinded randomized procedure-specific rating scale of standardized video recordings, and flap viability by fluorescence imaging.
Results
Face and content validity were demonstrated straightforwardly. Construct validity was demonstrated for average procedure time by HMA between trainees and experts (p = 0.036). Skill acquisition was demonstrated by trainees’ HMA average number of hand movements (p = 0.046) and fluorescence flap viability (p = 0.034).
Conclusion
Face and content validity for in vivo porcine flap elevation simulation training were established. Construct validity was established for an in vivo porcine latissimus dorsi flap elevation simulation specifically. Predictive validity will prove more challenging to establish.
Level of evidence: Not ratable .
Collapse
|
9
|
Gupta A, Lawendy B, Goldenberg MG, Grober E, Lee JY, Perlis N. Can video games enhance surgical skills acquisition for medical students? A systematic review. Surgery 2021; 169:821-829. [PMID: 33419578 DOI: 10.1016/j.surg.2020.11.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To systematically assess literature examining the impact of being a gamer or participating in video-game-based training on surgical skills acquisition amongst medical students. BACKGROUND Video games and surgical procedures share similar skills such as visuospatial abilities and hand-eye coordination; therefore, video games can be a valuable tool for surgical training amongst medical students. However, comprehensive, up-to-date systematic reviews are necessary to confirm. METHODS A systematic literature search of PubMed, MEDLINE, and EMBASE was performed in April 2020 with no limits set on the date of publication. Observational and randomized controlled studies were included. Quality and bias were assessed using the Newcastle-Ottawa Scale for nonrandomized studies and the Grading of Recommendations Assessment, Development and Evaluation system for randomized studies. RESULTS A total of 575 participants from 16 studies were included. The most common surgical skills tested were laparoscopy (n = 283, from 8 studies) and robotic surgery (n = 199, from 5 studies). A history of gaming and video-game-based training were associated with improved metrics in robotic surgery and laparoscopy, respectively. Neither was beneficial in arthroscopy or bronchoscopy. Studies using the Wii U and Underground reported significant improvement in overall laparoscopic performance. CONCLUSION Video games demonstrate potential as adjunctive training in surgical skill education, with a history of gaming and video-game-based training being beneficial in robotic surgery and laparoscopy, respectively. Methodological heterogeneity amongst included studies limit the ability to make conclusive decisions; thus, future studies with long-term follow-up, larger sample sizes, outcomes stratified by video-game characteristics, and up-to-date technology are necessary.
Collapse
Affiliation(s)
- Arnav Gupta
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Bishoy Lawendy
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mitchell G Goldenberg
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Sprott Department of Surgery, Division of Urology, University Health Network, Toronto, ON, Canada
| | - Ethan Grober
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Surgery, Division of Urology, Sinai Health System, Toronto, ON, Canada
| | - Jason Y Lee
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Sprott Department of Surgery, Division of Urology, University Health Network, Toronto, ON, Canada
| | - Nathan Perlis
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Sprott Department of Surgery, Division of Urology, University Health Network, Toronto, ON, Canada.
| |
Collapse
|
10
|
An early introduction to surgical skills: Validating a low-cost laparoscopic skill training program purpose built for undergraduate medical education. Am J Surg 2020; 221:95-100. [PMID: 32888629 DOI: 10.1016/j.amjsurg.2020.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 06/27/2020] [Accepted: 07/07/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Medical student exposure to laparoscopy is limited to observation despite the prevalence of minimally invasive techniques in practice. The high cost of laparoscopic simulation equipment, commonly called "box trainers", limits undergraduate exposure to skill training. METHODS Students at a Midwestern medical school were recruited to participate in an experimental laparoscopic skill training program. One cohort (n = 17) used a DIY box trainer design freely available on MedEdPORTAL. A second cohort (n = 17) used a commercially available equivalent. Pre- and post-training attempts for four tasks were scored and the difference was calculated. The average differences for each cohort were then contrasted statistically. RESULTS Significant performance improvements (pre- and post-training) were demonstrated regardless of group allocation. The difference in performance between the cohorts was not significant for any task (p > 0.05). CONCLUSIONS This low-cost training program using DIY box trainers is as effective as commercially available equivalent box trainers for introducing laparoscopic skills to medical students.
