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Chatziisaak D, Sparn M, Krstic D, Bauci G, Warschkow R, Brunner W, Schmied B, Hahnloser D, Bischofberger S. Be prepared! Impact of structured video-assisted coaching on performance in a simulated bleeding exercise during laparoscopic surgery. Surg Endosc 2024:10.1007/s00464-024-11173-3. [PMID: 39187730 DOI: 10.1007/s00464-024-11173-3] [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: 05/28/2024] [Accepted: 08/05/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Bleeding during laparoscopic surgery is stressful and requires immediate efficient management. Skills for complication management are rarely trained. This study aims to investigate the impact of video-assisted coaching on laparoscopic skills acquisition and performance in emergency bleeding situations. METHODS Participants faced simulated emergency scenarios during laparoscopy involving bleeding management in porcine aorta/kidney specimens. Four sequences were conducted over two days, with a structured video-assisted coaching provided between sequences. Performance was assessed using the Global Operative Assessment of Laparoscopic Skills (GOALS) score. The study involved 27 participants attending the advanced colorectal surgery module at the 40th Annual Davos Course in 2023. RESULTS 54 video sequences were analyzed. Structured video-assisted coaching improved the GOALS sum score by 0.36 (95%CI: 0.21-0.50, P < 0.001) in contrast to simple repetition (0.05 with 95%CI: -0.43 to 0.53, P = 0.826). This association was observed for depth of perception (P < 0.001), bimanual dexterity (P < 0.001), tissue handling (P < 0.001), overall performance (P < 0.001), and efficiency (P < 0.001). Autonomy did not significantly improve (P = 0.55). Findings were consistent regardless of age, gender, and overall laparoscopic experience of the participants. However, a weaker effect of structured video-assisted coaching was observed in participants with experience in laparoscopic surgery. CONCLUSION Structured video-assisted coaching improved performance in laparoscopic skills in complex and stress-inducing bleeding scenarios. The findings of this study support the incorporation of video-assisted coaching and complication management exercises into surgical training curricula.
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Affiliation(s)
- Dimitrios Chatziisaak
- Department of Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
- Department of Visceral Surgery, University Hospital Lausanne, Lausanne, Switzerland
| | - Moritz Sparn
- Department of Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Daniel Krstic
- Department of Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Gabriele Bauci
- Department of Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Réne Warschkow
- Department of Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Walter Brunner
- Department of Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
- Paracelsus Medical University, Salzburg, Austria
| | - Bruno Schmied
- Department of Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Dieter Hahnloser
- Department of Visceral Surgery, University Hospital Lausanne, Lausanne, Switzerland.
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Koch M, Günster SA, Widder A, Seyfried F, Germer CT, Backhaus J, König S, Lock JF. Improved Learning Gain in Medical Students by Using Animated Whiteboard-Videos in Comparison to Textbooks in Surgery. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241262684. [PMID: 38882026 PMCID: PMC11179544 DOI: 10.1177/23821205241262684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 04/18/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Animated videos have become popular in teaching medical students, although there is a certain lack of evidence concerning its efficacy. Surgery seems to be an ideal field for its application, since animations are very helpful to understand anatomic structures and complex procedures. The aim of this study was to investigate the effects of animated videos compared to textbooks on learning gain. METHODS A prospective 2-arm cohort study with 5th-year medical students was conducted during their 2-week surgical training module. The initial cohort of students received textbook sections on 3 major topics in visceral surgery as learning medium (text cohort). During the following semester, the second cohort of students received 3 animated whiteboard videos (animated videos) containing equivalent content (video cohort). All participants completed a multiple-choice test consisting of 15 questions on the learning content at baseline (pre-test) and after the learning period (post-test) and answered an additional evaluation questionnaire. RESULTS Both cohorts were similar in their descriptive data and demonstrated significant learning gain during the 2-week learning period. The video cohort achieved better results (80% vs 73% correct answers; P = .028) and a higher learning gain (17% vs 11%; P = .034) in the post-test compared to the text cohort. The estimated learning time was longer in the video cohort (62 min vs 37 min; P < .001) and watching the videos resulted in higher learning gain (21% vs 6%; P < .001). Subgroups with higher learning gain by video learning were female gender (20% vs 11%; P = .040), native German speakers (18% vs 11%; P = .009), students without prior surgical experience (19% vs 12%; P = .033) and those undecided concerning a surgical career (22% vs 9%; P = .020). Interestingly, "low digital orientation" students benefited from videos (22% vs 13%; P = .021), whereas "high digital orientation" students did not. CONCLUSIONS Animated videos increase medical students' learning gain and interest in surgery.
