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Emin EI, Emin E, Bimpis A, Pierides M, Dedeilia A, Javed Z, Rallis KS, Saeed F, Theophilou G, Karkanevatos A, Kitapcioglu D, Aksoy ME, Papalois A, Sideris M. Teaching and Assessment of Medical Students During Complex Multifactorial Team-Based Tasks: The "Virtual on Call" Case Study. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:457-465. [PMID: 35547870 PMCID: PMC9084906 DOI: 10.2147/amep.s357514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/31/2022] [Indexed: 06/15/2023]
Abstract
Abstract Although considerable efforts have been made to incorporate simulation-based learning (SBL) in undergraduate medical education, to date, most of the medical school curricula still focus on pure knowledge or individual assessment of objective structured clinical examination skills (OSCE). To this end, we designed a case study named "iG4 (integrated generation 4) virtual on-call (iVOC)". We aimed to simulate an on-call shift in a high-fidelity virtual hospital setting in order to assess delegates' team-based performance on tasks related to patient handovers (prioritisation, team allocation). Methods A total of 41 clinical year medical students were split into 3 cohorts, each of which included 3 groups of 4 or 5 people. The groups consisted of a structured mix of educational and cultural backgrounds of students to achieve homogeneity. Each performing group received the handover for 5 patients in the virtual hospital and had to identify and deal with the acutely unwell ones within 15 minutes. We used TEAMTM tool to assess team-based performances. Results The mean handover performance was 5.44/10 ± 2.24 which was the lowest across any performance marker. The overall global performance across any team was 6.64/10 ± 2.11. The first rotating team's global performance for each cycle was 6.44/10 ± 2.01, for the second 7.89/10 ± 2.09 and for the third 6.78/10 ± 1.64 (p = 0.099 between groups). Conclusion This is one of the first reported, high-fidelity, globally reproducible SBL settings to assess the capacity of students to work as part of a multinational team, highlighting several aspects that need to be addressed during undergraduate studies. Medical schools should consider similar efforts with the aim to incorporate assessment frameworks for individual performances of students as part of a team, which can be a stepping-stone for enhancing safety in clinical practice.
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Affiliation(s)
- Elif Iliria Emin
- Department of Acute Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Ece Emin
- EGA Institute for Women’s Health, University College London, London, UK
| | - Alexios Bimpis
- Department of Neurosurgery, Tzaneio General Hospital, Piraeus, Greece
| | - Michael Pierides
- Department of Acute Medicine, Kettering General Hospital NHS Trust, Northamptonshire, UK
| | - Aikaterini Dedeilia
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Zibad Javed
- Faculty of Medicine and Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kathrine-Sofia Rallis
- Faculty of Medicine and Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Ferha Saeed
- Faculty of Medicine and Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Georgios Theophilou
- Department of Gynaecological Oncology, St James Institute of Oncology, Leeds, UK
| | | | - Dilek Kitapcioglu
- Center of Advanced Simulation and Education, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Mehmet Emin Aksoy
- Center of Advanced Simulation and Education, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Apostolos Papalois
- Special Unit for Biomedical Research and Education, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Michail Sideris
- Faculty of Medicine and Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Lymperopoulos NS, Sideris M, Sofos S, Zografos C, Nanidis T, Manjumder S, Shokrollahi K, Zografos G, Papalois A. A novel plastic surgery simulation model for medical students. J Plast Reconstr Aesthet Surg 2021; 75:1261-1282. [PMID: 35034790 DOI: 10.1016/j.bjps.2021.11.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 04/24/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Affiliation(s)
| | - Michail Sideris
- Women's Health Research Unit, Queen Mary University of London, London, UK
| | - Stratos Sofos
- St Andrew's Centre for Plastic Surgery, Mid Essex Hospitals NHS Trust, Chelmsford, UK
| | | | - Theodore Nanidis
- Department of Plastic Surgery, The Royal Marsden Hospital NHS Trust, London, UK
| | - Sanjib Manjumder
- Department of Plastic Surgery, Pinderfields Hospital, Yorkshire, UK
| | - Kayvan Shokrollahi
- Mersey Regional Centre for Burns and Plastic Surgery, Whiston Hospital, Liverpool, UK; University of Liverpool, Merseyside, UK; Edge Hill University, Ormskirk, UK
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3