Collapse
|
11
|
Yang A, Fernando S, Tighe J, O-Halloran M, Morphet J, Kumar A. Introduction of an interprofessional gynaecology surgical skills workshop for undergraduate medical and nursing students. Aust N Z J Obstet Gynaecol 2019; 60:238-243. [PMID: 31650525 DOI: 10.1111/ajo.13086] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/19/2019] [Accepted: 09/24/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Medical and nursing students may feel under-prepared to perform basic surgical and gynaecology procedural skills. There also remains scope within undergraduate programs to integrate interprofessional education, and better prepare students for interprofessional collaboration to improve patient care. AIMS A simulation-based gynaecology surgical skills workshop program was introduced for undergraduate medical and nursing students. The aim of this study was to explore students' perceptions of a simulation-based interprofessional gynaecological skills program, using students' pre- and post-workshop confidence in taught skills reported in a post-workshop questionnaire as an outcome measure. MATERIALS AND METHODS One hundred and sixty undergraduate medical (n = 133) and nursing (n = 27) students attended the workshop program at a tertiary university in Melbourne, Australia. A survey was completed by all students immediately after the workshop, addressing students' perceptions of surgical education, the four skill-stations (gowning/gloving, suturing, intrauterine device insertion, and urethral catheterisation), and interprofessional education. A Wilcoxon signed-rank test was performed to compare students' pre- and post-workshop confidence scores. RESULTS Most medical and nursing students (86%) agreed their course should provide more structured surgical education. There was a statistically significant increase in post-workshop self-reported confidence scores for medical and nursing students in all four taught skills. Confidence in interprofessional behaviours also improved in both cohorts, but the improvement in nursing students did not reach statistical significance. CONCLUSIONS Simulation-based, interprofessional, gynaecological surgery skills workshops are practical and valuable additions to undergraduate medical and nursing curricula. Further research should explore long-term retention of procedural skills and changes in interprofessional attitudes in clinical practice.
Collapse
Affiliation(s)
- Amy Yang
- Austin Health, Melbourne, Australia
| | - Shavi Fernando
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - Josie Tighe
- School of Nursing and Midwifery, Monash University, Melbourne, Australia
| | - Monica O-Halloran
- School of Nursing and Midwifery, Monash University, Melbourne, Australia
| | - Julia Morphet
- School of Nursing and Midwifery, Monash University, Melbourne, Australia
| | - Arunaz Kumar
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| |
Collapse
|
12
|
Silva APGD, Rodriguez JER, Oliveira MCD, Negreiros RMDA, Cavalcante LP. The alternative model of silicone for experimental simulation of suture of living tissue in the teaching of surgical technique. Acta Cir Bras 2019; 34:e201900410. [PMID: 31038587 PMCID: PMC6583932 DOI: 10.1590/s0102-865020190040000010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 03/18/2019] [Indexed: 11/22/2022] Open
Abstract
Purpose: To develop a silicone alternative model of tissue suture simulation to be used in the teaching of surgical technique. Methods: Twelve alternative models of silicone for tissue suture simulation were manufactured and implemented as a tool for suture pattern training of undergraduate medical students of Universidade Federal do Amazonas. Forty-eight students participated in the research. The evaluation of the proposed model was done through a questionnaire using the Likert scale, in order to verify the student satisfaction index of the alternative resource and its performance as opposed to the model historically used in the discipline, which is to suture in cloths. Results: The alternative model showed satisfactory results, especially with respect to the structural aspect, such as, better perception of anatomical planes, handling and transport. About 89.58% of positive concordant responses demonstrating expressive approval for incorporation of a complementary form of the alternative methodological proposal of the discipline of surgical technique. Conclusions: The model developed for experimental simulation of tissue sutures has proved to be a fully feasible alternative method for the training of this surgical skill. It is a simple, reproducible and low-cost model.