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Affiliation(s)
- Markus Koch
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University of Würzburg, Würzburg, Germany
| | - Simone A Günster
- Department of Pediatric Surgery, University Medical Center Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Anna Widder
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Florian Seyfried
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Christoph-Thomas Germer
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Joy Backhaus
- Institute for Medical Teaching and Medical Educational Research, University Würzburg, Wurzburg, Germany
| | - Sarah König
- Institute for Medical Teaching and Medical Educational Research, University Würzburg, Wurzburg, Germany
| | - Johan F Lock
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Würzburg, Würzburg, Germany
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Palvia V, Huntly J, Seckin S, Ascher-Walsh C, Khalil S. Role of video self-assessment in laparoscopic simulation training: a randomized pilot trial. AJOG GLOBAL REPORTS 2023; 3:100224. [PMID: 37342469 PMCID: PMC10277594 DOI: 10.1016/j.xagr.2023.100224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Residency programs have implemented simulation training to compensate for reduced operating room exposure. Video recording is an educational tool that can be utilized for coaching, telepresence, and self-assessment during simulation training. Data is limited on the utility of video recording and self-assessment for laparoscopic training in Ob/Gyn residency programs.. OBJECTIVE This study aimed to determine the role of video self-assessment as an educational tool in laparoscopic simulation training and to establish the feasibility of our study design for a larger randomized controlled trial. STUDY DESIGN This was a prospective pilot study with a parallel, randomized, trial design that occurred in the Department of Obstetrics and Gynecology at the Mount Sinai Hospital. Subject participation took place in a surgical simulation training room. A total of 23 subjects were recruited (7 medical students, 15 residents, 1 fellow) voluntarily. All participants completed the study. All the subjects completed a pretest survey. The surgical simulation room contained a single Fundamentals of Laparoscopic Surgery box trainer and video-recording station. For session #1, each participant performed 2 Fundamentals of Laparoscopic Surgery tasks (A, peg transfer; B, intracorporeal knot tie). Participants were video recorded during session #1 and were randomized to either receive or not receive their video recording. The video group (n=13) and control group (n=10) repeated the Fundamentals of Laparoscopic Surgery tasks 7 to 10 days later (session #2). The primary outcome was percentage change in completion time between sessions. Secondary outcomes were percentage change in peg and needle drops between sessions. RESULTS The participant characteristics (video vs control) were as follows: average training level (6.15 vs 4.90 years), self-assessment (1=poor, 10=excellent) of surgical skill (4.8 vs 3.7), and laparoscopic skill (4.4 vs 3.5). Training level was inversely correlated with completion time for tasks A and B (r, -0.79 and -0.87; P<.0001). Less experienced trainees required the maximum time allotted for each task in session #1 (A, 3; B, 13). Regarding the primary outcome, the video group improved less than the control group (A, 16.7% vs 28.3%; B, 14.4% vs 17.3%). After controlling for training level (residents only), the video group improved more in the primary outcome (A, 17% vs 7.4%; B, 20.9% vs 16.5%) and secondary outcomes (A, 0.0% vs -194.1%; B, 41.3% vs 37.6%). CONCLUSION Video self-assessment has a potential role in simulation training for obstetrics-gynecology residents. With key improvements, the feasibility of our study design was demonstrated in preparation for a future definitive trial.
