WorldWideScience

Sample records for surgery training part

  1. Body Parts Removed during Surgery: A Useful Training Source

    Science.gov (United States)

    Macchi, Veronica; Porzionato, Andrea; Stecco, Carla; Tiengo, Cesare; Parenti, Anna; Cestrone, Adriano; De Caro, Raffaele

    2011-01-01

    Current undergraduate medical curricula provides relatively little time for cadaver dissection. The Department of Human Anatomy and Physiology at the University of Padova has organized a pilot project with the University Hospital for the donation of body parts that are surgically removed for therapeutic purposes and destined under Italian law for…

  2. Body Parts Removed during Surgery: A Useful Training Source

    Science.gov (United States)

    Macchi, Veronica; Porzionato, Andrea; Stecco, Carla; Tiengo, Cesare; Parenti, Anna; Cestrone, Adriano; De Caro, Raffaele

    2011-01-01

    Current undergraduate medical curricula provides relatively little time for cadaver dissection. The Department of Human Anatomy and Physiology at the University of Padova has organized a pilot project with the University Hospital for the donation of body parts that are surgically removed for therapeutic purposes and destined under Italian law for…

  3. [Hand surgery training].

    Science.gov (United States)

    Moutet, F; Haloua, J P

    2003-10-01

    ). Unfortunately it is non-sufficient to train the necessary number of hand surgeons needed in France today. So we try to obtain from the authority the formal recognition of a training period in private practice. Eleven out of the 28 hand units listed as formative by the French College of Hand Surgeons are in private practice and may be recognized as formative in the hand surgeon training. That needs to create an official agreement between university and private Units. This part of the training is yet accepted by the Right to the Title commission for a 6-month training period. But this needs a legal modification or adaptation of the private units legal status so they will be able to offer a quite equivalent conditions of training. Now a days 233 surgeons in France passed the Right to the Title. Among them, the oldest do not have emergency practice any more. So unfortunately, out of 1,400,000 hand injuries a year in France, only few are actually cared by hand surgeons. The emergency training needs at least a three to four senior surgeons team, operating and caring emergencies, 24 h a day, 365 days a year. They need to be surrounded by high-level technical facilities for this type of surgery. Only this type of unit may have a frequent severe hand traumatology practice, especially regarding microsurgery. But on the other hand a less complex hand unit operating only planed surgery and less complicated emergencies, may also be definitively formative. This only depends on the hand surgeon's qualification. It is only with a very demanding and high-level training program that our credibility as hand surgeon may be definitively established. The mainstay of this training is the combined action of the FESUM, the French College of Hand Surgeons and the DIU diploma. The Right to the Title formally confirms that training. For university or private unit, to be a member of the FESUM, must continue to guarantee a high level training regarding emergencies as in number as in complexity. We proposed

  4. Training in breast surgery in Spain.

    Science.gov (United States)

    Miguelena, José M; Domínguez Cunchillos, Fernando

    2016-01-01

    Breast surgery is a key part of training and competency in general surgery in Spain and is a "frontier area" that can be efficiently managed by general surgeons and gynecologists. The main objective of the training process consists of the surgical treatment of breast cancer, including conservative surgery, oncoplastic and reconstructive techniques. This article analyses the current status of breast surgery training in Spain and schematically proposes potential targets of the different training programs, to improve access and training for surgeons and residents in this area, taking into account the RD 639/2014 and European regulation. The priority is to specify the level of training that should be achieved, in relation to the group of professionals involved, considering their area of competency: surgery resident, educational programs, and surgeons with special dedication to this area.

  5. Oral surgery: part 2. Endodontic surgery.

    Science.gov (United States)

    Pop, I

    2013-09-01

    In the past, the interaction between dentoalveolar surgery and restorative dentistry has been limited to the removal of teeth with pulp and/or periradicular disease or those that were unrestorable. However, with the increasing dental awareness of the population and the retention of teeth into later life, the interaction between dentoalveolar surgery and restorative dentistry is becoming a fundamental aspect of clinical practice. Indeed, endodontic and implant surgery are core activities that facilitate the retention of a functional dentition.

  6. Survey of minimally invasive general surgery fellows training in robotic surgery.

    Science.gov (United States)

    Shaligram, Abhijit; Meyer, Avishai; Simorov, Anton; Pallati, Pradeep; Oleynikov, Dmitry

    2013-06-01

    Minimally invasive surgery fellowships offer experience in robotic surgery, the nature of which is poorly defined. The objective of this survey was to determine the current status and opportunities for robotic surgery training available to fellows training in the United States and Canada. Sixty-five minimally invasive surgery fellows, attending a fundamentals of fellowship conference, were asked to complete a questionnaire regarding their demographics and experiences with robotic surgery and training. Fifty-one of the surveyed fellows completed the questionnaire (83 % response). Seventy-two percent of respondents had staff surgeons trained in performing robotic procedures, with 55 % of respondents having general surgery procedures performed robotically at their institution. Just over half (53 %) had access to a simulation facility for robotic training. Thirty-three percent offered mechanisms for certification and 11 % offered fellowships in robotic surgery. One-third of the minimally invasive surgery fellows felt they had been trained in robotic surgery and would consider making it part of their practice after fellowship. However, most (80 %) had no plans to pursue robotic surgery fellowships. Although a large group (63 %) felt optimistic about the future of robotic surgery, most respondents (72.5 %) felt their current experience with robotic surgery training was poor or below average. There is wide variation in exposure to and training in robotic surgery in minimally invasive surgery fellowship programs in the United States and Canada. Although a third of trainees felt adequately trained for performing robotic procedures, most fellows felt that their current experience with training was not adequate.

  7. Ergonomic Factors during Laparoscopic Surgery Training

    NARCIS (Netherlands)

    Xiao, D.J.

    2014-01-01

    With the introduction of minimally invasive surgery (MIS), the patient experiences the benefits of less pain, a more rapid recovery and a shorter stay in hospital. However, MIS provides many challenges to surgeons and they need extensive training to acquire this new technique. This training consist

  8. Learning operational strategies in surgery training.

    Science.gov (United States)

    Paydar, Shahram; Ghahramani, Zahra; Bolandparvaz, Shahram; Khalili, Hosseinali; Abbasi, Hamid Reza

    2014-04-01

    Education and training in surgery is in the middle of apprenticeship style of learning especially in operating room with little importance of understanding on how trainees learn. This training is one of the most difficult types of training. Medical training and expertise are the specialty of this education system. We can name these complex fields as "Operational Strategies". The strategies are includes of "what to do", "what to think" and "what to create". These strategies are good to test and train higher functions in persons who have professional's positions. Most of educational fields are complex. It means that the training is not limited in an area and includes of theory fields, areas of decision making and areas of handy and practical skills. These fields are the most relevant skills or expertise which individual must be informed of the performance of maintenance and repair or upgrade and make a new system.   The operational strategy is a new training strategy for surgery students. It is useful to train surgery students to modify and improve their practices and doing surgeries and treating patients in best conditions.

  9. Ergonomic Factors during Laparoscopic Surgery Training

    OpenAIRE

    Xiao, D.J.

    2014-01-01

    With the introduction of minimally invasive surgery (MIS), the patient experiences the benefits of less pain, a more rapid recovery and a shorter stay in hospital. However, MIS provides many challenges to surgeons and they need extensive training to acquire this new technique. This training consists of developing cognitive, clinical, and technical skills. However, acquiring full training ‘‘on the job’’ is not always possible because of patient safety and restrictions of residents’ working hou...

  10. Advanced laparoscopic bariatric surgery Is safe in general surgery training.

    Science.gov (United States)

    Kuckelman, John; Bingham, Jason; Barron, Morgan; Lallemand, Michael; Martin, Matthew; Sohn, Vance

    2017-05-01

    Bariatric surgery makes up an increasing percentage of general surgery training. The safety of resident involvement in these complex cases has been questioned. We evaluated patient outcomes in resident performed laparoscopic bariatric procedures. Retrospective review of patients undergoing a laparoscopic bariatric procedure over seven years at a tertiary care single center. Procedures were primarily performed by a general surgery resident and proctored by an attending surgeon. Primary outcomes included operative volume, operative time and leak rate with perioperative outcomes evaluated as secondary outcomes. A total of 1649 bariatric procedures were evaluated. Operations included laparoscopic bypass (690) and laparoscopic sleeve gastrectomy (959). Average operating time was 136 min. Eighteen leaks (0.67%) were identified. Graduating residents performed an average of 89 laparoscopic bariatric cases during their training. There were no significant differences between resident levels with concern to operative time or leak rate (p 0.97 and p = 0.54). General surgery residents can safely perform laparoscopic bariatric surgery. When proctored by a staff surgeon, a resident's level of training does not significantly impact leak rate. Published by Elsevier Inc.

  11. Correctional Training. Institution Familiarization. Part II: The Training Program.

    Science.gov (United States)

    Bureau of Prisons (Dept. of Justice), Washington, DC.

    Designed to assist training coordinators in the initial institution familiarization training for new employees in correctional institutions, this manual consists of two documents: a training coordinator's guide (Part I - CE 017 285) and this document, the training program (Part II). Four training areas are treated: (1) an introduction consisting…

  12. Novel training methods for robotic surgery

    Directory of Open Access Journals (Sweden)

    Andrew J Sun

    2014-01-01

    Conclusions: The use of these different entities to create a standardized curriculum for robotic surgery remains elusive. Selection of training modalities and assessment tools should be based upon performance data-based validity and practical feasibility. Comparative assessment of different modalities (cross-modality validity can help strengthen the development of common skill sets. Constant data collection must occur to guide continuing curriculum improvement.

  13. Trends in cataract surgery training curricula.

    Science.gov (United States)

    Lotfipour, Mona; Rolius, Ramunas; Lehman, Erik B; Pantanelli, Seth M; Scott, Ingrid U

    2017-01-01

    To evaluate trends in cataract surgery training curricula and factors affecting timing of resident participation as a primary surgeon. Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA. Cross-sectional study of anonymous survey results. A description of the study and link to an online survey was e-mailed to program directors of each ophthalmology residency training program accredited by the Accreditation Council for Graduate Medical Education (ACGME). Fifty-one (44%) of the 116 program directors completed the survey. First-year, second-year, and third-year residents performed a mean of 2, 25, and 155 phacoemulsification surgeries, respectively, as a primary surgeon. Only 1 program (2%) required residents to perform extracapsular cataract extraction (ECCE) before performing phacoemulsification. Clear corneal phacoemulsification was the first technique taught to trainees at 91% of programs. More than two thirds (71%) of program directors indicated that their program had a cataract surgery training curriculum designed to transition residents gradually to the operating room. These curricula included structured wet laboratory (92%) and lecture (89%) components. Inadequate resident knowledge and surgical skill base (57%) and anticipation of increased surgical complication risk (37%) were the most commonly reported factors impeding earlier exposure to phacoemulsification in residency. Results show that residents today begin surgical training with phacoemulsification rather than ECCE, perform a higher number of phacoemulsification surgeries than is required by the ACGME, and begin performing phacoemulsification as early as their first or second year of residency. Despite these evolutions, 29% of respondent ACGME-accredited ophthalmology residency programs reported not having a formal cataract surgery training curriculum. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  14. Low Cost Simulator for Heart Surgery Training

    Directory of Open Access Journals (Sweden)

    Roberto Rocha e Silva

    Full Text Available Abstract Objective: Introduce the low-cost and easy to purchase simulator without biological material so that any institution may promote extensive cardiovascular surgery training both in a hospital setting and at home without large budgets. Methods: A transparent plastic box is placed in a wooden frame, which is held by the edges using elastic bands, with the bottom turned upwards, where an oval opening is made, "simulating" a thoracotomy. For basic exercises in the aorta, the model presented by our service in the 2015 Brazilian Congress of Cardiovascular Surgery: a silicone ice tray, where one can train to make aortic purse-string suture, aortotomy, aortorrhaphy and proximal and distal anastomoses. Simulators for the training of valve replacement and valvoplasty, atrial septal defect repair and aortic diseases were added. These simulators are based on sewage pipes obtained in construction material stores and the silicone trays and ethyl vinyl acetate tissue were obtained in utility stores, all of them at a very low cost. Results: The models were manufactured using inert materials easily found in regular stores and do not present contamination risk. They may be used in any environment and maybe stored without any difficulties. This training enabled young surgeons to familiarize and train different surgical techniques, including procedures for aortic diseases. In a subjective assessment, these surgeons reported that the training period led to improved surgical techniques in the surgical field. Conclusion: The model described in this protocol is effective and low-cost when compared to existing simulators, enabling a large array of cardiovascular surgery training.

  15. Immersive training and mentoring for laparoscopic surgery

    Science.gov (United States)

    Nistor, Vasile; Allen, Brian; Dutson, E.; Faloutsos, P.; Carman, G. P.

    2007-04-01

    We describe in this paper a training system for minimally invasive surgery (MIS) that creates an immersive training simulation by recording the pathways of the instruments from an expert surgeon while performing an actual training task. Instrument spatial pathway data is stored and later accessed at the training station in order to visualize the ergonomic experience of the expert surgeon and trainees. Our system is based on tracking the spatial position and orientation of the instruments on the console for both the expert surgeon and the trainee. The technology is the result of recent developments in miniaturized position sensors that can be integrated seamlessly into the MIS instruments without compromising functionality. In order to continuously monitor the positions of laparoscopic tool tips, DC magnetic tracking sensors are used. A hardware-software interface transforms the coordinate data points into instrument pathways, while an intuitive graphic user interface displays the instruments spatial position and orientation for the mentor/trainee, and endoscopic video information. These data are recorded and saved in a database for subsequent immersive training and training performance analysis. We use two 6 DOF DC magnetic trackers with a sensor diameter of just 1.3 mm - small enough for insertion into 4 French catheters, embedded in the shaft of a endoscopic grasper and a needle driver. One sensor is located at the distal end of the shaft while the second sensor is located at the proximal end of the shaft. The placement of these sensors does not impede the functionally of the instrument. Since the sensors are located inside the shaft there are no sealing issues between the valve of the trocar and the instrument. We devised a peg transfer training task in accordance to validated training procedures, and tested our system on its ability to differentiate between the expert surgeon and the novices, based on a set of performance metrics. These performance metrics

  16. Strength Training May Prevent Side Effect of Breast Cancer Surgery

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_162473.html Strength Training May Prevent Side Effect of Breast Cancer Surgery ... 9, 2016 FRIDAY, Dec. 9, 2016 (HealthDay News) -- Strength training might benefit breast cancer survivors who've undergone ...

  17. Robotic laparoscopic surgery: cost and training.

    Science.gov (United States)

    Amodeo, A; Linares Quevedo, A; Joseph, J V; Belgrano, E; Patel, H R H

    2009-06-01

    The advantages of minimally invasive surgery are well accepted. Shorter hospital stays, decreased postoperative pain, rapid return to preoperative activity, decreased postoperative ileus, and preserved immune function are among the benefits of the laparoscopic approach. However, the instruments of laparoscopy afford surgeons limited precision and poor ergonomics, and their use is associated with a significant learning curve and the amount of time and energy necessary to develop and maintain such advanced laparoscopic skills is not insignificant. The robotic surgery allows all laparoscopists to perform advanced laparoscopic procedures with greater ease. The potential advantages of surgical robotic systems include making advanced laparoscopic surgical procedures accessible to surgeons who do not have advanced video endoscopic training and broadening the scope of surgical procedures that can be performed using the laparoscopic method. The wristed instruments, x10 magnifications, tremor filtering, scaling of movements and three-dimensional view allow the urologist to perform the intricate dissection and anastomosis with high precision. The robot is not, however, without significant disadvantages as compared with traditional laparoscopy. These include greater expense and consumption of operating room resources such as space and the availability of skilled technical staff, complete elimination of tactile feedback, and more limited options for trocar placement. The current cost of the da Vinci system is $ 1.2 million and annual maintenance is $ 138000. Many studies suggest that depreciation and maintenance costs can be minimised if the number of robotic cases is increased. The high cost of purchasing and maintaining the instruments of the robotic system is one of its many disadvantages. The availability of the robotic systems to only a limited number of centres reduces surgical training opportunities. Hospital administrators and surgeons must define the reasons for

  18. Simulation in dermatologic surgery: a new paradigm in training.

    Science.gov (United States)

    Nicholas, Luke; Toren, Kristen; Bingham, Jonathan; Marquart, Jason

    2013-01-01

    Simulation-based training has become popular in many surgical residencies for acquiring procedural skills, but simulator use is rare in dermatologic training. To evaluate the perceived efficacy of obtaining dermatologic procedural skills using simulators. Opinions of dermatology residents and staff regarding simulator use were assessed using questionnaires completed after a 2-day surgical symposium in which participants were instructed on and practiced with simulators and cadavers. Overall, 93.9% strongly agreed that simulators are helpful in acquiring procedural skills. More than three-quarters of participants agreed that simulators are useful in acquiring, refining, assessing, and learning these skills. Many participants further thought that simulator use would be beneficial in learning anatomy and trouble-shooting techniques. An overwhelming majority of those surveyed believed that training on simulators would be helpful in learning various dermatologic procedures; 90.9% of participants thought that training using simulators should be, at least in part, a mandatory component of residency. It was felt that this training should be conducted at the beginning of residency, with additional with sessions held throughout training. Simulation offers an excellent model for the acquisition and assessment of dermatologic procedural skills. Cost and availability of instructors remain obstacles. Further studies are required to evaluate the implementation and effectiveness of these models. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  19. Optimal training design for procedural motor skills: a review and application to laparoscopic surgery.

    Science.gov (United States)

    Spruit, Edward N; Band, Guido P H; Hamming, Jaap F; Ridderinkhof, K Richard

    2014-11-01

    This literature review covers the choices to consider in training complex procedural, perceptual and motor skills. In particular, we focus on laparoscopic surgery. An overview is provided of important training factors modulating the acquisition, durability, transfer, and efficiency of trained skills. We summarize empirical studies and their theoretical background on the topic of training complex cognitive and motor skills that are pertinent to proficiency in laparoscopic surgery. The overview pertains to surgical simulation training for laparoscopy, but also to training in other demanding procedural and dexterous tasks, such as aviation, managing complex systems and sports. Evidence-based recommendations are provided for facilitating efficiency in laparoscopic motor skill training such as session spacing, adaptive training, task variability, part-task training, mental imagery and deliberate practice.

  20. Mechatronics Interface for Computer Assisted Prostate Surgery Training

    Science.gov (United States)

    Altamirano del Monte, Felipe; Padilla Castañeda, Miguel A.; Arámbula Cosío, Fernando

    2006-09-01

    In this work is presented the development of a mechatronics device to simulate the interaction of the surgeon with the surgical instrument (resectoscope) used during a Transurethral Resection of the Prostate (TURP). Our mechatronics interface is part of a computer assisted system for training in TURP, which is based on a 3D graphics model of the prostate which can be deformed and resected interactively by the user. The mechatronics interface, is the device that the urology residents will manipulate to simulate the movements performed during surgery. Our current prototype has five degrees of freedom, which are enough to have a realistic simulation of the surgery movements. Two of these degrees of freedom are linear, to determinate the linear displacement of the resecting loop and the other three are rotational to determinate three directions and amounts of rotation.

  1. Stress management training for breast cancer surgery patients

    NARCIS (Netherlands)

    Garssen, B.; Boomsma, M.F.; Ede, J. van; Porsild, T.; Berkhof, J.; Berbee, M.; Visser, A.; Meijer, S.; Beelen, R.H.

    2013-01-01

    OBJECTIVE: This study evaluated the psychological effects of a pre-surgical stress management training (SMT) in cancer patients. METHODS: Stress management training comprised four sessions in total: on 5 days and 1 day pre-surgery and on 2 days and 1 month post-surgery. Patients also received audio

  2. Feasibility of progressive strength training shortly after hip fracture surgery

    DEFF Research Database (Denmark)

    Overgaard, Jan; Kristensen, Morten T

    2013-01-01

    To investigate the feasibility of a 6-wk progressive strength-training programme commenced shortly after hip fracture surgery in community-dwelling patients.......To investigate the feasibility of a 6-wk progressive strength-training programme commenced shortly after hip fracture surgery in community-dwelling patients....

  3. Perioperatory antibiotic prophylaxis in Pediatric Surgery (Part I: abdominal surgery

    Directory of Open Access Journals (Sweden)

    Sergio Luis González López

    2005-12-01

    Full Text Available The surgical wound infection is the biggest cause of infectious morbility in surgical patients. It is an important cause of morbility that causes lincreased hospital demurrages, increased cost of medical attention and serious inconveniences to the patients and their familiies. 25% of all nosocomial infections are surgical wound infection. One of the big advances of the surgery in the last three decades is an introduction of antibiotic prophylaxis in the surgical practice. Is considered that it has saved more lives than any other novel procedure in surgery in the last 20 years. We presented the Good Clinical Practices Guideline for Antibiotic prophylaxis in abdominal surgery, approved by consensus in the 1st National Good Clinical Practices Workshop in Pediatric Surgery (Cienfuegos, Cuba, March 7 – 9, 2002.

  4. Virtual reality training for endoscopic surgery : composing a validated training program for basic skills

    NARCIS (Netherlands)

    Dongen, van Koen Willem

    2010-01-01

    Endoscopic surgery demands different specific psychomotor skills than open surgery. Virtual reality simulation training has the potential to be a valuable tool in training these skills, because simulation provides the opportunity to train psychomotor skills in a safe environment. In addition to trai

  5. Augmented reality assisted surgery: a urologic training tool.

    Science.gov (United States)

    Dickey, Ryan M; Srikishen, Neel; Lipshultz, Larry I; Spiess, Philippe E; Carrion, Rafael E; Hakky, Tariq S

    2016-01-01

    Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass ® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training.

  6. Augmented reality assisted surgery: a urologic training tool

    Directory of Open Access Journals (Sweden)

    Ryan M Dickey

    2016-01-01

    Full Text Available Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass ® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training.

  7. Augmented reality assisted surgery: a urologic training tool

    Science.gov (United States)

    Dickey, Ryan M; Srikishen, Neel; Lipshultz, Larry I; Spiess, Philippe E; Carrion, Rafael E; Hakky, Tariq S

    2016-01-01

    Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training. PMID:26620455

  8. [Appropriate cataract surgery training can promote work of blindness prevention].

    Science.gov (United States)

    Zhang, Mingzhi

    2014-03-01

    Cataract is the first blinding eye disease in the world and China. However, due to various reasons, cataract surgery rate (CSR) in China is much lower than in developed countries and even some developing countries. Properly and standardized training of cataract surgery for ophthalmologists from primary hospital and young eye doctors is one of the key point to improve CSR. For above, we had explored actively to establish an appropriate and suitable training model of cataract surgery. Ophthalmologist in primary hospital can provide high quality medical services to cataract patients in accordance with their own conditions after training and promote the sustainable development of blindness prevention work.

  9. Different models of training and certification in plastic surgery

    NARCIS (Netherlands)

    Fodor, L.; Ciuce, C.; Fodor, M.; Shrank, C.; Lapid, O.; Kon, M.; Ramon, Y.; Ullmann, Y.

    2009-01-01

    A varying period of training followed by examinations is the usual way to become a specialist in one of the many fields of Medicine. Plastic Surgery is one of the surgical fields that require good technical and cognitive skills. The best way to train and evaluate a candidate is hard to judge. The mo

  10. [Current problems in training of minimally invasive surgery: vision of residents in pediatric surgery].

    Science.gov (United States)

    Corona, C; Cano, I; Peláez, D; Fuentes, S; Tardáguila, A R

    2013-01-01

    Minimally Invasive Surgery (MIS) is getting more and more important in our specialty. However, the formation of the residents on MIS is, in many cases, irregular. The purpose of this study is to assess the state of training in MIS among the residents of Pediatric Surgery and their potential weaknesses. An electronic survey was distributed among 71 residents of Pediatric Surgery from 17 national hospitals. The response rate was 70.2%.100% of the residents are interested in a broadening of training activities in MIS. The main areas of interest are gastrointestinal (92%) and thoracic (47%) surgery. Only 57% have access to training facilities and less than half of them attend to courses and conferences. 80% believe that they are not given adequate attention from specialized associations. 52% think they should do rotations at referral centers, 86% that courses and seminars should be enhanced, and 44% that the responsibility of the resident in surgery should be increased. The main defects encountered in their training are scarce volume of patients, lack of financial support and overcoming the learning curve of surgeons in their services. Despite the advance of the MIS, resident's training in this discipline still has shortcomings, as expressed in their views. Knowledge of the current state of training should be the starting point for designing a training strategy that ensures adequate skills.

  11. Tele-surgery simulation with a patient organ model for robotic surgery training.

    Science.gov (United States)

    Suzuki, S; Suzuki, N; Hattori, A; Hayashibe, M; Konishi, K; Kakeji, Y; Hashizume, M

    2005-12-01

    Robotic systems are increasingly being incorporated into general laparoscopic and thoracoscopic surgery to perform procedures such as cholecystectomy and prostatectomy. Robotic assisted surgery allows the surgeon to conduct minimally invasive surgery with increased accuracy and with potential benefits for patients. However, current robotic systems have their limitations. These include the narrow operative field of view, which can make instrument manipulation difficult. Current robotic applications are also tailored to specific surgical procedures. For these reasons, there is an increasing demand on surgeons to master the skills of instrument manipulation and their surgical application within a controlled environment. This study describes the development of a surgical simulator for training and mastering procedures performed with the da Vinci surgical system. The development of a tele-surgery simulator and the construction of a training center are also described, which will enable surgeons to simulate surgery from or in remote places, to collaborate over long distances, and for off-site expert assistance.

  12. Virtual reality training for surgical trainees in laparoscopic surgery.

    Science.gov (United States)

    Gurusamy, Kurinchi Selvan; Aggarwal, Rajesh; Palanivelu, Latha; Davidson, Brian R

    2009-01-21

    Surgical training has traditionally been one of apprenticeship, where the surgical trainee learns to perform surgery under the supervision of a trained surgeon. This is time consuming, costly, and of variable effectiveness. Training using a virtual reality simulator is an option to supplement standard training. To determine whether virtual reality training can supplement or replace conventional laparoscopic surgical training (apprenticeship) in surgical trainees with limited or no prior laparoscopic experience. We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, and grey literature until March 2008. We included all randomised clinical trials comparing virtual reality training versus other forms of training including video trainer training, no training, or standard laparoscopic training in surgical trainees with little or no prior laparoscopic experience. We also included trials comparing different methods of virtual reality training. We collected the data on the characteristics of the trial, methodological quality of the trials, mortality, morbidity, conversion rate, operating time, and hospital stay. We analysed the data with both the fixed-effect and the random-effects models using RevMan Analysis. For each outcome we calculated the standardised mean difference with 95% confidence intervals based on intention-to-treat analysis. We included 23 trials with 612 participants. Four trials compared virtual reality versus video trainer training. Twelve trials compared virtual reality versus no training or standard laparoscopic training. Four trials compared virtual reality, video trainer training and no training, or standard laparoscopic training. Three trials compared different methods of virtual reality training. Most of the trials were of high risk of bias. In trainees without prior surgical experience, virtual

  13. Computational surgery and dual training computing, robotics and imaging

    CERN Document Server

    Bass, Barbara; Berceli, Scott; Collet, Christophe; Cerveri, Pietro

    2014-01-01

    This critical volume focuses on the use of medical imaging, medical robotics, simulation, and information technology in surgery. It offers a road map for computational surgery success,  discusses the computer-assisted management of disease and surgery, and provides a rational for image processing and diagnostic. This book also presents some advances on image-driven intervention and robotics, as well as evaluates models and simulations for a broad spectrum of cancers as well as cardiovascular, neurological, and bone diseases. Training and performance analysis in surgery assisted by robotic systems is also covered. This book also: ·         Provides a comprehensive overview of the use of computational surgery and disease management ·         Discusses the design and use of medical robotic tools for orthopedic surgery, endoscopic surgery, and prostate surgery ·         Provides practical examples and case studies in the areas of image processing, virtual surgery, and simulation traini...

  14. Congenital cardiac surgery fellowship training: A status update.

    Science.gov (United States)

    Kogon, Brian; Karamlou, Tara; Baumgartner, William; Merrill, Walter; Backer, Carl

    2016-06-01

    In 2007, congenital cardiac surgery became a recognized fellowship by the Accreditation Council of Graduate Medical Education (ACGME) and leads to board certification through the American Board of Thoracic Surgery (ABTS). We highlight the strengths and weaknesses in the current system of accredited training. Data were collected from program directors, the ACGME, and the ABTS. In addition, surveys were sent to training program graduates. Topics included program accreditation status, number of fellows trained per year and per program, match results, fellow operative experience, fellow satisfaction, and post-fellowship employment status. There are twelve active accredited fellowship programs, and 44 trainees have completed accredited training. Each active program has trained a median of 3 fellows (range: 0-7). Operative logs were obtained from 38 of 44 (86%) graduates. The median number of total cases (minimum 75) was 136 (range: 75-236). For complex neonates (minimum 5), the median number of cases was 6 (range: 2-17). Some fellows failed to meet the minimum requirements. Thirty-six (82%) graduates responded to the survey; most were satisfied with their overall operative experience, but less with their neonatal operative experience. Of this total, 84% are currently practicing congenital cardiac surgery, and 74% secured jobs prior to completing their residency. Since 2007, congenital cardiac surgery training has been accredited by the ACGME. In general, the training is uniform, the operative experience is robust, and the fellows are satisfied. Although shortcomings remain, this study highlights the many strengths of the current system. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  15. Factors influencing career choice after initial training in surgery.

    LENUS (Irish Health Repository)

    McHugh, Seamus

    2011-03-01

    Irish general surgery faces a recruitment crisis with only 87 of 145 (60%) basic surgical training (BST) places filled in 2009. We assessed basic surgical trainees to identify objective, and potentially modifiable, factors that influence ultimate recruitment into a general surgical career.

  16. Evaluation of haptic teaching approaches for laparoscopic surgery training.

    Science.gov (United States)

    Kato, Toma; Tagawa, Kazuyoshi; Marutani, Takafumi; Tanaka, Hiromi; Komori, Masaru; Kurumi, Yoshimasa; Morikawa, Shigehiro

    2014-01-01

    Laparoscopic surgery, one type of minimally invasive surgery (MIS) is a very important surgery technique which requires advanced surgical technique. At present, expert one-on-one teaching mainly supports the training of these advanced surgical techniques. However, time constraints prevent experts spending the amount of time desired for this training. Therefore, we aim to support training using a VR-based laparoscopic surgery simulator equipped with a guidance force display. This increases the amount of training a trainee can avail of while at the same time allow the expert and the trainee to increase the quality of the limited one-to-one time together. The first step of our research is to investigate approaches that displays the guidance force to teach experts hand movements. In this study, we used two guidance force-display approaches: Instrument-guiding approach and Hand-guiding approach. Through evaluative experiments, we found that the Hand-guiding approach is more suitable for skill transfer than the Instrument-guiding approach in particular tasks. The results are described below.

  17. Evaluation of a Multimodal VR training platform for maxillofacial surgery

    Directory of Open Access Journals (Sweden)

    Gabet Ludovic

    2011-12-01

    Full Text Available One of the most striking features of virtual reality systems is their ability to enrich training experience by allowing the developments of sophisticated feedbacks. This study focuses on the way to use modality management in virtual reality systems to accelerate training in a surgical task involving bone drilling. The study compares the efficiency of two punctual drilling training protocol implemented on the MFS SKILLS platform. The experiments were conducted with residents from 2 university hospitals. The results show that augmented simulation improves acquisition of specific aspects of the surgery in comparison with pure simulation.

  18. Training general surgery residents in pediatric surgery: educational value vs time and cost.

    Science.gov (United States)

    Lee, Steven L; Sydorak, Roman M; Applebaum, Harry

    2009-01-01

    This study evaluated the educational value of pediatric surgery rotations, the likelihood of performing pediatric operations upon completing general surgery (GS) residency, and time and cost of training GS residents in pediatric surgery. A survey was administered to GS residents that evaluated the pediatric surgery rotation and anticipated practice intentions. A retrospective analysis (2005-2006) of operative times for unilateral inguinal hernia repair, bilateral inguinal hernia repair, and umbilical hernia repair was also performed. Procedure times were compared for operations performed by a pediatric surgeon with and without GS residents. Cost analysis was based on time differences. General surgery residents (n = 19) considered the pediatric surgery rotation to have high educational value (4.7 +/- 0.6 of 5) with extensive teaching (4.6 +/- 0.7) and operative experience (4.4 +/- 0.8). Residents listed pediatric surgery exposure, operative technique, and observed work ethic as most valuable. Upon graduation, residents expect to perform pediatric operations 2 to 3 times annually. Thirty-seven percent of residents felt competent to perform appendectomy (patients >5 years), 32% appendectomy (3-5 years), 21% gastrostomy (>1 year), and 11% inguinal herniorrhaphy (>1 year). Operative times and costs were significantly higher in operative procedures performed with a GS resident. General surgery residents considered pediatric surgery as a valuable educational experience. Residents anticipate performing pediatric operations a few times annually. Training GS residents in pediatric surgery increased operative time and cost. This information may be useful in determining the appropriate setting for resident education as well as budget planning for pediatric surgical practices.

