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Crowley CJ, Yanowitch D, Baigorri M, Hwang KH, Cordero KN, Gonzalez A, Goes M, Bohórquez D, Sierra N, Zavaleta SG, Levy ES. Impact of an International Training on Interventionists' Expertise in Cleft Palate Speech: Results From Oaxaca, Mexico. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1456-1470. [PMID: 38557150 DOI: 10.1044/2024_ajslp-23-00397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
PURPOSE International cleft lip and palate surgical charities recognize that speech therapy is essential for successful care of individuals after palate repair. The challenge is how to ensure that cleft speech interventionists (i.e., speech-language pathologists and other speech therapy providers) provide quality care. This exploratory study investigated effects of a two-stage cleft training in Oaxaca, Mexico, aimed at preparing speech interventionists to provide research-based services to individuals born with cleft palate. Changes in the interventionists' content knowledge and clinical skills were examined. METHOD Twenty-three cleft speech interventionists from Mexico, Guatemala, and Nicaragua participated in a hybrid two-stage training, completing an online Spanish cleft speech course and a 5-day in-person training in Oaxaca. In-person training included a didactic component and supervised clinical practice with 14 individuals with repaired cleft palates. Testing of interventionists' content knowledge and clinical skills via questionnaires occurred before the online course (Test 1), immediately before in-person training (Test 2), and immediately after in-person training (Test 3). Qualitative data on experience/practice were also collected. RESULTS Significant increases in interventionists' overall content knowledge and clinical skills were found posttraining. Knowledge and clinical skills increased significantly between Tests 1 and 2. Clinical skills, but not knowledge, showed further significant increases between Tests 2 and 3. Posttraining, interventionists demonstrated greater expertise in research-based treatment, and fewer reported they would use nonspeech oral motor exercises (NSOME). CONCLUSIONS Findings provide preliminary support for such two-stage international trainings in preparing local speech interventionists to deliver high-quality speech services to individuals born with cleft palate. While content knowledge appears to be acquired primarily from the online course, the two-stage training incorporating in-person supervised practice working with individuals born with cleft palate may best enhance continued clinical skill development, including replacement of NSOME with evidence-based speech treatment. Such trainings contribute to building capacity for sustainable quality services for this population in underresourced regions.
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Affiliation(s)
- Catherine J Crowley
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - David Yanowitch
- Columbia Secondary School for Math, Science, and Engineering, New York, NY
| | - Miriam Baigorri
- Department of Communication Sciences and Disorders, Long Island University-Brooklyn, NY
| | - Kyung Hae Hwang
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | | | | | | | | | | | | | - Erika S Levy
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
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Sarilita E, Rafisa A, Desai P, Mossey PA. Utilising massive open online courses to enhance global learning dissemination in cleft lip and palate: a case report of penta helix collaboration. BMC MEDICAL EDUCATION 2024; 24:301. [PMID: 38500073 PMCID: PMC10949738 DOI: 10.1186/s12909-024-05225-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 02/24/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Educating and raising awareness in cleft lip and palate future generations is one vital effort to ensure the improvement of cleft care and research in the future. This study reported the overview in organising and evaluating the Massive Open Online Course (MOOC) in Cleft Lip and Palate as the alternative way for students' capacity building outside their study program whilst also earning credits towards their studies. METHODS Smile Train cleft charity generously donated recorded lectures from cleft experts around the world in which each of the experts agreed to provide one-hour live discussion sessions. The learning activities ranging from lectures, pre- and post-course evaluation, forum, live discussion sessions, virtual visits to Indonesian Cleft Centre, self-reflection assignments and final project. A survey was released to the participants to collect their feedback. RESULTS The course mainly attracted dental students, and several allied health professional students. In total, 414 out of 717 participants registered for this MOOC managed to finish the course and received a certificate of completion which was run between August-October 2021. In general, participants positively received the course. CONCLUSIONS The MOOC model and its objective of disseminating widespread information across geographical boundaries to enhance learning about cleft lip and palate treatment was achieved. This report serves as an example for other educational institutions and stakeholders who plan to use online educational engagement platforms to provide high-quality education and capacity building to participants in lower-middle income countries.
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Affiliation(s)
- Erli Sarilita
- Department of Oral Biology, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Anggun Rafisa
- Department of Oral Biology, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia.
| | - Priya Desai
- Research and Innovation, Smile Train, New York, USA
| | - Peter A Mossey
- Division of Oral Health Sciences and WHO Collaborating Centre for Oral Health & Craniofacial Anomalies, University of Dundee, Dundee, Scotland, UK
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Sasani AR, Soffer JM, Abdurrob A, Marston AP. Publishing Trends in International Humanitarian Cleft Lip and Palate Care: A Systematic Review. Facial Plast Surg Aesthet Med 2024; 26:91-97. [PMID: 37358592 DOI: 10.1089/fpsam.2023.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Abstract
Background: Humanitarian outreach delivers essential cleft lip and palate (CLP) care in low- and middle-income countries. Objective: To review the literature regarding humanitarian CLP care and determine if a shift toward more sustainable care delivery is observed. Methods: A systematic review was performed on articles describing CLP repair in humanitarian settings from 1985 to 2020. Publications were categorized into trip reports, outcomes, teaching, and public health. Articles were stratified into three 12-year intervals (T1-T3) for analysis. Results: A total of 246 publications were included. Average annual publications increased 15.4-fold from T1 to T3 (p < 0.001). Among publications focused on delivering CLP-related care, descriptive trip report articles trended downward (58% in T1 vs. 42% in T3), whereas outcome-focused publications trended upward (42% in T1 vs. 58% T3). Public health research represented the greatest percentage of publications in T3 (50%). There were 22 teaching-related publications in T3 and only one in prior years. Conclusion: Research trends demonstrate a shift away from focusing solely on the number of surgical cases completed and toward more sustainable models of care delivery that address barriers to receiving longitudinal care.