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Affiliation(s)
- Vijay Palvia
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, Manhattan, NY (Drs Palvia, Huntly, Seckin, Ascher-Walsh, and Khalil)
- Department of Obstetrics and Gynecology, Lincoln Hospital, Bronx, NY (Dr Palvia)
| | - Jaimie Huntly
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, Manhattan, NY (Drs Palvia, Huntly, Seckin, Ascher-Walsh, and Khalil)
| | - Serin Seckin
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, Manhattan, NY (Drs Palvia, Huntly, Seckin, Ascher-Walsh, and Khalil)
| | - Charles Ascher-Walsh
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, Manhattan, NY (Drs Palvia, Huntly, Seckin, Ascher-Walsh, and Khalil)
| | - Susan Khalil
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, Manhattan, NY (Drs Palvia, Huntly, Seckin, Ascher-Walsh, and Khalil)
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Hecker A, Nischwitz SP, Petritsch J, Holzer-Geissler JCJ, Draschl A, Wegscheider T, Lumenta DB. Undergraduate Skills Training in Pandemic Times: Where Is the Future of Medical Education? Eur J Investig Health Psychol Educ 2023; 13:1219-1228. [PMID: 37504481 PMCID: PMC10377890 DOI: 10.3390/ejihpe13070090] [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: 05/14/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic forced medical programs to rapidly switch to remote teaching from scratch, impacting hands-on skills training. This study compared the efficacy of a hybrid online format to a regular in-person session for a mandatory surgical skills class. METHODS Third-year undergraduate medical students attending the surgical skills class in the winter semester of 2020/21 at the Medical University of Graz were randomly assigned to either the hybrid or in-person class, depending on their course schedule and government regulations. The hybrid class involved online videos, one-on-one peer tutoring, and an Objective Structured Clinical Examination (OSCE). Pre- and post-class self-assessments were conducted to evaluate their theoretical and practical knowledge of a single interrupted suture. RESULTS The study included 85 students in the regular in-person class and 50 in the hybrid class. A pre-class assessment revealed higher self-assessments in the hybrid class for theoretical and practical knowledge, but a post-class assessment showed no significant difference. The advantages and disadvantages of both modalities were identified, providing valuable insights for future curriculum development. CONCLUSIONS Both teaching modes were effective for undergraduate surgical skills training. This study recommends implementing positive aspects of both the hybrid and in-person formats while recognizing their respective limitations.
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Affiliation(s)
- Andrzej Hecker
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria (D.B.L.)
- Research Unit for Digital Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria
| | - Sebastian P. Nischwitz
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria (D.B.L.)
- Research Unit for Digital Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria
| | - Johanna Petritsch
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria (D.B.L.)
| | - Judith C. J. Holzer-Geissler
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria (D.B.L.)
| | - Alexander Draschl
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria (D.B.L.)
| | - Thomas Wegscheider
- Clinical Skills Center (CSC), Medical University of Graz, 8036 Graz, Austria
| | - David Benjamin Lumenta
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria (D.B.L.)
- Research Unit for Digital Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria
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Mao BP, Teichroeb ML, Lee T, Wong G, Pang T, Pleass H. Is Online Video-Based Education an Effective Method to Teach Basic Surgical Skills to Students and Surgical Trainees? A Systematic Review and Meta-analysis. JOURNAL OF SURGICAL EDUCATION 2022; 79:1536-1545. [PMID: 35933308 PMCID: PMC9356715 DOI: 10.1016/j.jsurg.2022.07.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 07/13/2022] [Indexed: 05/11/2023]
Abstract
BACKGROUND Online education has been increasingly utilized over the past decades. The COVID-19 pandemic accelerated the transition of conventional face-to-face curricula to online platforms, with limited evidence for its teaching efficacy. This systematic review aims to assess the effectiveness of online video-based education compared with standard conventional education in teaching basic surgical skills to surgical trainees and students undergoing medical training. METHODS We performed a literature search in Embase, Medline, Cochrane CENTRAL and Scopus from inception until February 2022. Studies included were randomised controlled trials (RCTs) and observational studies. We included randomised controlled trials only for meta-analysis. The primary outcome was surgical skill proficiency. The secondary outcomes were participant perception, confidence and satisfaction. Two authors independently assessed the search results for eligibility, extracted the data and assessed the risk of bias using the Cochrane Risk of Bias tool 2. Where appropriate, we performed random effects meta-analyses of the pooled study data to calculate a standardized mean difference. RESULTS A total of 11 studies met the inclusion criteria totaling 715 participants; 603 were included in qualitative analysis and 380 in meta-analysis. All included studies were assessed as having a low risk of bias. The majority of studies found no significant difference between conventional and video-based education in teaching basic surgical skills, three studies found video-based education was superior and one study found conventional education was superior. There was no statistically significant difference in skill proficiency between the two groups (standardized mean difference of -0.02 (95% CI: -0.34, 0.30); p=0.90). Video-based education results in an equivalent improvement in confidence and satisfaction rates. Additional benefits of video-based education include convenience, accessibility and efficiency. CONCLUSIONS Basic surgical skills can be taught as effectively through online video-based education as conventional teaching methods. Online education should be utilized as an adjunct to medical curricula beyond the COVID-19 era.