  19. Virtual reality simulators and training in laparoscopic surgery.

    Science.gov (United States)

    Yiannakopoulou, Eugenia; Nikiteas, Nikolaos; Perrea, Despina; Tsigris, Christos

    2015-01-01

    Virtual reality simulators provide basic skills training without supervision in a controlled environment, free of pressure of operating on patients. Skills obtained through virtual reality simulation training can be transferred on the operating room. However, relative evidence is limited with data available only for basic surgical skills and for laparoscopic cholecystectomy. No data exist on the effect of virtual reality simulation on performance on advanced surgical procedures. Evidence suggests that performance on virtual reality simulators reliably distinguishes experienced from novice surgeons Limited available data suggest that independent approach on virtual reality simulation training is not different from proctored approach. The effect of virtual reality simulators training on acquisition of basic surgical skills does not seem to be different from the effect the physical simulators. Limited data exist on the effect of virtual reality simulation training on the acquisition of visual spatial perception and stress coping skills. Undoubtedly, virtual reality simulation training provides an alternative means of improving performance in laparoscopic surgery. However, future research efforts should focus on the effect of virtual reality simulation on performance in the context of advanced surgical procedure, on standardization of training, on the possibility of synergistic effect of virtual reality simulation training combined with mental training, on personalized training. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  20. Ergonomic factors on task performance in laparoscopic surgery training.

    Science.gov (United States)

    Xiao, D J; Jakimowicz, Jack J; Albayrak, A; Goossens, R H M

    2012-05-01

    This paper evaluates the effect of ergonomic factors on task performance and trainee posture during laparoscopic surgery training. Twenty subjects without laparoscopic experience were allotted into 2 groups. Group 1 was trained under the optimal ergonomic simulation setting according to current ergonomic guidelines (Condition A). Group 2 was trained under non-optimal ergonomic simulation setting that can often be observed during training in a skills lab (Condition B). Posture analysis showed that the subjects held a much more neutral posture under Condition A than under Condition B (poptimal ergonomic simulation setting leads to better task performance. In addition, no significant differences of task performance, for Groups 1 and 2 using the same test setting were found. However, better performance was observed for Group 1. It can be concluded that the optimal and non-optimal training setting have different learning effects on trainees' skill learning.

  1. Training of basic laparoscopy skills on SimSurgery SEP.

    Science.gov (United States)

    Buzink, Sonja N; Goossens, Richard H M; De Ridder, Huib; Jakimowicz, Jack J

    2010-01-01

    The aim of this study was to assess the performance curve for novices training in bimanual tissue manipulation and angled laparoscope navigation, and compare those performances with the performances of experienced laparoscopic surgeons. The Camera Navigation task with a 30 degrees angled laparoscope and the Place Arrow task of the new SimSurgery SEP virtual reality simulator were used. Fourteen medical trainees (no laparoscopy experience) performed four training sessions within one week, including 15 repetitions of each task in total. The experienced participants (>50 procedures & familiar with angled laparoscope) performed each task twice. The performance on both tasks by the novices improved significantly over the training sessions. The experienced participants performed both tasks significantly better than the novices in repetition 3. After repetition 15, the performances of the novices on both tasks were of the same level as the performances of the experienced participants. By training on SimSurgery SEP, medical trainees can extensively improve their skills in navigation with 30 degrees angled laparoscope and bimanual tissue manipulation. Further research should focus on the transfer of skills acquired on the simulator to the clinical setting. Knowledge on proficiency thresholds and training end-points for pre-clinical criterion-based training of different laparoscopic tasks also needs to be extended.

  2. Transfer between training of part-tasks in complex skill training : Model development and supporting data

    NARCIS (Netherlands)

    Roessingh, J.J.M.; Kappers, A.M.L.; Koenderink, J.J.

    2002-01-01

    One of the most common instruction-strategies for training complex skills is part-training. A complex task can often be divided into part-tasks. Part-training requires that certain part-tasks or combinations of part-tasks be practised in isolation in order to promote the transfer of skills that are

  3. Training and outcome monitoring in robotic urologic surgery.

    Science.gov (United States)

    Liberman, Daniel; Trinh, Quoc-Dien; Jeldres, Claudio; Valiquette, Luc; Zorn, Kevin C

    2011-11-08

    The use of robot-assisted laparoscopic technology is rapidly expanding, with applicability in numerous disciplines of surgery. Training to perform robot-assisted laparoscopic urological procedures requires a motivated learner, a motivated teacher or proctor, a curriculum with stepwise learning objectives, and regular access to a training robot. In light of the many constraints that limit surgical training, animal models should be utilized to quantifiably improve the surgical skills of residents and surgical fellows, before these skills are put into practice on patients. A system based on appropriate supervision, graduated responsibility, real-time feedback, and objective measure of progress has proven to be safe and effective. Surgical team education directed towards cohesion is perhaps the most important aspect of training. At present, there are very few published guidelines for the safe introduction of robotic urologic surgery at an institution. Increasing evidence demonstrates the effects of learning curve and surgical volume on oncological and functional outcomes in robotic surgery (RS). This necessitates the introduction of mechanisms and guidelines by which trainee surgeons can attain a sufficient level of skill, without compromising the safety of patients. Guidelines for outcome monitoring following RS should be developed, to ensure patient safety and sufficient baseline surgeon skill.

  4. Recent trends in resident career choices after plastic surgery training.

    Science.gov (United States)

    Herrera, Fernando A; Chang, Eric I; Suliman, Ahmed; Tseng, Charles Y; Bradley, James P

    2013-06-01

    The purpose of this study is to determine the initial career choice of plastic surgery residents after completion of training during the last five years and to identify any factors that may influence choice of career path. Demographic data were obtained from graduates of Accreditation Council for Graduate Medical Education (ACGME)-accredited US plastic surgery residency programs between the years of 2005 and 2010. The type of practice and pursuit of fellowship were recorded for each graduate. Sex, age at graduation, marital status, dependents, advanced degrees, previous research, type of training program, primary residency, and length of plastic surgery training were also documented. Comparison of outcomes between the two plastic surgery training pathways (integrated vs independent) was analyzed. Data were collected for 424 graduates from 37 different training programs. Of these programs, 11% were from the West coast, 32% from Midwest, 33% from East coast, and 24% from the South. Seventy-nine percent of residents were male, mean age at graduation was 35 (2.89) years. Forty-nine percent of residents were married, 30% had one or more dependents, 6% had advanced degrees, and 18% had previous research experience. Fifty-eight percent of graduates were from independent programs. Forty-eight percent of residents pursued private practice immediately after graduation, 8% pursued academic practice, 41% pursued specialty fellowships, and 3% had military commitments. Most of the residents chose to pursue private practice on completion of residency. Independent residents were significantly more likely to pursue private practice immediately compared to integrated/combined residents. No other factors were significant for practice choice.

  5. Factors influencing career choice after initial training in surgery.

    LENUS (Irish Health Repository)

    McHugh, Seamus

    2012-02-01

    INTRODUCTION: Irish general surgery faces a recruitment crisis with only 87 of 145 (60%) basic surgical training (BST) places filled in 2009. We assessed basic surgical trainees to identify objective, and potentially modifiable, factors that influence ultimate recruitment into a general surgical career. METHODS: Candidates commencing BST training during a 5-year period between 2004 and 2008 were included in a quantitative study. In addition a total of 2,536 candidates, representing all those who commenced surgical training in Ireland since 1960 were identified through the Royal College of Surgeons in Ireland (RCSI) database and invited to complete an online survey. Statistical analysis was performed using SPSS version 15, with p < 0.05 considered significant. RESULTS: During the 5-year quantitative study period there were 381 BST trainees. Gender was a significant predictor of career choice with women more likely to ultimately choose a nonsurgical career after initial surgical training (p = 0.049). Passing surgical membership examinations (MRCS) also was predictive of remaining in surgery (p = 0.005). Training region was not a significant predictor of ultimate career choice. There were 418 survey respondents. The influence of role models was most commonly cited as influencing candidates in choosing to commence surgical training. Candidates who rated "academic opportunity" (p = 0.023) and "intellectual challenge" (p = 0.047) as factors that influenced their decision to commence surgical training were more likely to ultimately continue their careers in a surgical speciality. CONCLUSIONS: This study describes the career pathway of surgical trainees and confirms the importance of academic achievement in discriminating between candidates applying for surgical training schemes.

  6. Bariatric surgery and the changing current scope of general surgery practice: implications for general surgery residency training.

    Science.gov (United States)

    Mostaedi, Rouzbeh; Ali, Mohamed R; Pierce, Jonathan L; Scherer, Lynette A; Galante, Joseph M

    2015-02-01

    The scope of general surgery practice has evolved tremendously in the last 20 years. However, clinical experience in general surgery residency training has undergone relatively little change. To evaluate the current scope of academic general surgery and its implications on surgical residency. The University HealthSystem Consortium and Association of American Medical Colleges established the Faculty Practice Solution Center (FPSC) to characterize physician productivity. The FPSC is a benchmarking tool for academic medical centers created from revenue data collected from more than 90,000 physicians who practice at 95 institutions across the United States. The FPSC database was queried to evaluate the annual mean procedure frequency per surgeon (PFS) in each calendar year from 2006 through 2011. The associated work relative value units (wRVUs) were also examined to measure physician effort and skill. During the 6-year period, 146 distinct Current Procedural Terminology codes were among the top 100 procedures, and 16 of these procedures ranked in the top 10 procedures in at least 1 year. The top 10 procedures accounted for more than half (range, 52.5%-57.2%) of the total 100 PFS evaluated for each year. Laparoscopic Roux-en-Y gastric bypass was consistently among the top 10 procedures in each year (PFS, 18.2-24.6). The other most frequently performed procedures included laparoscopic cholecystectomy (PFS, 30.3-43.5), upper gastrointestinal tract endoscopy (PFS, 26.5-34.3), mastectomy (PFS, 16.5-35.0), inguinal hernia repair (PFS, 15.5-22.1), and abdominal wall hernia repair (PFS, 21.6-26.1). In all years, laparoscopic Roux-en-Y gastric bypass generated the highest number of wRVUs (wRVUs, 491.0-618.2), and laparoscopic cholecystectomy was regularly the next highest (wRVUs, 335.8-498.7). A significant proportion of academic general surgery is composed of bariatric surgery, yet surgical training does not sufficiently emphasize the necessary exposure to technical expertise

  7. Virtual reality training for surgical trainees in laparoscopic surgery.

    Science.gov (United States)

    Nagendran, Myura; Gurusamy, Kurinchi Selvan; Aggarwal, Rajesh; Loizidou, Marilena; Davidson, Brian R

    2013-08-27

    Standard surgical training has traditionally been one of apprenticeship, where the surgical trainee learns to perform surgery under the supervision of a trained surgeon. This is time-consuming, costly, and of variable effectiveness. Training using a virtual reality simulator is an option to supplement standard training. Virtual reality training improves the technical skills of surgical trainees such as decreased time for suturing and improved accuracy. The clinical impact of virtual reality training is not known. To assess the benefits (increased surgical proficiency and improved patient outcomes) and harms (potentially worse patient outcomes) of supplementary virtual reality training of surgical trainees with limited laparoscopic experience. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE and Science Citation Index Expanded until July 2012. We included all randomised clinical trials comparing virtual reality training versus other forms of training including box-trainer training, no training, or standard laparoscopic training in surgical trainees with little laparoscopic experience. We also planned to include trials comparing different methods of virtual reality training. We included only trials that assessed the outcomes in people undergoing laparoscopic surgery. Two authors independently identified trials and collected data. We analysed the data with both the fixed-effect and the random-effects models using Review Manager 5 analysis. For each outcome we calculated the mean difference (MD) or standardised mean difference (SMD) with 95% confidence intervals based on intention-to-treat analysis. We included eight trials covering 109 surgical trainees with limited laparoscopic experience. Of the eight trials, six compared virtual reality versus no supplementary training. One trial compared virtual reality training versus box-trainer training and versus no supplementary training, and one trial compared

  8. Training manual for precision hand deburring, Part 2

    Energy Technology Data Exchange (ETDEWEB)

    Gillespie, L.K.

    1980-12-01

    Part 2 is presented of a 4-part training manual to be used by machinist trainees, production workers, and others removing burrs from precision miniature parts. The manuals are written to be self-teaching and are intended to be used with two hours of training each day along with another six hours of bench work in deburring.

  9. Training manual for precision hand deburring, Part 1

    Energy Technology Data Exchange (ETDEWEB)

    Gillespie, L.K.

    1980-05-01

    Part 1 is presented of 4 parts of a training manual to be used by machinist trainees, production workers, and others removing burrs from precision miniature parts. The manuals are written to be self-teaching and are intended to be used with two hours of training each day and are intended to be used with two hours of training each day along with another six hours of bench work in deburring.

  10. Robotic Surgery Simulator: Elements to Build a Training Program.

    Science.gov (United States)

    Tillou, Xavier; Collon, Sylvie; Martin-Francois, Sandrine; Doerfler, Arnaud

    2016-01-01

    Face, content, and construct validity of robotic surgery simulators were confirmed in the literature by several studies, but elements to build a training program are still lacking. The aim of our study was to validate a progressive training program and to assess according to prior surgical experience the amount of training needed with a robotic simulator to complete the program. Exercises using the Da Vinci Skill Simulator were chosen to ensure progressive learning. A new exercise could only be started if a minimal score of 80% was achieved in the prior one. The number of repetitions to achieve an exercise was not limited. We devised a "performance index" by calculating the ratio of the sum of scores for each exercise over the number of repetitions needed to complete the exercise with at least an 80% score. The study took place at the François Baclesse Cancer Center. Participants all work at the primary care university Hospital located next to the cancer center. A total of 32 surgeons participated in the study- 2 experienced surgeons, 8 junior and 8 senior residents in surgery, 6 registrars, and 6 attending surgeons. There was no difference between junior and senior residents, whereas the registrars had better results (p < 0.0001). The registrars performed less exercise repetitions compared to the junior or senior residents (p = 0.012). Attending surgeons performed significantly more repetitions than registrars (p = 0.024), but they performed fewer repetitions than junior or senior residents with no statistical difference (p = 0.09). The registrars had a performance index of 50, which is the best result among all novice groups. Attending surgeons were between senior and junior residents with an index at 33.85. Choice of basic exercises to manipulate different elements of the robotic surgery console in a specific and progressive order enables rapid progress. The level of prior experience in laparoscopic surgery affects outcomes. More advanced laparoscopic expertise

  11. Outcomes research in pediatric surgery. Part 1: overview and resources.

    Science.gov (United States)

    Abdullah, Fizan; Ortega, Gezzer; Islam, Saleem; Barnhart, Douglas C; St Peter, Shawn D; Lee, Steven L; Glynn, Loretto; Teitelbaum, Daniel H; Arca, Marjorie J; Chang, David C

    2011-01-01

    Outcomes research in pediatric surgery can be defined as the analysis of pediatric surgical outcomes and their predictors at different levels in the health care delivery system. The objectives of this article are to understand the differences between outcomes research and clinical trials as well as to gain familiarity with public multispecialty and specialty-specific databases. The utility of outcomes research extends to benchmarking the quality of care, refinement of management strategies, patient education, and marketing. Assessment of the integration of a new surgical technique into the health care system is best determined by examining a population-based registry, whereas comparative efficacy of surgical procedures is best assessed by randomized clinical trials. In the first part of this 2-part series, an overview and brief outline of available resources for outcomes research in pediatric surgery are reviewed. In part 2, a template is presented on how to structure and design an outcomes research question. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. Need for simulation in laparoscopic colorectal surgery training

    Institute of Scientific and Technical Information of China (English)

    Valerio; Celentano

    2015-01-01

    The dissemination of laparoscopic colorectal surgery(LCS) has been slow despite increasing evidence for the clinical benefits, with a prolonged learning curve being one of the main restrictions for a prompt uptake. Performing advanced laparoscopic procedures requires dedicated surgical skills and new simulation methods designed precisely for LCS have been established: These include virtual reality simulators, box trainers, animal andhuman tissue and synthetic materials. Studies have even demonstrated an improvement in trainees’ laparoscopic skills in the actual operating room and a staged approach to surgical simulation with a combination of various training methods should be mandatory in every colorectal training program. The learning curve for LCS could be reduced through practice and skills development in a riskfree setting.

  13. Training effect of using Touch Surgery for intramedullary femoral nailing.

    Science.gov (United States)

    Sugand, Kapil; Mawkin, Mala; Gupte, Chinmay

    2016-02-01

    Simulation in orthopaedic training is becoming increasingly popular and has been widely used in formal curricula. However, these resources are expensive and not easily accessible to every trainee. Other means of disseminating surgical education through virtual reality (VR) multimedia can act as useful adjunct to traditional methods of teaching. One validated VR platform is Touch Surgery, a cognitive task simulation and rehearsal app. The primary objective of this study was to identify the training effect of Touch Surgery intramedullary femoral nailing (IFN) modules using objective performance metrics over six consecutive attempts. Secondary objectives consisted of validated multiple choice questions (MCQ) testing before the first (pre) and after the sixth (post) attempts. 27 medical undergraduates were recruited to complete the decision-making process six consecutive times for four modules on the procedural steps of IFN. The modules consisted of (i) preparing the patient and equipment, (ii) femoral canal preparation, (iii) nail insertion and proximal locking, and (iv) distal locking and closure. Real-time objective performance metrics were obtained, stored electronically and analysed using the median and Bonett-Price 95% confidence intervals from the participants' attempts to assess training effect. Significance was calculated using the Mann-Whitney U test for independent data whilst the Wilcoxon signed ranked test was used for paired data. Significance was set as 2-tailed p-value training effect with practice. Novices demonstrated cognitive competencies to ensure patient safety prior to operating. The app is an effective adjunct to traditional learning methods and has the potential for curricular implementation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Ongoing deficits in resident training for minimally invasive surgery.

    Science.gov (United States)

    Park, Adrian; Witzke, Donald; Donnelly, Michael

    2002-01-01

    Patient preference has driven the adoption of minimally invasive surgery (MIS) techniques and altered surgical practice. MIS training in surgical residency programs must teach new skill sets with steep learning curves to enable residents to master key procedures. Because no nationally recognized MIS curriculum exists, this study asked experts in MIS which laparoscopic procedures should be taught and how many cases are required for competency. Expert recommendations were compared to the number of cases actually performed by residents (Residency Review Committee [RRC] data). A detailed survey was sent nationwide to all surgical residency programs (academic and private) known to offer training in MIS and/or have a leader in the field. The response rate was approximately 52%. RRC data were obtained from the resident statistics summary report for 1998-1999. Experts identified core procedures for MIS training and consistently voiced the opinion that to become competent, residents need to perform these procedures many more times than the RRC data indicate they currently do. At present, American surgical residency programs do not meet the suggested MIS case range or volume required for competency. Residency programs need to be restructured to incorporate sufficient exposure to core MIS procedures. More expert faculty must be recruited to train residents to meet the increasing demand for laparoscopy.

  15. Perceptions of society for vascular surgery members and surgery department chairs of the integrated 0 + 5 vascular surgery training paradigm.

    Science.gov (United States)

    Kiguchi, Misaki; Leake, Andrew; Switzer, Galen; Mitchell, Erica; Makaroun, Michel; Chaer, Rabih A

    2014-01-01

    As the first generation of integrated (0 + 5) vascular surgery (VS) residents enter the job market, this survey sought to understand how the surgical community perceives this training paradigm. An anonymous online survey was e-mailed to surgery chairpersons (n = 193) and Society for Vascular Surgery (SVS) members (n = 2193) in the United States/Canada with 26% (n = 38) and 14% (n = 309) response rates, respectively. Respondents were asked about their practice background, residency program, hiring patterns, and perceptions of the 0 + 5 training. Response rates were 26% (n = 38) and 14% (n = 309) for surgery chairpersons and SVS members, respectively. SVS respondents were from academic (62%) and private (38%) practices and included staff surgeons (62%), program directors (15%), and division chiefs (22%). Only 33% had a 0 + 5 program, and 57% had a VS fellowship. Overall, 94% were likely to hire a new vascular surgeon in the next 5 years. In some categories, SVS respondents believed 0 + 5 residents would be less prepared than 5 + 2 residents. Only 32% thought that 0 + 5 residents have the same level of surgical maturity, and 36% thought that they have the same level of open operative skills as 5 + 2 trainees. Another 34% thought 0 + 5 residents will need additional fellowship training in open surgery. However, there was also a general perception from SVS respondents that 0 + 5 residents would be prepared for clinical practice (67%) and would have equal endovascular skills to 5 + 2 trainees (92%). The chairpersons had similar perceptions as SVS members. Both SVS members (88%) and chairpersons (86%) would consider interviewing a 0 + 5 graduate for faculty position; 83% and 72%, respectively, would consider hiring. Moreover, 93% of SVS respondents who currently have a 0 + 5 program and 86% of SVS respondents who do not would consider hiring a 0 + 5 graduate. Both SVS members (62%) and chairpersons (50%) believed the 0 + 5 paradigm is essential for the advancement of VS

  16. Training and practice of pediatric surgery in Africa: past, present, and future.

    Science.gov (United States)

    Elhalaby, Essam A; Uba, Francis A; Borgstein, Eric S; Rode, Heinz; Millar, Alastair J W

    2012-05-01

    The evolution and recognition of pediatric surgery as a specialty in Africa can be divided into 4 distinct phases, starting from early 1920s till the present. The pace of development has been quite variable in different parts of Africa. Despite all recent developments, the practice of pediatric surgery in Africa continues to face multiple challenges, including limited facilities, manpower shortages, the large number of sick children, disease patterns specific to the region, late presentation and advanced pathology, lack of pediatric surgeons outside the tertiary hospitals, and inadequate governmental support. Standardization of pediatric surgery training across the continent is advocated. Collaboration with well-established pediatric surgical training centers in Africa and other developed countries is necessary. The problems of delivery of pediatric surgical services need to be addressed urgently, if the African child is to have access to essential pediatric surgical services like his or her counterpart in the high-income parts of the world. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Training manual for precision hand deburring, Part 3

    Energy Technology Data Exchange (ETDEWEB)

    Gillespie, L.K.

    1981-03-01

    This publication is Part 3 of a 4 part training manual to be used by machinist trainees, production workers, and others removing burrs from precision miniature parts. The manuals are written to be self-teaching and are intended to be used with two hours of training each day along with six additional hours of bench work in deburring. This part describes mounted stones, scrapers, hand stones, abrasive filled rubber and cotton tools, abrasive paper products, felt bobs and lapping compounds, mandrels and arbors, miscellaneous tools, personal techniques for assuring quality, cleaning parts, and deburring gears and plastic parts.

  18. Porcine Model In The Laparoscopic Liver Surgery Training

    Directory of Open Access Journals (Sweden)

    Komorowski Andrzej L.

    2015-08-01

    Full Text Available The aim of the study was to evaluate the possibility to use live anesthetized pigs as a model for laparoscopic liver resection. During two days laparoscopy course two trainees were operating on two live animals performing exposure of the liver, Pringle manoeuver, division of liver ligaments, dissecting of the structures inside the hepatoduodenal ligament, dissection of the hepatic veins and left lateral liver sectionectomy. Exposure of the liver and Pringle manoeuver were performed correctly within 50 and 35 minutes. Left lateral sectionectomy has been performed correctly within 2 hours. The full dissection of the hepatoduodenal ligament and exposure of the hepatic veins were judged as insufficient by experienced laparoscopic tutors. There was one injury to the suprahepatic vena cava that was managed laparoscopically. The porcine model can be used as an advanced training for laparoscopic liver surgery.

  19. A survey of the pediatric surgery program directors: optimizing resident research to make pediatric surgery training more efficient.

    Science.gov (United States)

    Markel, Troy A; Rescorla, Frederick J

    2015-06-01

    Resident Research (RR) has been a presumed requirement for pediatric surgery fellowship candidates. We hypothesized that: 1) pediatric surgery leaders would no longer feel that RR was necessary for fellowship candidates, 2) the type of study performed would not impact a program's opinion of candidates, and 3) the timing of RR could be altered for those interested in a research career. An anonymous survey was sent to pediatric surgery fellowship program directors (PDs). Sixty-three percent responded, and answers were compared via Chi square analysis with ppediatric surgery fellowship candidates. Seventy-five percent had no preference between one or two years of research (p=0.0005), 79% placed no heavier weight on basic or clinical research (psurgery may not be necessary. Pediatric surgery candidates who partake in RR are not penalized for their choice of study. Increasing efficiency of training is important in today's era of medical training. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Minimally invasive pediatric surgery: Increasing implementation in daily practice and resident's training

    NARCIS (Netherlands)

    E.A.T. Velde (Te); N.M.A. Bax (Klaas); S.H.A.J. Tytgat; J.R. de Jong (Justin); D.V. Travassos (Vieira); W.L.M. Kramer; D.C. van der Zee (David)

    2008-01-01

    textabstractBackground: In 1998, the one-year experience in minimally invasive abdominal surgery in children at a pediatric training center was assessed. Seven years later, we determined the current status of pediatric minimally invasive surgery in daily practice and surgical training. Methods: A

  1. Minimally invasive pediatric surgery : Increasing implementation in daily practice and resident's training

    NARCIS (Netherlands)

    Velde, E. A. te; Bax, N. M. A.; Tytgat, S. H. A. J.; de Jong, J. R.; Travassos, D. Vieira; Kramer, W. L. M.; van der Zee, D. C.

    Background: In 1998, the one-year experience in minimally invasive abdominal surgery in children at a pediatric training center was assessed. Seven years later, we determined the current status of pediatric minimally invasive surgery in daily practice and surgical training. Methods: A retrospective

  2. Inspiratory Muscle Training and Functional Capacity in Patients Undergoing Cardiac Surgery

    OpenAIRE

    André Luiz Lisboa Cordeiro; Thiago Araújo de Melo; Daniela Neves; Julianne Luna; Mateus Souza Esquivel; André Raimundo França Guimarães; Daniel Lago Borges; Jefferson Petto

    2016-01-01

    Abstract Introduction: Cardiac surgery is a highly complex procedure which generates worsening of lung function and decreased inspiratory muscle strength. The inspiratory muscle training becomes effective for muscle strengthening and can improve functional capacity. Objective: To investigate the effect of inspiratory muscle training on functional capacity submaximal and inspiratory muscle strength in patients undergoing cardiac surgery. Methods: This is a clinical randomized controlled tri...

  3. Voluntary autonomous simulator based training in minimally invasive surgery, residents' compliance and reflection

    NARCIS (Netherlands)

    van Empel, P.J.; Verdam, M.G.E.; Strypet, M.; van Rijssen, L.B.; Huirne, J. A.; Scheele, F.; Bonjer, H.J.; Meijerink, W.J.

    2012-01-01

    Background: Knot tying and suturing skills in minimally invasive surgery (MIS) differ markedly from those in open surgery. Appropriate MIS training is mandatory before implementation into practice. The Advanced Suturing Course (ASC) is a structured simulator based training course that includes a 6-w

  4. General surgery training in Spain: core curriculum and specific areas of training.

    Science.gov (United States)

    Miguelena Bobadilla, José Ma; Morales-García, Dieter; Iturburu Belmonte, Ignacio; Alcázar Montero, José Antonio; Serra Aracil, Xabier; Docobo Durantez, Fernando; López de Cenarruzabeitia, Ignacio; Sanz Sánchez, Mercedes; Hernández Hernández, Juan Ramón

    2015-03-01

    The royal decree RD 639/2014 has been published, regulating among others, the core curriculum, and specific areas of training (SAT). It is of great interest for the specialty of General and Digestive Surgery (GS and DS). The aim is to expose and clarify the main provisions and reflect on their implications for the practical application of the core curriculum and SAT in the specialty of General and Digestive Surgery, to promote initiatives and regulations. This RD will be a milestone in our specialty that will test the strength of the specialty, if it does not finally culminate in its degradation against the emergence of new surgical specialties. A new stage begins in which the Spanish Association of Surgeons should be involved to define the conceptual basis of GS and DS in the XXI century, and the creation of new SAT to continue to maintain the "essence of our specialty".

  5. Advanced GI Surgery Training-a Roadmap for the Future: the White Paper from the SSAT Task Force on Advanced GI Surgery Training.

    Science.gov (United States)

    Hutter, Matthew M; Behrns, Kevin E; Soper, Nathaniel J; Michelassi, Fabrizio

    2017-04-01

    There is the need for well-trained advanced GI surgeons. The super specialization seen in academic and large community centers may not be applicable for surgeons practicing in other settings. The pendulum that has been swinging toward narrow specialization is swinging the other way, as many trained subspecialists are having a harder time finding positions after fellowship, and if they do find a position, the majority of their practice can actually be advanced GI surgery and not exclusively their area of focused expertise. Many hospitals/practices desire surgeons who are competent and specifically credentialed to perform a variety of advanced GI procedures from the esophagus through the anus. Furthermore, broader exposure in training may provide complementary and overlapping skills that may lead to an even better trained GI surgeon compared to someone whose experience is limited to just the liver and pancreas, or to just the colon and rectum, or to only bariatric and foregut surgery. With work hour restrictions and limitations on autonomy for current trainees in residency, many senior trainees have not developed the skills and knowledge to allow them to be competent and comfortable in the broad range of GI surgery. Such training should reflect the needs of the patients and their diseases, and reflect what many practicing surgeons are currently doing, and what many trainees say they would like to do, if there were such fellowship pathways available to them. The goal is to train advanced GI surgeons who are competent and proficient to operate throughout the GI tract and abdomen with open, laparoscopic, and endoscopic techniques in acute and elective situations in a broad variety of complex GI diseases. The program may be standalone, or prepare a surgeon for additional subspecialty training (transition to fellowship and/or to practice). This group of surgeons should be distinguished from subspecialist surgeons who focus in a narrow area of GI surgery. Advanced GI

  6. Take part in a Django Girls training!

    CERN Multimedia

    2016-01-01

    Women are often under-represented in IT. And yet, at any age and whatever their level and background, it is a field that can arouse much interest.    To overcome this under-representation, the R0SEH1PSters community organises Django workshops targeted at women to introduce them to the world of coding and technology by teaching them how to successfully create a blog application and deploy it to the internet. And who knows, a spark of interest in the newly-discovered IT world may develop into a shine! The aim of Django Girls is also to increase the diversity within the industry. The mentors are mainly female volunteers who bring their passion to the workshop and are part of the awesome atmosphere attendees can feel during each event. Workshops have been organised worldwide regularly since 2014. Hosted by IdeaSquare and supported by the CERN IT department and the Diversity team, the Geneva workshop will take place in the evening on Friday evening, 26 February, and al...

  7. [Oral and maxillofacial surgery residency training in the United States: what can we learn].

    Science.gov (United States)

    Ren, Y F

    2017-04-09

    China is currently in the process of establishing formal residency training programs in oral and maxillofacial surgery and other medical and dental specialties. Regulatory agencies, and educational and academic institutions in China are exploring mechanisms, goals and standards of residency training that meet the needs of the Chinese healthcare system. This article provides an introduction of residency training in oral and maxillofacial surgery in the United States, with emphasis on the accreditation standard by the Commission on Dental Accreditation. As there are fundamental differences in the medical and dental education systems between China and United States, the training standards in the United States may not be entirely applicable in China. A competency-based training model that focus on overall competencies in medical knowledge, clinical skills and values at the time of graduation should be taken into consideration in a Chinese residency training program in oral and maxillofacial surgery.