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Affiliation(s)
- Ali R Sasani
- Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Justin M Soffer
- Tufts University School of Medicine, Boston, Massachusetts, USA
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Alexander P Marston
- Tufts University School of Medicine, Boston, Massachusetts, USA
- Dr. Elie E. Rebeiz Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts, USA
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Kantar RS, Esenlik E, Al Abyad OS, Melhem A, Younan RA, Haddad M, Keith K, Kassam S, Annan B, Vijayakumar C, Picard A, Padwa BL, Sommerlad B, Raposo-Amaral CE, Forrest CR, Gillett DA, Steinbacher DM, Runyan CM, Tanikawa DYS, Chong DK, Fisher DM, Mark H, Canter HI, Losee JE, Patel KG, Hartzell LD, Johnson AB, Collares MVM, Alonso N, Chen PKT, Tse R, Mann RJ, Prada-Madrid JR, Kobayashi S, Hussain SA, Kummer A, Sell DA, Pereira VJ, Mabry K, Gonsoulin CK, Persson M, Davies G, Sethna NF, Munoz-Pareja JC, Kuijpers-Jagtman AM, Grayson BH, Grollemund B, Garib DG, Meazzini MC, Kharbanda OP, Santiago PE, Nalabothu P, Batra P, Stieber E, Prasad D, Brewster H, Ayala R, Erbay E, Akcam MO, Don Griot JPW, Vyas RM, Flores RL, Breugem CC, Hamdan US. The First Hybrid International Educational Comprehensive Cleft Care Workshop. Cleft Palate Craniofac J 2023; 60:1189-1198. [PMID: 35532040 DOI: 10.1177/10556656221097820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Describe the first hybrid global simulation-based comprehensive cleft care workshop, evaluate impact on participants, and compare experiences based on in-person versus virtual attendance. DESIGN Cross-sectional survey-based evaluation. SETTING International comprehensive cleft care workshop. PARTICIPANTS Total of 489 participants. INTERVENTIONS Three-day simulation-based hybrid comprehensive cleft care workshop. MAIN OUTCOME MEASURES Participant demographic data, perceived barriers and interventions needed for global comprehensive cleft care delivery, participant workshop satisfaction, and perceived short-term impact on practice stratified by in-person versus virtual attendance. RESULTS The workshop included 489 participants from 5 continents. The response rate was 39.9%. Participants perceived financial factors (30.3%) the most significant barrier and improvement in training (39.8%) as the most important intervention to overcome barriers facing cleft care delivery in low to middle-income countries. All participants reported a high level of satisfaction with the workshop and a strong positive perceived short-term impact on their practice. Importantly, while this was true for both in-person and virtual attendees, in-person attendees reported a significantly higher satisfaction with the workshop (28.63 ± 3.08 vs 27.63 ± 3.93; P = .04) and perceived impact on their clinical practice (22.37 ± 3.42 vs 21.02 ± 3.45 P = .01). CONCLUSION Hybrid simulation-based educational comprehensive cleft care workshops are overall well received by participants and have a positive perceived impact on their clinical practices. In-person attendance is associated with significantly higher satisfaction and perceived impact on practice. Considering that financial and health constraints may limit live meeting attendance, future efforts will focus on making in-person and virtual attendance more comparable.