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Affiliation(s)
- B P Mao
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - M L Teichroeb
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - T Lee
- Department of Surgery, Westmead Hospital, Sydney, NSW, Australia
| | - G Wong
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Centre for Transplant and Renal Research, Westmead Hospital, Sydney, NSW, Australia
| | - T Pang
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Surgery, Westmead Hospital, Sydney, NSW, Australia
| | - H Pleass
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Surgery, Westmead Hospital, Sydney, NSW, Australia
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6
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Chao YP, Chuang HH, Hsin LJ, Kang CJ, Fang TJ, Li HY, Huang CG, Kuo TBJ, Yang CCH, Shyu HY, Wang SL, Shyu LY, Lee LA. Using a 360° Virtual Reality or 2D Video to Learn History Taking and Physical Examination Skills for Undergraduate Medical Students: Pilot Randomized Controlled Trial. JMIR Serious Games 2021; 9:e13124. [PMID: 34813485 PMCID: PMC8663656 DOI: 10.2196/13124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 04/02/2020] [Accepted: 09/10/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Learning through a 360° virtual reality (VR) or 2D video represents an alternative way to learn a complex medical education task. However, there is currently no consensus on how best to assess the effects of different learning materials on cognitive load estimates, heart rate variability (HRV), outcomes, and experience in learning history taking and physical examination (H&P) skills. OBJECTIVE The aim of this study was to investigate how learning materials (ie, VR or 2D video) impact learning outcomes and experience through changes in cognitive load estimates and HRV for learning H&P skills. METHODS This pilot system-design study included 32 undergraduate medical students at an academic teaching hospital. The students were randomly assigned, with a 1:1 allocation, to a 360° VR video group or a 2D video group, matched by age, sex, and cognitive style. The contents of both videos were different with regard to visual angle and self-determination. Learning outcomes were evaluated using the Milestone reporting form. Subjective and objective cognitive loads were estimated using the Paas Cognitive Load Scale, the National Aeronautics and Space Administration Task Load Index, and secondary-task reaction time. Cardiac autonomic function was assessed using HRV measurements. Learning experience was assessed using the AttrakDiff2 questionnaire and qualitative feedback. Statistical significance was accepted at a two-sided P value of <.01. RESULTS All 32 participants received the intended intervention. The sample consisted of 20 (63%) males and 12 (38%) females, with a median age of 24 (IQR 23-25) years. The 360° VR video group seemed to have a higher Milestone level than the 2D video group (P=.04). The reaction time at the 10th minute in the 360° VR video group was significantly higher than that in the 2D video group (P<.001). Multiple logistic regression models of the overall cohort showed that the 360° VR video module was independently and positively associated with a reaction time at the 10th minute of ≥3.6 seconds (exp B=18.8, 95% CI 3.2-110.8; P=.001) and a Milestone level of ≥3 (exp B=15.0, 95% CI 2.3-99.6; P=.005). However, a reaction time at the 10th minute of ≥3.6 seconds was not related to a Milestone level of ≥3. A low-frequency to high-frequency ratio between the 5th and 10th minute of ≥1.43 seemed to be inversely associated with a hedonic stimulation score of ≥2.0 (exp B=0.14, 95% CI 0.03-0.68; P=.015) after adjusting for video module. The main qualitative feedback indicated that the 360° VR video module was fun but caused mild dizziness, whereas the 2D video module was easy to follow but tedious. CONCLUSIONS Our preliminary results showed that 360° VR video learning may be associated with a better Milestone level than 2D video learning, and that this did not seem to be related to cognitive load estimates or HRV indexes in the novice learners. Of note, an increase in sympathovagal balance may have been associated with a lower hedonic stimulation score, which may have met the learners' needs and prompted learning through the different video modules. TRIAL REGISTRATION ClinicalTrials.gov NCT03501641; https://clinicaltrials.gov/ct2/show/NCT03501641.