  8. Repeated-sprint ability - part II: recommendations for training.

    Science.gov (United States)

    Bishop, David; Girard, Olivier; Mendez-Villanueva, Alberto

    2011-09-01

    Short-duration sprints, interspersed with brief recoveries, are common during most team sports. The ability to produce the best possible average sprint performance over a series of sprints (≤10 seconds), separated by short (≤60 seconds) recovery periods has been termed repeated-sprint ability (RSA). RSA is therefore an important fitness requirement of team-sport athletes, and it is important to better understand training strategies that can improve this fitness component. Surprisingly, however, there has been little research about the best training methods to improve RSA. In the absence of strong scientific evidence, two principal training theories have emerged. One is based on the concept of training specificity and maintains that the best way to train RSA is to perform repeated sprints. The second proposes that training interventions that target the main factors limiting RSA may be a more effective approach. The aim of this review (Part II) is to critically analyse training strategies to improve both RSA and the underlying factors responsible for fatigue during repeated sprints (see Part I of the preceding companion article). This review has highlighted that there is not one type of training that can be recommended to best improve RSA and all of the factors believed to be responsible for performance decrements during repeated-sprint tasks. This is not surprising, as RSA is a complex fitness component that depends on both metabolic (e.g. oxidative capacity, phosphocreatine recovery and H+ buffering) and neural factors (e.g. muscle activation and recruitment strategies) among others. While different training strategies can be used in order to improve each of these potential limiting factors, and in turn RSA, two key recommendations emerge from this review; it is important to include (i) some training to improve single-sprint performance (e.g. 'traditional' sprint training and strength/power training); and (ii) some high-intensity (80-90% maximal oxygen

  9. Urology residents training in laparoscopic surgery. Development of a virtual reality model.

    Science.gov (United States)

    Gutiérrez-Baños, J L; Ballestero-Diego, R; Truan-Cacho, D; Aguilera-Tubet, C; Villanueva-Peña, A; Manuel-Palazuelos, J C

    2015-11-01

    The training and learning of residents in laparoscopic surgery has legal, financial and technological limitations. Simulation is an essential tool in the training of residents as a supplement to their training in laparoscopic surgery. The training should be structured in an appropriate environment, with previously established and clear objectives, taught by professionals with clinical and teaching experience in simulation. The training should be conducted with realistic models using animals and ex-vivo tissue from animals. It is essential to incorporate mechanisms to assess the objectives during the residents' training progress. We present the training model for laparoscopic surgery for urology residents at the University Hospital Valdecilla. The training is conducted at the Virtual Hospital Valdecilla, which is associated with the Center for Medical Simulation in Boston and is accredited by the American College of Surgeons. The model is designed in 3 blocks, basic for R1, intermediate for R2-3 and advanced for R4-5, with 9 training modules. The training is conducted in 4-hour sessions for 4 afternoons, for 3 weeks per year of residence. Residents therefore perform 240 hours of simulated laparoscopic training by the end of the course. For each module, we use structured objective assessments to measure each resident's training progress. Since 2003, 9 urology residents have been trained, in addition to the 5 who are currently in training. The model has undergone changes according to the needs expressed in the student feedback. The acquisition of skills in a virtual reality model has enabled the safe transfer of those skills to actual practice. A laparoscopic surgery training program designed in structured blocks and with progressive complexity provides appropriate training for transferring the skills acquired using this model to an actual scenario while maintaining patient safety. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Operating Room Performance Improves after Proficiency-Based Virtual Reality Cataract Surgery Training

    DEFF Research Database (Denmark)

    Thomsen, Ann Sofia Skou; Bach-Holm, Daniella; Kjærbo, Hadi

    2017-01-01

    PURPOSE: To investigate the effect of virtual reality proficiency-based training on actual cataract surgery performance. The secondary purpose of the study was to define which surgeons benefit from virtual reality training. DESIGN: Multicenter masked clinical trial. PARTICIPANTS: Eighteen cataract...... surgeons with different levels of experience. METHODS: Cataract surgical training on a virtual reality simulator (EyeSi) until a proficiency-based test was passed. MAIN OUTCOME MEASURES: Technical performance in the operating room (OR) assessed by 3 independent, masked raters using a previously validated...... task-specific assessment tool for cataract surgery (Objective Structured Assessment of Cataract Surgical Skill). Three surgeries before and 3 surgeries after the virtual reality training were video-recorded, anonymized, and presented to the raters in random order. RESULTS: Novices (non...

  11. Operating Room Performance Improves after Proficiency-Based Virtual Reality Cataract Surgery Training.

    Science.gov (United States)

    Thomsen, Ann Sofia Skou; Bach-Holm, Daniella; Kjærbo, Hadi; Højgaard-Olsen, Klavs; Subhi, Yousif; Saleh, George M; Park, Yoon Soo; la Cour, Morten; Konge, Lars

    2017-04-01

    To investigate the effect of virtual reality proficiency-based training on actual cataract surgery performance. The secondary purpose of the study was to define which surgeons benefit from virtual reality training. Multicenter masked clinical trial. Eighteen cataract surgeons with different levels of experience. Cataract surgical training on a virtual reality simulator (EyeSi) until a proficiency-based test was passed. Technical performance in the operating room (OR) assessed by 3 independent, masked raters using a previously validated task-specific assessment tool for cataract surgery (Objective Structured Assessment of Cataract Surgical Skill). Three surgeries before and 3 surgeries after the virtual reality training were video-recorded, anonymized, and presented to the raters in random order. Novices (non-independently operating surgeons) and surgeons having performed fewer than 75 independent cataract surgeries showed significant improvements in the OR-32% and 38%, respectively-after virtual reality training (P = 0.008 and P = 0.018). More experienced cataract surgeons did not benefit from simulator training. The reliability of the assessments was high with a generalizability coefficient of 0.92 and 0.86 before and after the virtual reality training, respectively. Clinically relevant cataract surgical skills can be improved by proficiency-based training on a virtual reality simulator. Novices as well as surgeons with an intermediate level of experience showed improvement in OR performance score. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  12. Pointing with a One-Eyed Cursor for Supervised Training in Minimally Invasive Robotic Surgery

    DEFF Research Database (Denmark)

    Kibsgaard, Martin; Kraus, Martin

    2016-01-01

    Pointing in the endoscopic view of a surgical robot is a natural and effcient way for instructors to communicate with trainees in robot-assisted minimally invasive surgery. However, pointing in a stereo-endoscopic view can be limited by problems such as video delay, double vision, arm fatigue......-day training units in robot- assisted minimally invasive surgery on anaesthetised pigs....

  13. Vaccine cold chain: Part 2. Training personnel and program management.

    Science.gov (United States)

    Rogers, Bonnie; Dennison, Kim; Adepoju, Nikki; Dowd, Shelia; Uedoi, Kenneth

    2010-09-01

    The Centers for Disease Control and Prevention reports that professionals in clinic settings may not be adequately storing and handling vaccine, leading to insufficient immunity of vaccinated individuals. Part 2 of this article provides information about the importance of adequate personnel training and program management policies and procedures needed to implement and maintain an effective vaccine cold chain program. Copyright 2010, SLACK Incorporated.

  14. Advances in training for laparoscopic and robotic surgery

    NARCIS (Netherlands)

    Schreuder, H.W.R.

    2011-01-01

    Laparoscopic surgery is rapidly becoming a standard in many surgical procedures. This surgical technique should be mastered, up to a certain level, by all surgeons. Several unique psychomotor skills are required from the surgeon in order to perform laparoscopic surgery safely. These skills can be le

  15. Virtual reality training and equipment handling in laparoscopic surgery

    NARCIS (Netherlands)

    Verdaasdonk, E.G.G.

    2008-01-01

    Laparoscopic surgery is one of the most important surgical innovations of the 20th century. Despite the well-known benefits for the patient, such as reduced pain, reduced hospital stay and quicker return to normal physical activities, there are also some drawbacks. Performing laparoscopic surgery re

  16. Virtual reality training and equipment handling in laparoscopic surgery

    NARCIS (Netherlands)

    Verdaasdonk, E.G.G.

    2008-01-01

    Laparoscopic surgery is one of the most important surgical innovations of the 20th century. Despite the well-known benefits for the patient, such as reduced pain, reduced hospital stay and quicker return to normal physical activities, there are also some drawbacks. Performing laparoscopic surgery

  17. Advances in training for laparoscopic and robotic surgery

    NARCIS (Netherlands)

    Schreuder, H.W.R.

    2011-01-01

    Laparoscopic surgery is rapidly becoming a standard in many surgical procedures. This surgical technique should be mastered, up to a certain level, by all surgeons. Several unique psychomotor skills are required from the surgeon in order to perform laparoscopic surgery safely. These skills can be

  18. Perioperatory antibiotic prophylaxis in Pediatric Surgery (Part II: non-abdominal surgery.

    Directory of Open Access Journals (Sweden)

    Sergio Luis González López

    2005-12-01

    Full Text Available The surgical wound infection is the biggest cause of infectious morbility in surgical patients. It is an important cause of morbility that causes lincreased hospital demurrages, increased cost of medical attention and serious inconveniences to the patients and their familiies. 25% of all nosocomial infections are surgical wound infection. One of the big advances of the surgery in the last three decades is an introduction of antibiotic prophylaxis in the surgical practice. Is considered that it has saved more lives than any other novel procedure in surgery in the last 20 years. We presented the Good Clinical Practices Guideline for Antibiotic prophylaxis in no-abdominal surgery, approved by consensus in the 1st National Good Clinical Practices Workshop in Pediatric Surgery (Cienfuegos, Cuba, March 7 – 9, 2002.

  19. Application of Mental Skills Training in Surgery: A Review of Its Effectiveness and Proposed Next Steps.

    Science.gov (United States)

    Anton, Nicholas E; Bean, Eric A; Hammonds, Samuel C; Stefanidis, Dimitrios

    2017-05-01

    Mental skills training, which refers to the teaching of performance enhancement and stress management psychological strategies, may benefit surgeons. Our objective was to review the application of mental skills training in surgery and contrast it to other domains, examine the effectiveness of this approach in enhancing surgical performance and reducing stress, and provide future directions for mental skills training in surgery. A systematic literature search of MEDLINE, PubMed, PsycINFO, and ClinicalKey was performed between 1996 and 2016. Keywords included were mental readiness, mental competency, mental skill, mental practice, imagery, mental imagery, mental rehearsal, stress management training, stress coping, mental training, performance enhancement, and surgery. Reviews of mental skills interventions in sport and well-regarded sport psychology textbooks were also reviewed. Primary outcome of interest was the effect of mental skills on surgical performance in the simulated or clinical environment. Of 490 identified abstracts, 28 articles met inclusion criteria and were reviewed. The majority of the literature provides evidence that mental imagery and stress management training programs are effective at enhancing surgical performance and reducing stress. Studies from other disciplines suggest that comprehensive mental skills programs may be more effective than imagery and stress management techniques alone. Given the demonstrated efficacy of mental imagery and stress management training in surgery and the incremental value of comprehensive mental skills curricula used in other domains, a concerted effort should be made to apply comprehensive mental skills curricula during surgical training.

  20. Harvey W. Cushing and cerebrovascular surgery: Part I, Aneurysms.

    Science.gov (United States)

    Cohen-Gadol, Aaron A; Spencer, Dennis D

    2004-09-01

    The development of surgical techniques for the treatment of intracranial aneurysms has paralleled the evolution of the specialty of neurological surgery. During the Cushing era, intracranial aneurysms were considered inoperable and only ligation of the carotid artery was performed. Cushing understood the limitations of this approach and advised the need for a more thorough understanding of aneurysm pathology before further consideration could be given to the surgical treatment of cerebral aneurysms. Despite his focus on brain tumors, Cushing's contributions to the discipline of neurovascular surgery are of great importance. With the assistance of Sir Charles Symonds, Cushing described the syndrome of subarachnoid hemorrhage. He considered inserting muscle strips into cerebral aneurysms to promote aneurysm sac thrombosis and designed the "silver clip," which was modified by McKenzie and later used by Dandy to clip the first intracranial aneurysm. Cushing was the first surgeon to wrap aneurysms in muscle fragments to prevent recurrent hemorrhage. He established the foundation on which pioneers such as Norman Dott and Walter Dandy launched the modern era of neurovascular surgery.

  1. Stereoscopic Augmented Reality System for Supervised Training on Minimal Invasive Surgery Robots

    DEFF Research Database (Denmark)

    Matu, Florin-Octavian; Thøgersen, Mikkel; Galsgaard, Bo

    2014-01-01

    Training in the use of robot-assisted surgery systems is necessary before a surgeon is able to perform procedures using these systems because the setup is very different from manual procedures. In addition, surgery robots are highly expensive to both acquire and maintain --- thereby entailing...... the need for efficient training. When training with the robot, the communication between the trainer and the trainee is limited, since the trainee often cannot see the trainer. To overcome this issue, this paper proposes an Augmented Reality (AR) system where the trainer is controlling two virtual robotic...

  2. Are Nursing Students Appropriate Partners for the Interdisciplinary Training of Surgery Residents?

    Science.gov (United States)

    Stefanidis, Dimitrios; Ingram, Katherine M; Williams, Kristy H; Bencken, Crystal L; Swiderski, Dawn

    2015-01-01

    Interdisciplinary team training in a simulation center recreates clinical team interactions and holds promise in improving teamwork of clinicians by breaking down educational silos. The objective of our study was to assess the appropriateness of interdisciplinary training with general surgery residents and nursing students. Over 2 consecutive academic years (2012-2013 and 2013-2014), general surgery residents participated in interdisciplinary team-training simulation-based sessions with senior nursing students. Scenario objectives included demonstration of appropriate teamwork and communication, and clinical decision making; sessions incorporated interdisciplinary debriefing of the scenarios. Participants were asked to assess their team-training experience and the appropriateness of their team-training partner. Responses were compared. A total of 16 team-training sessions were conducted during the study period. Overall, 12 surgery residents (67%) and 44 nursing students (63%) who had participated in at least 1 session responded to the survey. Although both residents and nursing students indicated that the knowledge and team skills acquired during these sessions were useful to them in clinical practice (73% vs 86%, respectively; p = not significant), residents rated their educational value lower (3.3 vs 4.3 on a 5-point scale, respectively; p nursing students (p nursing students, debriefing (91%), observation of others (68%), and interaction with resident physicians (66%) ranked highest; 48% of student nurses preferred residents as team-training partners whereas 100% residents preferred practicing nurses and 0% with nursing students owing to their limited clinical experience. Interdisciplinary team training and debriefing of surgery residents with nursing students is feasible and highly valued by nursing students. Nevertheless, our experience indicates that residents do not prefer nursing students as team-training partners owing to their limited clinical experience

  3. Virtual vitreoretinal surgery: validation of a training programme

    DEFF Research Database (Denmark)

    Vergmann, Anna Stage; Vestergaard, Anders Højslet; Grauslund, Jakob

    2016-01-01

    PURPOSE: To test the validity of the eyesi surgical simulator as an assessment tool in a virtual reality vitreoretinal training programme. METHODS: In collaboration with an experienced vitreoretinal surgeon, a virtual vitreoretinal training programme was composed on the eyesi surgical simulator...... surgical simulator as an assessment tool for overall score and for four of six vitreoretinal modules. These findings could potentially make the programme a useful tool in the training of future vitreoretinal surgeons....

  4. Training general surgery residents to avoid postoperative cardiac events.

    Science.gov (United States)

    McLean, Thomas R; McGoldrick, Jennifer; Fox, Sheryl; Haller, Chris C; Arevalo, Jane

    2007-11-01

    Expertise in cardiac risk assessment takes years to acquire, but unnecessary cardiology consultation delays treatment and consumes scarce resources. A retrospective review was performed of the cardiac work-up and postoperative events during 1 year on a general surgery service. Postgraduate year 1-3 general surgery residents were instructed to obtain a cardiology consult if a patient had any of the following: (1) had undergone coronary artery intervention more than 2 years in the past; (2) was taking an anti-anginal medication (nitroglycerine, Ca channel, or beta-blocker); or (3) was symptomatic or had an abnormal electrocardiogram. Whether a patient was symptomatic was to be tempered by the nature of the planned procedure. Supervised residents screened 720 unique patients for surgery. Cardiology consultation was obtained in 37. All but 1 (97%) patient referred to cardiology met at least 1 of the earlier-described criteria; with 8 (22%) meeting all 3 criteria. On average, patients referred to the cardiologists were taking 1.4 anti-anginal medications; and 1 patient sustained a fatal myocardial infarction after referral. Cardiac imaging (stress test or catheterization) was performed on 24 (65%) referred patients and was positive in 8 (33%). After minimizing cardiac risk by medication or intervention, the surgery service declined to offer the planned procedure to 11 (30%) of the referred patients and an additional 5 (15%) patients declined surgery. The overall surgical mortality was 2%. None of the patients in this series sustained a postoperative myocardial infarction or cardiac death. Postoperative supraventricular tachycardia was not influenced significantly by cardiology consultation (5% referred patients vs 1% nonreferred). Our criteria for obtaining cardiology consultation in general surgery patients appears to appropriately select patients in need of further work-up. Information obtained from a cardiac consultation frequently leads to a re-evaluation of the

  5. Inspiratory Muscle Training and Functional Capacity in Patients Undergoing Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    André Luiz Lisboa Cordeiro

    Full Text Available Abstract Introduction: Cardiac surgery is a highly complex procedure which generates worsening of lung function and decreased inspiratory muscle strength. The inspiratory muscle training becomes effective for muscle strengthening and can improve functional capacity. Objective: To investigate the effect of inspiratory muscle training on functional capacity submaximal and inspiratory muscle strength in patients undergoing cardiac surgery. Methods: This is a clinical randomized controlled trial with patients undergoing cardiac surgery at Instituto Nobre de Cardiologia. Patients were divided into two groups: control group and training. Preoperatively, were assessed the maximum inspiratory pressure and the distance covered in a 6-minute walk test. From the third postoperative day, the control group was managed according to the routine of the unit while the training group underwent daily protocol of respiratory muscle training until the day of discharge. Results: 50 patients, 27 (54% males were included, with a mean age of 56.7±13.9 years. After the analysis, the training group had significant increase in maximum inspiratory pressure (69.5±14.9 vs. 83.1±19.1 cmH2O, P=0.0073 and 6-minute walk test (422.4±102.8 vs. 502.4±112.8 m, P=0.0031. Conclusion: We conclude that inspiratory muscle training was effective in improving functional capacity submaximal and inspiratory muscle strength in this sample of patients undergoing cardiac surgery.

  6. Inspiratory Muscle Training and Functional Capacity in Patients Undergoing Cardiac Surgery

    Science.gov (United States)

    Cordeiro, André Luiz Lisboa; de Melo, Thiago Araújo; Neves, Daniela; Luna, Julianne; Esquivel, Mateus Souza; Guimarães, André Raimundo França; Borges, Daniel Lago; Petto, Jefferson

    2016-01-01

    Introduction Cardiac surgery is a highly complex procedure which generates worsening of lung function and decreased inspiratory muscle strength. The inspiratory muscle training becomes effective for muscle strengthening and can improve functional capacity. Objective To investigate the effect of inspiratory muscle training on functional capacity submaximal and inspiratory muscle strength in patients undergoing cardiac surgery. Methods This is a clinical randomized controlled trial with patients undergoing cardiac surgery at Instituto Nobre de Cardiologia. Patients were divided into two groups: control group and training. Preoperatively, were assessed the maximum inspiratory pressure and the distance covered in a 6-minute walk test. From the third postoperative day, the control group was managed according to the routine of the unit while the training group underwent daily protocol of respiratory muscle training until the day of discharge. Results 50 patients, 27 (54%) males were included, with a mean age of 56.7±13.9 years. After the analysis, the training group had significant increase in maximum inspiratory pressure (69.5±14.9 vs. 83.1±19.1 cmH2O, P=0.0073) and 6-minute walk test (422.4±102.8 vs. 502.4±112.8 m, P=0.0031). Conclusion We conclude that inspiratory muscle training was effective in improving functional capacity submaximal and inspiratory muscle strength in this sample of patients undergoing cardiac surgery. PMID:27556313

  7. Evaluation of a multimodal VR training platform for maxillofacial surgery

    DEFF Research Database (Denmark)

    Bouchigny, Sylvain; Mégard, Christine; Gabet, Ludovic;

    2011-01-01

    One of the most striking features of virtual reality systems is their ability to enrich training experience by allowing the developments of sophisticated feedbacks. This study focuses on the way to use modality management in virtual reality systems to accelerate training in a surgical task involv...

  8. Current status of residency training in laparoscopic surgery in Brazil: a critical review.

    Science.gov (United States)

    Nácul, Miguel Prestes; Cavazzola, Leandro Totti; de Melo, Marco Cezário

    2015-01-01

    The surgeon's formation process has changed in recent decades. The increase in medical schools, new specialties and modern technologies induce an overhaul of medical education. Medical residency in surgery has established itself as a key step in the formation of the surgeon, and represents the ideal and natural way for teaching laparoscopy. However, the introduction of laparoscopic surgery in the medical residency programs in surgical specialties is insufficient, creating the need for additional training after its termination. To review the surgical teaching ways used in services that published their results. Survey of relevant publications in books, internet and databases in PubMed, Lilacs and Scielo through july 2014 using the headings: laparoscopy; simulation; education, medical; learning; internship and residency. The training method for medical residency in surgery focused on surgical procedures in patients under supervision, has proven successful in the era of open surgery. However, conceptually turns as a process of experimentation in humans. Psychomotor learning must not be developed directly to the patient. Training in laparoscopic surgery requires the acquisition of psychomotor skills through training conducted initially with surgical simulation. Platforms based teaching problem solving as the Fundamentals of Laparoscopic Surgery, developed by the American Society of Gastrointestinal Endoscopic Surgery and the Laparoscopic Surgical Skills proposed by the European Society of Endoscopic Surgery has been widely used both for education and for the accreditation of surgeons worldwide. The establishment of a more appropriate pedagogical process for teaching laparoscopic surgery in the medical residency programs is mandatory in order to give a solid surgical education and to determine a structured and safe professional activity.

  9. Evaluation of a multimodal VR training platform for maxillofacial surgery

    DEFF Research Database (Denmark)

    Bouchigny, Sylvain; Mégard, Christine; Gabet, Ludovic

    2011-01-01

    One of the most striking features of virtual reality systems is their ability to enrich training experience by allowing the developments of sophisticated feedbacks. This study focuses on the way to use modality management in virtual reality systems to accelerate training in a surgical task...... involving bone drilling. The study compares the efficiency of two punctual drilling training protocol implemented on the MFS SKILLS platform. The experiments were conducted with residents from 2 university hospitals. The results show that augmented simulation improves acquisition of specific aspects...

  10. Feasibility of Progressive Strength Training Implemented in the Acute Ward after Hip Fracture Surgery

    DEFF Research Database (Denmark)

    Kronborg, Lise; Bandholm, Thomas; Palm, Henrik;

    2014-01-01

    IMPORTANCE: Patients with a hip fracture lose more than 50% knee-extension strength in the fractured limb within one week of surgery. Hence, immediate progressive strength training following hip fracture surgery may be rational, but the feasibility unknown. OBJECTIVE: To examine the feasibility...... of in-hospital progressive strength training implemented in the acute ward following hip fracture surgery, based on pre-specified criteria for feasibility. DESIGN, SETTING AND PATIENTS: A prospective cohort study conducted in an acute orthopedic hip fracture unit at a university hospital. A consecutive...... sample of 36 patients, 18 with a cervical and 18 with a trochanteric hip fracture (27 women and 9 men, mean (SD) age of 79.4 (8.3) years) were included between June and December 2012. INTERVENTION: A daily (on weekdays) program of progressive knee-extension strength training for the fractured limb, using...

  11. Technical skill set training in natural orifice transluminal endoscopic surgery: how should we approach it?

    LENUS (Irish Health Repository)

    Nugent, Emmeline

    2011-03-01

    The boundaries in minimally invasive techniques are continually being pushed further. Recent years have brought new and exciting changes with the advent of natural orifice transluminal endoscopic surgery. With the evolution of this field of surgery come challenges in the development of new instruments and the actual steps of the procedure. Included in these challenges is the idea of developing a proficiency-based curriculum for training.

  12. Can statins improve outcome in colorectal surgery?: Part I

    Directory of Open Access Journals (Sweden)

    Júlio César M Santos Jr

    2012-09-01

    Full Text Available Statins are recommended for people who have high serum cholesterol, and this role of statins has been well documented. However, some activities of statins, independent of their lipid-lowering effect, in conditions such as systemic inflammatory response syndrome, nephropathy, and other anti-inflammatory activities that reduce proinflammatory cytokines, are called "pleiotropic" effects of statins. For this reason, many candidates for surgical treatment are users of statins. As a result, benefits are observed in these patients, such as minimized postoperative complications, especially in cardiac or coronary surgery. This study was designed with the purpose of determining the current status of the use of statins as an adjuvant in the prevention of postoperative complications in colorectal surgery. Ongoing studies and future researches will help clarify the potential impact of statins on the prophylaxis of postoperative complications.As estatinas são drogas com o poder de inibir a hidroxi-metil-glutaril coenzima A redutase (HMG-CoA redutase, enzima que age na ativação da cadeia metabólica do colesterol. Portanto, sua principal ação, entre outros efeitos, é diminuir a concentração sérica total desse lipídeo. Por essa razão, muitas pessoas candidatas ao tratamento cirúrgico são pacientes usuários das estatinas. Seus outros efeitos, independente de sua capacidade para baixar os lipídeos circulantes, são denominados "efeitos pleiotrópicos" e estão, principalmente, relacionados à ação de bloqueio das atividades pró-inflamatórias, sobretudo minimizando, nos cardiopatas ou coronariopatas submetidos às operações cardíacas ou coronarianas, a prevalência da síndrome da reação inflamatória sistêmica, inclusive quando desencadeada por infecção. Estudos recentes têm sido elaborados para maiores conhecimentos dos mecanismos de ação das estatinas, especialmente em pacientes cardiopatas submetidos a tratamentos cirúrgicos n

  13. Surface anatomy and surface landmarks for thoracic surgery: Part II.

    Science.gov (United States)

    Smith, Shona E; Darling, Gail E

    2011-05-01

    Surface anatomy is an integral part of a thoracic surgeon's armamentarium to assist with the diagnosis, staging, and treatment of thoracic pathology. As reviewed in this article, the surface landmarks of the lungs, heart, great vessels, and mediastinum are critical for appropriate patient care and should be learned in conjunction with classic anatomy.

  14. A Comparison of Training Experience, Training Satisfaction, and Job Search Experiences between Integrated Vascular Surgery Residency and Traditional Vascular Surgery Fellowship Graduates.

    Science.gov (United States)

    Colvard, Benjamin; Shames, Murray; Schanzer, Andres; Rectenwald, John; Chaer, Rabih; Lee, Jason T

    2015-10-01

    The first 2 integrated vascular residents in the United States graduated in 2012, and in 2013, 11 more entered the job market. The purpose of this study was to compare the job search experiences of the first cohort of integrated 0 + 5 graduates to their counterparts completing traditional 5 + 2 fellowship programs. An anonymous, Web-based, 15-question survey was sent to all 11 graduating integrated residents in 2013 and to the 25 corresponding 5 + 2 graduating fellows within the same institution. Questions focused on the following domains: training experience, job search timelines and outcomes, and overall satisfaction with each training paradigm. Survey response was nearly 81% for the 0 + 5 graduates and 64% for the 5 + 2 graduates. Overall, there was no significant difference between residents and fellows in the operative experience obtained as measured by the number of open and endovascular cases logged. Dedicated research time during the entire training period was similar between residents and fellows. Nearly all graduates were extremely satisfied with their training and had positive experiences during their job searches with respect to starting salaries, numbers of offers, and desired practice type. More 0 + 5 residents chose academic and mixed practices over private practices compared with 5 + 2 fellowship graduates. Although longer term data are needed to understand the impact of the addition of 0 + 5 graduating residents to the vascular surgery work force, preliminary survey results suggest that both training paradigms (0 + 5 and 5 + 2) provide positive training experiences that result in excellent job search experiences. Based on the current and future need for vascular surgeons in the work force, the continued growth and expansion of integrated 0 + 5 vascular surgery residency positions as an alternative to traditional fellowship training is thus far justified. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Education in laparoscopic surgery : All eyes towards in vivo training

    NARCIS (Netherlands)

    Kramp, Kelvin Harvey

    2016-01-01

    Tegenwoordig worden steeds meer buikoperaties d.m.v. laparoscopische (knoopsgat) chirurgie uitgevoerd. Omdat deze manier van chirurgie zo anders is dan conventionele chirurgie staat tegenwoordig de manier van selectie, training en beoordeling van artsen in opleiding tot chirurg ter discussie in de w

  16. [The advantages of the short intensive training course in endoscopic surgery].

    Science.gov (United States)

    Fedorov, A V; Khripun, A I; Ivanov, A A; Gushchin, A V; Tariverdiev, M L; Sazhin, A V

    2013-01-01

    The advantages of one-day training courses on the example of the short intensive course "manual suture in endoscopic surgery" are represented. The programme consists of the short 8-hours course, including theoretic lectures, practice seminars, virtual trainings and the trainee's self work under the control of the experienced supervisors. The preliminary assessment of the course, performed with the use of questionnaires and testing in small groups, showed it's unarguable efficacy for surgeons.

  17. Economic impact of training and career decisions on urological surgery.

    Science.gov (United States)

    Langston, Joshua P; Kirby, E Will; Nielsen, Matthew E; Smith, Angela B; Woods, Michael E; Wallen, Eric M; Pruthi, Raj S

    2014-03-01

    Medical students and residents make career decisions at a relatively young age that have significant implications for their future income. While most of them attempt to estimate the impact of these decisions, there has been little effort to use economic principles to illustrate the impact of certain variables. The economic concept of net present value was paired with available Medical Group Management Association and Association of American Medical Colleges income data to calculate the value of career earnings based on variations in the choice of specialty, an academic vs a private practice career path and fellowship choices for urology and other medical fields. Across all specialties academic careers were associated with lower career earnings than private practice. However, among surgical specialties the lowest difference in value between these 2 paths was for urologists at only $334,898. Fellowship analysis showed that training in pediatric urology was costly in forgone attending salary and it also showed a lower future income than nonfellowship trained counterparts. An additional year of residency training (6 vs 5 years) caused a $201,500 decrease in the value of career earnings. Choice of specialty has a dramatic impact on future earnings, as does the decision to pursue a fellowship or choose private vs academic practice. Additional years of training and forgone wages have a tremendous impact on monetary outcomes. There is also no guarantee that fellowship training will translate into a more financially valuable career. The differential in income between private practice and academics was lowest for urologists. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. Center of Cardiac Surgery Robotic Computerized Telemanipulation as Part of a Comprehensive Approach to Advanced Heart Care

    Science.gov (United States)

    2011-10-01

    Robotic OR Appendix E: Comparison Chart of daVinci Simulator Skill Sets and Training Exercise Activities 1 INTRODUCTION Robotic surgery recently...techniques in endoscopic cardiac bypass surgery is important not only for surgeons and surgical teams just beginning to perform robotic surgery , but also...Director, Robotic Surgery Scott Keith, PhD Faculty, Division of Biostatistics Rebecca O’Shea, MBA Senior Vice President for Clinical

  19. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by a trained ... Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by a trained ...

  20. Implementing a robotics curriculum at an academic general surgery training program: our initial experience.

    Science.gov (United States)

    Winder, Joshua S; Juza, Ryan M; Sasaki, Jennifer; Rogers, Ann M; Pauli, Eric M; Haluck, Randy S; Estes, Stephanie J; Lyn-Sue, Jerome R

    2016-09-01

    The robotic surgical platform is being utilized by a growing number of hospitals across the country, including academic medical centers. Training programs are tasked with teaching their residents how to utilize this technology. To this end, we have developed and implemented a robotic surgical curriculum, and share our initial experience here. Our curriculum was implemented for all General Surgical residents for the academic year 2014-2015. The curriculum consisted of online training, readings, bedside training, console simulation, participating in ten cases as bedside first assistant, and operating at the console. 20 surgical residents were included. Residents were provided the curriculum and notified the department upon completion. Bedside assistance and operative console training were completed in the operating room through a mix of biliary, foregut, and colorectal cases. During the fiscal years of 2014 and 2015, there were 164 and 263 robot-assisted surgeries performed within the General Surgery Department, respectively. All 20 residents completed the online and bedside instruction portions of the curriculum. Of the 20 residents trained, 13/20 (65 %) sat at the Surgeon console during at least one case. Utilizing this curriculum, we have trained and incorporated residents into robot-assisted cases in an efficient manner. A successful curriculum must be based on didactic learning, reading, bedside training, simulation, and training in the operating room. Each program must examine their caseload and resident class to ensure proper exposure to this platform.

  1. Training satisfaction and work environment in Otorhinolaryngology, Head and Neck surgery: a comparison between France and Germany.

    Science.gov (United States)

    Oker, Natalie; Escabasse, Virginie; Pensky, Helge; Alotaibi, Naif; Coste, Andre; Albers, Andreas E

    2014-09-01

    With the coalescing of Europe, increased mobility of professionals emerges. Initiatives to harmonize medical education were launched. In Otolaryngology, Head and Neck surgery (ORL) an European board examination was created to ensure standards. Quality of training, satisfaction and quality of life of residents and recent ORL specialists were compared to assess different aspects of work and hierarchical relationships in France (FRA) and Germany (GER) by means of an anonymous questionnaire. 120 FRA and 125 GER questionnaires were included. 78 % of respondents were residents. 86 % would choose the same training again. In both countries, a majority felt well considered with responsibilities adapted to their level of training and with supportive supervisors. Germans reported average daily work hours of 9.6 versus 11 in FRA with compensated overtime (76 %) and a possibility of part-time work (62 %), both nearly inexistent in FRA. In GER, the day-off after duty was more often respected. French attributed their seniors better pedagogic skills, taking time for explanations and providing better teaching. Offering a good training was a more important objective in French training centers (77 vs. 51 %). In both countries, surgical training relied on coaching. Research activities were comparable. The overall satisfaction with ORL training was high. Differences concerned structure of training, guidance by senior doctors and the working conditions. The study results provide guidance before choosing a program and may help to improve current training by identifying positive aspects that, if combined could lead to a convergence of programs. However, present high standards of education must be maintained.