Collapse
Affiliation(s)
- Ana Paula Gurjão da Silva
- Graduate student, Laboratory of Surgical Technique and Experimental Surgery, Medical School, Universidade Federal do Amazonas (UFAM), Manaus-AM, Brazil. Conception, design and scientific content of the study; acquisition and interpretation of data; manuscript preparation
| | - Juan Eduardo Rios Rodriguez
- Graduate student, Laboratory of Surgical Technique and Experimental Surgery, Medical School, Universidade Federal do Amazonas (UFAM), Manaus-AM, Brazil. Conception, design and scientific content of the study; acquisition and interpretation of data; manuscript preparation
| | - Maria Conceição de Oliveira
- PhD, Medical School, UFAM, Manaus-AM, Brazil. Conception, design and scientific content of the study; critical revision, final approval
| | - Róbson Miguel de Araújo Negreiros
- MSc, Laboratory of Surgical Technique and Experimental Surgery, Medical School, UFAM, Manaus-AM, Brazil. Conception, design and scientific content of the study; critical revision, final approval
| | - Leonardo Pessoa Cavalcante
- PhD, Laboratory of Surgical Technique and Experimental Surgery, Medical School, UFAM, Manaus-AM, Brazil. Conception, design and scientific content of the study; critical revision, final approval
| |
Collapse
|
13
|
Yang YY, Shulruf B. Expert-led and artificial intelligence (AI) system-assisted tutoring course increase confidence of Chinese medical interns on suturing and ligature skills: prospective pilot study. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2019; 16:7. [PMID: 30986892 PMCID: PMC6517322 DOI: 10.3352/jeehp.2019.16.7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 04/09/2019] [Indexed: 05/20/2023]
Abstract
PURPOSE Lack of confidence in suturing/ligature skills due to insufficient practices and assessments was common among novice Chinese medical interns. This study aims to improve the skill acquisition of medical interns with new interventional program. METHODS In addition to regular clinical training, additional expert-led or expert-led plus artificial intelligent (AI) system tutoring courses were implemented during the first 2 week of surgical block in our hospital. Interns can voluntarily join the regular (no additional tutoring), expert-led tutoring or expert-led+AI tutoring groups freely. In regular group, interns (n=25) did not join additional tutoring. The expert-led group received 3-hour expert-led tutoring and in-training formative assessment after twice practices. After similar expert-led course as expert-led group, the expert-led+AI group (n=23) practice and assess their skills on the AI system. Through the comparison with the internal standard, the system automatically recorded and evaluated every intern's suturing/ligature skills. Among expert-led+AI group, the performance and confidence were compared between interns whose doing one, two and three times of AI practices. RESULTS The end-of-surgical block OSCE' performance and self-assessed confidence for the suturing/ligature skills were highest in expert-led+AI group. In comparison with expert-led group, with similar performance in in-training assessment, expert-led+AI group have higher degree of improvement in their performance in end-of surgical block OSCE. Especially, in expert-led+AI group, the best performance and highest post-OSCE confidence were noted among trice AI practicing group. CONCLUSION This pilot study demonstrated the promising effects of incorporation of additional expert-led plus AI system-assisted tutoring course into regular surgical curriculum.