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Affiliation(s)
- Rami S Kantar
- Global Smile Foundation, Norwood, USA
- The University of Maryland Medical System/Shock Trauma, Baltimore, USA
- Amsterdam University Medical Center, Department of Plastic and Reconstructive Surgery, Amsterdam, the Netherlands
| | - Elçin Esenlik
- Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | | | | | | | | | | | - Serena Kassam
- Global Smile Foundation, Norwood, USA
- British Columbia Children's Hospital, Vancouver, Canada
| | | | - Charanya Vijayakumar
- Global Smile Foundation, Norwood, USA
- Cleft and Craniofacial Center, Sri Ramachandra University, Chennai, India
| | - Arnaud Picard
- Université de Paris, Hôpital Necker-Enfants Malades, Paris, France
| | - Bonnie L Padwa
- Children's Hospital and Harvard Medical School, Boston, USA
| | - Brian Sommerlad
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | | | - Christopher R Forrest
- Division of Plastic and Reconstructive Surgery, The University of Toronto and Hospital for Sick Children, Toronto, Canada
| | - David A Gillett
- Division of Plastic and Reconstructive Surgery, Perth Children's Hospital, Perth, Australia
| | - Derek M Steinbacher
- Division of Plastic Surgery, Yale University School of Medicine, New Haven, USA
| | | | - Daniela Y S Tanikawa
- Instituto Sírio-Libanês de Ensino e Pesquisa, Hospital Sírio-Libanês and Departamento de Fissura Lábio Palatina, Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil
| | | | - David M Fisher
- Division of Plastic and Reconstructive Surgery, The University of Toronto and Hospital for Sick Children, Toronto, Canada
| | - Hans Mark
- Sahlgrenska University Hospital and Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg, Sweden
| | | | - Joseph E Losee
- Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, USA
| | - Krishna G Patel
- Global Smile Foundation, Norwood, USA
- University of South Carolina, Charleston, USA
| | - Larry D Hartzell
- The University of Arkansas for Medical Sciences, Little Rock, USA
| | - Adam B Johnson
- Global Smile Foundation, Norwood, USA
- The University of Arkansas for Medical Sciences, Little Rock, USA
| | - Marcus Vinícius Martins Collares
- Plastic and Craniomaxillofacial Surgery Division, School of Medicine, Rio Grande do Sul Federal University, Porto Alegre, Brazil
| | | | | | - Raymond Tse
- University of Washington and Seattle Children's Hospital, Seattle, USA
| | - Robert J Mann
- Division of Pediatric Plastic Surgery, Spectrum Health Medical Group, Michigan State College of Human Medicine, Grand Rapids, USA
| | | | | | - Syed Altaf Hussain
- Cleft and Craniofacial Center, Sri Ramachandra University, Chennai, India
| | - Ann Kummer
- Division of Speech-Language Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Debbie A Sell
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), London, UK
| | - Valerie J Pereira
- Division of Speech Therapy, Department of Otorhinolaryngology, Head & Neck Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Kelly Mabry
- Division of Speech Pathology/Craniofacial, Connecticut Children's Medical Center, Hartford, USA
| | | | - Martin Persson
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Gareth Davies
- European Cleft and Craniofacial Initiative for Equality in Care, European Cleft Organization, the Netherlands
| | - Navil F Sethna
- Global Smile Foundation, Norwood, USA
- Critical Care and Pain Medicine, Boston Children's Hospital, Boston, USA
| | - Jennifer C Munoz-Pareja
- Global Smile Foundation, Norwood, USA
- University of Miami Miller School of Medicine, Miami, USA
| | - Anne Marie Kuijpers-Jagtman
- University Medical Centre Groningen, Groningen, the Netherlands
- School of Dental Medicine, Medical Faculty, University of Bern, Bern, Switzerland
- Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Barry H Grayson
- The Hansjörg Department of Plastic Surgery, New York University Langone Health, New York City, USA
| | - Bruno Grollemund
- Cleft Competence Center, Strasbourg University Hospital, Strasbourg, France
| | - Daniela G Garib
- Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), São Paulo, Brazil
| | | | - Om P Kharbanda
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Prasad Nalabothu
- University Hospital Basel and University of Basel, Basel, Switzerland
| | - Puneet Batra
- Manav Rachna Dental College, Faridabad, Haryana, India
| | | | | | | | - Ruben Ayala
- Operation Smile, Virginia Beach and The G4 Alliance, Chicago, USA
| | - Elif Erbay
- Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - M Okan Akcam
- Faculty of Dental Medicine, Ankara University, Ankara, Turkey
| | - J Peter W Don Griot
- Amsterdam University Medical Center, Department of Plastic and Reconstructive Surgery, Amsterdam, the Netherlands
| | - Raj M Vyas
- Global Smile Foundation, Norwood, USA
- University of California, Irvine, Department of Plastic and Reconstructive Surgery, California, USA
| | - Roberto L Flores
- The Hansjörg Department of Plastic Surgery, New York University Langone Health, New York City, USA
- Smile Train, New York City, USA
| | - Corstiaan C Breugem
- Amsterdam University Medical Center, Department of Plastic and Reconstructive Surgery, Amsterdam, the Netherlands
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Younan RA, Melhem AM, Haddad M, Annan B, Najjar W, Kantar RS, Hamdan US. Global Smile Foundation's Cleft Surgical Outreach Program: Clinical and Economic Impact During the Past 14 Years. J Craniofac Surg 2023; 34:1252-1255. [PMID: 37081641 DOI: 10.1097/scs.0000000000009320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/28/2023] [Indexed: 04/22/2023] Open
Abstract
Clefts of the lip and/or palate can result in significant morbidity as well as economic and psychosocial distress for patients and families. Global Smile Foundation is a non-profit organization committed to providing comprehensive cleft care to patients with cleft of the lip/palate around the world. Primary cleft lip and primary cleft palate repairs performed by the Global Smile Foundation in the last decade were reviewed. Averted disability-adjusted life years were estimated and assessed for their economic value. A total of 15,310 disability-adjusted life years were averted. The financial gain was estimated between $78,323,624 and $152,906,604, with an average financial benefit of $48,021 to $93,750 per patient.