  2. Development and Validation of Cognitive Rehearsal as a Training Strategy for Arthroscopic Surgery

    Science.gov (United States)

    Kovacevic, David; Hodgins, Justin Lane; Lowe, Dylan T.; He, Janice; Popkin, Charles Aaron; Lynch, Thomas Sean; Ahmad, Christopher S.

    2016-01-01

    Objectives: Surgical performance is a highly intellectual activity that involves the processing of perceptual information from the five senses. Strategies to process, organize, and retain this perceptual information may benefit learning techniques. Once such strategy, cognitive rehearsal, is the activity where a skill is rehearsed in memory prior to the actual performance. This study aimed to develop and validate a cognitive rehearsal strategy for arthroscopic knee surgery in orthopaedic residents. We hypothesized that this training tool will lead to increased comfort and confidence with arthroscopic surgery performance. Methods: An expert surgeon was filmed performing an arthroscopic ACL reconstruction using patellar bone-tendon-bone autograft. An instructional training video was then created incorporating the extracorporeal and arthroscopic footage with voice over and subtitles. Following the surgery, cognitive recall of the procedure was conducted with the surgeon to identify key visual, cognitive, and kinesthetic cues to develop a mental imagery script to enhance rehearsal of arthroscopic surgery. Orthopaedic residents from two academic training programs were invited to participate. Demographic information including training level, previous musical experience, organized sports participation, and preferred learning style was collected. The training session consisted of a relaxation exercise, instructional video of an expert performing the procedure, learning the mental imagery script, and rehearsing the procedure out loud with a partner. The residents’ ability to rehearse the procedure was assessed before and after the training session with a modified version of a previously validated questionnaire, and a post-training session survey was administered to define which components of the rehearsal seemed most beneficial. Statistical analysis included a reliability analysis for internal consistency, and a nonparametric Wilcoxon test to compare the composite

  3. Results of consecutive training procedures in pediatric cardiac surgery

    Directory of Open Access Journals (Sweden)

    Campbell David N

    2010-11-01

    Full Text Available Abstract This report from a single institution describes the results of consecutive pediatric heart operations done by trainees under the supervision of a senior surgeon. The 3.1% mortality seen in 1067 index operations is comparable across procedures and risk bands to risk-stratified results reported by the Society of Thoracic Surgeons. With appropriate mentorship, surgeons-in-training are able to achieve good results as first operators.

  4. Education in laparoscopic surgery: All eyes towards in vivo training

    OpenAIRE

    2016-01-01

    Tegenwoordig worden steeds meer buikoperaties d.m.v. laparoscopische (knoopsgat) chirurgie uitgevoerd. Omdat deze manier van chirurgie zo anders is dan conventionele chirurgie staat tegenwoordig de manier van selectie, training en beoordeling van artsen in opleiding tot chirurg ter discussie in de wetenschap. Uit dit proefschrift blijkt dat neuropsychologische testen voor ruimtelijk inzicht en psychomotorische vaardigheden een voorspellende waarde hebben in de laparoscopische chirurgie. Beoor...

  5. Review of Oral Surgery Services and Training: a case of prescription without a diagnosis.

    Science.gov (United States)

    Batchelor, P A; Ladwa, R A R

    2013-01-01

    In the Review of Oral Surgery Services and Training, the Oral Surgery Review Group supported the development of the specialty of oral surgery and some of the arguments put forward to support it concerned finance and quality. We argue that their analyses of the present situation are flawed. The economic argument and issues concerning skill-mix are very simplistic, but more importantly, the rationale given for the increase in referrals did not explore the myriad of likely reasons why in any substantive detail. These reasons include shortcomings in undergraduate training and a poor NHS primary dental contract including the arrangements for charging patients. Before implementation, the policy makers should consider a wide range of available options to address the failings, and take a "whole system approach" before they embark on developing a specialty, which may cause problems that exceed those currently facing the system.

  6. The university münster model surgery system for orthognathic surgery. Part II – KD-MMS

    Directory of Open Access Journals (Sweden)

    Ehmer Ulrike

    2013-01-01

    Full Text Available Abstract Background Model surgery is an integral part of the planning procedure in orthognathic surgery. Most concepts comprise cutting the dental cast off its socket. The standardized spacer plates of the KD-MMS provide for a non-destructive, reversible and reproducible means of maxillary and/or mandibular plaster cast separation. Methods In the course of development of the system various articulator types were evaluated with regard to their capability to provide a means of realizing the concepts comprised of the KD-MMS. Special attention was dedicated to the ability to perform three-dimensional displacements without cutting of plaster casts. Various utilities were developed to facilitate maxillary displacement in accordance to the planning. Objectives of this development comprised the ability to implement the values established in the course of two-dimensional ceph planning. Results The system - KD-MMS comprises a set of hardware components as well as a defined procedure. Essential hardware components are red spacer and blue mounting plates. The blue mounting plates replace the standard yellow SAM mounting elements. The red spacers provide for a defined leeway of 8 mm for three-dimensional movements. The non-destructive approach of the KD-MMS makes it possible to conduct different model surgeries with the same plaster casts as well as to restore the initial, pre-surgical situation at any time. Thereby, surgical protocol generation and gnathologic splint construction are facilitated. Conclusions The KD-MMS hardware components in conjunction with the defined procedures are capable of increasing efficiency and accuracy of model surgery and splint construction. In cases where different surgical approaches need to be evaluated in the course of model surgery, a significant reduction of chair time may be achieved.

  7. MIS training in Canada: a national survey of general surgery residents.

    Science.gov (United States)

    Qureshi, Alia; Vergis, Ashley; Jimenez, Carolina; Green, Jessica; Pryor, Aurora; Schlachta, Christopher M; Okrainec, Allan

    2011-09-01

    General surgery trainees' perceptions regarding their own laparoscopic training remain poorly defined. The objective of this survey was to identify and evaluate learner experiences with laparoscopic procedures in general surgery programs on a national level. Two hundred eighty-four residents were identified and contacted at English-speaking general surgery programs across Canada. Each was asked to complete a web- or paper-based survey regarding their demographics, experiences with basic and advanced minimally invasive surgery (MIS) procedures, and perceived barriers to training. Two hundred fifty-two of 284 (89%) surveyed residents responded. Eighty-seven percent of the residents had access to a skills lab that taught MIS techniques; however, standardized MIS curricula were implemented 53% of the time. Eighty percent of residents felt that skills lab training translated to improved performance in the OR. Although 90% of residents felt that they would be comfortable performing basic laparoscopic procedures, only 8% stated they would be comfortable performing advanced procedures at the end of their training. Moreover, 90% of general surgery residents felt that it was the academic surgical department's responsibility to teach both basic and advanced procedures, and 35% of respondents felt their surgical program was meeting this requirement. Half of the residents felt they had limited opportunity to be a primary surgeon because an MIS fellow was present. There exists a wide disparity between the expectations of residents and their actual experience. The majority of residents are concerned that they will not acquire sufficient laparoscopic skills during their training to perform advanced cases in practice. Additionally, the balance between resident and fellow-level cases needs to be more clearly defined as the majority of respondents identified the presence of a MIS fellow as a negative learning influence. Finally, although most centers had a surgical skills lab, 47% of

  8. Perception of Shame in Otolaryngology-Head and Neck Surgery Training.

    Science.gov (United States)

    McMains, Kevin Christopher; Peel, Jennifer; Weitzel, Erik K; Der-Torossian, Hirak; Couch, Marion

    2015-11-01

    This survey was developed to assess the prevalence and effects of the perception of shame in otolaryngology-head and neck surgery residency training in the United States. Survey. US otolaryngology training programs. Faculty and trainees in US otolaryngology training programs. A 14-item survey to assess the prevalence of the experience of shame and the attitudes toward use of shame in otolaryngology residency training was sent to all otolaryngology-head and neck surgery program directors for distribution among their respective faculty and resident cohorts. A total of 267 responses were received (women, 24.7%; men, 75.3%): 42.7% of respondents were trainees; 7.0% of trainees thought that shame was a necessary/effective tool, compared with 11.4% of faculty; 50% of respondents felt that they had been personally shamed during residency; and 69.9% of respondents had witnessed another trainee being shamed during residency training. Trainees were most commonly shamed in the operating room (78.4%). Otolaryngology faculty members did the shaming 95.1% of the time. Although shaming prompted internal reflection/self-improvement in 57.4% of trainees, it also caused loss of self-confidence in 52.5%. Trainees who had been shamed were more likely to view shame as an appropriate educational tool (P Otolaryngology—Head and Neck Surgery Foundation 2015.

  9. Development of an Augmented Reality Force Feedback Virtual Surgery Training Platform

    Directory of Open Access Journals (Sweden)

    Ruei-Jia Chen

    2011-09-01

    Full Text Available In order to develop a virtual surgery training platform with a force feedback function so as to facilitate the training of new medical personnel, this study first had to establish a virtual environment, and then implement interactions involving vision and tactile sensations. The system's augmented reality function modules include the establishment of an augmented reality environmental space, image loading and model establishment, and force feedback modules, as well as the required design for collision detection, object parameter settings, and controller functions. Apart from combining a virtual environment with force feedback and establishing diverse force feedback modules, this project also overcomes the single-point sensor restriction of most force feedback hardware, and establishes a tactile cutting function. In addition to the establishment of force feedback modules, the project further employs the conservation of energy principle in the design of the energy estimator and controller, and completes the design of a stable virtual surgery training platform.

  10. Evaluation of resident's training for endoscopic sinus surgery using a sheep's head.

    Science.gov (United States)

    Delgado-Vargas, Beatriz; Romero-Salazar, Azucena Lloris; Reyes Burneo, Pablo M; Vásquez Hincapie, Catalina; de Los Santos Granado, Gonzalo; Del Castillo López, Raúl; Frágola Arnau, Claudio; Cobeta Marco, Ignacio

    2016-08-01

    Training in functional endoscopic sinus surgery (FESS) is an essential part of each ENT resident and it takes place on a very fragile area. This study focus on showing the learning curve of FESS, using an anatomical model such as the sheep's head. Four residents in our centre performed dissections. Each of these residents operated eight sheep's head. They performed an endoscopic septoplasty followed by maxillary antrostomy, total ethmoidectomy and frontal sinusotomy on every head. A staff member guided all procedures and checked for the appropriate dissection and complications occurred. Analysis was made upon the residents' performance of their first four septoplasties and eight nasal sides against their subsequent performance of the same. Final procedures presented better outcomes than the initial ones on every step of them. Results were measured by means of decrease of time (P < 0.0001) and complications, showing no major complications on the latest ones. Sheep's head is a suitable substitute for the cadaveric human head, to obtain the surgical skills needed for FESS procedures. Sheep's nasal cavity allows gaining dexterity and it is an easy model to obtain.

  11. Validation of a model of intensive training in digestive laparoscopic surgery.

    Science.gov (United States)

    Enciso, Silvia; Díaz-Güemes, Idoia; Usón, Jesús; Sánchez-Margallo, Francisco Miguel

    2016-02-01

    Our objective was to assess a laparoscopic training model for general surgery residents. Twelve general surgery residents carried out a training program, consisting of a theoretical session (one hour) and a hands-on session on simulator (7 h) and on animal model (13 h). For the first and last repetitions of simulator tasks and the Nissen fundoplication technique, time and scores from the global rating scale objective structured assessment of technical skills (OSATS) were registered. Before and after the course, participants performed 4 tasks on the virtual reality simulator LAPMentor™: 1) hand-eye coordination, 2) hand-hand coordination, 3) transference of objects and 4) cholecystectomy task, registering time and movement metrics. Moreover, the residents completed a questionnaire related to the training components on a 5-point rating scale. The last repetition of the tasks and the Nissen fundoplication technique were performed faster and with a higher OSATS score. After the course, the participants performed all LAPMentor™ tasks faster, increasing the speed of movements in all tasks. Number of movements decreased in tasks 2, 3 and 4; as well as path length in tasks 2 and 4. Training components were positively rated by residents, being the suture task the aspect best rated (4.90 ± 0.32). This training model in digestive laparoscopic surgery has demonstrated to be valid for the improvement of basic and advanced skills of general surgery residents. Intracorporeal suturing and the animal model were the best rated training elements. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Where have all the cardiothoracic surgery residents gone? Placement of graduating residents by United States thoracic surgery training programs, 1998 to 2002.

    Science.gov (United States)

    Wheatley, Grayson H; Lee, Richard

    2006-01-01

    We studied the evolving job placement trends of graduating cardiothoracic surgery residents over a 5-year period from the perspective of the program director. Graduate placement questionnaires were sent to program directors of Accreditation Council for Graduate Medical Education-accredited United States thoracic surgery residency programs (n = 92). Program directors were asked to categorize the type of job that each resident chose upon graduation (1998-2002). Of the program directors surveyed, 71.7% (66/92) responded, representing 76.4% (545/714) of the total graduating resident population during the study period. Three-year training programs constituted 24.2% (16/66) of the respondents and accounted for 20.2% (110/545) of the graduates. Annually, graduates most commonly chose private practice jobs. Between 2001 and 2002, the percentage of graduates entering fellowships increased (11.8% [13/110] versus 19.1% [21/110], P = .008) as the percentage of graduates choosing private practice positions decreased (56.4% [62/110] versus 45.5% [50/110], P = .15). In total, 12.8% (70/545) of the graduates pursued fellowships, with associated specialty choices being: 38.6% (27/70) adult cardiac, 37.1% (26/70) congenital, 15.7% (11/70) transplantation, and 8.6% (6/70) thoracic. There were no significant differences between 2-year and 3-year training program graduates in choice of private practice versus academic jobs. In 2002, a greater percentage of graduates chose to pursue fellowship training at the expense of private practice employment. This difference may in part result from fewer employment opportunities rather than graduate choice. Ongoing studies are needed to follow this trend. Annual analysis of the placement of all graduating residents would help to identify changes in employment.

  13. Surgeon Training in Telerobotic Surgery via a Hardware-in-the-Loop Simulator

    Directory of Open Access Journals (Sweden)

    Xiao Li

    2017-01-01

    Full Text Available This work presents a software and hardware framework for a telerobotic surgery safety and motor skill training simulator. The aims are at providing trainees a comprehensive simulator for acquiring essential skills to perform telerobotic surgery. Existing commercial robotic surgery simulators lack features for safety training and optimal motion planning, which are critical factors in ensuring patient safety and efficiency in operation. In this work, we propose a hardware-in-the-loop simulator directly introducing these two features. The proposed simulator is built upon the Raven-II™ open source surgical robot, integrated with a physics engine and a safety hazard injection engine. Also, a Fast Marching Tree-based motion planning algorithm is used to help trainee learn the optimal instrument motion patterns. The main contributions of this work are (1 reproducing safety hazards events, related to da Vinci™ system, reported to the FDA MAUDE database, with a novel haptic feedback strategy to provide feedback to the operator when the underlying dynamics differ from the real robot’s states so that the operator will be aware and can mitigate the negative impact of the safety-critical events, and (2 using motion planner to generate semioptimal path in an interactive robotic surgery training environment.

  14. Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models.

    Science.gov (United States)

    Maluf, Miguel Angel; Gomes, Walter José; Bras, Ademir Massarico; Araújo, Thiago Cavalcante Vila Nova de; Mota, André Lupp; Cardoso, Caio Cesar; Coutinho, Rafael Viana dos S

    2015-01-01

    Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art.

  15. Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models

    Directory of Open Access Journals (Sweden)

    Miguel Angel Maluf

    2015-10-01

    Full Text Available ABSTRACT OBJECTIVE: Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. METHODS: First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. RESULTS: The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. CONCLUSION: 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art.

  16. Impact of endovascular simulator training on vascular surgery as a career choice in medical students.

    Science.gov (United States)

    Markovic, Jovan; Peyser, Chris; Cavoores, Ted; Fletcher, Erin; Peterson, David; Shortell, Cynthia

    2012-05-01

    The primary goal of this study was to determine whether exposure to endovascular simulator training increases interest in vascular surgery among medical students. Secondary goals were to determine whether interest in vascular surgery is inversely related to the time after exposure, to identify factors associated with interest, and to identify students' characteristics that positively influence performance metrics. This was a prospective, randomized, crossover study comprising 80 medical students who were randomized into group A (n = 40) and group B (n = 40). Participants completed a survey of their interest in vascular surgery and attitudinal factors using Vascular Surgery Interest Form (VSIF) before exposure to the simulator (pretest). At 1 month after exposure of group A to the simulator, both groups were tested using VSIF (test). Upon completion of testing, group B was exposed to simulator training, whereas group A received no further training. At 2 months after exposure of group B to the simulator, both groups were posttested using VSIF, which asked the students' level of interest in vascular surgery using a 1 to 10 scale. Performance metrics were recorded during each exposure. Differences among cohort demographics were determined using Pearson χ(2) analysis. Differences in interest were determined with paired sample correlations. Linear regression and analysis of variance were used to correlate VSIF responses with interest and the performance metrics. Both student cohorts had significant increases in interest after exposure to simulation. In group A, test interest (mean ± standard deviation) was significantly higher than pretest and posttest interests (5.51 ± 1.73 vs 4.00 ± 1.88 vs 4.18 ± 1.82; P training, radiation concerns, gender identification of a mentor, and personality fit with occupation were not correlated with interest. Sex, medical school year, comfort with endovascular procedures, willingness to work long hours, interest in performing

  17. Student perception of two different simulation techniques in oral and maxillofacial surgery undergraduate training

    Directory of Open Access Journals (Sweden)

    Sallnäs Eva-Lotta

    2011-10-01

    Full Text Available Abstract Background Yearly surveys among the undergraduate students in oral and maxillofacial surgery at Karolinska Institutet have conveyed a wish for increased clinical training, and in particular, in surgical removal of mandibular third molars. Due to lack of resources, this kind of clinical supervision has so far not been possible to implement. One possible solution to this problem might be to introduce simulation into the curriculum. The purpose of this study was to investigate undergraduate students' perception of two different simulation methods for practicing clinical reasoning skills and technical skills in oral and maxillofacial surgery. Methods Forty-seven students participating in the oral and maxillofacial surgery course at Karolinska Institutet during their final year were included. Three different oral surgery patient cases were created in a Virtual Patient (VP Simulation system (Web-SP and used for training clinical reasoning. A mandibular third molar surgery simulator with tactile feedback, providing hands on training in the bone removal and tooth sectioning in third molar surgery, was also tested. A seminar was performed using the combination of these two simulators where students' perception of the two different simulation methods was assessed by means of a questionnaire. Results The response rate was 91.5% (43/47. The students were positive to the VP cases, although they rated their possible improvement of clinical reasoning skills as moderate. The students' perception of improved technical skills after training in the mandibular third molar surgery simulator was rated high. The majority of the students agreed that both simulation techniques should be included in the curriculum and strongly agreed that it was a good idea to use the two simulators in concert. The importance of feedback from the senior experts during simulator training was emphasised. Conclusions The two tested simulation methods were well accepted and most

  18. Pointing with a One-Eyed Cursor for Supervised Training in Minimally Invasive Robotic Surgery

    DEFF Research Database (Denmark)

    Kibsgaard, Martin; Kraus, Martin

    2016-01-01

    Pointing in the endoscopic view of a surgical robot is a natural and effcient way for instructors to communicate with trainees in robot-assisted minimally invasive surgery. However, pointing in a stereo-endoscopic view can be limited by problems such as video delay, double vision, arm fatigue......, and reachability of the pointer controls. We address these problems by hardware-based overlaying the stereo-endoscopic view with a one-eyed cursor, which can be comfortably controlled by a wireless, gyroscopic air mouse. The proposed system was positively evaluated by five experienced instructors in four full......-day training units in robot- assisted minimally invasive surgery on anaesthetised pigs....

  19. "Just-In-Time" Simulation Training Using 3-D Printed Cardiac Models After Congenital Cardiac Surgery.

    Science.gov (United States)

    Olivieri, Laura J; Su, Lillian; Hynes, Conor F; Krieger, Axel; Alfares, Fahad A; Ramakrishnan, Karthik; Zurakowski, David; Marshall, M Blair; Kim, Peter C W; Jonas, Richard A; Nath, Dilip S

    2016-03-01

    High-fidelity simulation using patient-specific three-dimensional (3D) models may be effective in facilitating pediatric cardiac intensive care unit (PCICU) provider training for clinical management of congenital cardiac surgery patients. The 3D-printed heart models were rendered from preoperative cross-sectional cardiac imaging for 10 patients undergoing congenital cardiac surgery. Immediately following surgical repair, a congenital cardiac surgeon and an intensive care physician conducted a simulation training session regarding postoperative care utilizing the patient-specific 3D model for the PCICU team. After the simulation, Likert-type 0 to 10 scale questionnaire assessed participant perception of impact of the training session. Seventy clinicians participated in training sessions, including 22 physicians, 38 nurses, and 10 ancillary care providers. Average response to whether 3D models were more helpful than standard hand off was 8.4 of 10. Questions regarding enhancement of understanding and clinical ability received average responses of 9.0 or greater, and 90% of participants scored 8 of 10 or higher. Nurses scored significantly higher than other clinicians on self-reported familiarity with the surgery (7.1 vs. 5.8; P = .04), clinical management ability (8.6 vs. 7.7; P = .02), and ability enhancement (9.5 vs. 8.7; P = .02). Compared to physicians, nurses and ancillary providers were more likely to consider 3D models more helpful than standard hand off (8.7 vs. 7.7; P = .05). Higher case complexity predicted greater enhancement of understanding of surgery (P = .04). The 3D heart models can be used to enhance congenital cardiac critical care via simulation training of multidisciplinary intensive care teams. Benefit may be dependent on provider type and case complexity. © The Author(s) 2016.

  20. Children subjected to cardiac surgery for congenital heart disease. Part 2 - parental emotional experiences.

    Science.gov (United States)

    Menahem, Samuel; Poulakis, Zeffie; Prior, Margot

    2008-08-01

    Parents experience considerable distress when their children are subjected to cardiac surgery. This study investigated their psychological and emotional experiences. As part of a prospective study reviewing the emotional and psychological outcomes of children aged 2-12 years subjected to cardiac surgery, that age group being chosen to allow for objective testing following infancy and before adolescence, their parents were assessed prior to and 12-50 months following the surgery. The measures reviewed their mental health, locus of control, family functioning and social support. There were 39 children. Most of the parental information was obtained from the mothers, who reported increased anxiety, and a tendency to attribute events to luck and/or chance greater than published norms, irrespective of the cardiac anomaly, whether the surgery was 'curative', or if further surgery was required. At follow-up, their ratings approximated to norms, except for a continued perception that life events were a function of fate and beyond one's control. The results confirmed that a substantial increase in the emotional distress of mothers at the time of surgery essentially resolved by 12 months or later. In contrast, they still seemed not to feel in 'control' when reviewed on follow-up.

  1. Consideration of Cosmetic Surgery As Part of Women’s Benefit-Provisioning Mate Retention Strategy

    Directory of Open Access Journals (Sweden)

    Mohammad Atari

    2017-08-01

    Full Text Available Individuals perform mate retention behaviors to minimize the risk of partner infidelity and relationship dissolution. The current study investigates whether consideration of cosmetic surgery can be conceptualized as part of a broader strategy of mate retention for women, but not men. We hypothesized that women’s consideration of cosmetic surgery would be positively associated with performance frequencies of Benefit-Provisioning and Cost-Inflicting mate retention behaviors. We recruited 203 individuals (54% women in committed heterosexual relationships from Tehran, Iran. Results indicate a positive association between consideration of cosmetic surgery and Benefit-Provisioning mate retention behaviors for women, but not men. There was no association between consideration of cosmetic surgery and Cost-Inflicting mate retention behaviors. Women therefore may consider cosmetic surgery to improve their physical attractiveness as part of a Benefit-Provisioning strategy to retain a long-term mate. We discuss limitations of the study and highlight future directions for research from an evolutionary perspective.

  2. 17 CFR Appendix B to Part 3 - Statement of Acceptable Practices With Respect to Ethics Training

    Science.gov (United States)

    2010-04-01

    ... Practices With Respect to Ethics Training B Appendix B to Part 3 Commodity and Securities Exchanges... Practices With Respect to Ethics Training (a) The provisions of Section 4p(b) of the Act (7 U.S.C. 6p(b... ethics training sessions within six months of registration, and all registrants to attend such training...

  3. Awake surgery between art and science. Part I: clinical and operative settings.

    Science.gov (United States)

    Talacchi, Andrea; Santini, Barbara; Casagrande, Francesca; Alessandrini, Franco; Zoccatelli, Giada; Squintani, Giovanna M

    2013-01-01

    Awake surgery requires coordinated teamwork and communication between the surgeon and the anesthesiologist, as he monitors the patient, the neuroradiologist as he interprets the images for intraoperative confirmation, and the neuropsychologist and neurophysiologist as they evaluate in real-time the patient's responses to commands and questions. To improve comparison across published studies on clinical assessment and operative settings in awake surgery, we reviewed the literature, focusing on methodological differences and aims. In complex, interdisciplinary medical care, such differences can affect the outcome and the cost-benefit ratio of the treatment. Standardization of intraoperative mapping and related controversies will be discussed in Part II.

  4. Sensory submodalities testing in neurolinguistic programming, part of mental training

    Directory of Open Access Journals (Sweden)

    Vlad Teodor GROSU

    2017-03-01

    Full Text Available Introduction: this study is part of a larger work, which involves increasing sporting performance by applying mental training techniques – special techniques of neurolinguistic programming. In this case we will discuss some aspects of the test application Jacobson S. (2011. Purpose of study and hypothesis: In neurolinguistic programming (NLP we have studied the relationship between sensory submodalities, in accordance with the Jacobson test (2011. We wanted to check the degree of significance of the mean difference parameters studied and if the materiality result falls within the objective parameters. If ideomotor representations of athletes are completed with multiple sensations of all sensory submodalities such as visual, auditory, kinesthetic, olfactory and gustatory, the possibility of applying the techniques of NLP (neurolinguistic programming will have more effective results. Methods and material: two records were made by using two tests, test1 and test2 on master students of the University “Babes-Bolyai” Cluj-Napoca, from FEFS from APS department (training and sports performance. The statistical indicators were calculated on elements of descriptive statistics and the data is presented using indicators of centrality, location and distribution. Statistical analysis of non-parametric Wilcoxon test was used for sample pairs (data uneven distribution/rank. Materiality tests used was α=0.05 (5%, α=0.01 (1% or α=0.001. Results and deliberations: to detect the correlation between the two variables we used the Spearman rank correlation coefficient (ρ. Statistical analysis was performed using the correlation coefficients Colton’s rule. It was found that no statistically significant differences were observed (p>0.05 in the statistical analysis of sample pairs Jacobson test values (times T1-T2. This is a result of the short timeframe – just one month – for objectives reasons. However, many of them appear in a good and a very good

  5. Microperimetric Biofeedback Training Improved Visual Acuity after Successful Macular Hole Surgery

    Directory of Open Access Journals (Sweden)

    Tomoko Ueda-Consolvo

    2015-01-01

    Full Text Available Purpose. To evaluate the efficacy of setting a preferred retinal locus relocation target (PRT and performing Macular Integrity Assessment (MAIA biofeedback training in patients showing insufficient recovery of best corrected visual acuity (BCVA despite successful closure of an idiopathic macular hole (MH. Methods. Retrospective interventional case series. Nine eyes of 9 consecutive patients with the decimal BCVA of less than 0.6 at more than 3 months after successful MH surgery were included. A PRT was chosen based on MAIA microperimetry and the patients underwent MAIA biofeedback training. BCVA, reading speed, fixation stability, and 63% bivariate contour ellipse area (BCEA were evaluated before and after the training. Statistical analysis was carried out using paired Student’s t-test. Results. PRT was chosen on the nasal side of the closed MH fovea in 8 patients. After the MAIA training, BCVA improved in all patients. The mean logMAR value of BCVA significantly improved from 0.33 to 0.12 (p=0.007. Reading speed improved in all patients (p=0.29, fixation stability improved in 5 patients (p=0.70, and 63% BCEA improved in 7 patients (p=0.21, although these improvements were not statistically significant. Conclusion. MAIA biofeedback training improved visual acuity in patients with insufficient recovery of BCVA after successful MH surgery.

  6. DOES GENDER IMPACT ON FEMALE DOCTORS' EXPERIENCES IN THE TRAINING AND PRACTICE OF SURGERY?

    Science.gov (United States)

    Umoetok, F; van Wyk, J; Madiba, T E

    2017-06-01

    Surgery has been a male-dominated speciality both in South Africa and abroad. This mixed methodology case study collected data from a purposive sample of female surgical registrars enrolled at one institution in South Africa. A self-administered questionnaire was used to explore whether or not female doctors perceived any benefits of being in a male-dominated specialty. It explored problems encountered due to gender, the participants' perceptions of the influence of gender on their surgical training, practice and challenges. Thirty-two female registrars participated in the study. The respondents were mainly South African (91%) and enrolled in seven surgical specialities. Twenty-seven (84%) respondents were satisfied with their practical training and skills development as surgeons. Twenty-four (75%) respondents had identified a mentor from the department and all respondents indicated that the gender of their mentor did not impact on the quality of their training. Seventeen (53%) respondents perceived having received differential treatment due to their gender and 25 (78.2%) thought that the gender of their mentor did not impact on the quality of the guidance in surgery. Challenges included physical threats to them as females from patients and disrespect, emotional threats and defaming statements from male registrars. Other challenges included time-constraints for family and academic work, poor work life balance and being treated differently due to their gender. Seventeen (53%) respondents would consider teaching in the Department of Surgery. Twenty-five respondents (78%) would recommended the specialty to young female students, as they were convinced that surgery had been the right choice for them. Seventeen respondents (53%) were also open to pursuing teaching posts in the Department of Surgery. Generally, females had positive perceptions of their training in Surgery. They expressed concern about finding a worklife balance. The gender of their mentor did not impact

  7. Supply and demand mismatch for flexible (part-time) surgical training in Australasia.

    Science.gov (United States)

    McDonald, Rachel E; Jeeves, Amy E; Vasey, Carolyn E; Wright, Deborah M; O'Grady, Gregory

    2013-05-06

    To define current patterns of flexible (part-time) surgical training in Australasia, determine supply and demand for part-time positions, and identify work-related factors motivating interest in flexible training. All Royal Australasian College of Surgeons trainees (n = 1191) were surveyed in 2010. Questions assessed demographic characteristics and working patterns, interest in flexible training, work-related fatigue and work-life balance preferences. Interest in part-time training, and work-related factors motivating this interest. Of the 1191 trainees, 659 responded (response rate, 55.3%). Respondents were representative of all trainees in terms of specialty and sex. The median age of respondents was 32 2013s, and 187 (28.4%) were female. Most of the 659 respondents (627, 95.1%) were in full-time clinical training; only two (0.3%) were in part-time clinical training, and 30 (4.6%) were not in active clinical training. An interest in part-time training was reported by 208 respondents (31.6%; 54.3% of women v 25.9% of men; P work and limited their social or family life, and that they had insufficient time in life for things outside surgical training, including study or research (P flexible surgical training and the number of trainees currently in part-time training positions in Australia and New Zealand. Efforts are needed to facilitate part-time surgical training.

  8. Clinic-based training in comparison to home-based training after first-time lumbar disc surgery: a randomised controlled trial.

    Science.gov (United States)

    Johansson, Ann-Christin; Linton, Steven J; Bergkvist, Leif; Nilsson, Olle; Cornefjord, Michael

    2009-03-01

    The effectiveness of physiotherapy after first-time lumbar disc surgery is still largely unknown. Studies in this field are heterogeneous and behavioural treatment principles have only been evaluated in one earlier study. The aim of this randomised study was to compare clinic-based physiotherapy with a behavioural approach to a home-based training programme regarding back disability, activity level, behavioural aspects, pain and global health measures. A total of 59 lumbar disc patients without any previous spine surgery or comorbidity participated in the study. Clinic-based physiotherapy with a behavioural approach was compared to home-based training 3 and 12 months after surgery. Additionally, the home training group was followed up 3 months after surgery by a structured telephone interview evaluating adherence to the exercise programme. Outcome measures were: Oswestry Disability Index (ODI), physical activity level, kinesiophobia, coping, pain, quality of life and patient satisfaction. Treatment compliance was high in both groups. There were no differences between the two groups regarding back pain disability measured by ODI 3 and 12 months after surgery. However, back pain reduction and increase in quality of life were significantly higher in the home-based training group. The patients in the clinic-based training group had significantly higher activity levels 12 months after surgery and were significantly more satisfied with physiotherapy care 3 months after surgery compared to the home-based training group. Rehabilitation after first-time lumbar disc surgery can be based on home training as long as the patients receive both careful instructions from a physiotherapist and strategies for active pain coping, and have access to the physiotherapist if questions regarding training arise. This might be a convenient treatment arrangement for most patients.