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Affiliation(s)
- Yi-Ping Chao
- Department of Computer Science and Information Engineering, Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan.,Department of Neurology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Hai-Hua Chuang
- Department of Family Medicine, Chang Gung Memorial Hospital, Taipei Branch & Linkou Main Branch, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Li-Jen Hsin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Chung-Jan Kang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Tuan-Jen Fang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Hsueh-Yu Li
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Chung-Guei Huang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan.,Department of Medical Biotechnology and Laboratory Science, Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Terry B J Kuo
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cheryl C H Yang
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsin-Yih Shyu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Educational Technology, Tamkang University, New Taipei, Taiwan
| | - Shu-Ling Wang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Center of Teacher Education, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Liang-Yu Shyu
- Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan, Taiwan
| | - Li-Ang Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan.,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Koka A, Suppan M, Carrera E, Fraga-Freijeiro P, Massuk K, Imbeault ME, Missilier Perruzzo N, Achab S, Salerno A, Strambo D, Michel P, Stuby L, Suppan L. Knowledge Retention of the NIH Stroke Scale among Stroke Unit Health Care Workers Using Video vs. E-Learning: Protocol for a Web-Based, Randomized Controlled Trial. Healthcare (Basel) 2021; 9:healthcare9111460. [PMID: 34828505 PMCID: PMC8620278 DOI: 10.3390/healthcare9111460] [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] [Received: 09/22/2021] [Revised: 10/20/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022] Open
Abstract
The National Institutes of Health Stroke Scale (NIHSS) is commonly used to triage and monitor the evolution of stroke victims. Data regarding NIHSS knowledge in nurses and physicians working with stroke patients are scarce, and a progressive decline in specific knowledge regarding this challenging scale is to be expected even among NIHSS certified personnel. This protocol was designed according to the CONSORT-eHealth (Consolidated Standards of Reporting Trials) guidelines. It describes the design of a randomized controlled trial whose primary objective is to determine if nurses and physicians who work in stroke units improve their NIHSS knowledge more significantly after following a highly interactive e-learning module than after following the traditional didactic video. Univariate and multivariable linear regression will be used to analyze the primary outcome, which will be the difference between the score on a 50-question quiz answered before and immediately after following the allocated learning material. Secondary outcomes will include knowledge retention at one month, assessed using the same 50-question quiz, user satisfaction, user course duration perception, and probability of recommending the allocated learning method. The study is scheduled to begin during the first semester of 2022.
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Affiliation(s)
- Avinash Koka
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, 1211 Geneva, Switzerland
- Correspondence: (A.K.); (L.S.)
| | - Mélanie Suppan
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, 1211 Geneva, Switzerland;
| | - Emmanuel Carrera
- Stroke Center, Department of Neurology, Geneva University Hospitals and Faculty of Medicine University of Geneva, 1211 Geneva, Switzerland; (E.C.); (N.M.P.)
| | - Paula Fraga-Freijeiro
- Stroke Center, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital, 1011 Lausanne, Switzerland; (P.F.-F.); (K.M.); (M.-E.I.); (A.S.); (D.S.); (P.M.)
| | - Kiril Massuk
- Stroke Center, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital, 1011 Lausanne, Switzerland; (P.F.-F.); (K.M.); (M.-E.I.); (A.S.); (D.S.); (P.M.)
| | - Marie-Eve Imbeault
- Stroke Center, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital, 1011 Lausanne, Switzerland; (P.F.-F.); (K.M.); (M.-E.I.); (A.S.); (D.S.); (P.M.)
| | - Nathalie Missilier Perruzzo
- Stroke Center, Department of Neurology, Geneva University Hospitals and Faculty of Medicine University of Geneva, 1211 Geneva, Switzerland; (E.C.); (N.M.P.)
| | - Sophia Achab
- Specialized Facility in Behavioral Addictions ReConnecte HUG, 1211 Geneva, Switzerland;
- WHO Collaborating Center in Training and Research in Mental Health, UniGe, 1211 Geneva, Switzerland
| | - Alexander Salerno
- Stroke Center, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital, 1011 Lausanne, Switzerland; (P.F.-F.); (K.M.); (M.-E.I.); (A.S.); (D.S.); (P.M.)