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Affiliation(s)
| | | | | | | | | | - Rami S Kantar
- Global Smile Foundation, Norwood, MA
- Department of Plastic and Reconstructive Surgery, The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York City, NY
- Department of Plastic and Reconstructive Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
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6
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Butterworth S, Hodgkinson EL, Stock NM, Sainsbury DCG, Hodgkinson PD. Evolution of Cleft Lip and Palate Surgical Training in the UK: A Qualitative Study. Cleft Palate Craniofac J 2023; 60:197-210. [PMID: 34786999 DOI: 10.1177/10556656211058443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Although the United Kingdom (UK) cleft surgeons follow a similar training pathway, and cleft centers adhere to similar protocols regarding the timing of palate surgery and surgical technique, speech outcomes still vary between centers. OBJECTIVE To explore the training experiences of consultant cleft lip and palate (CL/P) surgeons, performing a Sommerlad radical intravelar veloplasty (IVVP) and their approach to teaching others. DESIGN An exploratory, qualitative approach was adopted to understand the views of UK cleft surgeons performing a Sommerlad radical IVVP and discuss what was important during training and upon qualifying as a consultant. METHOD A semi-structured interview schedule was designed, interviews were conducted in-person or via videoconferencing, depending on preference and availability, with interested surgeons. The interviews were recorded, transcribed, and checked for accuracy. Analysis involved inductive thematic analysis. RESULTS Fourteen cleft consultants from the UK participated (3F:11M). Seven of the consultants were trained in plastic surgery and four in maxillofacial surgery. Seven themes were identified from the thematic analysis. Three themes, namely Learning to perform palate repair, Teaching others to perform palate repair, and Ongoing learning as a consultant are discussed. CONCLUSIONS Cleft palate repair is clearly a technically challenging procedure to learn and teach with the potential to cause harm if performed incorrectly. Positive changes have been made to improve exposure to palate surgery, encourage practice away from the patient, and increase supervised practical experience. The role of colleagues in providing mentorship and support appears invaluable. We provide some simple recommendations that may improve the training experience and ensure parity for all trainees.
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Affiliation(s)
- Sophie Butterworth
- 5983Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Emma L Hodgkinson
- 5983Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Nicola M Stock
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - David C G Sainsbury
- 5983Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Peter D Hodgkinson
- 5983Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
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Woods A, Shofner C, Hodge B. International pediatric surgery partnerships in sub-Saharan Africa: a scoping literature review. Glob Health Action 2022; 15:2111780. [PMID: 36047712 PMCID: PMC9448389 DOI: 10.1080/16549716.2022.2111780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Sub-Saharan Africa (SSA) faces a critical shortage of pediatric surgical providers. International partnerships can play an important role in pediatric surgical capacity building but must be ethical and sustainable. Objective The purpose of this study is to perform a scoping literature review of international pediatric surgery partnerships in SSA from 2009 to 2019. We aim to categorize and critically assess past partnerships to aid in future capacity-building efforts. Methods We performed a scoping literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. We searched the PubMed and Embase databases for articles published from 2009 to 2019 using 24 keywords. Articles were selected according to inclusion criteria and assessed by two readers. Descriptive analyses of the data collected were conducted in Excel. Results A total of 2376 articles were identified. After duplicates were removed, 405 articles were screened. In total, 83 articles were assessed for eligibility, and 62 were included in the review. The most common partnership category was short-term surgical trip (28 articles, 45%). A total of 35 articles (56%) included education of host country providers as part of the partnership. Only 45% of partnerships included follow-up care, and 50% included postoperative outcomes when applicable. Conclusions To increase sustainability, more partnerships must include education of local health-care providers, and short-term surgical trips must be integrated into long-term partnerships. More partnerships need to report postoperative outcomes and ensure follow-up care. Educating peri-operative providers, training general surgeons in common pediatric procedures, and increasing telehealth use are other goals for future partnerships.
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Affiliation(s)
- Alison Woods
- Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN, USA
| | - Charles Shofner
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Bethany Hodge
- Department of Pediatrics, Division of Pediatric Hospital Medicine, Global Education Office, University of Louisville School of Medicine, Louisville, KY, USA
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The Feasibility of Cross-Linguistic Speech Evaluation in the Care of International Cleft Palate Patients. J Craniofac Surg 2022; 33:1413-1417. [PMID: 35275855 DOI: 10.1097/scs.0000000000008645] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 02/09/2022] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Many patients with cleft palate in developing countries never receive postoperative speech assessment or therapy. The use of audiovisual recordings could improve access to post-repair speech care. The present study evaluated whether English-speaking speech-language pathologists (SLPs) could assess cleft palate patients speaking an unfamiliar language (Tamil) using recorded media. Recordings obtained from Tamil-speaking participants were rated by 1 Tamil-speaking SLP and 3 English-speaking SLPs. Ratings were analyzed for inter-rater reliability and scored for percent correct. Accuracy of the English SLPs was compared with independent t tests and Analysis of Variance. Sixteen participants (mean age 14.5 years, standard deviation [SD] 7.4 years; mean age of surgery of 2.7 years, SD 3.7 years; time since surgery: 10.8 years, SD 5.7 years) were evaluated. Across the 4 SLPs, 5 speech elements were found to have moderate agreement, and the mean kappa was 0.145 (slight agreement). Amongst the English-speaking SLPs, 10 speech elements were found to have substantial or moderate agreement, and the mean kappa was 0.333 (fair agreement). Speech measures with the highest inter-rater reliability were hypernasality and consonant production errors. The average percent correct of the English SLPs was 60.7% (SD 20.2%). English SLPs were more accurate if the participant was female, under eighteen, bilingual, or had speech therapy. The results demonstrate that English SLPs without training in a specific language (Tamil) have limited potential to assess speech elements accurately. This research could guide training interventions to augment the ability of SLPs to conduct cross-linguistic evaluations and improve international cleft care by global health teams.