Collapse
Affiliation(s)
- Ying-Ying Yang
- Division of Clinical Skills Training and High-fidelity Medical Simulation for Holistic Care and Inter-Professional Collaboration, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Corresponding
| | - Boaz Shulruf
- Office of Medical Education, University of New South Wales Australia, Sydney, Australia
| |
Collapse
|
14
|
Manning EP, Mishall PL, Weidmann MD, Flax H, Lan S, Erlich M, Burton WB, Olson TR, Downie SA. Early and prolonged opportunities to practice suturing increases medical student comfort with suturing during clerkships: Suturing during cadaver dissection. ANATOMICAL SCIENCES EDUCATION 2018; 11:605-612. [PMID: 29603672 PMCID: PMC6165707 DOI: 10.1002/ase.1785] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 03/04/2018] [Accepted: 03/06/2018] [Indexed: 05/16/2023]
Abstract
Medical students are expected to perform common procedures such as suturing on patients during their third-year clerkships. However, these experiences are often viewed by medical students as stressors rather than opportunities for learning. The source of this stress is the lack of instruction on common procedures prior to being asked to observe or perform the procedure on a patient. First-time exposures to procedures in stressful environments may result in decreased confidence in medical students and decrease the frequency with which they perform these procedures in the future. The authors sought to change this paradigm by: (1) introducing a suturing module to first-year medical students in the context of the anatomy dissection laboratory and (2) measuring its effects on student attitudes and behavior over the course of their third-year clerkships when they encounter patients. The authors found that early and prolonged introduction to suturing was associated with increased student confidence relative to suturing a patient. Participation in the suturing module was associated with increased student confidence in identifying suturing instruments (P < 0.001) and suturing patients (P = 0.013). Further it positively affected their behavior as demonstrated by increased performance of suturing events from students exposed to the suturing module. (P < 0.001) This study demonstrates that early and prolonged opportunities to practice a procedural skill in a low-stress environment increases student confidence during patient interactions and alters student behavior.
Collapse
Affiliation(s)
- Edward P. Manning
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Priti L. Mishall
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, New York
- Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Bronx, New York
| | - Maxwell D. Weidmann
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, New York
| | - Herschel Flax
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, New York
| | - Sam Lan
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, New York
| | - Mark Erlich
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, New York
| | - William B. Burton
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Todd R. Olson
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, New York
| | - Sherry A. Downie
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, New York
- Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Bronx, New York
| |
Collapse
|
15
|
Hanrahan J, Sideris M, Pasha T, Tsitsopoulos PP, Theodoulou I, Nicolaides M, Georgopoulou EM, Kombogiorgas D, Bimpis A, Papalois A. Hands train the brain-what is the role of hand tremor and anxiety in undergraduate microsurgical skills? Acta Neurochir (Wien) 2018; 160:1673-1679. [PMID: 29968093 PMCID: PMC6105223 DOI: 10.1007/s00701-018-3609-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 06/25/2018] [Indexed: 01/28/2023]
Abstract
Introduction Physiological hand tremor occurs naturally, due to oscillations of the upper extremities. Tremor can be exacerbated by stress and anxiety, interfering with fine motor tasks and potentially impact on surgical performance, particularly in microsurgery. We investigated the link between tremor, anxiety and performance in a neurosurgical module as part of an international surgical course. Methods Essential Skills in the Management of Surgical Cases (ESMSC) course recruits medical students from European Union (EU) medical schools. Students are asked to suture the dura mater in an ex vivo swine model, of which the first suture completed was assessed. Questionnaires were distributed before and after the module, eliciting tremor risk factors, self-perception of tremor and anxiety. Johnson O’Connor dexterity pad was used to objectively measure dexterity. Direct Observation of Procedural Skills (DOPS) was used to assess skills-based performance. Anxiety was assessed using the Westside Test Anxiety Scale (WTAS). Tremor was evaluated by four qualified neurosurgeons. Results Forty delegates participated in the study. Overall performance decreased with greater subjective perception of anxiety (p = 0.032, rho = − 0.392). Although increasing scores for tremor at rest and overall WTAS score were associated with decreased performance, this was not statistically significant (p > 0.05). Tremor at rest did not affect dexterity (p = 0.876, rho = − 0.027). Conclusions Physiological tremor did not affect student performance and microsurgical dexterity in a simulation-based environment. Self-perception of anxiety affected performance in this module, suggesting that more confident students perform better in a simulated neurosurgical setting.