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Sideris M, Nicolaides M, Jagiello J, Rallis KS, Emin E, Theodorou E, Hanrahan JG, Mallick R, Odejinmi F, Lymperopoulos N, Papalois A, Tsoulfas G. In vivo Simulation-Based Learning for Undergraduate Medical Students: Teaching and Assessment. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:995-1002. [PMID: 34512069 PMCID: PMC8416184 DOI: 10.2147/amep.s272185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 07/20/2021] [Indexed: 02/05/2023]
Abstract
An increasing emphasis on simulation has become evident in the last three decades following fundamental shifts in the medical profession. Simulation-based learning (SBL) is a wide term that encompasses several means for imitating a skill, attitude, or procedure to train personnel in a safe and adaptive environment. A classic example has been the use of live animal tissue, named in vivo SBL. We aimed to review all published evidence on in vivo SBL for undergraduate medical students; this includes both teaching concepts as well as focused assessment of students on those concepts. We performed a systematic review of published evidence on MEDLINE. We also incorporated evidence from a series of systematic reviews (eviCORE) focused on undergraduate education which have been outputs from our dedicated research network (eMERG). In vivo SBL has been shown to be valuable at undergraduate level and should be considered as a potential educational tool. Strict adherence to 3R (Reduce, Refine, Replace) principles in order to reduce animal tissue usage, should always be the basis of any curriculum. In vivo SBL could potentially grant an extra mile towards medical students' inspiration and aspiration to become safe surgeons; however, it should be optimised and supported by a well-designed curriculum which enhances learning via multi-level fidelity SBL.
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Affiliation(s)
- Michail Sideris
- Women’s Health Research Unit, Queen Mary University of London, London, UK
| | - Marios Nicolaides
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Kathrine S Rallis
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Elif Emin
- Women’s Health Research Unit, Queen Mary University of London, London, UK
| | - Efthymia Theodorou
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Rebecca Mallick
- Princess Royal Hospital, Brighton and Sussex University Hospitals NHS Trust, Haywards Heath, UK
| | - Funlayo Odejinmi
- Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
| | | | - Apostolos Papalois
- Special Unit for Biomedical Research and Education, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Tsoulfas
- Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
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4
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Sideris M, Nicolaides M, Theodoulou I, Emin EI, Hanrahan JG, Dedeilia A, Theodorou E, Paparoidamis G, Abdullah Z, Papoutsos C, Pittaras T, Odejinmi F, Papalois A. Student Views on a Novel Holistic Surgical Education Curriculum (iG4): A Multi-national Survey in a Changing Landscape. In Vivo 2021; 34:1063-1069. [PMID: 32354893 DOI: 10.21873/invivo.11876] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 11/10/2022]
Abstract
AIM Essential Skills in the Management of Surgical Cases (ESMSC Marathon Course™) Integrated Generation 4 (iG4) is the first reported multifaceted undergraduate surgical course aiming to provide holistic surgical teaching. In this prospective observational study, we explored students' views on the iG4 curriculum, and identified how it can potentially address modern challenges in surgical training. MATERIAL AND METHODS Medical students were invited to apply to the course online and were screened against pre-defined criteria. A multi-national structured questionnaire incorporating five domains related to the course curriculum and our dedicated research network, was designed and distributed to participants after successful completion of the course. RESULTS Forty-one students from European and Asian medical schools completed the course and filled in the survey. The median overall evaluation score of the course was 4.73 out of 5 (interquartile range=4.21-4.72) and all students found that iG4 served the vision of holistic surgical education. ESMSC had a positive motivational effect towards following a career in surgery (p=0.012) and 92.7% of students declared that it should be an essential part of a future medical school curriculum. There was no statistically significant difference (p>0.05) in results between participants of different countries of study, year of studies or age group. CONCLUSION The ESMSC Marathon Course™ is perceived as a unique course model, with an established educational value and a positive motivational effect towards surgery. It might potentially be implemented in future medical school curricula as an essential element of undergraduate surgical education. The iG4 curriculum has opened a new exciting horizon of opportunities for advancing undergraduate holistic surgical education.