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Chahine EM, Ramly EP, Marston AP, Teng SN, Nader M, Kassam SN, Kantar RS, Hamdan US. Quality Assurance Standards for Outreach Cleft Lip and Cleft Palate Repair Programs in Low-Resource Settings. Cleft Palate Craniofac J 2022; 60:773-779. [PMID: 35179415 DOI: 10.1177/10556656221074883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Comprehensive cleft care is a multidisciplinary team endeavor. While untreated craniofacial conditions have multiple undue repercussions, cleft care in outreach settings can be fraught with significant perioperative morbidity risks. AIM Propose updated quality assurance standards addressing logistic and operational considerations essential for the delivery of safe and effective cleft lip and /or palate (CL/P) care in low and middle-income countries (LMICs) settings. METHODS Based on American Cleft Palate-Craniofacial Association (ACPA) quality standards, published literature, published protocols by Global Smile Foundation (GSF), and the senior author's three-decade experience, updated standards for outreach cleft care were synthesized. RESULTS Ten axes for safe, effective, and sustainable cleft lip and palate care delivery in underserved settings were generated: 1) site assessment, 2) establishment of community partnerships, 3) team composition and credentialing, 4) team training and mission preparation, 5) implementation of quality assurance guidelines, operative safety checklists, and emergency response protocols, 6) immediate and long-term postoperative care, 7) medical record keeping, 8) outcomes evaluation, 9) education, and 10) capacity building and sustainability. Subsequent analysis further characterized essential components of each of those ten axes to delineate experience derived and evidence-based recommendations. DISCUSSION Quality assurance guidelines are essential for the safe delivery of comprehensive cleft care to patients with CL/P in any setting. Properly designed surgical outreach programs relying on honest community partnerships can be effectively used as vehicles for local capacity building and the establishment of sustainable cleft care ecosystems.
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Affiliation(s)
| | - Elie P Ramly
- Global Smile Foundation, Norwood, MA, USA.,6684Oregon Health & Science University, Portland, OR, USA
| | | | | | - Marie Nader
- Global Smile Foundation, Norwood, MA, USA.,Yale School of Medicine, New Haven, CT, USA
| | - Serena N Kassam
- Global Smile Foundation, Norwood, MA, USA.,New York University College of Dentistry, New York, NY, USA.,21668The University of Maryland Medical System, Baltimore, MD, USA
| | - Rami S Kantar
- Global Smile Foundation, Norwood, MA, USA.,21668The University of Maryland Medical System, Baltimore, MD, USA
| | - Usama S Hamdan
- Global Smile Foundation, Norwood, MA, USA.,12261Tufts University School of Medicine, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Boston University School of Medicine, Boston, MA, USA
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10
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Batra P, Sybil D, Izhar A, Batra P, Thiruvenkatachari B. Standard of Care for Patients With Cleft Lip and Palate in India-A Questionnaire-Based Study. Cleft Palate Craniofac J 2022; 60:536-543. [PMID: 35099313 DOI: 10.1177/10556656221074212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A national survey of cleft teams was undertaken to evaluate the current standard of care for patients with cleft lip and palate (CLP) in India as a part of Cleft Care India study. This was a cross-sectional questionnaire-based study. Cleft teams across India attending the 19th Annual Conference of the Indian Society of Cleft Lip and Palate were invited to complete the questionnaire. The questionnaire consisted of 18 questions that included demographics, institutional details, patient protocols, surgical technique, rehabilitation facilities, and accessibility. The data are descriptively reported. A total of 112 centers completed the survey. Nongovernment organizations funded 87% of the cleft centers and 8% did not receive any funding. Only 39% of the centers had centralized cleft services providing multidisciplinary care. Speech therapy was provided either onsite or through referral at 90% of the centers, whereas audiology was provided only at 4% of centers. Feeding advice was routinely provided in 52% of centers. Millard technique was the most preferred technique for unilateral cleft lip repair (66%). The 2-flap technique (37%) and pharyngeal flap (48%) were the most common surgeries for cleft palate and pharyngoplasty, respectively. Although 54% of centers reported their patients to be interested in comprehensive care, 43% reported that their patients only wanted surgical correction. There is wide diversity in access to cleft care and clinical practices across centers in India. Further work is needed to evaluate the quality of care by assessing outcomes of centers treating patients with CLP.
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Affiliation(s)
- Panchali Batra
- Faculty of Dentistry, 28849Jamia Millia Islamia University, New Delhi, India
| | - Deborah Sybil
- Faculty of Dentistry, 28849Jamia Millia Islamia University, New Delhi, India
| | - Arisha Izhar
- Faculty of Dentistry, 28849Jamia Millia Islamia University, New Delhi, India
| | - Puneet Batra
- 29873Manav Rachna Dental College (Faculty of Dental Sciences), Manav Rachna International Institute of Research and Studies (MRIIRS), Faridabad, India
| | - Badri Thiruvenkatachari
- School of Dentistry, 5292University of Manchester, Manchester, UK.,Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Pallikaranai, Chennai, India
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Cleft Lip and Palate Repair Training to Bridge the Gap in Low-Income Countries. J Craniofac Surg 2022; 33:1331-1334. [PMID: 35013070 PMCID: PMC9275852 DOI: 10.1097/scs.0000000000008420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/25/2021] [Indexed: 11/27/2022] Open
Abstract
There is a significant unmet need for cleft repair in low-income countries. The procedure is challenging due to limited access, small fragile flaps, and the depth at which sutures need to be placed. The aim of this analysis is to review available literature pertaining to cleft lip and palate repair training, with a focus on those applicable to low-income countries.