Collapse
Affiliation(s)
- John Hanrahan
- Faculty of Life Sciences and Medicine, King's College London, Strand, London, WC2R 2LS, UK.
| | - Michail Sideris
- Women's Health Research Unit, Queen Mary University of London, Mile End Rd, London, E1 4NS, UK
| | - Terouz Pasha
- Faculty of Life Sciences and Medicine, King's College London, Strand, London, WC2R 2LS, UK
| | - Parmenion P Tsitsopoulos
- Section of Neurosurgery, Department of Neuroscience, Uppsala University, 752 36, Uppsala, Sweden
| | - Iakovos Theodoulou
- Faculty of Life Sciences and Medicine, King's College London, Strand, London, WC2R 2LS, UK
| | - Marios Nicolaides
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Mile End Rd, London, E1 4NS, UK
| | | | | | - Alexios Bimpis
- Department of Neurosurgery, General Hospital of Tripoli, Erythrou Stavrou str., 22100, Tripoli, Greece
| | | |
Collapse
|
16
|
Hanrahan J, Sideris M, Tsitsopoulos PP, Bimpis A, Pasha T, Whitfield PC, Papalois AE. Increasing motivation and engagement in neurosurgery for medical students through practical simulation-based learning. Ann Med Surg (Lond) 2018; 34:75-79. [PMID: 30271592 PMCID: PMC6160393 DOI: 10.1016/j.amsu.2018.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 07/03/2018] [Accepted: 08/12/2018] [Indexed: 11/02/2022] Open
Abstract
Background Simulation-based learning (SBL) is an essential adjunct to modern surgical education. Our study aimed to evaluate the educational benefit and motivational impact of a pilot practical neurosurgical module. Materials and methods 38 clinical medical students from several EU Medical Schools attended an international surgical course focused on teaching and learning basic surgical skills. We designed a pilot neurosurgical workshop instructing students to insert an intracranial pressure bolt using an ex vivo pig model. Each delegate was assessed by two consultant neurosurgeons using a validated assessment tool. Structured questionnaires were distributed on completion of the module. Results Delegate performance increased (p < 0.001) with no difference in performance improvement across year of study (p = 0.676) or medical school (p = 0.647). All delegates perceived this workshop as a potential addition to their education (median 5/5, IQR = 0), and indicated that the course provided motivational value towards a neurosurgical career (median 4/5, IQR = 1), with no difference seen between year of study or medical school (p > 0.05). Conclusion Our pilot neurosurgical workshop demonstrated the educational value of practical SBL learning for motivating students towards a surgical career. Homogeneous views across year of study and medical school underline the value of developing a unified strategy to develop and standardise undergraduate surgical teaching with a practical focus.
Collapse
Affiliation(s)
- John Hanrahan
- Faculty of Life Sciences and Medicine, King's College London, Great Maze Pond, London, SE1 9RT, United Kingdom
| | - Michail Sideris
- Women's Health Research Unit, Queen Mary University of London, United Kingdom, Mile End Rd, London, E1 4NS, United Kingdom
| | - Parmenion P Tsitsopoulos
- Section of Neurosurgery, Department of Neuroscience, Uppsala University, Sweden, 751 05, Uppsala, Sweden
| | - Alexios Bimpis
- Department of Neurosurgery, General Hospital of Tripoli, Greece, Erythrou Stavrou Odos, Tripoli, 22100, Greece
| | - Terouz Pasha
- Faculty of Life Sciences and Medicine, King's College London, Great Maze Pond, London, SE1 9RT, United Kingdom
| | - Peter C Whitfield
- Southwest Neurosurgical Centre, Plymouth Hospitals NHS Trust, Plymouth, PL6 8DH, UK
| | | |
Collapse
|
17
|