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Affiliation(s)
- Michail Sideris
- Women's Health Research Unit, Queen Mary University of London, London, U.K.
| | - Marios Nicolaides
- Barts Cancer Institute, Queen Mary University of London, London, U.K
| | - Iakovos Theodoulou
- Faculty of Life Sciences and Medicine, King's College London, London, U.K
| | - Elif Iliria Emin
- Faculty of Life Sciences and Medicine, King's College London, London, U.K
| | | | - Aikaterini Dedeilia
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Efthymia Theodorou
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
| | | | - Ziena Abdullah
- Barking, Havering and Redbridge Hospitals NHS Trust, London, U.K
| | - Constantinos Papoutsos
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
| | - Theodoros Pittaras
- Hematology Laboratory-Blood Bank, Aretaieion Hospital, University of Athens School of Medicine, Athens, Greece
| | | | - Apostolos Papalois
- Experimental, Educational and Research Centre ELPEN, Athens, Greece.,School of Medicine, European University of Cyprus, Nicosia, Cyprus
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Sideris M, Papalois V, Athanasiou T, Papagrigoriadis S, Pierides M, Velmahos G, Papalois A. A Novel Multi-faceted Course Blueprint to Support Outcome-based Holistic Surgical Education: The Integrated Generation 4 Model (iG4). In Vivo 2020; 34:503-509. [PMID: 32111747 DOI: 10.21873/invivo.11801] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/04/2019] [Accepted: 12/06/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM We present a novel multi-faceted, internationally adaptable course curriculum blueprint, which provides holistic surgical education at the undergraduate level. MATERIALS AND METHODS The Integrated Generation 4 (iG4) course (Essential Skills in the Management of Surgical Cases - ESMSC Marathon course) curriculum consists of four essential learning components: core skills-based learning, case-based discussions, basic science workshops and soft-skills. These are all clustered in a specialty-led network architecture. Every cluster consists of modules from the four learning cores, while network nodes are modules that are mutually shared by more than one clusters. RESULTS We produced a standardized blueprint of 50 modules based on the 4 learning cores, covering 9 surgical specialties. This resulted in a curriculum map where every module is described using 3 parameters: χ axis (skills component), y axis (knowledge component), z axis (specialty component). CONCLUSION iG4 proof of concept sets the ground for a novel, reproducible and standardised effort to produce a portfolio of undergraduate surgical skills serving the vision of holistic surgical education.
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Affiliation(s)
- Michail Sideris
- Women's Health Research Unit, Queen Mary University of London, London, U.K.
| | - Vassilios Papalois
- Department of Surgery and Cancer, Renal Transplant Directorate, Imperial College Healthcare NHS Trust, London, U.K
| | - Thanos Athanasiou
- Department of Surgery and Cancer, Cardiothoracic Directorate, Imperial College Healthcare NHS Trust, London, U.K
| | | | | | - George Velmahos
- Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical Care, Harvard Medical School, Boston, MD, U.S.A
| | - Apostolos Papalois
- Experimental Educational and Research Centre ELPEN, Athens, Greece.,School of Medicine European University Cyprus, Nicosia, Cyprus
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6
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Sideris M, Emin EI, Hanrahan JG, Odejinmi F, Mallick R, Nicolaides M, Velmahos G, Athanasiou T, Papalois V, Papalois A. ABC of Surgical Teaching: Time to Consider a Global Blueprint for Holistic Education. J INVEST SURG 2020; 34:1355-1365. [PMID: 32806964 DOI: 10.1080/08941939.2020.1800870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Educating and equipping students and trainees into clinicians capable of meeting healthcare demands and service provision needs is essential. Unprecedented events like COVID-19 pandemic, highlight urgent need for reformation of training to ensure high quality education is maintained. To this end, we describe an innovative and globally adaptable blueprint for establishing a surgical curriculum, aiming to optimize preparation of future surgeons. METHODS We used a structured protocol to synthesize evidence from previous systematic reviews focused on surgical education alongside a series of focused original educational studies. This approach allowed incorporation of prospectively applied novel ideas into the existing landscape of published evidence. All material used for this proof of concept derives from the outputs of a dedicated research network for surgical education (eMERG). RESULTS We propose the foundation blueprint framework called "Omnigon iG4" as a globally applicable model. It allows adaptation to individual local educational environments for designing, appraising and/or refining surgical curricula. We also describe the "Omnigon iG4 Hexagon Pragmatic Model," a novel perspective model which assesses the performance of our blueprint in a multi-layer fashion. This "Hexagon" model is the first to introduce pragmatic outcomes in curricula performance assessment. CONCLUSIONS This proof of concept, "Omnigon iG4," proposes an adaptable version of a curriculum blueprint. The framework allows educators to establish a surgical curriculum with the ability to map out competencies, permitting full control over their intended learning outcomes. This can form the basis for developing globally adaptable multifaceted Simulation-Based learning (SBL) courses or even surgical curricula for undergraduates.
