Accuracy of Cutaneous Landmarks Compared to Ultrasound to Locate the Calcaneal Footprint of the CFL

The purpose was to determine the accuracy of the techniques of Lopes et al. and Michels et al., compared to ultrasound, to locate the center of the calcaneal footprint of the CFL in healthy volunteers. The authors recruited 17 healthy adult volunteers at 1 center with no current ankle pathologies and no previous surgical antecedents on either ankle. The authors recorded the age, sex, height, BMI, and ankle side for each volunteer. Measurements were made on both ankles of the 17 volunteers to increase the sample size and ensure less dispersion of data, independently by 2 surgeons: 1 senior surgeon with 15 years' experience and 1 junior with 3 years' experience. The location of the center of the calcaneal footprint of the CFL was determined by each surgeon using 3 methods: (1) the cutaneous technique of Lopes et al., (2) the cutaneous technique of Michels et al., and (3) ultrasound imaging. The 17 volunteers (34 feet) had a mean age of 26.3 ± 8.7 and a BMI of 21.7 ± 2.9. The Michels point was significantly closer (4.6 ± 3.7 mm) than the Lopes point (11.1 ± 5.4 mm) to the true center of the calcaneal footprint of the CFL determined by ultrasound, notably in the vertical direction. The Michels point was located significantly closer to the true center of the calcaneal footprint of the CFL and demonstrated less dispersion than the Lopes point, indicated by significantly lower absolute mean deviation from the true center of the calcaneal footprint of the CFL, and that ultrasound is therefore preferred to locate the footprint the CFL.

Continuous Instrument Tracking in a Cerebral Corticectomy Ex Vivo Calf Brain Simulation Model: Face and Content Validation

BACKGROUND AND OBJECTIVES

Subpial corticectomy involving complete lesion resection while preserving pial membranes and avoiding injury to adjacent normal tissues is an essential bimanual task necessary for neurosurgical trainees to master. We sought to develop an ex vivo calf brain corticectomy simulation model with continuous assessment of surgical instrument movement during the simulation. A case series study of skilled participants was performed to assess face and content validity to gain insights into the utility of this training platform, along with determining if skilled and less skilled participants had statistical differences in validity assessment.

METHODS

An ex vivo calf brain simulation model was developed in which trainees performed a subpial corticectomy of three defined areas. A case series study assessed face and content validity of the model using 7-point Likert scale questionnaires.

RESULTS

Twelve skilled and 11 less skilled participants were included in this investigation. Overall median scores of 6.0 (range 4.0-6.0) for face validity and 6.0 (range 3.5-7.0) for content validity were determined on the 7-point Likert scale, with no statistical differences between skilled and less skilled groups identified.

CONCLUSION

A novel ex vivo calf brain simulator was developed to replicate the subpial resection procedure and demonstrated face and content validity.

COMPARING THE EFFICIENCY OF A REAL-TIME ARTIFICIAL INTELLIGENCE INSTRUCTOR TO HUMAN EXPERT INSTRUCTORS IN SIMULATED SURGICAL TECHNICAL SKILLS TRAINING– A RANDOMIZED CONTROLLED TRIAL

BTFC travel award recipient

Artificial intelligence systems provide risk-free training on realistically simulated patient cases and objective assessment of surgical technical skills. This randomized controlled study compared a real-time intelligent tutoring system in technical skills learning with human expert instructor-mediated training.

METHODS: Ninety-eight medical students performed six simulated brain tumor resections. Participants were randomly allocated into (1)no-real-time feedback, (2)real-time intelligent instruction, and (3)in- person human instruction. All students performed the first repetition without receiving feedback (baseline). Group-1 received visual feedback only after each procedure based on expert benchmarks. Group-2 was instructed by the intelligent system in real-time. After each task, the students were shown their error-video clips generated by this system alongside expert-level demonstrations on how to improve. Group-3 was instructed by human instructors during the tasks. After each task, instructors summarized the areas of improvement and demonstrated correction techniques. Participant performance was scored by the intelligent system and also by blinded experts using OSATS scores. The performance score was compared within groups and between groups to compare learning. RESULTS: Compared to baseline performance, Group-2 and Group-3 significantly improved in the performance score by the third and second repetition, respectively (p<0.01, p=0.01). The between-groups comparison demonstrated that Group-2 scored significantly higher than Group-3 in the fifth repetition (p<0.01). Group-2 achieved significantly higher OSATS scores than Group-1 in the sixth task. CONCLUSIONS: Artificial intelligence may facilitate trainee learning by providing equally or more efficient learning when compared to human instruction. These systems may aid in developing competency-based standardized curricula in surgical training.

Sustaining global partnerships for simulation integration: lessons from the field

AIM

A reciprocal partnership between two World Health Organization Collaborating Centers in the Americas region aimed to strengthen nursing and midwifery education through innovative integration of high-fidelity simulation.

METHODS/IMPLEMENTATION

Immersion of a visiting scholar in six-week training within a North American nursing school (host) solidified simulation champion designation, upon return at the home institution. Next, two expert nursing faculty implemented a train-the-trainer simulation course on-site. Following evaluation and virtual debriefing, a midwifery faculty visited the host institution for second-round training.

CONCLUSION

This ongoing program targets faculty development needs through a strong academic partnership, built upon global awareness and sustainable engagement.