Dhaif F, Paparoidamis G, Sideris M, Hanrahan J, Georgopoulou EM, Tsagkaraki I, Staikoglou N, Saeed F, Michail T, Tzavelas A, Kenanidis E, Potoupnis M, Tsiridis E, Papalois A. The Role of Anxiety in Simulation-Based Dexterity and Overall Performance: Does It Really Matter? J INVEST SURG 2017; 32:164-169. [PMID: 29286827 DOI: 10.1080/08941939.2017.1387624] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Essential Skills in the Management of Surgical Cases (ESMSC) is an international undergraduate surgical masterclass which combines ex vivo, dry lab and high fidelity in vivo simulation-based learning (SBL). It consists of 32 stations of skills-based learning, including open reduction internal fixation (ORIF) of fractures. Current literature suggests early involvement in skills-based learning at the undergraduate level is vital. AIMS To compare students' dexterity and skills-based performance with demographic and educational background parameters. METHODS 112 medical students from European Union countries including the United Kingdom, Germany, Greece, Cyprus, Germany, and Bulgaria were selected from a competitive pool of candidates to attend the course. Students undertook ORIF in an ex vivo swine model, and in a simulated fracture on a bamboo rod. Skills-based performance was assessed by two consultant surgeons with validated direct observation of procedural skills (DOPS) forms. Anxiety was self-assessed using the Westside Anxiety Scale prior to the ORIF stations. Dexterity was measured with the O'Connor tweezer dexterity test. RESULTS Female students had significantly higher dexterity scores (median difference 7, p =.003). Right-handed students achieved higher dexterity than left-handed students (median difference 7, p =.043). There was no difference in students' performance across different medical schools, and across year groups (p <.05 for any correlation). Self-reported anxiety was not correlated with high fidelity skills-based performance (r = 0.032, p =.74). CONCLUSION Anxiety does not seem to play a significant role in Simulation Skills-Based learning. Undergraduate surgical curricula should incorporate SBL-based modules to enhance practical skills learning and motivate future orthopedic surgeons.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Ferha Saeed
- e Newham University Hospital, Bartshealth NHS Trust , London , UK
| | | | | | | | | | | | - Apostolos Papalois
- e Newham University Hospital, Bartshealth NHS Trust , London , UK.,f Experimental Research Centre ELPEN , Athens , Greece
| |
Collapse
|
18
|
Sideris M, Papalois A, Theodoraki K, Dimitropoulos I, Johnson EO, Georgopoulou EM, Staikoglou N, Paparoidamis G, Pantelidis P, Tsagkaraki I, Karamaroudis S, Potoupnis ME, Tsiridis E, Dedeilias P, Papagrigoriadis S, Papalois V, Zografos G, Triantafyllou A, Tsoulfas G. Promoting Undergraduate Surgical Education: Current Evidence and Students' Views on ESMSC International Wet Lab Course. J INVEST SURG 2016; 30:71-77. [PMID: 27611894 DOI: 10.1080/08941939.2016.1220652] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Undergraduate Surgical Education is becoming an essential element in the training of the future generation of safe and efficient surgeons. Essential Skills in the Management of Surgical Cases (ESMSC), is an international, joint applied surgical science and simulation-based learning wet lab course. METHODS We performed a review of the existing literature on the topic of undergraduate surgical education. Following that, we analyzed the feedback questionnaire received 480 from 2 recent series of ESMSC courses (May 2015, n = 49 and November 2015, n = 40), in order to evaluate European Union students' (UK, Germany, Greece) views on the ESMSC course, as well as on the undergraduate surgical education. Results Using a 10 point graded scale, the overall ESMSC concept was positively evaluated, with a mean score of 9.41 ± 0.72 (range: 8-10) and 8.94 ± 1.1 (range: 7-10). The majority of delegates from both series [9.86 ± 0.43 (range: 8-10) and 9.58 ± 0.91 (range: 6-10), respectively] believed that ESMSC should be incorporated in the undergraduate surgical curriculum. Comparison of responses from the UK to the Greek Medical Student, as well as the findings from the third and fourth year versus the fifth and sixth year Medical Students, revealed no statistically significant differences pertaining to any of the questions (p > 0.05). CONCLUSIONS Current evidence in the literature supports the enhancement of surgical education through the systematic use of various modalities that provide Simulation-Based Training (SBT) hands-on experience, starting from the early undergraduate level. The findings of the present study are in agreement with these previous reports.