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Affiliation(s)
- Michail Sideris
- Women's Health Research Unit, Queen Mary University of London, London, UK
| | - Elif Iliria Emin
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | | | - Funlayo Odejinmi
- Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
| | - Rebecca Mallick
- Princess Royal Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Marios Nicolaides
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - George Velmahos
- Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical Care, Harvard Medical School, Boston, Maryland, USA
| | | | | | - Apostolos Papalois
- Experimental Educational and Research Centre ELPEN, Athens, Greece.,School of Medicine, European University Cyprus, Nicosia, Cyprus
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7
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Nicolaides M, Theodorou E, Emin EI, Theodoulou I, Andersen N, Lymperopoulos N, Odejinmi F, Kitapcioglu D, Aksoy ME, Papalois A, Sideris M. Team performance training for medical students: Low vs high fidelity simulation. Ann Med Surg (Lond) 2020; 55:308-315. [PMID: 32551104 PMCID: PMC7292889 DOI: 10.1016/j.amsu.2020.05.042] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives The aim of this study is to evaluate a simulation-based team performance course for medical students and compare its low- and high-fidelity components. Study design This is a prospective crossover observational study. Groups participated in one low- and one high-fidelity session twice. Low-fidelity scenarios included management of an emergency case on a simulated-patient, whereas high-fidelity scenarios constituted of multiple-trauma cases where simulated-patients wore a hyper-realistic suit. Team performance was assessed objectively, using the TEAM™ tool, and subjectively using questionnaires. Questionnaires were also used to assess presence levels, stress levels and evaluate the course. Results Participants’ team performance was higher in the low-fidelity intervention as assessed by the TEAM™ tool. An overall mean increase in self-assessed confidence towards non-technical skills attitudes was noted after the course, however there was no difference in self-assessed performance between the two interventions. Both reported mean stress and presence levels were higher for the high-fidelity module. Evaluation scores for all individual items of the questionnaire were ≥4.60 in both NTS modules. Students have assessed the high-fidelity module higher (4.88 out of 5, SD = 0.29) compared to low-fidelity module (4.74 out of 5, SD = 0.67). Conclusions Both the low- and high-fidelity interventions demonstrated an improvement in team performance of the attending medical students. The high-fidelity intervention was more realistic, yet more stressful. Furthermore, it proved to be superior in harvesting leadership, teamwork and task management skills. Both modules were evaluated highly by the students, however, future research should address retention of the taught skills and adaptability of such interventions. The high-fidelity intervention was superior in harvesting leadership, teamwork and task management skills, yet more stressful. We set the group to develop a novel group of team-based OSCE performance. The next step is to adapt such taught skills to different specialties and implement initiatives in the medical school curricula.