| | - Davide Strambo
- Stroke Center, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital, 1011 Lausanne, Switzerland; (P.F.-F.); (K.M.); (M.-E.I.); (A.S.); (D.S.); (P.M.)
| | - Patrik Michel
- Stroke Center, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital, 1011 Lausanne, Switzerland; (P.F.-F.); (K.M.); (M.-E.I.); (A.S.); (D.S.); (P.M.)
| | - Loric Stuby
- Genève TEAM Ambulances, Emergency Medical Services, 1201 Geneva, Switzerland;
| | - Laurent Suppan
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, 1211 Geneva, Switzerland
- Correspondence: (A.K.); (L.S.)
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8
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Tejos R, Crovari F, Achurra P, Avila R, Inzunza M, Jarry C, Martinez J, Riquelme A, Alseidi A, Varas J. Video-Based Guided Simulation without Peer or Expert Feedback is Not Enough: A Randomized Controlled Trial of Simulation-Based Training for Medical Students. World J Surg 2020; 45:57-65. [PMID: 32892271 DOI: 10.1007/s00268-020-05766-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Feedback is a pivotal cornerstone and a challenge in psychomotor training. There are different teaching methodologies; however, some may be less effective. METHODS A prospective randomized controlled trial was conducted in 130 medical students to compare the effectiveness of the video-guided learning (VLG), peer-feedback (PFG) and the expert feedback (EFG) for teaching suturing skills. The program lasted 4 weeks. Students were recorded making 3-simple stitches (pre-assessment and post-assessment). The primary outcome was a global scale (OSATS). The secondary outcomes were performance time, specific rating scale (SRS) and the impact of the intervention (IOI), defined as the variation between the final and initial OSATS and SRS scores. RESULTS No significant differences were found between PFG and EFG in post-assessment results of OSATS, SRS scores or in the IOI for OSATS and SRS scores. Post-assessment results of PFG and EFG were significantly superior to VLG in OSATS and SRS scores [(19.8 (18.5-21); 16.6 (15.5-17.5)) and (20.3 (19.88-21); 16.8 (16-17.5)) vs (15.7 (15-16); 13.3 (12.5-14)) (p < 0.05)], respectively. The results of PFG and EFG were significantly superior to VLG in the IOI for OSATS [7 (4.5-9) and 7.4 (4.88-10) vs 3.5 (1.5-6) (p < 0.05)] and SRS scores [5.4 (3.5-7) and 6.3 (4-8.5) vs 3.1 (1.13-4.88) (p < 0.05)], respectively. CONCLUSION The video-guided learning methodology without any kind of feedback is not enough for teaching suturing skills compared to expert or peer feedback. The peer feedback methodology appears to be a viable alternative to handling the emerging demands in medical education.
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Affiliation(s)
- Rodrigo Tejos
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 377, 8330024, Santiago, Chile
| | - Fernando Crovari
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 377, 8330024, Santiago, Chile
| | - Pablo Achurra
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 377, 8330024, Santiago, Chile
| | - Ruben Avila
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 377, 8330024, Santiago, Chile
| | - Martín Inzunza
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 377, 8330024, Santiago, Chile
| | - Cristian Jarry
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 377, 8330024, Santiago, Chile
| | - Jorge Martinez
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 377, 8330024, Santiago, Chile
| | - Arnoldo Riquelme
- Department of Gastroenterology and Centre for Medical Education, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077, Santiago, Chile
| | - Adnan Alseidi
- Department of Surgery, University of California San Francisco, 400 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Julian Varas
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 377, 8330024, Santiago, Chile.