  9. [Laparoscopic training--the guarantee of a future in pediatric surgery].

    Science.gov (United States)

    Drăghici, I; Drăghici, L; Popescu, M; Copăescu, C; Mitoiu, D; Dragomirescu, C

    2009-01-01

    Laparoscopy is considered today the highlight of modern surgery, the forerunner of the fascinating world of video and robotic surgery, both of them derived from the sophisticated areas of aeronautic industry. Remarkably, Romanian specialists keep up with the pace of worldwide technological developments, assimilating one by one each and every video endoscopic procedure. In the early 90s, the Romanian laparos-copic school was founded with the contribution of many important personalities; their activities and achievements have been an inspiration for the following generation of laparoscopic surgeons. In this last decade, the newest branch of laparoscopic surgery in our country, pediatric laparoscopy, managed to evolve from its "shy" beginnings to become an important method of improving the quality of surgical procedures, to the benefit of our "small patients". The purpose of this article is to encourage and promote minimally invasive video endoscopic surgery training, emphasizing its crucial role in the education and professional development of the next generation of pediatric surgeons, and not only. The modem concept of laparoscopic training includes experimental scientific practices, as well as the newest technical acquisitions such as virtual reality video-electronic simulation.

  10. A pilot study of surgical training using a virtual robotic surgery simulator.

    Science.gov (United States)

    Tergas, Ana I; Sheth, Sangini B; Green, Isabel C; Giuntoli, Robert L; Winder, Abigail D; Fader, Amanda N

    2013-01-01

    Our objectives were to compare the utility of learning a suturing task on the virtual reality da Vinci Skills Simulator versus the da Vinci Surgical System dry laboratory platform and to assess user satisfaction among novice robotic surgeons. Medical trainees were enrolled prospectively; one group trained on the virtual reality simulator, and the other group trained on the da Vinci dry laboratory platform. Trainees received pretesting and post-testing on the dry laboratory platform. Participants then completed an anonymous online user experience and satisfaction survey. We enrolled 20 participants. Mean pretest completion times did not significantly differ between the 2 groups. Training with either platform was associated with a similar decrease in mean time to completion (simulator platform group, 64.9 seconds [P = .04]; dry laboratory platform group, 63.9 seconds [P virtual reality platform. The majority found the training "definitely useful" in improving robotic surgical skills (mean, 4.6) and would attend future training sessions (mean, 4.5). Training on the virtual reality robotic simulator or the dry laboratory robotic surgery platform resulted in significant improvements in time to completion and economy of motion for novice robotic surgeons. Although there was a perception that both simulators improved performance, there was a preference for the virtual reality simulator. Benefits unique to the simulator platform include autonomy of use, computerized performance feedback, and ease of setup. These features may facilitate more efficient and sophisticated simulation training above that of the conventional dry laboratory platform, without loss of efficacy.

  11. STS-93 Pilot Ashby takes part in emergency egress training

    Science.gov (United States)

    1999-01-01

    STS-93 Pilot Jeffrey S. Ashby pauses for the photographer before climbing into an M-113 armored personnel carrier at the launch pad to take part in emergency egress training. In preparation for their mission, the STS-93 crew are participating in Terminal Countdown Demonstration Test activities that also include a launch-day dress rehearsal culminating with a simulated main engine cut-off. Others in the crew are Commander Eileen M. Collins and Mission Specialists Steven A. Hawley (Ph.D.), Catherine G. Coleman (Ph.D.), and Michel Tognini of France, who represents the Centre National d'Etudes Spatiales (CNES). Collins is the first woman to serve as a mission commander. The primary mission of STS-93 is the release of the Chandra X-ray Observatory, which will allow scientists from around the world to obtain unprecedented X-ray images of exotic environments in space to help understand the structure and evolution of the universe. Chandra is expected to provide unique and crucial information on the nature of objects ranging from comets in our solar system to quasars at the edge of the observable universe. Since X-rays are absorbed by the Earth's atmosphere, space-based observatories are necessary to study these phenomena and allow scientists to analyze some of the greatest mysteries of the universe. The targeted launch date for STS-93 is no earlier than July 20 at 12:36 a.m. EDT from Launch Pad 39B.

  12. Techniques and applications of endoscopic spine surgery. Part I:overview of current techniques

    Institute of Scientific and Technical Information of China (English)

    Kai-Xuan Liu; MD; PhD

    2013-01-01

    Background Spinal pain is a serious health and social-economic problem. Endoscopic spine surgery as a treatment option for spinal pain has gained tremendous attention and growth in the past 2 decades, and a variety of endoscopic techniques have been invented to treat a wide range of spinal conditions. Purposes The purposes of this 2-part review article are to 1 ) overview the published techniques of endoscopic spine surgery, 2 ) summarize the applications of these techniques in treating various spinal conditions, and 3 ) evaluate the clinical evidence of the safety and effectiveness of these endoscopic techniques in treating some of the most common spinal conditions. The first part of the review article provides an overview of currently most commonly used techniques. Methods We searched the PubMed database for publications concerning endoscopic spine surgery and reviewed the relevant articles published in the English language. Results Discectomy and foraminotomy are the most common types of spine surgery that can currently be done endoscopically. Endoscopic techniques have been used to treat a wide range of spinal disorders located in the lumbar, cervical, as well as the thoracic regions of the spine.

  13. Training potential in minimally invasive surgery in a tertiary care, paediatric urology centre.

    Science.gov (United States)

    Schroeder, R P J; Chrzan, R J; Klijn, A J; Kuijper, C F; Dik, P; de Jong, T P V M

    2015-10-01

    Minimally invasive surgery (MIS) is being utilized more frequently as a surgical technique in general surgery and in paediatric urology. It is associated with a steep learning curve. Currently, the centre does not offer a MIS training programme. It is hypothesized that the number of MIS procedures performed in the low-volume specialty of paediatric urology will offer insufficient training potential for surgeons. To assess the MIS training potential of a highly specialized, tertiary care, paediatric urology training centre that has been accredited by the Joint Committee of Paediatric Urology (JCPU). The clinical activity of the department was retrospectively reviewed by extracting the annual number of admissions, outpatient consultations and operative procedures. The operations were divided into open procedures and MIS. Major ablative procedures (nephrectomy) and reconstructive procedures (pyeloplasty) were analysed with reference to the patients' ages. The centre policy is not to perform major MIS in children who are under 2 years old or who weigh less than 12 kg. Every year, this institution provides approximately 4300 out-patient consultations, 600 admissions, and 1300 procedures under general anaesthesia for children with urological problems. In 2012, 35 patients underwent major intricate MIS: 16 pyeloplasties, eight nephrectomies and 11 operations for incontinence (seven Burch, and four bladder neck procedures). In children ≥2 years of age, 16/21 of the pyeloplasties and 8/12 of the nephrectomies were performed laparoscopically. The remaining MIS procedures included 25 orchidopexies and one intravesical ureteral reimplantation. There is no consensus on how to assess laparoscopic training. It would be valuable to reach a consensus on a standardized laparoscopic training programme in paediatric urology. Often training potential is based on operation numbers only. In paediatric urology no minimum requirement has been specified. The number of procedures quoted

  14. Quality assurance review of training in oral and maxillofacial surgery by the General Medical Council: areas of good practice, requirements, and recommendations.

    Science.gov (United States)

    Sandhu, Davinder P S; Dover, Michael Stephen; Lay, Sarah

    2016-04-01

    The purpose of this paper is to disseminate the outcome of the 2012/13 UK-wide quality assurance review of postgraduate training in oral and maxillofacial surgery (OMFS) by the General Medical Council (GMC), as part of its review of small specialties. OMF surgeons need to be aware of the evidence on which the conclusions are based, and to know about the strengths of the specialty and the areas for future development so that postgraduate training, and ultimately the outcomes for patients, can be improved. This paper, by the authors involved in the review, summarises the salient points and is not a verbatim report. Copyright © 2016. Published by Elsevier Ltd.

  15. Working and training conditions of residents in pediatric surgery: a nationwide survey in Germany.

    Science.gov (United States)

    Reismann, M; Ellerkamp, V; Dingemann, J

    2010-09-01

    As in other surgical specialties, increasing concern has been expressed worldwide about the shortage of trainees in pediatric surgery training programs. We performed a nationwide survey to investigate the current situation in Germany. An internet-based nationwide survey comprising 36 questions on training conditions in pediatric surgery was linked to the homepage of the German Society of Pediatric Surgery from June to September 2008. Statements on the following aspects were evaluated by responding residents using a scale from 1 (I do not agree at all) to 5 (I fully agree): workplace, cooperation with colleagues, head of the department, cooperation with other specialties, training and research conditions. A median value of 3 indicated an unsatisfactory assessment, with at least 50% of respondents giving an indifferent or negative response. 70 questionnaires were completed. Some of the evaluations revealed problematic areas. In particular, statements regarding working hours revealed dissatisfaction among the responding doctors. The median value accorded the statement "I am satisfied with the current working time regulation" was 2.9. With regard to departmental heads, some criticisms were directed against a perceived lack of soft skills. According to the respondents, their involvement in decision-making processes was insufficient ("We are involved in decision-making processes affecting our working conditions" - median value 2.4). Residents were also dissatisfied with the feedback they received for their work ("I get enough feedback regarding my achievement" - median value 2.6). Another problem area was career development ("I will finish my specialist training in time" - median value 2.9). However, these points did not affect overall satisfaction. Trainee satisfaction with regulations on working hours is low. Despite a general satisfaction with all fields appraised, improvements in various individual areas, e. g., the attitude of departmental heads and strategies of

  16. Validity of NBME Parts I and II for the Selection of Residents: The Case of Orthopaedic Surgery.

    Science.gov (United States)

    Case, Susan M.

    The predictive validity of scores on the National Board of Medical Examiners (NBME) Part I and Part II examinations for the selection of residents in orthopaedic surgery was investigated. Use of NBME scores has been criticized because of the time lag between taking Part I and entering residency and because Part I content is not directly linked to…

  17. Relationships between study habits, burnout, and general surgery resident performance on the American Board of Surgery In-Training Examination.

    Science.gov (United States)

    Smeds, Matthew R; Thrush, Carol R; McDaniel, Faith K; Gill, Roop; Kimbrough, Mary K; Shames, Brian D; Sussman, Jeffrey J; Galante, Joseph M; Wittgen, Catherine M; Ansari, Parswa; Allen, Steven R; Nussbaum, Michael S; Hess, Donald T; Knight, David C; Bentley, Frederick R

    2017-09-01

    The American Board of Surgery In-Training Examination (ABSITE) is used by programs to evaluate the knowledge and readiness of trainees to sit for the general surgery qualifying examination. It is often used as a tool for resident promotion and may be used by fellowship programs to evaluate candidates. Burnout has been associated with job performance and satisfaction; however, its presence and effects on surgical trainees' performance are not well studied. We sought to understand factors including burnout and study habits that may contribute to performance on the ABSITE examination. Anonymous electronic surveys were distributed to all residents at 10 surgical residency programs (n = 326). Questions included demographics as well as study habits, career interests, residency characteristics, and burnout scores using the Oldenburg Burnout Inventory, which assesses burnout because of both exhaustion and disengagement. These surveys were then linked to the individual's 2016 ABSITE and United States Medical Licensing Examination (USMLE) step 1 and 2 scores provided by the programs to determine factors associated with successful ABSITE performance. In total, 48% (n = 157) of the residents completed the survey. Of those completing the survey, 48 (31%) scored in the highest ABSITE quartile (≥75th percentile) and 109 (69%) scored less than the 75th percentile. In univariate analyses, those in the highest ABSITE quartile had significantly higher USMLE step 1 and step 2 scores (P burnout scores (disengagement, P Burnout Inventory exhaustion (P = 0.02), and USMLE step 1 and 2 scores (P = 0.007 and 0.0001, respectively). Residents who perform higher on the ABSITE have a regular study schedule throughout the year, report less burnout because of exhaustion, study away from home, and have shown success in prior standardized tests. Further study is needed to determine the effects of burnout on clinical duties, career advancement, and satisfaction. Copyright © 2017

  18. Laparoscopic Upper Urinary System Surgery After Specialty Training: Presentation of 50 Cases

    Directory of Open Access Journals (Sweden)

    Alper Gok

    2014-03-01

    Full Text Available Aim: Results of first 50 laparoscopic upper urinary tractus surgeries which were performed in Adiyaman State Hospital during compulsory duty after specialty training are presented. Material and Method: Fifty patients who underwent laparoscopic upper urinary tractus surgeries in our clinic between February 2012 and January 2013 were retrospectively evaluated. All of the laparoscopic procedures were performed using transperitoneal method. Results: Mean age of the patients was 42,6±13,6 (17-74, and mean operation duration was 96,8±12,4 minutes (28-165. Thirty two patients were males and 18 were females. Intraoperative complications were not seen in any of the patients and operations didn%u2019t proceed to open surgeries. All patients were mobilized at first day after the operation. No patient needed opioids as painkillers at postoperative period. Decrease in hematocrit level was obseved in a patient at early postoperative period and this patient was followed conservatively with 6 units of erythrocyte suspension. Herniation from the port area was observed in a patient who had cortical cyst excision at postoperative 3rd month. No major complication was observed. Discussion: Laparoscopic surgery which is becoming more commonly used nowadays can be safely applied in state hospitals if appropriate infrastructure is provided.

  19. Laparoscopic skill laboratory in urological surgery: tools and methods for resident training

    Directory of Open Access Journals (Sweden)

    Fabio C. M. Torricelli

    2011-02-01

    Full Text Available PURPOSE: Laparoscopy has certainly brought considerable benefits to patients, but laparoscopic surgery requires a set of skills different from open surgery, and learning in the operating room may increase surgical time, and even may be harmful to patients. Several training programs have been developed to decrease these potential prejudices. PURPOSES: to describe the laparoscopic training program for urological residents of the "Hospital das Clinicas" of the Sao Paulo Medical School, to report urological procedures that are feasible in dry and wet labs, and to perform a critical analysis of the cost-benefit relation of advanced laparoscopic skills laboratory. MATERIALS AND METHODS: The laparoscopic skill lab has two virtual simulators, three manual simulators, and four laparoscopic sets for study with a porcine model. The urology residents during their first year attend classes in the virtual and manual simulator and helps the senior urological resident in activities carried out with the laparoscopic sets. During the second year, the urological resident has six periods per week, each period lasting four hours, to perform laparoscopic procedures with a porcine model. Results: In a training program of ten weeks, one urological resident performs an average of 120 urological procedures. The most common procedures are total nephrectomy (30%, bladder suture (30%, partial nephrectomy (10%, pyeloplasty (10%, ureteral replacement or transuretero anastomosis (10%, and others like adrenalectomy, prostatectomy, and retroperitoneoscopy. These procedures are much quicker and caused less morbidity. CONCLUSION: Laparoscopic skills laboratory is a good method for achieving technical ability.

  20. Dental foundation year 2 training in oral and maxillofacial surgery units - the trainees' perspective.

    Science.gov (United States)

    Wildan, T; Amin, J; Bowe, D; Gerber, B; Saeed, N R

    2013-10-01

    Most dental foundation year 2 (DF2) training takes place in oral and maxillofacial surgery (OMFS) units. We did a survey of DF2 trainees in these units by telephone interviews and an online questionnaire to find out about their experience of training and their career aspirations. A total of 123 responded, which is roughly 41% of the total estimated number of trainees. Trainees applied for these posts mainly to improve their dentoalveolar skills (50%), and this was cited as the best aspect of the training. Most (81%) were on-call at night and this was generally thought to be a valuable training experience (77%), but 20% thought that it was the worst aspect of the job. Most did not regret taking up the post although the experience had caused 75% to alter their intentions about their future career; general dental practice was the commonest choice. In conclusion, trainees are generally satisfied with their training and these positions have guided their choices about future careers.

  1. Resistance Training: Physiological Responses and Adaptations (Part 2 of 4).

    Science.gov (United States)

    Fleck, Stephen J.; Kraerner, William J.

    1988-01-01

    Resistance training causes a variety of physiological reactions, including changes in muscle size, connective tissue size, and bone mineral content. This article summarizes data from a variety of studies and research. (JL)

  2. Surgery for gastrointestinal malignant melanoma:Experience from surgical training center

    Institute of Scientific and Technical Information of China (English)

    Thawatchai; Akaraviputh; Satida; Arunakul; Varut; Lohsiriwat; Cherdsak; Iramaneerat; Atthaphorn; Trakarnsanga

    2010-01-01

    AIM:To characterize clinical features,surgery,outcome,and survival of malignant melanoma(MM) of the gastrointestinal(GI) tract in a surgical training center in Bangkok,Thailand. METHODS:A retrospective review was performed for all patients with MM of the GI tract treated at our institution between 1997 and 2007. RESULTS:Fourteen patients had GI involvement either in a metastatic form or as a primary melanoma. Thirteen patients with sufficient data were reviewed. The median age of the patients was 66 years(r...

  3. A National Needs Assessment to Identify Technical Procedures in Vascular Surgery for Simulation Based Training

    DEFF Research Database (Denmark)

    Nayahangan, Leizl Joy; Konge, Lars; Schroeder, T V

    2017-01-01

    to identify technical procedures that vascular surgeons should learn. Round 2 was a survey that used a needs assessment formula to explore the frequency of procedures, the number of surgeons performing each procedure, risk and/or discomfort, and feasibility for simulation based training. Round 3 involved...... a national needs assessment to identify the technical procedures that should be integrated in a simulation based curriculum. DESIGN AND METHODS: A national needs assessment using a Delphi process was initiated by engaging 33 predefined key persons in vascular surgery. Round 1 was a brainstorming phase...... elimination and ranking of procedures. RESULTS: The response rate for round 1 was 70%, with 36 procedures identified. Round 2 had a 76% response rate and resulted in a preliminary prioritised list after exploring the need for simulation based training. Round 3 had an 85% response rate; 17 procedures were...

  4. Impact of a weekly reading program on orthopedic surgery residents' in-training examination.

    Science.gov (United States)

    Weglein, Daniel G; Gugala, Zbigniew; Simpson, Suzanne; Lindsey, Ronald W

    2015-05-01

    In response to a decline in individual residents' performance and overall program performance on the Orthopaedic In-Training Examination (OITE), the authors' department initiated a daily literature reading program coupled with weekly tests on the assigned material. The goal of this study was to assess the effect of the reading program on individual residents' scores and the training program's OITE scores. The reading program consisted of daily review articles from the Journal of the American Academy of Orthopaedic Surgeons, followed by a weekly written examination consisting of multiple-choice or fill-in-the-blank questions. All articles were selected and all questions were written by the departmental chair. A questionnaire was given to assess residents' perceptions of the weekly tests. As a result of implementing the reading program for a 10-month period, residents' subsequent performance on the OITE significantly improved (mean score increase, 4, Porthopedic surgery residents.

  5. Four-year experience with a regional program providing simulation-based endovascular training for vascular surgery fellows.

    Science.gov (United States)

    Dawson, David L; Lee, Eugene S; Hedayati, Nasim; Pevec, William C

    2009-01-01

    High-fidelity procedure simulation has been found useful for training vascular surgery residents in endovascular procedures, but the costs of acquiring, maintaining, and operating simulators represent a barrier to routine use of endovascular simulation in vascular surgery programs. Providing simulation training opportunities through regional centers may make simulation more cost effective, but the costs and benefits of this approach have not been reported previously. We reviewed participation costs in a regional simulation program to provide a benchmark for comparison with other training options. Simulation-based training was offered annually from 2004 to 2007 to the 11 vascular surgery fellowships in Washington, Oregon, California, Arizona, and Utah. Participation was at the discretion of the program directors and fellows. Sessions were designed to offer individualized, hands-on training with 2-4 participants per 2-day session. SimSuite (Medical Simulation Corporation, Denver, Colorado) simulators were used. During the 4-year period, participation by invited programs averaged 75%. Ten of 11 programs in the western United States region participated, with 34 fellows participating during the 4 years of the program. In addition, 2 program directors or faculty attended sessions to participate as learners, and 8 other individuals were allowed to participate (including 7 senior surgery residents and 1 vascular surgery fellow from out of the region). The average participant costs for travel, which include transportation, lodging, and meals, were $571. Simulation facility expenses, which included use of the simulator, computer-based training modules, and instructional support by an educational specialist, averaged $1055 per participant. Surgical faculty spent 12 hours per 2-day session instructing and in other direct educational activities. Costs for this time were not calculated separately. Vascular surgery fellows' participation in simulation training at regional centers

  6. Synthetic surgical meshes used in abdominal wall surgery: Part I-materials and structural conformation.

    Science.gov (United States)

    Todros, S; Pavan, P G; Natali, A N

    2017-04-01

    Surgical implants are commonly used in abdominal wall surgery for hernia repair. Many different prostheses are currently offered to surgeons, comprising permanent synthetic polymer meshes and biologic scaffolds. There is a wide range of synthetic meshes currently available on the market with differing chemical compositions, fiber conformations, and mesh textures. These chemical and structural characteristics determine a specific biochemical and mechanical behavior and play a crucial role in guaranteeing a successful post-operative outcome. Although an increasing number of studies report on the structural and mechanical properties of synthetic surgical meshes, nowadays there are no consistent guidelines for the evaluation of mechanical biocompatibility or common criteria for the selection of prostheses. The aim of this work is to review synthetic meshes by considering the extensive bibliography documentation of their use in abdominal wall surgery, taking into account their material and structural properties, in Part I, and their mechanical behavior, in Part II. The main materials available for the manufacture of polymeric meshes are described, including references to their chemical composition, fiber conformation, and textile structural properties. These characteristics are decisive for the evaluation of mesh-tissue interaction process, including foreign body response, mesh encapsulation, infection, and adhesion formation. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 689-699, 2017. © 2015 Wiley Periodicals, Inc.

  7. [Influence of tendon surgery training on the quality of the suture].

    Science.gov (United States)

    Poniński, Michał; Tokarski, Maciej; Andrzejewski, Tomasz; Czarnecki, Piotr; Spławski, Robert

    2010-01-01

    Injuries of flexor tendons are one of the most common injuries that need surgical treatment at emergency room. Technique and quality of the surgery was performed are two factors of the utmost importance. The aim of the study was to determine influence of basic surgical training on the quality of suture. Research was divided into four surgical sessions which were held each once a week. Sutures were put by three medical students. Material that was used were deep flexor tendons dissected from fresh pig's legs. Sessions 1st, 2nd and 4th were preceded by training done by experienced surgeon. During study 90 modified-Kessler sutures without additional running suture were made. Breaking strength was assesed by tensile machine (INSTRON 4481). Time of each suture was also recorded. Outcomes were analyzed by tests: ANOVA and post-hoc LSD tests. Time significantly dropped by 64% after the first session and was held on the same level. Strength of sutures rises in each session preceded by training. There was statistically significant difference between session 1 (mean 13.58; SD 9.86N) and 2nd (mean 42.69; SD 9.27N) and 3rd (mean 38.42; SD 12.28N) and 4th (mean 57.12; SD 12.78N). Conclusions. Time of procedure significantly dropped after first teaching course and was held on the same level despite further training. Breaking strength rise in every session that was preceded by teaching course.

  8. Cardiovascular-interventional-surgery virtual training platform and its preliminary evaluation.

    Science.gov (United States)

    Zhou, Chaozheng; Xie, Le; Shen, Xianglong; Luo, Maisheng; Wu, Zhaoli; Gu, Lixu

    2014-10-13

    Cardiovascular interventional surgery (CIS) training has mainly been performed with fluoroscopic guidance on animals. However, this has potential drawbacks, including from the anatomical differences between animal models and the human body. The purpose of this research is to develop a virtual training platform for inexperienced trainees. The CIS virtual training platform is composed of a mechanical manipulation unit, a simulation platform and a user interface. A decoupled haptic device offers high-quality force feedback. An efficient physically based hybrid model was simulated. The CIS procedure was tested with three simulation studies. Translational and rotational tests were employed to preliminarily evaluate the platform. Tests showed that accuracies improved by 50% and 32.5%. Efficient collision detection and continuous collision response allowed real-time interactions. Furthermore, three simulation studies indicated that the platform had reasonable accuracy and robustness. The proposed simulation platform has the potential to be a good virtual training platform. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

  9. [Undergraduate training in orthopaedic and trauma surgery: analysis of contextual and structural implementation models for undergraduate training in the newly combined specialty].

    Science.gov (United States)

    Ruesseler, M; Froehlich, S; Mittelmeier, W; Walcher, F; Obertacke, U

    2010-09-01

    The fusion of orthopaedic and trauma surgery into a combined specialty requires a new evaluation of postgraduate and undergraduate training. This study presents a structured analysis of the implementation possibilities for undergraduate training. After defining 3 implementation alternatives for both clinical training and last year electives, SWOT analyses were performed. RESULTS. The SWOT analysis demonstrates for each of these 6 implementation models the strengths, weaknesses, opportunities and threats. In order to strengthen undergraduate training in the “new” specialty all medical faculties should discuss and define their implementation concepts.

  10. Training Manual for Local Head Start Staff. Part IV.

    Science.gov (United States)

    Rudolph, Carol; And Others

    This manual is the fourth in a set of training manuals for Head Start staff. It contains descriptions of workshop modules on the topics of (1) language development in children, (2) creativity in children, (3) the Individualized Education Program (IEP), (4) building self-esteem in families, (5) family development, (6) effective communication, and…

  11. DOBD Algorithm for Training Neural Network: Part I. Method

    Institute of Scientific and Technical Information of China (English)

    吴建昱; 何小荣

    2002-01-01

    Overfitting is one of the important problems that restrain the application of neural network. The traditional OBD (Optimal Brain Damage) algorithm canavoid overfitting effectively. But it needs to train the network repeatedly with low calculational efficiency. In this paper, the Marquardt algorithm is incorporated into the OBD algorithm and a new method for pruning network-the Dynamic Optimal Brain Damage (DOBD) is introduced. This algorithm simplifies a network and obtains good generalization through dynamically deleting weight parameters with low sensitivity that is defined as the change of error function value with respect to the change of weights. Also a simplified method is presented through which sensitivities can be calculated during training with a little computation. Arule to determine the lower limit of sensitivity for deleting the unnecessary weights and other control methods during pruning and training are introduced. Thetraining course is analyzed theoretically and the reason why DOBD algorithm canobtain a much faster training speed than the OBD algorithm and avoid overfitting effectively is given.``

  12. Integrating technical and non-technical skills coaching in an acute trauma surgery team training: Is it too much?

    Science.gov (United States)

    Alken, Alexander; Luursema, Jan-Maarten; Weenk, Mariska; Yauw, Simon; Fluit, Cornelia; van Goor, Harry

    2017-08-25

    Research on effective integration of technical and non-technical skills in surgery team training is sparse. In a previous study we found that surgical teachers predominantly coached on technical and hardly on non-technical skills during the Definitive Surgical and Anesthetic Trauma Care (DSATC) integrated acute trauma surgery team training. This study aims to investigate whether the priming of teachers could increase the amount of non-technical skills coaching during such a training. Coaching activities of 12 surgical teachers were recorded on audio and video. Six teachers were primed on non-technical skills coaching prior to the training. Six others received no priming and served as controls. Blind observers reviewed the recordings of 2 training scenario's and scored whether the observed behaviors were directed on technical or non-technical skills. We compared the frequency of the non-technical skills coaching between the primed and the non-primed teachers and analyzed for differences according to the trainees' level of experience. Surgical teachers coached trainees during the highly realistic DSATC integrated acute trauma surgery team training. Trainees performed damage control surgery in operating teams on anesthetized porcine models during 6 training scenario's. Twelve experienced surgical teachers participated in this study. Coaching on non-technical skills was limited to about 5%. The primed teachers did not coach more often on non-technical skills than the non-primed teachers. We found no differences in the frequency of non-technical skills coaching based on the trainees' level of experience. Priming experienced surgical teachers does not increase the coaching on non-technical skills. The current DSATC acute trauma surgery team training seems too complex for integrating training on technical and non-technical skills. Patient care, Practice based learning and improvement. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... implant surgery is, of course, surgery, and is best performed by a trained surgeon with specialized education ... implant surgery is, of course, surgery, and is best performed by a trained surgeon with specialized education ...

  14. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

  15. Facial Cosmetic Surgery

    Science.gov (United States)

    ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

  16. Career decisions and the structure of training: an American Board Of Colon and Rectal Surgery survey of colorectal residents.

    Science.gov (United States)

    Schmitz, Constance C; Rothenberger, David A; Trudel, Judith L; Wolff, Bruce G

    2009-07-01

    To investigate potential impacts of restructuring general surgery training on colorectal (CR) surgery recruitment and expertise. In response to the American Surgical Association Blue Ribbon Committee report on surgical education (2004), the American Board of Colon and Rectal Surgery, working with the Accreditation Council for Graduate Medical Education and American Board of Surgery, established a committee (2006) to review residency training curricula and study new pathways to certification as a CR surgeon. To address concerns related to shortened general surgery residency, the American Board of Colon and Rectal Surgery committee surveyed recent, current, and entering CR residents on the timing and factors associated with their career choice and opinions regarding restructuring. A 10-item, online survey of 189 CR surgeons enrolled in the class years of 2005, 2006, and 2007 was administered and analyzed May to July 2007. One hundred forty-five CR residents responded (77%); results were consistent across class years and types of general surgery training program. Seventy percent of respondents had rotated onto a CR service by the end of their PGY-2 year. Most identified CR as a career interest in their PGY-3 or PGY-4 year. Overall interest in CR surgery, the influence of CR mentors and teachers, and positive exposure to CR as PGY-3, PGY-4, or PGY-5 residents were the top cited factors influencing choice decisions. Respondents were opposed to restructuring by a 2:1 ratio, primarily because of concerns about inadequate training and lack of time to develop technical expertise. Shortening general surgery residency would not necessarily limit exposure to CR rotations and mentors unless such rotations are cut. The details of proposed restructuring are critical.

  17. An analysis of ophthalmology trainees' perceptions of feedback for cataract surgery training

    Directory of Open Access Journals (Sweden)

    Saedon H

    2013-12-01

    Full Text Available Habiba Saedon Birmingham Midland Eye Centre, Birmingham, West Midlands, UK Objectives: To determine whether feedback for cataract surgery is perceived to be given to trainee ophthalmologists, the way in which any feedback is given, and what the trainee perceives to be the effect of feedback on their performance. Design: Cross-sectional qualitative study. Participants: Twelve trainee ophthalmologists at various levels of specialty training in the UK. Methods: Semi-structured interviews were conducted via telephone or face to face. Interviews were transcribed and underwent thematic analysis using a qualitative software data package. Main outcome measures: The importance of feedback to the trainee and methods to improve the giving of feedback. Results: Feedback was thought to be a useful tool for improving performance in cataract surgery by all participants. Emergent themes were the importance of specificity of feedback and having confidence in the supervisor. Participants suggested ways that the feedback given can be improved upon. An insight was gained into how the feedback has an effect on their performance. Conclusion: This study showed that trainees perceive the feedback they receive to be of high quality. Feedback enables the trainees to self-reflect and improve their surgical techniques. Keywords: postgraduate training, education, phacoemulsification, microsurgical skills, cognitive learning, reflection

  18. Gallbladder Removal Simulation for Laparoscopic Surgery Training:A Hybrid Modeling Method

    Institute of Scientific and Technical Information of China (English)

    Youngjun Kim; Dongjune Chang; Jungsik Kim; Sehyung Park

    2013-01-01

    Laparoscopic surgery has many advantages,but it is difficult for a surgeon to achieve the necessary surgical skills.Recently,virtual training simulations have been gaining interest because they can provide a safe and efficient learning environment for medical students and novice surgeons.In this paper,we present a hybrid modeling method for simulating gallbladder removal that uses both the boundary element method (BEM) and the finite element method (FEM).Each modeling method is applied according to the deformable properties of human organs:BEM for the liver and FEM for the gallbladder.Connective tissues between the liver and the gallbladder are also included in the surgical simulation.Deformations in the liver and the gallbladder models are transferred via connective tissue springs using a mass-spring method.Special effects and techniques are developed to achieve realistic simulations,and the software is integrated into a custom-designed haptic interface device.Various computer graphical techniques are also applied in the virtual gallbladder removal laparoscopic surgery training.The detailed techniques and the results of the simulations are described in this paper.