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Affiliation(s)
- Marios Nicolaides
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Efthymia Theodorou
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Elif Iliria Emin
- Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Iakovos Theodoulou
- Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | | | | | - Funlayo Odejinmi
- Department of Obstetrics and Gynaecology, Whipps Cross University Hospital, London, United Kingdom
| | - Dilek Kitapcioglu
- Center of Advanced Simulation and Education, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Mehmet Emin Aksoy
- Center of Advanced Simulation and Education, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Apostolos Papalois
- European University Cyprus, Nicosia, Cyprus.,Experimental, Educational and Research Centre Elpen, Athens, Greece
| | - Michail Sideris
- Blizard Institute of Cell and Molecular Science, Queen Mary University of London, London, United Kingdom
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Theodoulou I, Louca C, Sideris M, Nicolaides M, Agrawal D, Halapas A, Diamantopoulos A, Papalois A. A prospective study integrating a curriculum of interventional radiology in undergraduate education: a tetra-core simulation model. CVIR Endovasc 2020; 3:12. [PMID: 32147761 PMCID: PMC7061096 DOI: 10.1186/s42155-020-0104-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 01/20/2020] [Indexed: 12/01/2022] Open
Abstract
Background Interventional radiology (IR) is underrepresented in undergraduate medical curricula across Europe. By continuing to challenge the boundaries of IR, a rise in the demand for radiologists has been inevitable – a trend not met by a corresponding rise in the supply of radiologists. On tracing the roots of this shortage, lack of awareness of the specialty within medical trainees coupled with a global lack of IR teaching in undergraduate education seem to constitute major exacerbating factors. The purpose of this study was to identify gaps in the field of IR education and address these by implementing an international IR simulation-based course for undergraduates. Results Implementation of a multi-modality simulation-based course consisted of seven modules incorporating technical and non-technical skills, basic science and applied clinical science modules. Of all participants, 90.7% (N = 68) never had previous IR teaching experience and only 28% (N = 21) had a previous placement in an IR department. Following the course, confidence improvement was statistically significant both in IR skills (1/5, p < 0.01) and knowledge (1/5, p < 0.01)]. The majority (90.7%) said they would benefit with more exposure to IR. In terms of the students’ motivation for a career in IR, 32% (N = 24) reported that they would more likely consider a career in IR after completing the course. Conclusion Delivery of a tetra-core simulation course with the aim to address the gaps in undergraduate IR education has had a positive impact on students’ skills, confidence levels as well as motivation. We propose reviewing the curricula across medical schools in Europe to identify gaps and address any inadequacies; for this, we consider our simulation course an excellent starting point.
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Affiliation(s)
- Iakovos Theodoulou
- Faculty of Life Sciences and Medicine, King's College London, Great Maze Pond, London, SE1 9RT, UK. .,Department of Interventional Radiology, Guy's and St Thomas' Hospitals, NHS Foundation Trust, London, UK.
| | - Christina Louca
- Faculty of Life Sciences and Medicine, King's College London, Great Maze Pond, London, SE1 9RT, UK
| | - Michail Sideris
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Marios Nicolaides
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Deepsha Agrawal
- County Durham and Darlington NHS Foundation Trust, Darlington, UK
| | - Antonios Halapas
- Department of Transcatheter Heart Valves, Hygeia Hospital, Athens, Greece
| | - Athanasios Diamantopoulos
- Faculty of Life Sciences and Medicine, King's College London, Great Maze Pond, London, SE1 9RT, UK.,Department of Interventional Radiology, Guy's and St Thomas' Hospitals, NHS Foundation Trust, London, UK
| | - Apostolos Papalois
- Experimental Educational and Research Centre ELPEN, Athens, Greece.,School of Medicine, European University Cyprus, Nicosia, Cyprus
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9
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Theodoulou I, Sideris M, Lawal K, Nicolaides M, Dedeilia A, Emin EI, Tsoulfas G, Papalois V, Velmahos G, Papalois A. Retrospective qualitative study evaluating the application of IG4 curriculum: an adaptable concept for holistic surgical education. BMJ Open 2020; 10:e033181. [PMID: 32041855 PMCID: PMC7044980 DOI: 10.1136/bmjopen-2019-033181] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Faced with a costly and demanding learning curve of surgical skills acquisition, the growing necessity for improved surgical curricula has now become irrefutable. We took this opportunity to formulate a teaching framework with the capacity to provide holistic surgical education at the undergraduate level. SETTING Data collection was conducted in all the relevant healthcare centres the participants worked in. Where this was not possible, interviews were held in quiet public places. PARTICIPANTS We performed an in-depth retrospective evaluation of a proposed curriculum, through semi-structured interviews with 10 participants. A targeted sampling technique was employed in order to identify senior academics with specialist knowledge in surgical education. Recruitment was ceased on reaching data saturation after which thematic data analysis was performed using NVivo 11. RESULTS Thematic analysis yielded a total of 4 main themes and 29 daughter nodes. Majority of study participants agreed that the current landscape of basic surgical education is deficient at multiple levels. While simulation cannot replace surgical skills acquisition taking place in operating rooms, it can be catalytic in the transition of students to postgraduate training. Our study concluded that a standardised format of surgical teaching is essential, and that the Integrated Generation 4 (IG4) framework provides an excellent starting point. CONCLUSIONS Through expert opinion, IG4 has been validated for its capacity to effectively accommodate learning in a safer and more efficacious environment. Moreover, we support that through dissemination of IG4, we can instil a sense of motivation to students as well as develop robust data sets, which will be amenable to data analysis through the application of more sophisticated methodologies.