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12
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Comprehensive Cleft Care Delivery in Developing Countries: Impact of Geographic and Demographic Factors. J Craniofac Surg 2021; 32:2041-2044. [PMID: 33710048 DOI: 10.1097/scs.0000000000007624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The authors analyzed the insights of participants and faculty members of Global Smile Foundation's Comprehensive Cleft Care Workshops concerning the barriers and interventions to multidisciplinary cleft care delivery, after stratification based on demographic and geographic factors. METHODS During 2 simulation-based Comprehensive Cleft Care Workshops organized by Global Smile Foundation, participants and faculty members filled a survey. Surveys included demographic and geographic data and investigated the most relevant barrier to multidisciplinary cleft care and the most significant intervention to deliver comprehensive cleft care in outreach settings, as perceived by participants. RESULTS The total response rate was 57.8%. Respondents reported that the greatest barrier to comprehensive cleft care was financial, and the most relevant intervention to deliver multidisciplinary cleft care was building multidisciplinary teams. Stratification by age, gender, and geographical area showed no statistical difference in reporting that the greatest barrier to cleft care was financial. However, lack of multidisciplinary teams was the most important barrier according to respondents with less than 5 years of experience (P = 0.03). Stratification by gender, years in practice, specialty, and geographical area showed no statistical difference, with building multidisciplinary teams reported as the most significant intervention. However, increased training was reported as the main intervention to cleft care for those aged less than 30 years old (P = 0.04). CONCLUSIONS Our study delivers an assessment for barriers facing multidisciplinary cleft care delivery and interventions required to improve cleft care delivery. The authors are hoping that stratification by demographic and geographic factors will help them delineate community-specific road maps to refine cleft care delivery.
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Reply: Knowledge and Skills Acquisition by Plastic Surgery Residents through Digital Simulation Training: A Prospective, Randomized, Blinded Trial. Plast Reconstr Surg 2021; 147:710e-711e. [PMID: 33764948 DOI: 10.1097/prs.0000000000007744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Kantar RS, Breugem CC, Alfonso AR, Keith K, Kassam S, Annan B, Chahine EM, Wasicek PJ, Patel KG, Flores RL, Hamdan US. Perceived Barriers to Comprehensive Cleft Care Delivery: Results From A Capacity-Building Educational Initiative and Implications. Ann Plast Surg 2021; 87:194-198. [PMID: 34253700 DOI: 10.1097/sap.0000000000002604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION We analyzed the perceptions of participants and faculty members in simulation-based comprehensive cleft care workshops regarding comprehensive cleft care delivery in developing countries. METHODS Data were collected from participants and faculty members in 2 simulation-based comprehensive cleft care workshops organized by Global Smile Foundation. We collected demographic data and surveyed what they believed was the most significant barrier to comprehensive cleft care delivery and the most important intervention to deliver comprehensive cleft care in developing countries. We also compared participant and faculty responses. RESULTS The total number of participants and faculty members was 313 from 44 countries. The response rate was 57.8%. The majority reported that the most significant barrier facing the delivery of comprehensive cleft care in developing countries was financial (35.0%), followed by the absence of multidisciplinary cleft teams (30.8%). The majority reported that the most important intervention to deliver comprehensive cleft care was creating multidisciplinary cleft teams (32.2%), followed by providing cleft training (22.6%). We found no significant differences in what participants and faculty perceived as the greatest barrier to comprehensive cleft care delivery (P = 0.46), or most important intervention to deliver comprehensive cleft care in developing countries (P = 0.38). CONCLUSIONS Our study provides an appraisal of barriers facing comprehensive cleft care delivery and interventions required to overcome these barriers in developing countries. Future studies will be critical to validate or refute our findings, as well as determine country-specific roadmaps for delivering comprehensive cleft care to those who need it the most.
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Affiliation(s)
| | - Corstiaan C Breugem
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | | | | | | | | | | | - Philip J Wasicek
- Department of Surgery, The University of Maryland Medical System, Baltimore, MD
| | | | - Roberto L Flores
- The Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York City, NY
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Chahine EM, Kantar RS, Kassam SN, Vyas RM, Ghotmi LH, Haddad AG, Hamdan US. Sustainable Cleft Care: A Comprehensive Model Based on the Global Smile Foundation Experience. Cleft Palate Craniofac J 2020; 58:647-652. [PMID: 32914647 DOI: 10.1177/1055665620957531] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Clefts of the lip and palate are leading congenital facial anomalies. Underserved patients with these facial differences lack access to medical care, surgical expertise, prenatal care, or psychological support. Moreover, the disease results in significant economic strains on patients and their families. While surgical outreach programs have attempted to fill this void, significant challenges facing international comprehensive cleft care persist. OBJECTIVE Propose a path toward international sustainable cleft care based on the Global Smile Foundation experience. RESULTS International sustainable comprehensive cleft care can be achieved by regulating surgical outreach programs. Regulation of these missions would ensure standardized care and encourage stakeholders to cooperate and adequately allocate funding and resources. Capacity building can be achieved through "diagonal" cleft care delivery models, multidisciplinary workshops, fellowship programs, research and quality assurance, as well as leveraging emerging technologies such as Augmented Reality. CONCLUSION International comprehensive cleft care requires continuous collaborative efforts between visiting and local teams as well as international and national organizations. Standardizing and regulating current practices as well as promoting capacity building initiatives can contribute to sustainable cleft care.