  19. Robotic surgery training: construct validity of Global Evaluative Assessment of Robotic Skills (GEARS).

    Science.gov (United States)

    Sánchez, Renata; Rodríguez, Omaira; Rosciano, José; Vegas, Liumariel; Bond, Verónica; Rojas, Aram; Sanchez-Ismayel, Alexis

    2016-09-01

    The objective of this study is to determine the ability of the GEARS scale (Global Evaluative Assessment of Robotic Skills) to differentiate individuals with different levels of experience in robotic surgery, as a fundamental validation. This is a cross-sectional study that included three groups of individuals with different levels of experience in robotic surgery (expert, intermediate, novice) their performance were assessed by GEARS applied by two reviewers. The difference between groups was determined by Mann-Whitney test and the consistency between the reviewers was studied by Kendall W coefficient. The agreement between the reviewers of the scale GEARS was 0.96. The score was 29.8 ± 0.4 to experts, 24 ± 2.8 to intermediates and 16 ± 3 to novices, with a statistically significant difference between all of them (p robotic surgery and, therefore, is a validated and useful tool to evaluate surgeons in training.

  20. Training in laparoscopic renal surgery, in a few weeks of intense exposure.

    Science.gov (United States)

    Hennayake, S; Jayawardhena, D; Kumara, S; Sakelaris, G

    2005-08-01

    Laparoscopic renal surgery has only recently become popular in the UK and, still, only a handful of pediatric urologists are offering the laparoscopic approach to their patients; therefore, there are only limited places available for training in this discipline. In this institution, which is a major tertiary referral center for pediatric urology having four consultants, one urologist specializes in laparoscopic renal surgery and about 50 laparoscopic ablative renal surgical procedures are performed annually. The aim of this study was to determine the effectiveness of the training provided, for three trainees, in light of the complexity of the ablative procedures performed. Patients who required laparoscopic ablative renal surgery from June 2003 to May 2004 were identified from the prospectively maintained database and data were analyzed. During this period of 12 months, 49 operations have been performed laparoscopically. There were three trainees, A, B and C, who joined the mentor, at different times, for a continuous period of 6, 12 and 6 weeks, respectively. The training was one to one and, at an appropriate level of expertise, the trainees were allowed to perform operations independently; they continued to do so after returning to their units. There were 22 males and 27 females, age ranging from 8 months to 16 years (mean 3.6 years). There were 25 nephrectomies, 23 via the prone retroperitoneal (PRP) approach and two via the transperitoneal (TP) approach; the mean time taken was 70 min. There were 12 nephroureterectomies, six via the PRP, three via the TP, and the other three via the lateral retroperitoneal (LRP) approach; the mean time taken was 100 min. There were 10 heminephroureterectomies (six upper pole and four lower pole), six via the PRP, three via the TP and one via the LRP approach; the mean time taken was 160 min. Of two bilateral nephrectomies one was via the PRP and one the TP approach, and the mean time taken was 170 min. The mean time to

  1. Welcome to cultural competency: surgery's efforts to acknowledge diversity in residency training.

    Science.gov (United States)

    Ly, Catherine L; Chun, Maria B J

    2013-01-01

    Although cultural competency is not a new concept in healthcare, it has only recently been formally embraced as important in the field of surgery. All physicians, including and especially surgeons, must acknowledge the potential influence of culture in order to provide effective and equitable care for patients of all backgrounds. The Accreditation Council for Graduate Medical Education (ACGME) recognizes cultural competency as a component of "patient care," "professionalism," and "interpersonal and communication skills." A systematic literature search was conducted using the MEDLINE, EBSCOhost, Web of Science, and Google Scholar databases. All publications focusing on surgical residents and the assessment of patient care, professionalism, interpersonal and communication skills, or specifically cultural competency and/or were considered. This initial search resulted in 12 articles. To further refine the review, publications discussing curricula in residencies other than surgery, the assessment of technical, or clinical skills and/or without any explicit focus on cultural competency were excluded. Based on the specified inclusion and exclusion criteria, 5 articles were selected. These studies utilized various methods to improve surgical residents' cultural competency, including lectures, Objective Structural Clinical Examinations (OSCE), and written exercises and evaluations. A number of surgical residency programs have made promising strides in training culturally competent surgeons. Ultimately, in order to maximize our collective efforts to improve the quality of health care, the development of cultural competency curricula must be made a priority and such training should be a requirement for all trainees in surgical residency programs. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  2. Identifying Needs: A Missing Part in Teacher Training Programs

    Directory of Open Access Journals (Sweden)

    Hosein Moeini

    2008-01-01

    Full Text Available Diverse compositions of student populations, changing paradigms in teaching and learning, and changing expectations about the quality of education occur in every society at an unexpected rate. In the absence of well designed professional development programs, teachers have been expected to learn how to improve their teaching on their own, learn from trial and error, and individually seek the required professional development. In the new educational era, the trial and error teaching, and take it or leave it professional development programs cannot be accepted anymore. Teacher training is more than the matter of only mastery of certain practical knowledge, pedagogical skills, and techniques. It has to concern teachers’ own perception about the fields in which they don’t feel knowledgeable. This article is a theoretical study intended to give an insight into teachers’ training, their professional development, importance of needs analysis, and integration of needs analysis and information and communication technology in teacher preparation programs. It emphasizes that information and communication technology can enhance teachers’ learning and their professional developments by giving opportunities to initiate new ideas through their training programs.

  3. The Science of Selection: Using Best Practices From Industry to Improve Success in Surgery Training.

    Science.gov (United States)

    Gardner, Aimee K; Grantcharov, Teodor; Dunkin, Brian J

    2017-07-24

    The selection of high-quality applicants is critical to the future of surgery. However, it is unclear if current practices meet industry criteria of a successful selection system, as measured by administrative efficiency and performance and attrition of those selected. We performed a modified systematic review process to gain an understanding of current selection processes, remediation practices, and attrition rates in surgery residency training programs in the United States. We also conducted semistructured interviews with local residency program directors and coordinators to obtain a specific snapshot of the amount of time and resources dedicated to these activities in various sized programs. The associated financial costs of these activities are also presented. The administrative costs for current residency selection processes are substantial, ranging from $45,000 to $148,000 for each program per year. Approximately 30% of residents require at least 1 remediation intervention, costing programs $3400 to $5300 per episode, and typically involve concerns around nontechnical skills. Attrition rates range from 20% to 40%. This review suggests that additional methodologies may allow surgery residency programs to identify best-fit candidates more efficiently and effectively, while also decreasing remediation and attrition rates. Possible solutions include incorporation of structured interviews, personality inventories, and situational judgment tests. Resources dedicated to current interview practices, remediation efforts, and attrition management can be redirected to support these methodologies. By applying the science of selection and assessment to the recruitment process, programs may be able to make more data-driven decisions to identify candidates who will be successful at their institution. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  4. [Surgery training of gynecologic residents: master and student in the operating room].

    Science.gov (United States)

    Rathat, G; Hoa, D; Gagnayre, R; Hoffet, M; Mares, P

    2008-02-01

    Describe the surgical training of gynecologic residents in the operating room, by collecting the opinion of French gynecologists. A questionnaire investigating this subject was put on a web site. Every French gynecologist could answer the questionnaire from a duration of six months. The data of the inquiry were studied by comparing five groups: residents (group 1), fellows (group 2), seniors of public hospital (group 3), and seniors of private hospitals (group 4), or, groups 2, 3 and 4 together, as Group A. Six hundred and fifty-seven gynecologists answered the inquiry. For the residents, lack of time and senior's weak educational motivation are the explanations most frequently retained in order to explain that residents do not operate. For group A, it is rather the residents' skills which is the most important fact to have residents operate. Residents more often practice surgery in general public hospital that in faculty hospital. For 31% of all the referees, heads of departments do not incite their teams to have residents operate. Nearly 25% of all the investigated believe that a man operates more than a woman in resident curriculum. Besides, by analyzing the answers of groups 1 and 2, we were able to correlate resident seniority at their first practice of 13 surgical operations. For 26% of the group A, residents operate less than they do during their own studies. Finally, all the investigated confirm the lack of surgical assessment in the resident curriculum. Decision to let the resident operate remains too dependent on senior personal appreciation and does not seem to join a strategy of training. Opinions of surgical training in the operating room is different between residents and seniors. Operating time increases when residents operate but there is no effect on quality of care. These results show again the necessity of a formal teaching and assessment, in a resident program with objectives, collecting every resident's surgery volume. These educational

  5. Conversion of the dual training aircraft (DC into single control advanced training aircraft (SC. Part I

    Directory of Open Access Journals (Sweden)

    Ioan ŞTEFĂNESCU

    2011-03-01

    Full Text Available Converting the DC school jet aircraft into SC advanced training aircraft - and use them forthe combat training of military pilots from the operational units, has become a necessity due to thebudget cuts for Air Force, with direct implications on reducing the number of hours of flight assignedto operating personnel for preparing and training.The purpose of adopting such a program is to reduce the number of flight hours allocated annuallyfor preparing and training in advanced stages of instruction, for every pilot, by more intensive use ofthis type of aircraft, which has the advantage of lower flight hour costs as compared to a supersoniccombat plane.

  6. Newly Established Cardiac Surgery Clinic: Results of First 195 Cases At Diyarbakır Training and Research Hospital

    OpenAIRE

    Kocabeyoğlu, Sinan Sabit; Çetin, Erdem; Özyüksel, Arda; Kutaş, Barış; Çalışkan, Ahmet; Özdemir, Ferit; Paç, Mustafa

    2013-01-01

    OBJECTIVE: The aim of this article is to present the early results of 195 heart surgery procedures performed in a newly established cardiovascular clinic at Diyarbakır Training and Research Hospital. METHODS: Between June 2009-June 2011, 195 consecutive patients were evaluated retrospectively. A total of 144 cases of coronary artery bypass surgery has been applied; in 43 of them beating heart was performed, in four patients simultaneous carotid endarterectomy was performed. Valve replacement ...

  7. Design and evaluation of safety operation VR training system for robotic catheter surgery.

    Science.gov (United States)

    Wang, Yu; Guo, Shuxiang; Li, Yaxin; Tamiya, Takashi; Song, Yu

    2017-06-30

    A number of remote robotic catheter systems have been developed to protect physicians from X-ray exposure in endovascular surgery. However, the teleoperation prevents the physicians sensing the force directly which may easily result in healthy vessels injured. To realize the safe operation, a tissue protection-based VR training system has been developed in this paper to prevent collateral damage by collision. The integrated VR simulator cannot only remind the novice possible collisions by visual signs, but also cooperate with the newly designed tissue protection mechanism to remit collision trauma beforehand. Such mechanism exploits the diameter variable pulley in order to implement the safe interaction between catheter and vasculature. To testify the effectiveness of the tissue protection in training system, we invited four non-medical students to participate the successive 5 days training session. The evaluation results show that the average impingement distance (representing tissue damage) to vascular wall has been reduced to 0.6 mm, and the collision frequency is greatly decreased which implies the realization of relative safe catheterization.

  8. Is current surgery resident and GI fellow training adequate to pass FES?

    Science.gov (United States)

    Gardner, Aimee K; Scott, Daniel J; Willis, Ross E; Van Sickle, Kent; Truitt, Michael S; Uecker, John; Brown, Kimberly M; Marks, Jeffrey M; Dunkin, Brian J

    2017-01-01

    The purpose of this study was to assess the adequacy of current surgical residency and gastroenterology (GI) fellowship flexible endoscopy training as measured by performance on the FES examination. Fifth-year general surgery residents and GI fellows across six institutions were invited to participate. All general surgery residents had met ACGME/ABS case volume requirements as well as additional institution-specific requirements for endoscopy. All participants completed FES testing at the end of their respective academic year. Procedure volumes were obtained from ACGME case logs. Curricular components for each specialty and institution were recorded. Forty-eight (28 surgery and 20 GI) trainees completed the examination. Average case numbers for residents were 76 ± 26 colonoscopies and 45 ± 12 EGDs. Among GI fellows, PGY4 s (N = 10) reported 99 ± 64 colonoscopies and 147 ± 79 EGDs. PGY5 s (N = 3) reported 462 ± 307 colonoscopies and 411 ± 260 EGDs. PGY6 GI fellows (N = 7) reported 515 ± 111 colonoscopies and 418 ± 146 EGDs. The overall pass rate for all participants was 75 %, with 68 % of residents and 85 % of fellows passing both the cognitive and skills components. For surgery residents, pass rates were 75 % for manual skills and 85.7 % for cognitive. On the skills examination, Task 2 (loop reduction) was associated with the lowest performance. Skills scores correlated with both colonoscopy (r = 0.46, p < 0.001) and EGD experience (r = 0.46, p < 0.001). Receiver operating characteristics curves were examined among the resident cohort. The minimum number of total cases associated with passing the FES skills component was 103. Significant variability existed in curricular components across institutions. These data suggest that current flexible endoscopy training may not be sufficient for all trainees to pass the examination. Implementing additional components of the FEC may prove beneficial in achieving more uniform pass

  9. Improving the Efficiency of Virtual Reality Training by Integrating Partly Observational Learning

    Science.gov (United States)

    Yuviler-Gavish, Nirit; Rodríguez, Jorge; Gutiérrez, Teresa; Sánchez, Emilio; Casado, Sara

    2014-01-01

    The current study hypothesized that integrating partly observational learning into virtual reality training systems (VRTS) can enhance training efficiency for procedural tasks. A common approach in designing VRTS is the enactive approach, which stresses the importance of physical actions within the environment to enhance perception and improve…

  10. Surgical Training and Education in Promoting Professionalism: a comparative assessment of virtue-based leadership development in otolaryngology-head and neck surgery residents.

    Science.gov (United States)

    Schulz, Kristine; Puscas, Liana; Tucci, Debara; Woodard, Charles; Witsell, David; Esclamado, Ramon M; Lee, Walter T

    2013-10-29

    Surgical Training and Education in Promoting Professionalism (STEPP) was developed in 2011 to train tomorrow's leaders during residency. It is based on virtue ethics and takes an approach similar to West Point military academy. The purpose of this research was: (i) to compare the virtue profiles of our residents with that of the military cohort using a standardized virtue assessment tool; and (ii) to assess the value of virtue education on residents. As part of STEPP, otolaryngology residents participated in a virtue-based validated assessment tool called Virtue in Action (VIA) Inventory. This was completed at the initiation of STEPP in July 2011 as well as 1 year later in June 2012. Comparison of the VIA to a military cohort was performed. Leadership 'Basic Training' is a series of forums focused on virtues of initiative, integrity, responsibility, self-discipline, and accountability. A pre- and post-test was administered assessing resident perceptions of the value of this 'Basic Training'. Virtues are shared between otolaryngology residents (n=9) and military personnel (n=2,433) as there were no significant differences in strength scores between two military comparison groups and otolaryngology-head and neck surgery (OHNS) residents. There was a significant improvement (pvirtue-based approach is valued by residents as a part of leadership training during residency.

  11. 14 CFR Appendix E to Part 121 - Flight Training Requirements

    Science.gov (United States)

    2010-01-01

    ... (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Pt. 121, App. E Appendix E to Part 121—Flight... in Command (SIC). B=PIC and SIC. F=Flight Engineer. PJ=PIC transition Jet to Jet. PP=PIC...

  12. A comparative analysis of predictive models of morbidity in intensive care unit after cardiac surgeryPart I: model planning

    Directory of Open Access Journals (Sweden)

    Biagioli Bonizella

    2007-11-01

    Full Text Available Abstract Background Different methods have recently been proposed for predicting morbidity in intensive care units (ICU. The aim of the present study was to critically review a number of approaches for developing models capable of estimating the probability of morbidity in ICU after heart surgery. The study is divided into two parts. In this first part, popular models used to estimate the probability of class membership are grouped into distinct categories according to their underlying mathematical principles. Modelling techniques and intrinsic strengths and weaknesses of each model are analysed and discussed from a theoretical point of view, in consideration of clinical applications. Methods Models based on Bayes rule, k-nearest neighbour algorithm, logistic regression, scoring systems and artificial neural networks are investigated. Key issues for model design are described. The mathematical treatment of some aspects of model structure is also included for readers interested in developing models, though a full understanding of mathematical relationships is not necessary if the reader is only interested in perceiving the practical meaning of model assumptions, weaknesses and strengths from a user point of view. Results Scoring systems are very attractive due to their simplicity of use, although this may undermine their predictive capacity. Logistic regression models are trustworthy tools, although they suffer from the principal limitations of most regression procedures. Bayesian models seem to be a good compromise between complexity and predictive performance, but model recalibration is generally necessary. k-nearest neighbour may be a valid non parametric technique, though computational cost and the need for large data storage are major weaknesses of this approach. Artificial neural networks have intrinsic advantages with respect to common statistical models, though the training process may be problematical. Conclusion Knowledge of model

  13. Complex Spine Pathology Simulator: An Innovative Tool for Advanced Spine Surgery Training.

    Science.gov (United States)

    Gragnaniello, Cristian; Abou-Hamden, Amal; Mortini, Pietro; Colombo, Elena V; Bailo, Michele; Seex, Kevin A; Litvack, Zachary; Caputy, Anthony J; Gagliardi, Filippo

    2016-11-01

    Background Technical advancements in spine surgery have made possible the treatment of increasingly complex pathologies with less morbidity. Time constraints in surgeons' training have made it necessary to develop new training models for spine pathology. Objective To describe the application of a novel compound, Stratathane resin ST-504 derived polymer (SRSDP), that can be injected at different spinal target locations to mimic spinal epidural, subdural extra-axial, and intra-axial pathologies for the use in advanced surgical training. Material and Methods Fresh-frozen thoracolumbar and cervical spine segments of human and sheep cadavers were used to study the model. SRSDP is initially liquid after mixing, allowing it to be injected into target areas where it expands and solidifies, mimicking the entire spectrum of spinal pathologies. Results Different polymer concentrations have been codified to vary adhesiveness, texture, spread capability, deformability, and radiologic visibility. Polymer injection was performed under fluoroscopic guidance through pathology-specific injection sites that avoided compromising the surgical approach for subsequent excision of the artificial lesion. Inflation of a balloon catheter of the desired size was used to displace stiff cadaveric neurovascular structures to mimic pathology-related mass effect. Conclusion The traditional cadaveric training models principally only allow surgeons to practice the surgical approach. The complex spine pathology simulator is a novel educational tool that in a user-friendly, low-cost fashion allows trainees to practice advanced technical skills in the removal of complex spine pathology, potentially shortening some of the aspects of the learning curve of operative skills that may otherwise take many years to acquire.

  14. DOBD Algorithm for Training Neural Network:Part II. Application

    Institute of Scientific and Technical Information of China (English)

    吴建昱; 何小荣

    2002-01-01

    In the first part of the article, a new algorithm for pruning network?Dynamic Optimal Brain Damage(DOBD) is introduced. In this part, two cases and an industrial application are worked out to test the new algorithm. It is verified that the algorithm can obtain good generalization through deleting weight parameters with low sensitivities dynamically and get better result than the Marquardt algorithm or the cross-validation method. Although the initial construction of network may be different, the finial number of free weights pruned by the DOBD algorithm is similar and the number is just close to the optimal number of free weights. The algorithm is also helpful to design the optimal structure of network.

  15. Orthopedic surgery postgraduate year 1 intern curriculum improves initial orthopedic in-training examination performance.

    Science.gov (United States)

    Roberts, Craig S; Nyland, John; Broome, Brandon

    2012-04-01

    To determine the efficacy of an educational curriculum designed for orthopedic surgery postgraduate year 1 (PGY-1) interns to improve initial Orthopedic In-Training Examination (OITE) performance. A retrospective cohort study was performed that evaluated the PGY-1 intern OITE performance of one residency training program (n = 55) during 7-year periods before (1996-2002) and after structured curriculum implementation (2003-2009). Linear regression analysis revealed insignificant changes in median PGY-1 intern OITE percentile rank during the precurriculum period (R = 0.08, P = 0.53). Postcurriculum period comparisons revealed significantly improving PGY-1 intern OITE percentile rank (R = 0.46, P = 0.048). Pre- and postcurriculum median US Medical Licensing Examination (USMLE) Step I scores did not display statistically significant differences (218.2 ± 6.6 vs 229.1 ± 13.8, Mann-Whitney U test, z = -1.5, P = 0.10). Spearman rho correlations revealed a moderate relation (r = 0.61) between postcurriculum PGY-1 intern OITE percentile rank and USMLE Step I score, but not during the precurriculum period. A moderate relation (r = 0.50) also was observed between postcurriculum USMLE Step I score and average OITE percentile rank during the 5-year residency program, but not during the precurriculum period. PGY-1 intern OITE percentile rank improved significantly with the addition of a specially designed educational curriculum. The stronger USMLE Step I score and PGY-1 intern OITE percentile rank relation observed during the postcurriculum period suggests that interns who participated in the educational curriculum were better prepared to translate general medical and patient care knowledge into orthopedic surgery knowledge.

  16. A 31-day time to surgery compliant exercise training programme improves aerobic health in the elderly.

    Science.gov (United States)

    Boereboom, C L; Phillips, B E; Williams, J P; Lund, J N

    2016-06-01

    Over 41,000 people were diagnosed with colorectal cancer (CRC) in the UK in 2011. The incidence of CRC increases with age. Many elderly patients undergo surgery for CRC, the only curative treatment. Such patients are exposed to risks, which increase with age and reduced physical fitness. Endurance-based exercise training programmes can improve physical fitness, but such programmes do not comply with the UK, National Cancer Action Team 31-day time-to-treatment target. High-intensity interval training (HIT) can improve physical performance within 2-4 weeks, but few studies have shown HIT to be effective in elderly individuals, and those who do employ programmes longer than 31 days. Therefore, we investigated whether HIT could improve cardiorespiratory fitness in elderly volunteers, age-matched to a CRC population, within 31 days. This observational cohort study recruited 21 healthy elderly participants (8 male and 13 female; age 67 years (range 62-73 years)) who undertook cardiopulmonary exercise testing before and after completing 12 sessions of HIT within a 31-day period. Peak oxygen consumption (VO2 peak) (23.9 ± 4.7 vs. 26.2 ± 5.4 ml/kg/min, p = 0.0014) and oxygen consumption at anaerobic threshold (17.86 ± 4.45 vs. 20.21 ± 4.11 ml/kg/min, p = 0.008) increased after HIT. It is possible to improve cardiorespiratory fitness in 31 days in individuals of comparable age to those presenting for CRC surgery.

  17. Third-space fluid shift in elderly patients undergoing gastrointestinal surgery: Part II: nursing assessment.

    Science.gov (United States)

    Wotton, Karen; Redden, Maurine

    2002-08-01

    Third-space fluid shift is the mobilisation of body fluid to a non-contributory space rendering it unavailable to the circulatory system. It is a recurrent clinical phenomenon requiring swift identification to minimise deleterious effects. Nurses experience difficulties however in its early identification, diagnosis and subsequent treatment because of the lack of consensual and consistent information regarding third-spacing. This article, part II, building on the previous article, explores the clinical validly and reliability of signs and symptoms of both phases of third-space fluid shift. In addition it reinforces the use multiple patient assessment cues if nurses are to differentiate between, and accurately respond to, the various causes of both hypovolaemia and hypervolaemia. It assists nurses to increase their knowledge and uderstanding of third-space fluid shift in patients undergoing gastrointestinal surgery.

  18. Does gender impact on female doctors'experiences in the training and practice of surgery? A single centre study.

    Science.gov (United States)

    Umoetok, F; Van Wyk, J M; Madiba, T E

    2017-09-01

    Surgery has been identified as a male-dominated specialty in South Africa and abroad. This study explored how female registrars perceived the impact of gender on their training and practice of surgery. A self-administered questionnaire was used to explore whether females perceived any benefits to training in a male-dominated specialty, their choice of mentors and the challenges that they encountered during surgical training. Thirty-two female registrars participated in the study. The respondents were mainly South African (91%) and enrolled in seven surgical specialties. Twenty-seven (84%) respondents were satisfied with their training and skills development. Twenty-four (75%) respondents had a mentor from the department. Seventeen (53%) respondents perceived having received differential treatment due to their gender and 25 (78.2%) thought that the gender of their mentor did not impact on the quality of the guidance received in surgery. Challenges included physical threats to female respondents from patients and disrespect, emotional threats and defaming statements from male registrars. Additional challenges included time-constraints for family and academic work, poor work-life balance and being treated differently due to their gender. Seventeen (53%) respondents would consider teaching in the Department of Surgery. Generally, females had positive perceptions of their training in Surgery. They expressed concern about finding and maintaining a work-life balance. The gender of their mentor did not impact on the quality of the training but 'bullying' from male peers and selected supervisors occurred. Respondents will continue to recommend the specialty as a satisfying career to young female students.

  19. The University Münster model surgery system for Orthognathic surgery. Part I – The idea behind

    Directory of Open Access Journals (Sweden)

    Ehmer Ulrike

    2012-05-01

    Full Text Available Abstract Background We describe a procedure for diagnosis and planning for orthognatic surgery based on international standards. A special 2D planning based on lateral cephalograms (Axis Orbital Marker Lines System realize a transmission to the SAM 2P articulator (3D by means of the Axis Orbital Plane. Methods Former intraoperative measurement of the average height of the LeFort I osteotomy plane relative to the molar occlusal plane allow to construct a virtual osteotomy plane in the lateral cephalogram. This is the basis for the development of the Axis Orbital Marker Lines System (AO-MLS. Results The AO-MLS is presented graphically, and in detail, with construction guidelines. The system could be integrated into various lateral cephalometric analysis- and surgical prediction schemes. It forms the basis for a standardized transfer of the 2D planning to the 3D planning in the articulator, and vice versa. This procedure makes it possible to generate surgical planning protocols based on the model surgery, which represent the dislocations in the proximity of the real osteotomy planes. Conclusions The Axis Orbital Marker Lines System (software component in conjunction with the University Münster Model Surgery System (hardware system increases the predictability of model operations in orthognathic surgery.

  20. Single incision laparoscopic surgery – is it time for laboratory skills training?

    Science.gov (United States)

    Łaski, Dariusz; Makarewicz, Wojciech; Bobowicz, Maciej; Kobiela, Jarosław; Nateghi, Behzad; Proczko, Monika; Madejewska, Ilona; Gruca, Zbigniew; Śledzinski, Zbigniew

    2013-01-01

    Introduction With the introduction of new surgical equipment, there is always the need for new, more advanced training. The authors try to answer whether the use of the newest generation tools has an impact on achieving better results in single incision laparoscopic surgery (SILS) technique during the exercises in the surgical skills laboratory. Material and methods There were 51 participants in the study: 44 ‘novices’ and 7 ‘experts’. All subjects performed the ‘advanced grasping’ exercise according to the FLS programme manual using four types of laparoscopic approach including two SILS ports and SILS-dedicated instruments. The outcome measures involved task completion time and the number of errors. Results Tasks using straight laparoscopic instruments set together with classic three-port access as well as SILS access ports were finished significantly faster when compared with SILS-dedicated instruments (p < 0.05). There were no significant differences in performance times between the two setups with straight instruments (p < 0.05) and both setups with SILS-dedicated instruments, irrespective of the use of curved or dynamic articulated tools. Students with no previous laparoscopic experience had significantly worse task completion times in all tasks in comparison to students with laparoscopic laboratory training and the ‘experts’ group. Conclusions The use of the straight instruments in the SILS technique remain similar to its performance in full triangulation. SILS-dedicated instruments paradoxically increase the task completion time irrespective of possessed skills. The study showed the necessity of a SILS-dedicated tools training programme. PMID:24130635

  1. Hypnosis-induced mental training improves performance on the Fundamentals of Laparoscopic Surgery (FLS) simulator.

    Science.gov (United States)

    Sroka, Gideon; Arnon, Zahi; Laniado, Monica; Schiff, Elad; Matter, Ibrahim

    2015-05-01

    Mental training (MT) is used extensively by musicians and athletes to improve their performance. Recently, it has been suggested as a training method for surgical trainees. We assessed the influence of MT, induced by hypnosis, on the performance of simulated tasks on a laparoscopic simulator, as compared to a non-specific relaxing intervention. 11 surgeons completed a proficiency-based training program on the Fundamentals of Laparoscopic Surgery (FLS) simulator, until they reached performance plateau of the peg transfer task. Thereafter, they received a single music session, as a relaxing intervention, followed by repeating of the peg transfer task. Then they went through a hypnosis session guided by an experienced psychologist, with suggestions of smooth flow of pegs from one position on the board to another, and re-performed the task. Plateau performance was 51.1 ± 6.9 s. After the music session performance improved by 6.3% to 47.9 ± 5.4 s (p = 0.86). After the MT session performance further improved by 15.3% to 40.1 ± 5.8 s (p = 0.009), which was a 21.6% improvement from baseline (p Hypnosis-induced MT significantly improves performance on the FLS simulator, which cannot be attributed to its relaxing qualities alone. This study contributes evidence to the effectiveness of MT in surgical skills acquisition and suggests that hypnotic techniques should be used in mental preparation processes. There is a need to further study these effects on operating room performance.

  2. Part 2: effect of training surface on acute physiological responses after sport-specific training.

    Science.gov (United States)

    Binnie, Martyn J; Dawson, Brian; Pinnington, Hugh; Landers, Grant; Peeling, Peter

    2013-04-01

    This study compared the effect of sand and grass training surfaces during a sport-specific conditioning session in well-trained team sport athletes (n = 10). The participants initially completed a preliminary testing session to gather baseline (BASE) performance data for vertical jump, repeated sprint ability, and 3-km running time trial. Three days subsequent to BASE, all the athletes completed the first sport-specific conditioning session, which was followed by a repeat of the BASE performance tests the following day (24 hours postexercise). Seven days later, the same training session was completed on the opposing surface and was again followed 24 hours later by the BASE performance tests. During each session, blood lactate, ratings of perceived exertion (RPE), and heart rate (HR) were recorded, with player movement patterns also monitored via global positioning system units. Additionally, venous blood was collected preexercise, postexercise, and 24 hours postexercise, and analyzed for serum concentrations of Myoglobin, Haptoglobin, and C-Reactive Protein. Results showed significantly higher HR and RPE responses on SAND (p > 0.05), despite significantly lower distance and velocity outputs for the training session (p > 0.05). There were no differences in 24 hours postexercise performance (p > 0.05), and blood markers of muscle damage, inflammation and hemolysis were also similar between the surfaces (p > 0.05). These results suggest that performing a sport-specific conditioning session on a sand (vs. grass) surface can result in a greater physiological response, without any additional decrement to next-day performance.

  3. Establishment of an operating room committee and a training program to improve aseptic techniques for rodent and large animal surgery.

    Science.gov (United States)

    Héon, Hélène; Rousseau, Nathalie; Montgomery, Jane; Beauregard, Gilles; Choiniére, Manon

    2006-11-01

    Investigators of our research facility generally accept the concept of asepsis as an important component of adequate surgical care for animals. However, they experience difficulties putting it into practice, especially in the case of rodents. The reasons for this are inconvenience, cost, and lack of training. To better assist investigators in the implementation of aseptic surgical techniques in their laboratories, we have created an Operating Room (OR) Committee modeled after OR committees found in human hospitals. A reconstructive surgeon, a veterinarian, a research scientist, a nurse involved in the training of OR personnel, interns, graduate students, and an animal health technician were chosen as committee members in light of their OR and animal care expertise. The first task of the OR Committee was to establish institutional guidelines for aseptic surgery, taking into account the costs imposed on research budgets by these procedures. The OR Committee also supports a complete training program in aseptic surgery techniques, which consists of lectures, a training manual, videos, and a practical course. Furthermore, when experimental procedures require specialized equipment, the OR Committee collaborates with researchers to develop strategies to achieve asepsis. This OR Committee and the training program proved to be important tools to promote and improve the quality of animal care during surgery.

  4. Dietary glutamine supplementation partly reverses impaired macrophage function resulting from overload training in rats.

    Science.gov (United States)

    Xiao, Weihua; Chen, Peijie; Dong, Jingmei; Wang, Ru; Luo, Beibei

    2015-04-01

    The aim of this study was to evaluate the effect of overload training on the function of peritoneal macrophages in rats, and to test the hypothesis that glutamine in vivo supplementation would partly reverse the eventual functional alterations induced by overload training in these cells. Forty male Wistar rats were randomly divided into 5 groups: control group (C), overload training group (E1), overload training and restore one week group (E2), glutamine-supplementation group (EG1), and glutamine-supplementation and restore 1-week group (EG2). All rats, except those placed on sedentary control were subjected to 11 weeks of overload training protocol. Blood hemoglobin, serum testosterone, and corticosterone of rats were measured. Moreover, the functions (chemotaxis, phagocytosis, cytokines synthesis, reactive oxygen species generation) of peritoneal macrophages were determined. Data showed that blood hemoglobin, serum testosterone, corticosterone and body weight in the overload training group decreased significantly as compared with the control group. Meanwhile, the chemotaxis capacity (decreased by 31%, p = .003), the phagocytosis capacity (decreased by 27%, p = .005), the reactive oxygen species (ROS) generation (decreased by 35%, p = .003) and the cytokines response capability of macrophages were inhibited by overload training. However, the hindering of phagocytosis and the cytokines response capability of macrophages induced by overload training could be ameliorated and reversed respectively, by dietary glutamine supplementation. These results suggest that overload training impairs the function of peritoneal macrophages, which is essential for the microbicidal actions of macrophages. This may represent a novel mechanism of immunodepression induced by overload training. Nonetheless, dietary glutamine supplementation could partly reverse the impaired macrophage function resulting from overload training.