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Augestad KM, Butt K, Ignjatovic D, Keller DS, Kiran R. Video-based coaching in surgical education: a systematic review and meta-analysis. Surg Endosc 2019; 34:521-535. [PMID: 31748927 DOI: 10.1007/s00464-019-07265-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/12/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND In the era of competency-based surgical education, VBC has gained increased attention and may enhance the efficacy of surgical education. The objective of this systematic review was to summarize the existing evidence of video-based coaching (VBC) and compare VBC to traditional master-apprentice-based surgical education. METHODS We performed a systematic review and meta-analysis of randomized controlled trials (RCT) assessing VBC according to the PRISMA and Cochrane guidelines. The MEDLINE, EMBASE, and COCHRANE and Researchgate databases were searched for eligible manuscripts. Standard mean difference (SMD) of performance scoring scales was used to assess the effect of VBC versus traditional training without VBC (control). RESULTS Of 627 studies identified, 24 RCTs were eligible and evaluated. The studies included 778 surgical trainees (n = 386 VBC vs. n = 392 control). 13 performance scoring scales were used to assess technical competence; OSATS-GRS was the most common (n = 15). VBC was provided preoperative (n = 11), intraoperative (n = 1), postoperative (n = 10), and perioperative (n = 2). The majority of studies were unstructured, where identified coaching frameworks were PRACTICE (n = 1), GROW (n = 2) and Wisconsin Coaching Framework (n = 1). There was an effect on performance scoring scales in favor of VBC coaching (SMD 0.87, p < 0.001). In subgroup analyses, the residents had a larger relative effect (SMD 1.13; 0.61-1.65, p < 0.001) of VBC compared to medical students (SMD 0.43, 0.06-0.81, p < 0.001). The greatest source of potential bias was absence of blinding of the participants and personnel (n = 20). CONCLUSION Video-based coaching increases technical performance of medical students and surgical residents. There exist significant study and intervention heterogeneity that warrants further exploration, showing the need to structure and standardize video-based coaching tools.
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Affiliation(s)
- Knut Magne Augestad
- Department of Postgraduate Surgical Education, University Hospital North Norway, Tromsö, Norway. .,Department of GI Surgery, Sandnessjøen Regional Hospital, Sandnessjøen, Norway. .,Division of Colorectal Surgery, Columbia University Medical Center, New York, NY, USA.
| | - Khayam Butt
- Department of GI Surgery, Nordlandssykehuset, Bodø, Norway
| | - Dejan Ignjatovic
- Department of GI Surgery, Akershus University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Deborah S Keller
- Division of Colorectal Surgery, Columbia University Medical Center, New York, NY, USA
| | - Ravi Kiran
- Division of Colorectal Surgery, Columbia University Medical Center, New York, NY, USA
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10
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Hah H, Goldin D. Exploring Care Providers' Perceptions and Current Use of Telehealth Technology at Work, in Daily Life, and in Education: Qualitative and Quantitative Study. JMIR MEDICAL EDUCATION 2019; 5:e13350. [PMID: 31008708 PMCID: PMC6658315 DOI: 10.2196/13350] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/17/2019] [Accepted: 03/24/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND A telehealth technology education curriculum designed to integrate information technology and telecommunication well has great potential to prepare care providers for health care delivery across space, time, and social and cultural barriers. It is important to assess the readiness level of care providers to use and maximize the benefits of telehealth technology in the health care delivery process. Therefore, this study explored care providers' existing experience using technology in various use contexts and compared their familiarity with telehealth technology's relevant features. OBJECTIVE This study's objective was to explore care providers' familiarity with using technology in different settings and their perceptions of telehealth-driven care performance to lay a foundation for the design of an effective telehealth education program. METHODS The study used quantitative and qualitative analyses. The online survey included four items that measured care providers' perceptions of care performance when using telehealth technology. Advanced practice registered nurse students rated each item on a 7-point Likert scale, ranging from 1 ("strongly disagree") to 7 ("strongly agree"). They also responded to three open-ended questions about what kinds of health information technology they use at work, after work, and in their current educational program. RESULTS A total of 109 advanced practice registered nurse students responded to the online survey and open-ended questionnaire. Most indicated that using telehealth technology enhances care performance (mean 5.67, median 6.0, SD 1.36), helps make their care tasks more effective (mean 5.73, median 6.0, SD 1.30), improves the quality of performing care tasks (mean 5.71, median 6.0, SD 1.30), and decreases error in communicating and sharing information with others (mean 5.35, median 6.0, SD 1.53). In addition, our qualitative analyses revealed that the students used the electronic health records technology primarily at work, combined with clinical decision support tools for medication and treatment management. Outside work, they primarily used video-text communication tools and were exposed to some telehealth technology in their education setting. Further, they believe that use of nonhealth technology helps them use health information technology to access health information, confirm their diagnoses, and ensure patient safety. CONCLUSIONS This research highlights the importance of identifying care providers' existing experience of using technology to better design a telehealth technology education program. By focusing explicitly on the characteristics of care providers' existing technology use in work, nonwork, and educational settings, we found a potential consistency between practice and education programs in care providers' requirements for technology use, as well as areas of focus to complement their frequent use of nonhealth technologies that resemble telehealth technology. Health policymakers and practitioners need to provide compatible telehealth education programs tailored to the level of care providers' technological familiarity in both their work and nonwork environments.