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Affiliation(s)
| | - Michail Sideris
- Women's Health Research Unit, Queen Mary University of London, London, UK
| | - Kola Lawal
- King's College London - Strand Campus, London, UK
| | | | | | | | | | - Vassilios Papalois
- Renal Transplant Directorate, Imperial College Healthcare NHS Trust, London, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
| | | | - Apostolos Papalois
- European University Cyprus, Nicosia, Nicosia, Cyprus
- Experimental Educational and Research Centre ELPEN, Athens, Greece
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10
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Nicolaides M, Theodorou E, Hanrahan JG, Theodoulou I, Emin EI, Papalois A, Sideris M. Advancing Medical Students' Non-technical Skills in a Group-Based Setting. J INVEST SURG 2019; 34:39-43. [PMID: 31035823 DOI: 10.1080/08941939.2019.1602691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aim of the study: Introduction of non-technical skill (NTS) modules in undergraduate medical curricula is essential to prevent errors that occur due to inadequate communication and malfunctioning teams. We primarily aimed to observe medical students' NTS performance improvement in a group-based setting and compare it across participants of different countries of study. Secondarily, we aimed to assess students' views on such initiatives. Material and Methods: We designed a pilot module for assessing and improving a group's NTS performance. This was based on three main pillars: simulation-based learning, constructive feedback and objective assessment. Senior medical students from EU universities were invited to apply online. Delegates were divided according to their country of study and participated in two surgical scenarios. Groups had two attempts at each scenario and feedback was given in between. Performance was assessed using a modified version of the Individual Teamwork Observation and Feedback Tool (iTOFT). Participant feedback was collected at the end of the module. Results: Eighty delegates were recruited and finished the study. A mean increase performance of 0.81 out of 3 was noted between attempts in trauma-case scenarios and 0.88 out of 3 in ward round scenarios. Overall performance improvement was similar across all groups (p > 0.05). Feedback of delegates was encouragingly positive. Conclusions: The reported improvement and positive feedback received highlight that such an intervention can be implemented in medical school curricula of all countries. Our module design, along with the use of iTOFT, should act as the basis for future development of group-based learning and assessment in undergraduate medical education.
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Affiliation(s)
- Marios Nicolaides
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Efthymia Theodorou
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Iakovos Theodoulou
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Elif Iliria Emin
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | | | - Michail Sideris
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Experimental Educational and Research Centre ELPEN, Athens, Greece
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11
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Self-confidence and clinical skills: the case of students who study medicine in English in a non-English speaking setting. Ir J Med Sci 2018; 188:1057-1066. [PMID: 30569373 DOI: 10.1007/s11845-018-1947-2] [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: 09/20/2018] [Accepted: 12/10/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND An increasing number of international students has been enrolling in medical studies in the English language offered by the countries of Eastern Europe. Development of practical skills is likely more challenging when students learn in the English language, while their patients are non-English speaking persons. AIMS To evaluate self-perception of practical skills of medical students in the English language program. METHODS From December 2016 to December 2017, a total of 52 students from the Studies in English program of two universities in Serbia were included in the study. Data were obtained by a previously validated questionnaire. RESULTS Participants were most confident when measuring blood pressure, checking the arterial pulse, and taking history. Students were the least confident when placing urinary catheters, performing rectal examinations, and suturing wounds. Male students reported higher confidence in "Major interventions" compared to females (p = 0.004), and no difference between male and female students was found in the total skill score of "knowledge of Serbian language" (p = 0.339). Adjusted analysis showed that a higher grade point average remains associated with a more confident perception of one's practical skills (B 26.48, 95% confidence interval 8.98-43.98). Rasch analysis showed that because the scores were distributed around the mean value between "not confident at all" and "quite confident," the majority of students had similar perceptions of their skills. CONCLUSION Active supervision by teaching staff is also recommended in an attempt to rectify the lack of confidence at performing a range of clinical procedures which is present among international students.