Collapse
Affiliation(s)
- Michail Sideris
- a NIHR Academic Clinical Fellow ST1 level , The London Deanery, Queen Mary's University London (QMUL) , London , UK , Lead of the ESMSC Project
| | - Apostolos Papalois
- b Equal Contribution with 1st Author, Director of the Experimental Research Centre ELPEN , Lead of the ESMSC Project
| | | | - Ioannis Dimitropoulos
- d Consultant in Diabetes and Endocrine Medicine , Plymouth Hospitals NHS Foundation Trust
| | - Elizabeth O Johnson
- e Associate Professor of Anatomy , National and Kapodistrian University of Athens
| | | | | | | | | | | | | | - Michael E Potoupnis
- h Assistant Professor of Orthopedic Surgery , Aristotle University of Thessaloniki (AUTH)
| | - Eleftherios Tsiridis
- i Associate Professor of Orthopedic Surgery , Aristotle University of Thessaloniki (AUTH)
| | | | - Savvas Papagrigoriadis
- k Consultant Colorectal Surgeon , King's College Hospital NHS Foundation Trust, Senior Clinical Lecturer in Surgery, King's College London , London , UK
| | - Vassilios Papalois
- l Consultant Transplant Surgeon , Hammersmith Hospital, London, UK, Professor of Surgery , Imperial College , London , UK
| | - Georgios Zografos
- m Professor of Surgery, Vice Rector , University of Athens, Director of 1st Surgical Department , Hippocratio General Hospital, Athens , Greece
| | | | - Georgios Tsoulfas
- o Assistant Professor of Surgery , Aristotle University of Thessaloniki (AUTH)
| |
Collapse
|
19
|
Dydykin S, Kapitonova M. The role of student surgical interest groups and surgical Olympiads in anatomical and surgical undergraduate training in Russia. ANATOMICAL SCIENCES EDUCATION 2015; 8:471-477. [PMID: 25688979 DOI: 10.1002/ase.1523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 01/05/2015] [Accepted: 01/26/2015] [Indexed: 06/04/2023]
Abstract
Traditional department-based surgical interest groups in Russian medical schools are useful tools for student-based selection of specialty training. They also form a nucleus for initiating research activities among undergraduate students. In Russia, the Departments of Topographical Anatomy and Operative Surgery play an important role in initiating student-led research and providing learners with advanced, practical surgical skills. In tandem with department-led activities, student surgical interest groups prepare learners through surgical competitions, known as "Surgical Olympiads," which have been conducted in many Russian centers on a regular basis since 1988. Surgical Olympiads stimulate student interest in the development of surgical skills before graduation and encourage students to choose surgery as their postgraduate specialty. Many of the participants in these surgical Olympiads have become highly qualified specialists in general surgery, orthopedic surgery, neurosurgery, urology, gynecology, and emergency medicine. The present article emphasizes the role of student interest groups and surgical Olympiads in clinical anatomical and surgical undergraduate training in Russia.
Collapse
Affiliation(s)
- Sergey Dydykin
- Department of Topographical Anatomy and Operative Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Marina Kapitonova
- Department of Anatomy, Faculty of Medicine, MARA University of Technology, Jalan Hospital, Sungai Buloh, Selangor, Malaysia
| |
Collapse
|
20
|
Zyluk A, Puchalski P, Szlosser Z. The usefulness of the surgical knowledge and skills acquired via the university curriculum for doctors' medical practice several years after graduation. JOURNAL OF SURGICAL EDUCATION 2015; 72:509-514. [PMID: 25475497 DOI: 10.1016/j.jsurg.2014.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 10/16/2014] [Accepted: 10/23/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Teaching surgery during university curriculum comprises transferring theoretical knowledge traditionally and simultaneously acquiring manual skills, i.e., suturing, stitch removal, limb immobilization, catheterization, and assisting operations. Observations of doctors several years after graduation led to the reflection that teachers' ideas about surgical knowledge and skills that are useful in daily practice frequently fail to meet the facts of the case. The objective of this study was to determine which part of the surgical knowledge and skills taught via the university surgical curriculum proved to be useful in the daily practice of young doctors. MATERIAL AND METHODS A custom-made questionnaire was designed and mailed to 200 randomly chosen doctors who had graduated from the medical faculty at the authors' university 5 to 6 years previously. The questionnaire comprised 9 items concerning the knowledge and skills that proved to be the most useful in participants' daily practice, regardless of