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Affiliation(s)
| | - Rami S Kantar
- Global Smile Foundation, Norwood, MA, USA.,Department of Surgery, 21688University of Maryland Medical System, Baltimore, USA
| | - Serena N Kassam
- Dental and Pre-Surgical Division, Global Smile Foundation, Norwood, MA, USA.,Department of Pediatric Dentistry, New York University College of Dentistry, New York, NY, USA.,Division of Pediatric Dentistry, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Pediatric Dentistry, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Raj M Vyas
- Department of Plastic Surgery, 8788University of California Irvine, Irvine, CA, USA
| | | | - Anthony G Haddad
- Global Smile Foundation, Norwood, MA, USA.,Department of Surgery, Brigham and Women's Hospital, 1811Harvard Medical School, Boston, MA, USA
| | - Usama S Hamdan
- Global Smile Foundation, Norwood, MA, USA.,Otolaryngology, Tufts University School of Medicine, Boston, MA, USA.,Otology and Laryngology, Harvard Medical School, Boston, MA, USA.,Otolaryngology, Boston University School of Medicine, Boston, MA, USA
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16
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Bruneel L, Alighieri C, D'haeseleer E, Kissel I, Adriaansen A, Sseremba D, Van Lierde K. Reliability results of perceptual ratings of resonance, nasal airflow and speech acceptability in patients with cleft palate by Ugandan speech-language pathologists following a two-day workshop. Int J Pediatr Otorhinolaryngol 2020; 136:110191. [PMID: 32593063 DOI: 10.1016/j.ijporl.2020.110191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION To meet the scarcity of training and/or educational initiatives in Uganda regarding state-of-the-art speech diagnosis and treatment in patients with cleft palate, a workshop was organized for all interested speech-language pathologists and health care workers. OBJECTIVE To evaluate and compare the inter- and intra-rater reliability of the perceptual evaluation of hypernasality, hyponasality, nasal emission, nasal turbulence and speech acceptability before and after a two-day workshop in Ugandan speech-language pathologists. METHODS On the first day, perceptual speech evaluation was discussed and practiced. Perceptual exercises included individual ratings of a specific speech variable followed by a group discussion and consensus listening exercises in listener pairs. The second day focused on speech treatment. Ten Ugandan speech-language pathologists rated speech samples of Ugandan patients with a CP ± L before and immediately following the two-day workshop. Inter- and intra-rater reliability of the perceptual ratings of hypernasality, hyponasality, nasal emission, nasal turbulence and speech acceptability were determined by means of the absolute percentage of agreement. The Wilcoxon signed-rank test was used to compare results at both time points. RESULTS Overall inter- and intra-rater reliability improved when observing the absolute percentage agreement. However, median agreement results only showed enhanced reliability for hypernasality, hyponasality and nasal turbulence whereas (limited) deteriorated reliability was observed for nasal emission and speech acceptability. Regarding inter-rater reliability only the median percentage agreement for hyponasality exceeded 50% (median: 56.3%). Overall, better results were found for intra-rater reliability, with only weak results for speech acceptability. DISCUSSION AND CONCLUSION Training positively affected reliability results. Nonetheless, this improvement was not achieved for each speech variable and reliability improvements were modest. Findings indicate the need for continued training and the search for the most effective training paradigm and feedback techniques, whilst taking into account clinical relevance and practical considerations.
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Affiliation(s)
- Laura Bruneel
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10 2P1, 9000, Ghent, Belgium.
| | - Cassandra Alighieri
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10 2P1, 9000, Ghent, Belgium
| | - Evelien D'haeseleer
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10 2P1, 9000, Ghent, Belgium
| | - Imke Kissel
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10 2P1, 9000, Ghent, Belgium
| | - Anke Adriaansen
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10 2P1, 9000, Ghent, Belgium
| | - Daniel Sseremba
- Comprehensive Rehabilitation Services in Uganda (CoRSU) Hospital, P.O. Box 46, Kisubi, Uganda
| | - Kristiane Van Lierde
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10 2P1, 9000, Ghent, Belgium
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Kantar RS, Breugem CC, Keith K, Kassam S, Vijayakumar C, Bow M, Alfonso AR, Chahine EM, Ghotmi LH, Patel KG, Shetye PR, Santiago PE, Losee JE, Steinbacher DM, Rossell-Perry P, Garib DG, Alonso N, Mann RJ, Prada-Madrid JR, Esenlik E, Pamplona MDC, Collares MVM, Bennun RD, Kummer A, Giugliano C, Padwa BL, Raposo-Amaral CE, Tse R, Sommerlad B, Flores RL, Hamdan US. Simulation-Based Comprehensive Cleft Care Workshops: A Reproducible Model for Sustainable Education. Cleft Palate Craniofac J 2020; 57:1238-1246. [PMID: 32729337 DOI: 10.1177/1055665620944781] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Evaluate simulation-based comprehensive cleft care workshops as a reproducible model for education with sustained impact. DESIGN Cross-sectional survey-based evaluation. SETTING Simulation-based comprehensive cleft care workshop. PARTICIPANTS Total of 180 participants. INTERVENTIONS Three-day simulation-based comprehensive cleft care workshop. MAIN OUTCOME MEASURES Number of workshop participants stratified by specialty, satisfaction with the workshop, satisfaction with simulation-based workshops as educational tools, impact on cleft surgery procedural confidence, short-term impact on clinical practice, medium-term impact on clinical practice. RESULTS The workshop included 180 participants from 5 continents. The response rate was 54.5%, with participants reporting high satisfaction with all aspects of the workshop and with simulation-based workshops as educational tools. Participants reported a significant improvement in cleft lip (33.3 ± 5.7 vs 25.7 ± 7.6; P < .001) and palate (32.4 ± 7.1 vs 23.7 ± 6.6; P < .001) surgery procedural confidence following the simulation sessions. Participants also reported a positive short-term and medium-term impact on their clinical practices. CONCLUSION Simulation-based comprehensive cleft care workshops are well received by participants, lead to improved cleft surgery procedural confidence, and have a sustained positive impact on participants' clinical practices. Future efforts should focus on evaluating and quantifying this perceived positive impact, as well reproducing these efforts in other areas of need.