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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.
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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
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Sideris M, Hanrahan J, Staikoglou N, Pantelidis P, Pidgeon C, Psychalakis N, Andersen N, Pittaras T, Athanasiou T, Tsoulfas G, Papalois A. Optimizing engagement of undergraduate students in medical education research: The eMERG training network. Ann Med Surg (Lond) 2018; 31:6-10. [PMID: 29922460 PMCID: PMC6004769 DOI: 10.1016/j.amsu.2018.05.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 05/16/2018] [Accepted: 05/23/2018] [Indexed: 02/08/2023] Open
Abstract
Background The practice of evidence-based medicine and critical appraisal are essential for the modern doctor. Early engagement of medical students in research methodology is considered as a rising need for most medical school curricula; however, few peer-reviewed initiatives have been reported so far. We developed a Medical Education Research Group (eMERG) as part of a novel undergraduate surgical masterclass, which aimed to train undergraduate students on basic research methodology, as well as to motivate them to pursue a clinical and academic career in surgical specialties. Methods: eMERG consists of an international structured network of senior academics, consultant-level clinicians, senior and junior trainees who support undergraduate trainees. Students are selected from a competitive pool of applicants. Several small prospective studies in skills-based education, as well as systematic reviews on similar topics, have run under the umbrella of this framework, in the form of scholarship awards. Structured feedback questionnaires were distributed to evaluate the experience of the first three years. Results 12 students have participated in this pilot initiative. 11 manuscripts have been submitted for publication and 8 were accepted following peer-review in MEDLINE-indexed journals. Delegates perceived this experience as an excellent training opportunity which improved their research productivity. Delegates also stated engagement in research developed interest in the relevant surgical speciality, impacting their career aspirations. Conclusions eMERG is one of the first reported European educational research networks for undergraduates. Research outcomes and students' perceptions conclude that eMERG enhances engagement with research methodology and motivation towards a career in surgery. eMERG is a pilot international research training network where medical students receive support to conduct research in Medical Education. eMERG structure can serve as a novel model to convey research experience from one generation to another, and in the same time, motivate and aspire students to develop leadership skills. eMERG was developed in a financial crisis environment with promising research outputs and positive students' feedback.
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Affiliation(s)
- Michail Sideris
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Queen Mary University of London, Yvonne Carter Building, London E1 2AB, United Kingdom
| | - John Hanrahan
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,King's College London, Faculty of Life Sciences and Medicine, Strand, London WC2R 2LS, United Kingdom
| | - Nikolaos Staikoglou
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Aristotle University of Thessaloniki, Thessaloniki 541 24, Greece
| | - Panteleimon Pantelidis
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Aristotle University of Thessaloniki, Thessaloniki 541 24, Greece
| | - Connie Pidgeon
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Royal London Hospital, Bartshealth NHS Trust, United Kingdom
| | - Nikolaos Psychalakis
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Experimental Research Centre ELPEN, Athens, Greece
| | - Nikolai Andersen
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,PPA-International Medical, Denmark
| | - Theodore Pittaras
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,National and Kapodistrian University of Athens, Athens, 115 27, Greece
| | - Thanos Athanasiou
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Imperial College London, London SW7 2AZ, United Kingdom
| | - Georgios Tsoulfas
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Aristotle University of Thessaloniki, Thessaloniki 541 24, Greece
| | - Apostolos Papalois
- esmsc Medical Education Research Group (eMERG Collaboration), Experimental Research Center ELPEN, Greece.,Experimental Research Centre ELPEN, Athens, Greece
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