their specialty. RESULTS A total of 64 completed questionnaires were returned (32% of 200 sent) and were the subject of analysis. The most useful knowledge in daily practice was that acquired from general surgery, followed by oncological and vascular surgery. The most useful was knowledge about the rational interpretation of clinical symptoms and signs acquired from examination of the patient, followed by arriving at an accurate diagnosis through logical analysis, and next developing "oncological sensitivity" to diagnosing neoplasms. The most effective teaching model was specialized outpatient clinic rounds, followed by training manual skills on a model and classical ward-round teaching. The most frequently learned (acquired) manual skills were removal of stitches, rectal examination, and examination of the abdomen. Of these skills, the most useful in daily practice appeared to be removal of stitches, catheterization of the urinary bladder, and wound suturing. Learning and practicing manual skills followed by classical ward-round teaching was considered "skill-/competency-oriented teaching" surgery by all respondents. CONCLUSION The results of this study show some discrepancy between the knowledge and skills taught during university surgical curriculum and their actual usefulness in the daily practice of graduates. Awareness of this should have an effect on modification of the curriculum and methods for undergraduate surgery teaching.
Collapse
Affiliation(s)
- Andrzej Zyluk
- Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland.
| | - Piotr Puchalski
- Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland
| | - Zbigniew Szlosser
- Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland
| |
Collapse
|
21
|
Abbas P, Holder-Haynes J, Taylor DJ, Scott BG, Brandt ML, Naik-Mathuria B. More than a camera holder: teaching surgical skills to medical students. J Surg Res 2015; 195:385-9. [PMID: 25777824 DOI: 10.1016/j.jss.2015.01.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 01/13/2015] [Accepted: 01/21/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Students often experience passive learning in their surgical rotations as they are delegated to holding the camera during laparoscopic cases. We introduced a laparoscopic skills course to medical students to provide hands-on experience. We hypothesized that the course will improve basic laparoscopic skills and increase interest in a surgical career. MATERIALS AND METHODS All students on the core surgery rotation attended two sessions in the surgical simulation laboratory lead by Department of Surgery faculty members. Surveys were used before and after the course to assess video game (VG) use and interest in a surgical career. Course effectiveness was assessed with a laparoscopic peg transfer exercise. RESULTS One hundred one students participated with 82 students documenting preinstruction and postinstruction peg transfer times. There was an overall improvement in median transfer times after instruction (before 63 s [interquartile range {IQR} 46-84.5] versus after 50.5 s [IQR 39-65.2], P < 0.001). When stratified by gender, men (n = 40) had faster median preintervention peg transfer times than women (n = 61; 65 s [IQR 51-88]) versus 81 s [IQR 65-98] (P = 0.030). However, both genders had equivalent postinstruction transfer times (men 48 s [IQR 36-61] versus women 51.3 s [IQR 43.2-68.3], P = 0.478). A similar trend was observed between students with and without prior VG use. Of the 50 students who completed both surveys, there was no significant increase (pre-24% versus post-34%, P = 0.29) or decrease (pre-32% versus post-22%, P = 0.13) in interest in a surgical career after the course. CONCLUSIONS A laparoscopic course for medical students is effective in improving laparoscopic skills. Although male gender and VG use may be associated with better intrinsic skills, instruction and practice allow female students and non-VG users to "catch up." A longer follow-up study is warranted to determine true interest in a surgical career.
Collapse
Affiliation(s)
- Paulette Abbas
- Texas Children's Hospital, Division of Pediatric Surgery, Houston, Texas; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Juliet Holder-Haynes
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Deborah J Taylor
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Bradford G Scott
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Mary L Brandt
- Texas Children's Hospital, Division of Pediatric Surgery, Houston, Texas; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Bindi Naik-Mathuria
- Texas Children's Hospital, Division of Pediatric Surgery, Houston, Texas; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
| |
Collapse
|
22
|
|