  5. Part-task training in the context of automation: current and future directions.

    Science.gov (United States)

    Gutzwiller, Robert S; Clegg, Benjamin A; Blitch, John G

    2013-01-01

    Automation often elicits a divide-and-conquer outlook. By definition, automation has been suggested to assume control over a part or whole task that was previously performed by a human (Parasuraman & Riley, 1997). When such notions of automation are taken as grounds for training, they readily invoke a part-task training (PTT) approach. This article outlines broad functions of automation as a source of PTT and reviews the PTT literature, focusing on the potential benefits and costs related to using automation as a mechanism for PTT. The article reviews some past work in this area and suggests a path to move beyond the type of work captured by the "automation as PTT" framework. An illustrative experiment shows how automation in training and PTT are actually separable issues. PTT with automation has some utility but ultimately remains an unsatisfactory framework for the future broad potential of automation during training, and we suggest that a new conceptualization is needed.

  6. 3D-printed pediatric endoscopic ear surgery simulator for surgical training.

    Science.gov (United States)

    Barber, Samuel R; Kozin, Elliott D; Dedmon, Matthew; Lin, Brian M; Lee, Kyuwon; Sinha, Sumi; Black, Nicole; Remenschneider, Aaron K; Lee, Daniel J

    2016-11-01

    Surgical simulators are designed to improve operative skills and patient safety. Transcanal Endoscopic Ear Surgery (TEES) is a relatively new surgical approach with a slow learning curve due to one-handed dissection. A reusable and customizable 3-dimensional (3D)-printed endoscopic ear surgery simulator may facilitate the development of surgical skills with high fidelity and low cost. Herein, we aim to design, fabricate, and test a low-cost and reusable 3D-printed TEES simulator. The TEES simulator was designed in computer-aided design (CAD) software using anatomic measurements taken from anthropometric studies. Cross sections from external auditory canal samples were traced as vectors and serially combined into a mesh construct. A modified tympanic cavity with a modular testing platform for simulator tasks was incorporated. Components were fabricated using calcium sulfate hemihydrate powder and multiple colored infiltrants via a commercial inkjet 3D-printing service. All components of a left-sided ear were printed to scale. Six right-handed trainees completed three trials each. Mean trial time (n = 3) ranged from 23.03 to 62.77 s using the dominant hand for all dissection. Statistically significant differences between first and last completion time with the dominant hand (p < 0.05) and average completion time for junior and senior residents (p < 0.05) suggest construct validity. A 3D-printed simulator is feasible for TEES simulation. Otolaryngology training programs with access to a 3D printer may readily fabricate a TEES simulator, resulting in inexpensive yet high-fidelity surgical simulation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Multimedia Exercise Training Program Improves Distance Walked, Heart Rate Recovery, and Self-efficacy in Cardiac Surgery Patients.

    Science.gov (United States)

    Wang, Li-Wei; Ou, Shu-Hua; Tsai, Chien-Sung; Chang, Yue-Cune; Kao, Chi-Wen

    2016-01-01

    Patient education has been shown to be more effective when delivered using multimedia than written materials. However, the effects of using multimedia to assist patients in cardiac rehabilitation have not been investigated. The purpose of this study is to examine the effect of an inpatient multimedia exercise training program on distance walked in the 6-minute walking test (6MWT), heart rate recovery, and walking self-efficacy of patients who had undergone heart surgery. For this longitudinal quasi-experimental study, 60 consecutive patients were assigned to an experimental (n = 20; inpatient multimedia exercise training program) or control (n = 40; routine care) group. Data were collected at 3 times (before surgery, 1 to 2 days before hospital discharge, and 1 month after hospital discharge) and analyzed with the generalized estimating equation approach. Most subjects were men (66.7%), had a mean age of 61.32 ± 13.4 years and left ventricular ejection fraction of 56.96% ± 13.28%, and underwent coronary artery bypass graft surgery (n = 34, 56.7%). Subjects receiving the exercise training program showed significantly greater improvement than those in the control group in the 6MWT walking distance (P surgery and maintained their improvement in 6MWT and self-efficacy 1 month later.

  8. Inventory-transportation integrated optimization for maintenance spare parts of high-speed trains.

    Science.gov (United States)

    Lin, Boliang; Wang, Jiaxi; Wang, Huasheng; Wang, Zhongkai; Li, Jian; Lin, Ruixi; Xiao, Jie; Wu, Jianping

    2017-01-01

    This paper presents a 0-1 programming model aimed at obtaining the optimal inventory policy and transportation mode for maintenance spare parts of high-speed trains. To obtain the model parameters for occasionally-replaced spare parts, a demand estimation method based on the maintenance strategies of China's high-speed railway system is proposed. In addition, we analyse the shortage time using PERT, and then calculate the unit time shortage cost from the viewpoint of train operation revenue. Finally, a real-world case study from Shanghai Depot is conducted to demonstrate our method. Computational results offer an effective and efficient decision support for inventory managers.

  9. Neuroimaging for patient selection for medial temporal lobe epilepsy surgery: Part 1 Structural neuroimaging.

    Science.gov (United States)

    Stylianou, Petros; Hoffmann, Chen; Blat, Ilan; Harnof, Sagi

    2016-01-01

    The objective of part one of this review is to present the structural neuroimaging techniques that are currently used to evaluate patients with temporal lobe epilepsy (TLE), and to discuss their potential to define patient eligibility for medial temporal lobe surgery. A PubMed query, using Medline and Embase, and subsequent review, was performed for all English language studies published after 1990, reporting neuroimaging methods for the evaluation of patients with TLE. The extracted data included demographic variables, population and study design, imaging methods, gold standard methods, imaging findings, surgical outcomes and conclusions. Overall, 56 papers were reviewed, including a total of 1517 patients. This review highlights the following structural neuroimaging techniques: MRI, diffusion-weighted imaging, tractography, electroencephalography and magnetoencephalography. The developments in neuroimaging during the last decades have led to remarkable improvements in surgical precision, postsurgical outcome, prognosis, and the rate of seizure control in patients with TLE. The use of multiple imaging methods provides improved outcomes, and further improvements will be possible with future studies of larger patient cohorts. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Respiratory Muscle Training in Patients Recovering Recent Open Cardiothoracic Surgery: A Randomized-Controlled Trial

    Directory of Open Access Journals (Sweden)

    Ernesto Crisafulli

    2013-01-01

    Full Text Available Objectives. To evaluate the clinical efficacy and feasibility of an expiratory muscle training (EMT device (Respilift applied to patients recovering from recent open cardiothoracic surgery (CTS. Design. Prospective, double-blind, 14-day randomised-controlled trial. Participants and Setting. A total of 60 inpatients recovering from recent CTS and early admitted to a pulmonary rehabilitation program. Interventions. Chest physiotherapy plus EMT with a resistive load of 30 cm H2O for active group and chest physiotherapy plus EMT with a sham load for control group. Measures. Changes in maximal expiratory pressure (MEP were considered as primary outcome, while maximal inspiratory pressures (MIP, dynamic and static lung volumes, oxygenation, perceived symptoms of dyspnoea, thoracic pain, and well being (evaluated by visual analogic scale—VAS and general health status were considered secondary outcomes. Results. All outcomes recorded showed significant improvements in both groups; however, the change of MEP (+34.2 mmHg, and +26.1%, for absolute and % of predicted, resp. was significantly higher in active group. Also VAS dyspnoea improved faster and more significantly ( at day 12, and 14 in active group when compared with control. The drop-out rate was 6%, without differences between groups. Conclusions. In patients recovering from recent CTS, specific EMT by Respilift is feasible and effective. This trial is registered with ClinicalTrials.gov NCT01510275.

  11. [Current status of thoracoscopic surgery for thoracic and lumbar spine. Part 1: general aspects and treatment of fractures].

    Science.gov (United States)

    Beisse, Rudolf; Verdú-López, Francisco

    2014-01-01

    Thoracoscopic surgery or video-assisted thoracic surgery (VATS) of the thoracic and lumbar spine has greatly evolved since it appeared less than 20 years ago. Nowadays, it is indicated in a large number of processes and injuries. The aim of this article, in its 2 parts, is to review the current status of VATS in treatment of the thoracic and lumbar spine in its entire spectrum. After reviewing the current literature, we develop each of the large groups of indications where VATS is used, one by one. This first part contains a description of general thoracoscopic surgical technique including the necessary prerequisites, transdiaphragmatic approach, techniques and instrumentation used in spine reconstruction, as well as a review of treatment and specific techniques in the management of spinal fractures. Thoracoscopic surgery is in many cases an alternative to conventional open surgery. The transdiaphragmatic approach has made endoscopic treatment of many thoracolumbar junction processes possible, thus widening the spectrum of therapeutic indications. These include the treatment of fractures and deformities, as well as the reconstruction of injured spinal segments and decompression of the spinal canal in any etiological processes if the lesion placement is favourable to antero-lateral approach. Good clinical results of thoracoscopic surgery are supported by the growing experience reflected in a large number of articles. The degree of complications in thoracoscopic surgery is comparable to open surgery, with benefits in morbidity of the approach and subsequent patient recovery. Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  12. Effect of the full implementation of the European Working Time Directive on operative training in adult cardiac surgery.

    Science.gov (United States)

    Mahesh, Balakrishnan; Sharples, Linda; Codispoti, Massimiliano

    2014-01-01

    Surgical specialties rely on practice and apprenticeship to acquire technical skills. In 2009, the final reduction in working hours to 48 per week, in accordance with the European Working Time Directive (EWTD), has also led to an expansion in the number of trainees. We examined the effect of these changes on operative training in a single high-volume [>1500 procedures/year] adult cardiac surgical center. Setting: A single high-volume [>1500 procedures/year] adult cardiac surgical center. Design: Consecutive data were prospectively collected into a database and retrospectively analyzed. Procedures and Main Outcome Measures: Between January 2006 and August 2010, 6688 consecutive adult cardiac surgical procedures were analyzed. The proportion of cases offered for surgical training were compared for 2 non-overlapping consecutive time periods: 4504 procedures were performed before the final implementation of the EWTD (Phase 1: January 2006-December 2008) and 2184 procedures after the final implementation of the EWTD (Phase 2: January 2009-August 2010). Other predictors of training considered in the analysis were grade of trainee, logistic European system for cardiac operative risk evaluation (EuroSCORE), type of surgical procedure, weekend or late procedure, and consultant. Logistic regression analysis was used to determine the predictors of training cases (procedure performed by trainee) and to evaluate the effect of the EWTD on operative surgical training after correcting for confounding factors. Proportion of training cases rose from 34.6% (1558/4504) during Phase 1 to 43.6% (953/2184) in Phase 2 (p surgery other than coronary artery bypass grafts. Implementation of the final phase of EWTD has not decreased training in a high-volume center. The positive adjustment of trainers' attitudes and efforts to match trainees' needs allow maintenance of adequate training, despite reduction in working hours and increasing patients' risk profile. Copyright © 2014 Association of

  13. Impact of aerobic exercise training on heart rate variability and functional capacity in obese women after gastric bypass surgery.

    Science.gov (United States)

    Castello, Viviane; Simões, Rodrigo Polaquini; Bassi, Daniela; Catai, Aparecida Maria; Arena, Ross; Borghi-Silva, Audrey

    2011-11-01

    Obesity is a major public health concern on a global scale. Bariatric surgery is among the treatment options, resulting in significant and sustainable weight loss as well as amelioration of comorbidities. The purpose of this study was to evaluate whether a 12-week aerobic exercise program positively impacts heart rate variability (HRV) and functional capacity after gastric bypass surgery (GBS) in a female cohort. Of the 52 patients initially recruited, 21 were randomized to a training group (TG) or control group and successfully completed the study. Patients were tested on two occasions: 1 week before GBS and 4 months after GBS. Anthropometric variables, body composition, record of heart rate and R-R intervals, and 6-min walk test (6MWT) were assessed at both time points. The TG underwent an aerobic exercise training program on a treadmill (1-h session, totaling 36 sessions over 12 weeks). The main findings from this study were: (1) only the TG demonstrated a significant increase (p heart rate variability (HRV) after 12 weeks of aerobic exercise training and (2) only the TG demonstrated a significant increase (p exercise training. We conclude that 12 weeks of aerobic exercise training improves cardiac autonomic modulation and functional capacity 4 months after GBS.

  14. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... best performed by a trained surgeon with specialized education and training. Click here to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, ...

  15. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... best performed by a trained surgeon with specialized education and training. Click here to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, ...

  16. 7 CFR Appendix to Part 227 - Apportionment of Funds for Nutrition Education and Training

    Science.gov (United States)

    2010-01-01

    ... PROGRAM Pt. 227, App. Appendix to Part 227—Apportionment of Funds for Nutrition Education and Training...,551 6,307 390,237 New Mexico 108,673 5,448 235 2,619 116,975 Oklahoma 229,166 3,969 1,916 8,639 243...

  17. 49 CFR Appendix to Part 380 - LCV Driver Training Programs, Required Knowledge and Skills

    Science.gov (United States)

    2010-10-01

    ... and Skills Appendix to Part 380 Transportation Other Regulations Relating to Transportation (Continued..., Required Knowledge and Skills The following table lists topics of instruction required for drivers of...-wheel training designed to provide an opportunity to develop the skills outlined under the Proficiency...

  18. Microsurgical Bypass Training Rat Model, Part 1: Technical Nuances of Exposure of the Aorta and Iliac Arteries.

    Science.gov (United States)

    Tayebi Meybodi, Ali; Lawton, Michael T; Mokhtari, Pooneh; Yousef, Sonia; Gandhi, Sirin; Benet, Arnau

    2017-06-21

    Animal models using rodents are frequently used for practicing microvascular anastomosis-an essential technique in cerebrovascular surgery. However, safely and efficiently exposing rat's target vessels is technically difficult. Such difficulty may lead to excessive hemorrhage and shorten animal survival. This limits the ability to perform multiple anastomoses on a single animal and may increase the overall training time and costs. We report our model for microsurgical bypass training in rodents in 2 consecutive articles. In part 1, we describe the technical nuances for a safe and efficient exposure of the rat abdominal aorta and common iliac arteries (CIAs) for bypass. Over a 2-year period, 50 Sprague-Dawley rats underwent inhalant anesthesia for practicing microvascular anastomosis on the abdominal aorta and CIAs. Lessons learned regarding the technical nuances of vessel exposure were recorded. Several technical nuances were important for avoiding intraoperative bleeding and preventing animal demise while preparing an adequate length of vessels for bypass. The most relevant technical nuances include (1) generous subcutaneous dissection; (2) use of cotton swabs for the blunt dissection of the retroperitoneal fat; (3) combination of sharp and blunt dissection to isolate the aorta and iliac arteries from the accompanying veins; (4) proper control of the posterior branches of the aorta; and (5) efficient division and mobilization of the left renal pedicle. Applying the aforementioned technical nuances enables safe and efficient preparation of the rat abdominal aorta and CIAs for microvascular anastomosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Patient safety in dermatologic surgery: Part I. Safety related to surgical procedures.

    Science.gov (United States)

    Hansen, Timothy J; Lolis, Margarita; Goldberg, David J; MacFarlane, Deborah F

    2015-07-01

    Surgical procedures involve unique elements related to patient safety. One must be aware of potential complications and safety issues within the practice of dermatologic surgery. Developing a high level of competence in skin surgery will address some safety issues, while implementing protocols and redundancies provides systems-based correction for other safety issues. We provide an in-depth review of patient safety in dermatologic surgery. In particular, we highlight the most common safety issues and methods for reducing error. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  20. A Methodological Systematic Review on Surgical Site Infections Following Spinal Surgery: Part 1: Risk Factors

    NARCIS (Netherlands)

    Pull ter Gunne, A.F.; Hosman, A.J.F.; Cohen, D.B.; Schuetz, M.; Habil, D.; Laarhoven, C.J. van; Middendorp, J.J. van

    2012-01-01

    STUDY DESIGN.: A methodological systematic review. OBJECTIVE.: To critically appraise the validity of risk factors for surgical site infection (SSI) after spinal surgery. SUMMARY OF BACKGROUND DATA.: SSIs lead to higher morbidity, mortality, and increased health care costs. Understanding which

  1. Structured training strategy for robot surgery%机器人外科结构化培训策略

    Institute of Scientific and Technical Information of China (English)

    郗洪庆; 张珂诚; 卫勃; 陈凛

    2016-01-01

    With surgical strategy progresses towarding to precision and minimally invasive surgery, the Da Vinci robotic surgical system comes into being� Compared with conventional surgery, the Da Vinci robotic surgical system enjoys several advantages including clear operation field, flexibility and tremor filtration�Normative operation plays an important role in translating such advantages into clinical benefits�Training physicians systematically and comprehensively is very important� Compared with conventional training strategy, multi⁃modal simulation training is more preferred for the Da Vinci robotic surgical system training�Based on comprehensive literature retrieval and the current development of the robotic surgery, training modalities, learning curve, training of young surgeons as well as teamwork are included to provide evidence for future establishment and implement of structured training programs of the robotic surgery.%随着外科手术向精细化、微创化的方向不断发展,达芬奇机器人外科手术系统应运而生。相比于传统外科手术器械,达芬奇机器人外科手术系统具有术野更加清晰、操作更加灵活和除颤等诸多优点。将这些优点转化成患者的获益离不开术者规范的操作,因此,对术者进行全面系统的培训显得尤为重要。与传统外科教学形式相比,整合多种模拟训练模式更适合机器人外科手术系统的培训需求,包括训练模式、学习曲线、青年医师培训和机器人团队培训四个方面,希望能为结构化培训项目的优化建立和实施提供参考。

  2. Development of a standardised training curriculum for robotic surgery: a consensus statement from an international multidisciplinary group of experts.

    Science.gov (United States)

    Ahmed, Kamran; Khan, Reenam; Mottrie, Alexandre; Lovegrove, Catherine; Abaza, Ronny; Ahlawat, Rajesh; Ahlering, Thomas; Ahlgren, Goran; Artibani, Walter; Barret, Eric; Cathelineau, Xavier; Challacombe, Ben; Coloby, Patrick; Khan, Muhammad S; Hubert, Jacques; Michel, Maurice Stephan; Montorsi, Francesco; Murphy, Declan; Palou, Joan; Patel, Vipul; Piechaud, Pierre-Thierry; Van Poppel, Hendrik; Rischmann, Pascal; Sanchez-Salas, Rafael; Siemer, Stefan; Stoeckle, Michael; Stolzenburg, Jens-Uwe; Terrier, Jean-Etienne; Thüroff, Joachim W; Vaessen, Christophe; Van Der Poel, Henk G; Van Cleynenbreugel, Ben; Volpe, Alessandro; Wagner, Christian; Wiklund, Peter; Wilson, Timothy; Wirth, Manfred; Witt, Jörn; Dasgupta, Prokar

    2015-07-01

    To explore the views of experts about the development and validation of a robotic surgery training curriculum, and how this should be implemented. An international expert panel was invited to a structured session for discussion. The study was of a mixed design, including qualitative and quantitative components based on focus group interviews during the European Association of Urology (EAU) Robotic Urology Section (ERUS) (2012), EAU (2013) and ERUS (2013) meetings. After introduction to the aims, principles and current status of the curriculum development, group responses were elicited. After content analysis of recorded interviews generated themes were discussed at the second meeting, where consensus was achieved on each theme. This discussion also underwent content analysis, and was used to draft a curriculum proposal. At the third meeting, a quantitative questionnaire about this curriculum was disseminated to attendees to assess the level of agreement with the key points. In all, 150 min (19 pages) of the focus group discussion was transcribed (21 316 words). Themes were agreed by two raters (median agreement κ 0.89) and they included: need for a training curriculum (inter-rater agreement κ 0.85); identification of learning needs (κ 0.83); development of the curriculum contents (κ 0.81); an overview of available curricula (κ 0.79); settings for robotic surgery training ((κ 0.89); assessment and training of trainers (κ 0.92); requirements for certification and patient safety (κ 0.83); and need for a universally standardised curriculum (κ 0.78). A training curriculum was proposed based on the above discussions. This group proposes a multi-step curriculum for robotic training. Studies are in process to validate the effectiveness of the curriculum and to assess transfer of skills to the operating room. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

  3. The value of haptic feedback in conventional and robot-assisted minimal invasive surgery and virtual reality training: a current review.

    Science.gov (United States)

    van der Meijden, O A J; Schijven, M P

    2009-06-01

    Virtual reality (VR) as surgical training tool has become a state-of-the-art technique in training and teaching skills for minimally invasive surgery (MIS). Although intuitively appealing, the true benefits of haptic (VR training) platforms are unknown. Many questions about haptic feedback in the different areas of surgical skills (training) need to be answered before adding costly haptic feedback in VR simulation for MIS training. This study was designed to review the current status and value of haptic feedback in conventional and robot-assisted MIS and training by using virtual reality simulation. A systematic review of the literature was undertaken using PubMed and MEDLINE. The following search terms were used: Haptic feedback OR Haptics OR Force feedback AND/OR Minimal Invasive Surgery AND/OR Minimal Access Surgery AND/OR Robotics AND/OR Robotic Surgery AND/OR Endoscopic Surgery AND/OR Virtual Reality AND/OR Simulation OR Surgical Training/Education. The results were assessed according to level of evidence as reflected by the Oxford Centre of Evidence-based Medicine Levels of Evidence. In the current literature, no firm consensus exists on the importance of haptic feedback in performing minimally invasive surgery. Although the majority of the results show positive assessment of the benefits of force feedback, results are ambivalent and not unanimous on the subject. Benefits are least disputed when related to surgery using robotics, because there is no haptic feedback in currently used robotics. The addition of haptics is believed to reduce surgical errors resulting from a lack of it, especially in knot tying. Little research has been performed in the area of robot-assisted endoscopic surgical training, but results seem promising. Concerning VR training, results indicate that haptic feedback is important during the early phase of psychomotor skill acquisition.

  4. Cataract surgery: factors influencing decision to treat and implications for training (south-east Scotland 2008–2014

    Directory of Open Access Journals (Sweden)

    Sniatecki JJ

    2015-09-01

    Full Text Available Jan J Sniatecki, Caroline Styles, Natalie Boyle, Roshini Sanders Cataract Unit, Queen Margaret Hospital, Dunfermline, Fife, UK Purpose: To describe the population referred for cataract surgery, identify factors that influenced decision to treat, and patients suitable for ophthalmic training. Patients and methods: A total of 2,693 consecutive referrals over 6 years were interrogated using Business Objects software on cataract electronic patient records. Results: A total of 2,693 patients were referred for cataract surgery (group A. Of these patients 2,132 (79% had surgery (group B and 561 (21% did not (group C. Age for group B vs group C: 672 (32% vs 115 (20% ≤69 years, P<0.001; 803 (38% vs 225 (40% 70–79 years, P=0.48; 586 (27% vs 203 (36% 80–89 years, P<0.05; 71 (3% vs 18 (3% ≥90 years, P=1.0. Visual acuity, group B vs group C: 556 (26% vs 664 (59% 6/12 or better; 1,275 (60% vs 367 (33% 6/18–6/60; 266 (12% vs 64 (6% counting fingers or worse, P<0.05. Medical history for group B vs C: cognitive impairment: 55 (2.6% vs 29 (5.2%, P<0.05; cardiovascular accident: 158 (7.4% vs 60 (10.7%, P<0.05; diabetes: 372 (17.4% vs 96 (17.1%, P=0.87; COPD/asthma: 382 (17.9% vs 93 (16.6%, P=0.53; heart disease: 535 (25.1% vs 155 (27.6%, P=0.35; hypertension: 971 (45.5% vs 263 (46.9%, P=0.73. Ocular history for group B vs C was significant (P<0.05 for age-related macular degeneration 255 (12.0% vs 93 (16.6%, other macular pathology 38 (1.8% vs 25 (4.5%, corneal pathology 92 (4.3% vs 36 (6.4%, amblyopia 37 (1.7% vs 22 (3.9%. Detailed data on presenting complaint, ophthalmic history, and social status is discussed. Conclusion: We observed that surgery at a younger age with good levels of visual acuity was a factor in deferring cataract surgery. Cognitive impairment, cardiovascular accident, amblyopia, corneal and macular pathology significantly affected decision not to operate. We estimate that 80% of patients would be suitable for ophthalmic training

  5. Percutaneous minimal-access fetoscopic surgery for spina bifida aperta. Part II: maternal management and outcome.

    Science.gov (United States)

    Degenhardt, J; Schürg, R; Winarno, A; Oehmke, F; Khaleeva, A; Kawecki, A; Enzensberger, C; Tinneberg, H-R; Faas, D; Ehrhardt, H; Axt-Fliedner, R; Kohl, T

    2014-11-01

    To assess maternal morbidity and outcome in women undergoing minimal-access fetoscopic surgery for spina bifida aperta. This was a retrospective study of 51 women undergoing minimal-access fetoscopic surgery to improve postnatal neurological outcome of spina bifida aperta, at a mean gestational age of 24 weeks, at our center between July 2010 and June 2013. We analyzed various perioperative complications of surgery, namely: maternal and fetal death, need for maternal blood transfusion, placental abruption, pulmonary edema, spontaneous labor, oligohydramnios, chorioamnionitis, chorioamniotic membrane separation, duration of hospitalization, amniotic fluid leakage, gestational age at delivery and status of hysterotomy site. In none of the 51 women was there maternal demise, spontaneous labor, placental abruption or a need for maternal blood transfusion in the perioperative period. Chorioamniotic membrane separation occurred in one patient, mild pulmonary edema occurred in one and oligohydramnios occurred in seven. All fetuses survived surgery, but there was one very early preterm delivery 1 week after the procedure and this neonate died immediately, from early postoperative chorioamnionitis. Amniotic fluid leakage occurred in 43 patients, at a mean gestational age of 29.7 (range, 22.6-37.3) weeks; two of these patients developed chorioamnionitis. Duration of maternal hospitalization after surgery was 7.2 (range, 4-12) days. Mean gestational age at delivery was 33 (range, 24.6-38.1) weeks. All abdominal and uterine trocar insertion sites healed well. Minimal-access fetoscopic surgery for spina bifida aperta is apparently safe for most maternal patients. Despite the common occurrence of amniotic leakage, the majority of women deliver beyond 32 weeks of gestation. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

  6. Two-part silicone mold. A new tool for flexible ureteroscopy surgical training

    Directory of Open Access Journals (Sweden)

    Bruno Marroig

    Full Text Available ABSTRACT Introduction and objectives: Flexible ureteroscopy is a common procedure nowadays. Most of the training programs use virtual reality simulators. The aim of this study was to standardize the building of a three-dimensional silicone mold (cavity of the collecting system, on the basis of polyester resin endocasts, which can be used in surgical training programs. Materials and Methods: A yellow polyester resin was injected into the ureter to fill the collecting system of 24 cadaveric fresh human kidneys. After setting off the resin, the kidneys were immersed in hydrochloric acid until total corrosion of the organic matter was achieved and the collecting system endocasts obtained. The endocasts were used to prepare white color two-part silicone molds, which after endocasts withdrawn, enabled a ureteroscope insertion into the collecting system molds (cavities. Also, the minor calices were painted with different colors in order to map the access to the different caliceal groups. The cost of the materials used in the molds is $30.00 and two days are needed to build them. Results: Flexible ureteroscope could be inserted into all molds and the entire collecting system could be examined. Since some anatomical features, as infundular length, acute angle, and perpendicular minor calices may difficult the access to some minor calices, especially in the lower caliceal group, surgical training in models leads to better surgical results. Conclusions: The two-part silicone mold is feasible, cheap and allows its use for flexible ureteroscopy surgical training.

  7. Image-guided endoscopic spine surgery: Part I. A feasibility study.

    Science.gov (United States)

    Assaker, R; Cinquin, P; Cotten, A; Lejeune, J P

    2001-08-01

    A feasibility study was performed to determine the efficacy of computer assistance in endoscopic spine surgery. To assess a new method for computer assistance based on image guidance during thoracoscopic or any endoscopic spine procedure. To evaluate the reproducibility, the sensitivity and the reliability of the technique first in vitro and second in clinical use. The computer-based, image-guided surgery is now a routine tool used in open spine surgery. Exposure of the anatomy of the vertebra is needed for registration. This methodology is inapplicable in endoscopic approach. Fluoroscopic-based navigation combines the technology of image-guided surgery and C-arm fluoroscopy. The navigation is based on the fluoroscopic images acquired before surgery. This technology is applicable to endoscopic surgery but the navigation is based on fluoroscopic image. The computed tomography images are not exploited. There are no published data on a technique that allows image-guided surgery based on computed tomography and magnetic resonance imaging. A laboratory study was performed on a thoracic human spine. One vertebra was marked on the right lateral side of the body with five titanium marks. A percutaneous reference frame was specifically designed to be placed in the pedicle of the same marked vertebrae. The reference frame acted as a 3D localizer and a registration tool. The spine model was scanned including the reference frame. A standard Stealth station treatment guidance platform (Medtronic, Sofamor Danek, Memphis, TN) was used for simulation. The registration was obtained using the reference frame. Twenty navigation procedure trials were done and the error was recorded based on the distance between the anatomical point and the corresponding virtual one. Registration was always possible using the stealth station and a standard spine navigational software (spine 3, Medtronic Sofamor Danek, Memphis, TN). The mean error after registration given by the computer was 0.96 mm

  8. Part Two: Surgery--Can This Be a Cure for Epilepsy?

    Science.gov (United States)

    McGoldrick, Patricia E.

    2010-01-01

    In the first installment of this series (Exceptional Parent Magazine, May 2010), the author discussed epilepsy surgery performed in persons whose areas of brain abnormality were initially deemed to be too extensive to safely perform a resection of the involved area. The process leading to surgical remediation for seizures is an involved one, but…

  9. A benefit-risk review of systemic haemostatic agents - Part 1 : In major surgery

    NARCIS (Netherlands)

    Fraser, Ian S.; Porte, Robert J.; Kouides, Peter A.; Lukes, Andrea S.

    2008-01-01

    Systemic haemostatic agents play an important role in the management of blood loss during major surgery where significant blood loss is likely and their use has increased in recent times as a consequence of demand for blood products outstripping supply and the risks associated with transfusions. The

  10. Part Two: Surgery--Can This Be a Cure for Epilepsy?

    Science.gov (United States)

    McGoldrick, Patricia E.

    2010-01-01

    In the first installment of this series (Exceptional Parent Magazine, May 2010), the author discussed epilepsy surgery performed in persons whose areas of brain abnormality were initially deemed to be too extensive to safely perform a resection of the involved area. The process leading to surgical remediation for seizures is an involved one, but…

  11. An outbreak of Fusarium solani endophthalmitis after cataract surgery in an eye training and research hospital in Istanbul.

    Science.gov (United States)

    Güngel, Hülya; Eren, Mümin Hakan; Pınarcı, Eylem Yaman; Altan, Ciğdem; Baylançiçek, Deniz Oygar; Kara, Necip; Gürsel, Tanıl; Yegenoğlu, Yildiz; Susever, Serdar

    2011-11-01

    To report an outbreak of Fusarium solani endophthalmitis after uneventful cataract surgeries performed on the same day in the same operating room. Nine patients underwent phacoemulsification at 4th Clinic of Beyoglu Eye Training and Research Hospital in Istanbul. Cefuroxime axetyl was injected intracamerally from the same vial to all patients at the end of surgery. All patients developed acute postoperative endophthalmitis. Presentation, cultural studies, treatment, clinical responses and risk factors were evaluated. Cultural and DNA sequence findings revealed F. solani. Antifungal therapy was begun and pars plana vitrectomy, intraocular lens and capsule extraction were performed. Corneal involvement was correlated with old age and systemic disease. Fusarium solani should be considered in acute postoperative endophthalmitis. This infection can be controlled with early and aggressive combined antifungal and surgical treatment. The patients with corneal involvement had poor prognosis. It is important to use solutions prepared separately for each patient. © 2011 Blackwell Verlag GmbH.