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Affiliation(s)
- Hyeyoung Hah
- Department of Information Systems and Business Analytics, Florida International University, Miami, FL, United States
| | - Deana Goldin
- Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, United States
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11
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Mantica G, Pacchetti A, Aimar R, Cerasuolo M, Dotta F, Olivero A, Pini G, Passaretti G, Maffezzini M, Terrone C. Developing a five-step training model for transperineal prostate biopsies in a naïve residents' group: a prospective observational randomised study of two different techniques. World J Urol 2018; 37:1845-1850. [PMID: 30535716 DOI: 10.1007/s00345-018-2599-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 12/04/2018] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To evaluate a five-step training model for transperineal prostate biopsies (TPPB) and the differences in terms of the detection rate (DR) and the ease of execution when using either the "fan technique" (FT) or the use of a Free Hand technique (FH). METHODS A prospective observational randomised study was conducted from September 2015 to November 2017. Six naïve residents, who underwent the same five-steps training model, were randomly subdivided into two different groups of three residents based on the selected TPPB technique: A (FT) and B (FH). Patient characteristics (age, PSA, prostatic volume, DRE, MRI), intraoperative (operative time, number of samples) and postoperative parameters (histologic, pain) were evaluated in the 2 groups. The overall and stratified DR for PSA ranges and prostate volume (PV), operative time and complications were compared. RESULTS The overall detection rate was very high in both groups (FT 58.2% vs FH 59.6%) and not statistically different between the two techniques. There were no differences in terms of complication rates and pain. The FH showed a better detection rate in prostates smaller than 40 cc (p = 0.023) and a faster operative time (p = 0.025) compared to FT. CONCLUSIONS Within the TPPB, FH is associated with a higher detection rate in patients with prostate < 40 cc compared to an FT when performed by inexperienced trainees. Standardised training organised in consecutive steps seems to contribute to the achievement of overall high detection rates with both methods.
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Affiliation(s)
- Guglielmo Mantica
- Department of Urology, Policlinico San Martino Hospital, University of Genova, Largo Rosanna Benzi 10, 16130, Genova, Italy. .,Department of Urology, San Raffaele Turro Hospital, San Raffaele University, Milan, Italy.
| | - Andrea Pacchetti
- Department of Urology, Policlinico San Martino Hospital, University of Genova, Largo Rosanna Benzi 10, 16130, Genova, Italy
| | - Roberta Aimar
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Mattia Cerasuolo
- Department of Urology, Policlinico San Martino Hospital, University of Genova, Largo Rosanna Benzi 10, 16130, Genova, Italy
| | - Federico Dotta
- Department of Urology, Policlinico San Martino Hospital, University of Genova, Largo Rosanna Benzi 10, 16130, Genova, Italy
| | - Alberto Olivero
- Department of Urology, Policlinico San Martino Hospital, University of Genova, Largo Rosanna Benzi 10, 16130, Genova, Italy
| | - Giovannalberto Pini
- Department of Urology, San Raffaele Turro Hospital, San Raffaele University, Milan, Italy
| | - Giovanni Passaretti
- Department of Urology, San Raffaele Turro Hospital, San Raffaele University, Milan, Italy
| | - Massimo Maffezzini
- Department of Urology, Policlinico San Martino Hospital, University of Genova, Largo Rosanna Benzi 10, 16130, Genova, Italy
| | - Carlo Terrone
- Department of Urology, Policlinico San Martino Hospital, University of Genova, Largo Rosanna Benzi 10, 16130, Genova, Italy
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