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Affiliation(s)
- Rami S Kantar
- Global Smile Foundation, Norwood, MA, USA
- Department of Surgery, The University of Maryland Medical System, Baltimore, MD, USA
| | - Corstiaan C Breugem
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | | | - Serena Kassam
- Global Smile Foundation, Norwood, MA, USA
- Department of Pediatric Dentistry, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Charanya Vijayakumar
- Cleft and Craniofacial Center, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
| | | | - Allyson R Alfonso
- Global Smile Foundation, Norwood, MA, USA
- The Hansjörg Department of Plastic Surgery, New York University Langone Health, New York City, NY, USA
| | | | | | - Krishna G Patel
- Global Smile Foundation, Norwood, MA, USA
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Pradip R Shetye
- The Hansjörg Department of Plastic Surgery, New York University Langone Health, New York City, NY, USA
| | | | - Joseph E Losee
- Department of Plastic Surgery, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, PA, USA
| | - Derek M Steinbacher
- Division of Plastic Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Percy Rossell-Perry
- Edgardo Rebagliati Hospital ESSALUD and San Martin de Porres University, Lima, Peru
| | - Daniela G Garib
- Department of Orthodontics, Bauru Dental School and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Nivaldo Alonso
- Department of Plastic Surgery, University of São Paulo, São Paulo, Brazil
| | - Robert J Mann
- Division of Pediatric Plastic Surgery, Spectrum Health Medical Group, Michigan State College of Human Medicine, Grand Rapids, MI, USA
| | - Jose Rolando Prada-Madrid
- Department of Plastic and Reconstructive Surgery, Hospital Infantil Universitario de San José, Bogotá, Colombia
| | - Elçin Esenlik
- Department of Orthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - María Del Carmen Pamplona
- Hablarte e Integrarte, AC, Cleft Palate Clinic, Hospital Gea Gonzalez and Universidad San Sebastián, Mexico City, Mexico
| | - Marcus Vinícius Martins Collares
- Plastic and Craniomaxillofacial Surgery Division, School of Medicine, Rio Grande do Sul Federal University, Porto Alegre, Brazil
| | - Ricardo D Bennun
- Asociacion PIEL and School of Medicine, National University of Buenos Aires, Buenos Aires, Argentina
| | - Ann Kummer
- Division of Speech-Language Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Carlos Giugliano
- Plastic Surgery Unit, Alfredo Gantz Mann Foundation, and Clínica Alemana, Santiago, Chile
| | - Bonnie L Padwa
- Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Raymond Tse
- University of Washington and Seattle Children's Hospital, Seattle, WA, USA
| | - Brian Sommerlad
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Roberto L Flores
- The Hansjörg Department of Plastic Surgery, New York University Langone Health, New York City, NY, USA
| | - Usama S Hamdan
- Global Smile Foundation, Norwood, MA, USA
- Otology and Laryngology, Harvard Medical School, Boston, MA, USA
- Otolaryngology, Tufts University School of Medicine, Boston, MA, USA
- Otolaryngology, Boston University School of Medicine, MA, USA
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18
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Kantar RS, Alfonso AR, Ramly EP, Diaz-Siso JR, Breugem CC, Flores RL. Simulation in Cleft Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2438. [PMID: 31942398 PMCID: PMC6908384 DOI: 10.1097/gox.0000000000002438] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 07/12/2019] [Indexed: 11/25/2022]
Abstract
A number of digital and haptic simulators have been developed to address challenges facing cleft surgery education. However, to date, a comprehensive review of available simulators has yet to be performed. Our goal is to appraise cleft surgery simulators that have been described to date, their role within a simulation-based educational strategy, the costs associated with their use, and data supporting or refuting their utility.
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Affiliation(s)
- Rami S Kantar
- The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Allyson R Alfonso
- The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Elie P Ramly
- The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - J Rodrigo Diaz-Siso
- The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Corstiaan C Breugem
- Department of Plastic and Reconstructive Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Roberto L Flores
- The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
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