  12. Progressive resistance training and stretching following surgery for breast cancer: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Ward Leigh C

    2006-12-01

    Full Text Available Abstract Background Currently 1 in 11 women over the age of 60 in Australia are diagnosed with breast cancer. Following treatment, most breast cancer patients are left with shoulder and arm impairments which can impact significantly on quality of life and interfere substantially with activities of daily living. The primary aim of the proposed study is to determine whether upper limb impairments can be prevented by undertaking an exercise program of prolonged stretching and resistance training, commencing soon after surgery. Methods/design We will recruit 180 women who have had surgery for early stage breast cancer to a multicenter single-blind randomized controlled trial. At 4 weeks post surgery, women will be randomly assigned to either an exercise group or a usual care (control group. Women allocated to the exercise group will perform exercises daily, and will be supervised once a week for 8 weeks. At the end of the 8 weeks, women will be given a home-based training program to continue indefinitely. Women in the usual care group will receive the same care as is now typically provided, i.e. a visit by the physiotherapist and occupational therapist while an inpatient, and receipt of pamphlets. All subjects will be assessed at baseline, 8 weeks, and 6 months later. The primary measure is arm symptoms, derived from a breast cancer specific questionnaire (BR23. In addition, range of motion, strength, swelling, pain and quality of life will be assessed. Discussion This study will determine whether exercise commencing soon after surgery can prevent secondary problems associated with treatment of breast cancer, and will thus provide the basis for successful rehabilitation and reduction in ongoing problems and health care use. Additionally, it will identify whether strengthening exercises reduce the incidence of arm swelling. Trial Registration The protocol for this study is registered with the Australian Clinical Trials Registry (ACTRN012606000050550.

  13. Can primary health care staff be trained in basic life-saving surgery?

    African Journals Online (AJOL)

    2012-08-03

    Aug 3, 2012 ... those who can provide basic surgery and anesthesia in order to compensate for .... and essays 1985 – 1990, Epistemology and Learning. Research Group, the Media Lab, Massachusetts Institute of Technology, Ablex Pub.

  14. The sum of many parts: potential mechanisms for improvement in glucose homeostasis after bariatric surgery.

    Science.gov (United States)

    Nguyen, Kim T; Korner, Judith

    2014-01-01

    Bariatric surgery has emerged as the most durably effective treatment of type 2 diabetes (DM). However, the mechanisms governing improvement in glucose homeostasis have yet to be fully elucidated. In this review we discuss the various types of surgical interventions and the multitude of factors that potentially mediate the effects on glycemia, such as altered delivery of nutrients to the distal ileum, duodenal exclusion, gut hormone changes, bile acid reabsorption, and amino acid metabolism. Accumulating evidence that some of these changes seem to be independent of weight loss questions the rationale of using body mass index as the major indication for surgery in diabetic patients. Understanding the complex mechanisms and interactions underlying improved glycemic control could lead to novel therapeutic targets and would also allow for greater individualization of therapy and optimization of surgical outcomes.

  15. Breast cancer surgery: an historical narrative. Part I. From prehistoric times to Renaissance.

    Science.gov (United States)

    Sakorafas, George H; Safioleas, Michael

    2009-11-01

    Cancer was known as a disease since prehistoric times. Management of breast cancer evolved slowly through centuries in the ancient world up to the Renaissance. This period is marked by the absence of any scientifically verifiable understanding of the true nature of cancer and its natural history and consequently by a lack of effective treatment. Breast has been considered as a symbol of femininity, fertility and beauty. Hippocrates proposed that breast cancer, among other neoplasms, was a 'systemic disease' caused by an excess of black bile. The humoral theory was further supported by Galen and dominated for centuries in medicine. Fulguration and breast amputation by using various instruments to achieve a rapid operation were widely used up to the 18th century. The Renaissance was a revolutionary period, since it stimulated medical practice; at that time physicians started to scientifically study medicine. Vesalius greatly contributed in the advancement of surgery, and he vigorously opposed Galen's doctrines. Many great surgeons of that time (including Paré, Cabrol, Servetto, Scultetus, Tulp, Fabry von Hilded, etc.) advanced the science of surgery. Interestingly, Bartoleny Gabrol (1590) in Montpellier advocated radical mastectomy, which was popularised by Halsted, 300 years later. However, the lack of anaesthesia and the problem of wound infections (due to the lack of the aseptic techniques) generated significance and often problems for the surgeons of that time. Surgery was often 'heroic' but primitive and even inhumane by current standards. Therapeutic nihilism was the prevailing altitude regarding breast cancer, at least among the vast majority of surgeons.

  16. CLONIDINE PREMEDICATION AS A DESIRABLE PART OF HYPOTENSIVE ANAESTHESIA FOR FUNCTIONAL ENDOSCOPIC SINUS SURGERY

    Directory of Open Access Journals (Sweden)

    Praveen

    2016-04-01

    Full Text Available BACKGROUND Clonidine an ideal agent for hypotensive anaesthesia, also attenuates stress response to laryngoscopy, decreases requirement of inhalational anaesthetic agents, decreases postoperative analgesic requirements, prevents post-operative shivering. MATERIAL AND METHODS 60 patients under 16-60 years age group posted for functional endoscopic sinus surgery (FESS were randomly divided into 2 groups of 30 each. Placebo group (Group P received 20 mL normal saline intravenously and Clonidine group (Group C received 2.5 micrograms Clonidine per kilogram body weight in 20 mL saline intravenously 20 mins before surgery. Haemodynamic variability during surgery, intraoperative inhalational agent requirement and perioperative bleeding as assessed by surgeon, postoperative analgesic requirement and post-operative shivering were compared between two groups. RESULTS There was statistically significant reduction in heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure in Group C compared to Group P. There was statistically significant decrease in requirement of Isoflurane, decreased bleeding from surgical site, decreased analgesic consumption and nil incidence of postoperative shivering in Group C compared to Group P. CONCLUSION Clonidine is an ideal agent for hypotensive anaesthesia as it has got other favourable effects along with controlled hypotension, as it was observed in this study

  17. The Effect of Additional Virtual Reality Training on Balance in Children with Cerebral Palsy after Lower Limb Surgery: A Feasibility Study.

    Science.gov (United States)

    Meyns, Pieter; Pans, Liene; Plasmans, Kaat; Heyrman, Lieve; Desloovere, Kaat; Molenaers, Guy

    2017-02-01

    Impaired balance is disabling for children with cerebral palsy (CPc), especially for CPc who recently underwent lower limb surgery. Positive results of using virtual reality (VR) in balance rehabilitation have been published in several outpatient populations. We investigated the feasibility of applying additional VR training focused on sitting balance in CP inpatients of a rehabilitation center after lower limb surgery. Additionally, we investigated the rate of enjoyment of VR training compared with conventional physiotherapy. Eleven spastic CPc (4/7 males/females) following rehabilitation after lower limb orthopedic surgery were included (5-18 years). The control group received conventional physiotherapy. The intervention group received additional VR training. Balance was measured using the Trunk Control Measurement Scale every 3 weeks of the rehabilitation period. Enjoyment was analyzed using a 10-point Visual Analog Scale. Providing additional VR training was feasible in terms of recruitment, treatment adherence, and assessment adherence. Both groups improved sitting balance after therapy. The current games were not perceived as more enjoyable than conventional physiotherapy. Including additional VR training to conventional physiotherapy is feasible and might be promising to train sitting balance in CPc after lower limb surgery. Future research should take equal patient allocation and training duration between groups into consideration.

  18. Augmentation of motor evoked potentials using multi-train transcranial electrical stimulation in intraoperative neurophysiologic monitoring during spinal surgery.

    Science.gov (United States)

    Tsutsui, Shunji; Iwasaki, Hiroshi; Yamada, Hiroshi; Hashizume, Hiroshi; Minamide, Akihito; Nakagawa, Yukihiro; Nishi, Hideto; Yoshida, Munehito

    2015-02-01

    Transcranial motor evoked potentials (TcMEPs) are widely used to monitor motor function during spinal surgery. Improvements in transcranial stimulation techniques and general anesthesia have made it possible to record reliable and reproducible potentials. However, TcMEPs are much smaller in amplitude compared with compound muscle action potentials (CMAPs) evoked by maximal peripheral nerve stimulation. In this study, multi-train transcranial electrical stimulation (mt-TES) was introduced to enhance TcMEPs, and the optimal setting of mt-TES was investigated. In 30 patients undergoing surgical correction of spinal deformities (4 males and 26 females with normal motor status; age range 11-75 years), TcMEPs from the abductor hallucis (AH) and quadriceps femoris (QF) were analyzed. A multipulse (train) stimulus with an individual pulse width of 0.5 ms and an inter-pulse interval of 2 ms was delivered repeatedly (2-7 times) at different rates (2, 5, and 10 Hz). TcMEP amplitudes increased with the number of train stimuli for AH, with the strongest facilitation observed at 5 Hz. The response amplitude increased 6.1 times on average compared with single-train transcranial electrical stimulation (st-TES). This trend was also observed in the QF. No adverse events (e.g., seizures, cardiac arrhythmias, scalp burns, accidental injury resulting from patient movement) were observed in any patients. Although several facilitative techniques using central or peripheral stimuli, preceding transcranial electrical stimulation, have been recently employed to augment TcMEPs during surgery, responses are still much smaller than CMAPs. Changing from conventional st-TES to mt-TES has potential to greatly enhance TcMEP responses.

  19. 微创手术时代胸外科进修医师培训体会%Experiences of Training Refresher Doctors in Thoracic Surgery in Minimally Invasive Surgery Era

    Institute of Scientific and Technical Information of China (English)

    郭俊唐; 梁朝阳; 刘阳

    2016-01-01

    Minimally invasive surgery such as video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgery have developed widely in thoracic surgery. In this minimally invasive surgery era, it is an important task to train refresher doctors learning thoracic minimally invasive surgery effectively and legally. Systematic employee orientation and "three basic"training including basal knowledge and basal theories, the basal skills are important foundations for clinical practice. At the same time, the teachers implemented minimally invasive surgery skills training step by step. Several study types by mobile internet were also recommended. During daily clinical practice, prevent and management of complication was trained. The training process was proved to shorten the learning curve signiifcantly and be an effective teaching method.%以胸腔镜和机器人外科为代表的微创手术逐步在胸外科普及,如何高效、规范地对进修医师进行微创手术技能培训是临床教学中一个重要课题。我们通过进行临床三基训练,分阶梯进行微创外科技能的训练,让进修医师接受互联网时代多种学习方式,以及进行并发症预防和处理的培训等,提高了学习效率,缩短了学习曲线,是一种值得推广的临床教学方法。

  20. Specific training for LESS surgery results from a prospective study in the animal model

    Directory of Open Access Journals (Sweden)

    Giovannni Scala Marchini

    2016-02-01

    Full Text Available ABSTRACT Objective to prospectively evaluate the ability of post-graduate students enrolled in a laparoscopy program of the Institute for Teaching and Research to complete single port total nephrectomies. Materials and Methods 15 post-graduate students were enrolled in the study, which was performed using the SILStm port system for single-port procedures. All participants were already proficient in total nephrectomies in animal models and performed a left followed by a right nephrectomy. Analyzed data comprised incision size, complications, and the time taken to complete each part of the procedure. Statistical significance was set at p<0.05. Results All students successfully finished the procedure using the single-port system. A total of 30 nephrectomies were analyzed. Mean incision size was 3.61 cm, mean time to trocar insertion was 9.61 min and to dissect the renal hilum was 25.3 min. Mean time to dissect the kidney was 5.18 min and to complete the whole procedure was 39.4 min. Total renal hilum and operative time was 45.8% (p<0.001 and 38% (p=0.001 faster in the second procedure, respectively. Complications included 3 renal vein lesions, 2 kidney lacerations and 1 lesion of a lumbar artery. All were immediately identified and corrected laparoscopically through the single-port system, except for one renal vein lesion, which required the introduction an auxiliary laparoscopic port. Conclusion Laparoscopic single-port nephrectomy in the experimental animal model is a feasible but relatively difficult procedure for those with intermediate laparoscopic experience. Intraoperative complications might be successfully treated with the single-port system. Training aids reducing surgical time and improves outcomes.

  1. Surgical Training and Education in Promoting Professionalism: a comparative assessment of virtue-based leadership development in otolaryngology-head and neck surgery residents

    Directory of Open Access Journals (Sweden)

    Kristine Schulz

    2013-10-01

    Full Text Available Introduction: Surgical Training and Education in Promoting Professionalism (STEPP was developed in 2011 to train tomorrow's leaders during residency. It is based on virtue ethics and takes an approach similar to West Point military academy. The purpose of this research was: (i to compare the virtue profiles of our residents with that of the military cohort using a standardized virtue assessment tool; and (ii to assess the value of virtue education on residents. Methods: As part of STEPP, otolaryngology residents participated in a virtue-based validated assessment tool called Virtue in Action (VIA Inventory. This was completed at the initiation of STEPP in July 2011 as well as 1 year later in June 2012. Comparison of the VIA to a military cohort was performed. Leadership ‘Basic Training’ is a series of forums focused on virtues of initiative, integrity, responsibility, self-discipline, and accountability. A pre- and post-test was administered assessing resident perceptions of the value of this ‘Basic Training’. Results: Virtues are shared between otolaryngology residents (n=9 and military personnel (n=2,433 as there were no significant differences in strength scores between two military comparison groups and otolaryngology-head and neck surgery (OHNS residents. There was a significant improvement (p<0.001 in the understanding of components of the leadership vision and a significant improvement in the understanding of key leadership concepts based on ‘Basic Training’. All residents responded in the post-test that the STEPP program was valuable, up from 56%. Conclusions: A virtue-based approach is valued by residents as a part of leadership training during residency.

  2. Surgical Training and Education in Promoting Professionalism: a comparative assessment of virtue-based leadership development in otolaryngology-head and neck surgery residents

    Science.gov (United States)

    Schulz, Kristine; Puscas, Liana; Tucci, Debara; Woodard, Charles; Witsell, David; Esclamado, Ramon M.; Lee, Walter T.

    2013-01-01

    Introduction Surgical Training and Education in Promoting Professionalism (STEPP) was developed in 2011 to train tomorrow's leaders during residency. It is based on virtue ethics and takes an approach similar to West Point military academy. The purpose of this research was: (i) to compare the virtue profiles of our residents with that of the military cohort using a standardized virtue assessment tool; and (ii) to assess the value of virtue education on residents. Methods As part of STEPP, otolaryngology residents participated in a virtue-based validated assessment tool called Virtue in Action (VIA) Inventory. This was completed at the initiation of STEPP in July 2011 as well as 1 year later in June 2012. Comparison of the VIA to a military cohort was performed. Leadership ‘Basic Training’ is a series of forums focused on virtues of initiative, integrity, responsibility, self-discipline, and accountability. A pre- and post-test was administered assessing resident perceptions of the value of this ‘Basic Training’. Results Virtues are shared between otolaryngology residents (n=9) and military personnel (n=2,433) as there were no significant differences in strength scores between two military comparison groups and otolaryngology-head and neck surgery (OHNS) residents. There was a significant improvement (p<0.001) in the understanding of components of the leadership vision and a significant improvement in the understanding of key leadership concepts based on ‘Basic Training’. All residents responded in the post-test that the STEPP program was valuable, up from 56%. Conclusions A virtue-based approach is valued by residents as a part of leadership training during residency. PMID:24172053

  3. Virtual reality training for improving the skills needed for performing surgery of the ear, nose or throat.

    Science.gov (United States)

    Piromchai, Patorn; Avery, Alex; Laopaiboon, Malinee; Kennedy, Gregor; O'Leary, Stephen

    2015-09-09

    Virtual reality simulation uses computer-generated imagery to present a simulated training environment for learners. This review seeks to examine whether there is evidence to support the introduction of virtual reality surgical simulation into ear, nose and throat surgical training programmes. 1. To assess whether surgeons undertaking virtual reality simulation-based training achieve surgical ('patient') outcomes that are at least as good as, or better than, those achieved through conventional training methods.2. To assess whether there is evidence from either the operating theatre, or from controlled (simulation centre-based) environments, that virtual reality-based surgical training leads to surgical skills that are comparable to, or better than, those achieved through conventional training. The Cochrane Ear, Nose and Throat Disorders Group (CENTDG) Trials Search Co-ordinator searched the CENTDG Trials Register; Central Register of Controlled Trials (CENTRAL 2015, Issue 6); PubMed; EMBASE; ERIC; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 27 July 2015. We included all randomised controlled trials and controlled trials comparing virtual reality training and any other method of training in ear, nose or throat surgery. We used the standard methodological procedures expected by The Cochrane Collaboration. We evaluated both technical and non-technical aspects of skill competency. We included nine studies involving 210 participants. Out of these, four studies (involving 61 residents) assessed technical skills in the operating theatre (primary outcomes). Five studies (comprising 149 residents and medical students) assessed technical skills in controlled environments (secondary outcomes). The majority of the trials were at high risk of bias. We assessed the GRADE quality of evidence for most outcomes across studies as 'low'. Operating theatre environment (primary outcomes) In

  4. Current training on the basics of robotic surgery in the Netherlands: time for a multidisciplinary approach?

    NARCIS (Netherlands)

    Brinkman, W.; Angst, I. de; Schreuder, H.; Schout, B.M.A.; Draaisma, W.; Verweij, L.; Hendrikx, A.; Poel, H. van der

    2016-01-01

    Introduction: The following research questions were answered: (1) What are the training pathways followed by the current robot professionals? (2) Are there any differences between the surgical specialties in robot training and robot use? (3) What is their opinion about multidisciplinary basic skills

  5. Current training on the basics of robotic surgery in the Netherlands: Time for a multidisciplinary approach?

    NARCIS (Netherlands)

    W. Brinkman (Willem); I. de Angst (Isabel); H.W.R. Schreuder (Henk); B. Schout (Barbara); W.A. Draaisma (Werner); L.M. Verweij (Lisanne); A.J.M. Hendrikx (A. J M); H.G. van der Poel (Henk G.)

    2017-01-01

    textabstractIntroduction: The following research questions were answered: (1) What are the training pathways followed by the current robot professionals? (2) Are there any differences between the surgical specialties in robot training and robot use? (3) What is their opinion about multidisciplinary

  6. Current training on the basics of robotic surgery in the Netherlands: time for a multidisciplinary approach?

    NARCIS (Netherlands)

    Brinkman, W.; Angst, I. de; Schreuder, H.; Schout, B.M.A.; Draaisma, W.; Verweij, L.; Hendrikx, A.; Poel, H. van der

    2016-01-01

    Introduction: The following research questions were answered: (1) What are the training pathways followed by the current robot professionals? (2) Are there any differences between the surgical specialties in robot training and robot use? (3) What is their opinion about multidisciplinary basic skills

  7. Current training on the basics of robotic surgery in the Netherlands: Time for a multidisciplinary approach?

    NARCIS (Netherlands)

    Brinkman, Willem; de Angst, Isabel; Schreuder, Henk; Schout, Barbara; Draaisma, Werner; Verweij, Lisanne; Hendrikx, Ad; van der Poel, Henk

    Introduction The following research questions were answered: (1) What are the training pathways followed by the current robot professionals? (2) Are there any differences between the surgical specialties in robot training and robot use? (3) What is their opinion about multidisciplinary basic skills

  8. Current training on the basics of robotic surgery in the Netherlands: Time for a multidisciplinary approach?

    NARCIS (Netherlands)

    W. Brinkman (Willem); I. de Angst (Isabel); H.W.R. Schreuder (Henk); B. Schout (Barbara); W.A. Draaisma (Werner); L.M. Verweij (Lisanne); A.J.M. Hendrikx (A. J M); H.G. van der Poel (Henk G.)

    2017-01-01

    textabstractIntroduction: The following research questions were answered: (1) What are the training pathways followed by the current robot professionals? (2) Are there any differences between the surgical specialties in robot training and robot use? (3) What is their opinion about multidisciplinary

  9. Stereoscopic Augmented Reality System for Supervised Training on Minimal Invasive Surgery Robots

    DEFF Research Database (Denmark)

    Matu, Florin-Octavian; Thøgersen, Mikkel; Galsgaard, Bo

    2014-01-01

    the need for efficient training. When training with the robot, the communication between the trainer and the trainee is limited, since the trainee often cannot see the trainer. To overcome this issue, this paper proposes an Augmented Reality (AR) system where the trainer is controlling two virtual robotic...

  10. Current training on the basics of robotic surgery in the Netherlands: Time for a multidisciplinary approach?

    NARCIS (Netherlands)

    Brinkman, Willem; de Angst, Isabel; Schreuder, Henk|info:eu-repo/dai/nl/304815977; Schout, Barbara; Draaisma, Werner; Verweij, Lisanne; Hendrikx, Ad; van der Poel, Henk

    2017-01-01

    Introduction The following research questions were answered: (1) What are the training pathways followed by the current robot professionals? (2) Are there any differences between the surgical specialties in robot training and robot use? (3) What is their opinion about multidisciplinary basic skills

  11. Virtual vitreoretinal surgery: construction of a training programme on the Eyesi Surgical Simulator

    DEFF Research Database (Denmark)

    Vergmann, Anna Stage; Vestergaard, Anders Højslet; Grauslund, Jakob

    Purpose: The purpose of this study was to test the construct validity of a full virtual reality vitreoretinal training program at the Eyesi Surgical simulator. Design and methods: A virtual vitreoretinal training program was composed on the Eyesi Surgical simulator, software version 2.9.2 (VRmagic...... GmbH, Manheim, Germany). It was completed twice by three groups: Group 1: Twenty medical students Group 2: Ten ophthalmology residents Group 3: Five vitreoretinal surgeons The program consisted of six training modules (Figure 1): Navigation level 2 (Nav2) Forceps Training level 5 (ForT5) Bimanual...... Training level 3 (BimT3) Laser Coagulation level 3 (LasC3) Posterior Hyaloid level 3 (PostH3) Internal Limiting Membrane Peeling level 3 (ILMP3). Construct validity for a module was obtained if the median score for Group 3 was higher than for Group 2, which in turn was higher than for Group 1.This...

  12. One or two trainees per workplace in a structured multimodality training curriculum for laparoscopic surgery?

    DEFF Research Database (Denmark)

    Nickel, Felix; Jede, Felix; Minassian, Andreas;

    2014-01-01

    different approaches for optimal training outcome. However, no standards currently exist for the number of trainees assigned per workplace. Methods. This is a monocentric, open, three-arm randomized controlled trial. The participants are laparoscopically-naive medical students from Heidelberg University...... individual factors that might exert influence on training outcome. Discussion. This study aims to assess whether workplaces in laparoscopy training courses for beginners should be used by one trainee or two trainees simultaneously, by measuring the impact on operative performance and learning curves....... Possible factors of influence, such as the role of observing the training partner, exchange of thoughts, active reflection, model learning, motivation, pauses, and sympathy will be explored in the data analysis. This study will help optimize the efficiency of laparoscopy training courses. Trial...

  13. Special training in maxillofacial surgery for medical students--economic burden or investment in the future?

    Science.gov (United States)

    Bauer, Florian; Rommel, Niklas; Rohleder, Nils; Koerdt, Steffen; Wolff, Klaus-Dietrich; Mitchell, David A; Kesting, Marco

    2015-12-01

    We measured the motivation and interest of medical students in oral and maxillofacial surgery at a German university. After a detailed cost-benefit analysis of a course that used an ex-vivo animal model and active participation in the operating theatre, we measured changes in the students' interest in taking up a surgical specialty in the future. We found that practical experience could lower the expenses of the course by almost 70%. Twenty per cent of students chose oral and maxillofacial surgery as an elective in their final year. These students could be residents one day.

  14. A study on visual outcomes after cataract surgery with intraocular lens implants at the rural health training center, Paithan, Maharashtra

    Directory of Open Access Journals (Sweden)

    Vijay K Domple

    2011-01-01

    Full Text Available A study was conducted to assess the visual outcomes of patients after cataract surgery with intraocular lens implants with reference to visual acuity (VA and visual function (VF and to assess patient satisfaction with surgical outcome. The retrospective study was carried out using operation theatre records at the Rural Health Training Centre (RHTC, Paithan, during 2007. Out of 819 cataract surgery patients operated in 2007 a total of 50 were selected randomly. Door-to-door visits were paid by investigator and multipurpose worker to previously operated patients for VA examination and to fill predesigned questionnaire. Statistical analysis was done by using SPSS 17.0 Version; 50% patients had VA in fair vision range of <6/18-6/60 and 52% showed the VF in the range of 76-100. Of the 32 satisfied patients, majority were in the age group 70-79 years. The patients with good visual outcomes achieved after surgery would act as pamphlets for the community.

  15. Perioperatory antibiotic prophylaxis in Pediatric Surgery (Part I: abdominal surgery) Profilaxis antibiótica perioperatoria en Cirugía Pediátrica (Parte I: cirugía abdominal)

    National Research Council Canada - National Science Library

    Berta Fonseca Romero; Guillermo Cortiza Orbe; Lorenzo Pérez Romano; Carlos Cabrera Machado; Zoe Quintero Delgado; Rafael Trinchet Soler; Luis Marcano Sanz; Sergio Luis González López

    2005-01-01

    .... We presented the Good Clinical Practices Guideline for Antibiotic prophylaxis in abdominal surgery, approved by consensus in the 1st National Good Clinical Practices Workshop in Pediatric Surgery...

  16. Effects of preoperative inspiratory muscle training in obese women undergoing open bariatric surgery: respiratory muscle strength, lung volumes, and diaphragmatic excursion

    Directory of Open Access Journals (Sweden)

    Marcela Cangussu Barbalho-Moulim

    2011-01-01

    Full Text Available OBJECTIVE: To determine whether preoperative inspiratory muscle training is able to attenuate the impact of surgical trauma on the respiratory muscle strength, in the lung volumes, and diaphragmatic excursion in obese women undergoing open bariatric surgery. DESIGN: Randomized controlled trial. SETTING: Meridional Hospital, Cariacica/ES, Brazil. SUBJECTS: Thirty-two obese women undergoing elective open bariatric surgery were randomly assigned to receive preoperative inspiratory muscle training (inspiratory muscle training group or usual care (control group. MAIN MEASURES: Respiratory muscle strength (maximal static respiratory pressure - maximal inspiratory pressure and maximal expiratory pressure, lung volumes, and diaphragmatic excursion. RESULTS: After training, there was a significant increase only in the maximal inspiratory pressure in the inspiratory muscle training group. The maximal expiratory pressure, the lung volumes and the diaphragmatic excursion did not show any significant change with training. In the postoperative period there was a significant decrease in maximal inspiratory pressure in both the groups. However, there was a decrease of 28% in the inspiratory muscle training group, whereas it was 47% in the control group. The decrease in maximal expiratory pressure and in lung volumes in the postoperative period was similar between the groups. There was a significant reduction in the measures of diaphragmatic excursion in both the groups. CONCLUSION: The preoperative inspiratory muscle training increased the inspiratory muscle strength (maximal inspiratory pressure and attenuated the negative postoperative effects of open bariatric surgery in obese women for this variable, though not influencing the lung volumes and the diaphragmatic excursion.

  17. Advances in Pediatric Surgical Education: A Critical Appraisal of Two Consecutive Minimally Invasive Pediatric Surgery Training Courses.

    Science.gov (United States)

    Gause, Colin D; Hsiung, Grace; Schwab, Ben; Clifton, Matthew; Harmon, Carroll M; Barsness, Katherine A

    2016-08-01

    Mandates for improved patient safety and increasing work hour restrictions have resulted in changes in surgical education. Educational courses increasingly must meet those needs. We sought to determine the experience, skill level, and the impact of simulation-based education (SBE) on two cohorts of pediatric surgery trainees. After Institutional Review Board (IRB) exempt determination, a retrospective review was performed of evaluations for an annual advanced minimally invasive surgery (MIS) course over 2 consecutive years. The courses included didactic content and hands-on skills training. Simulation included neonatal/infant models for rigid bronchoscopy-airway foreign body retrieval, laparoscopic common bile duct exploration, and real tissue diaphragmatic hernia (DH), duodenal atresia (DA), pulmonary lobectomy, and tracheoesophageal fistula models. Categorical data were analyzed with chi-squared analyses with t-tests for continuous data. Participants had limited prior advanced neonatal MIS experience, with 1.95 ± 2.84 and 1.16 ± 1.54 prior cases in the 2014 and 2015 cohorts, respectively. The 2015 cohort had significantly less previous experience in lobectomy (P = .04) and overall advanced MIS (P = .007). Before both courses, a significant percentage of participants were not comfortable with DH repair (39%-42%), DA repair (50%-74%), lobectomy (34%-43%), and tracheoesophageal fistula repair (54%-81%). After course completion, > 60% of participants reported improvement in comfort with procedures and over 90% reported that the course significantly improved their perceived ability to perform each operation safely. Pediatric surgery trainees continue to have limited exposure to advanced MIS during clinical training. SBE results in significant improvement in both cognitive knowledge and trainee comfort with safe operative techniques for advanced MIS.

  18. Effect of virtual reality training on laparoscopic surgery: randomised controlled trial

    DEFF Research Database (Denmark)

    2009-01-01

    OBJECTIVE: To assess the effect of virtual reality training on an actual laparoscopic operation. DESIGN: Prospective randomised controlled and blinded trial. SETTING: Seven gynaecological departments in the Zeeland region of Denmark. PARTICIPANTS: 24 first and second year registrars specialising...... in gynaecology and obstetrics. INTERVENTIONS: Proficiency based virtual reality simulator training in laparoscopic salpingectomy and standard clinical education (controls). MAIN OUTCOME MEASURE: The main outcome measure was technical performance assessed by two independent observers blinded to trainee......-14 minutes) and in the control group was 24 (20-29) minutes (Pvirtual reality simulator training. The performance level of novices...

  19. Feasibility of Exercise Training in Cancer Patients Scheduled for Elective Gastrointestinal Surgery

    NARCIS (Netherlands)

    Valkenet, Karin; Trappenburg, Jaap C A; Schippers, Carlo C; Wanders, Lisa; Lemmens, Lidwien; Backx, Frank J G; van Hillegersberg, Richard

    2016-01-01

    BACKGROUND/AIMS: This study examines the feasibility of a preoperative exercise program to improve the physical fitness of a patient before gastrointestinal surgery. METHODS: An outpatient exercise program was developed to increase preoperative aerobic capacity, peripheral muscle endurance and respi

  20. Feasibility of Exercise Training in Cancer Patients Scheduled for Elective Gastrointestinal Surgery

    NARCIS (Netherlands)

    Valkenet, Karin; Trappenburg, Jaap C.A.; Schippers, Carlo C.; Wanders, Lisa; Lemmens, Lidwien; Backx, Frank J.G.; Hillegersberg, van Richard

    2016-01-01

    Background/Aims: This study examines the feasibility of a preoperative exercise program to improve the physical fitness of a patient before gastrointestinal surgery. Methods: An outpatient exercise program was developed to increase preoperative aerobic capacity, peripheral muscle endurance and re

  1. Identification of Best Practices for Resident Aesthetic Clinics in Plastic Surgery Training: The ACAPS National Survey

    Directory of Open Access Journals (Sweden)

    C. Scott Hultman, MD, MBA, FACS

    2015-03-01

    Conclusions: RACs are an important component of plastic surgery education. Most clinics are financially viable but carry high malpractice risk and consume significant resources. Best practices, to maximize patient safety and optimize resident education, include use of accredited procedural rooms and direct faculty supervision of all components of care.

  2. Feasibility and Effectiveness of a Home-Based Exercise Training Program Before Lung Resection Surgery

    Directory of Open Access Journals (Sweden)

    Valérie Coats

    2013-01-01

    Full Text Available BACKGROUND: Patients with lung cancer often experience a reduction in exercise tolerance, muscle weakness and decreased quality of life. Although the effectiveness of pulmonary rehabilitation programs is well recognized in other forms of cancers and in many pulmonary diseases, few researchers have studied its impact in patients with lung cancer, particularly in those awaiting lung resection surgery (LRS.

  3. Training in laparoscopic colorectal surgery: A new educational model using specially embalmed human anatomical specimen

    NARCIS (Netherlands)

    J.C. Slieker (Juliette); H. Theeuwes (Hilco); G.L. van Rooijen (Göran); J.F. Lange (Johan); G.J. Kleinrensink (Gert Jan)

    2012-01-01

    textabstractBackground: With an increasing percentage of colorectal resections performed laparoscopically nowadays, there is more emphasis on training "before the job" on operative skills, including the comprehension of specific laparoscopic surgical anatomy. As integration of technical skills with

  4. Training in laparoscopic colorectal surgery: A new educational model using specially embalmed human anatomical specimen

    NARCIS (Netherlands)

    J.C. Slieker (Juliette); H. Theeuwes (Hilco); G.L. van Rooijen (Göran); J.F. Lange (Johan); G.J. Kleinrensink (Gert Jan)

    2012-01-01

    textabstractBackground: With an increasing percentage of colorectal resections performed laparoscopically nowadays, there is more emphasis on training "before the job" on operative skills, including the comprehension of specific laparoscopic surgical anatomy. As integration of technical skills with

  5. Multimedia and Training: Practice and Skills of European Producers, Results of the European Project "START-UP" (Part 2).

    Science.gov (United States)

    Gutierrez, Christine Gardiol; Boder, Andre

    1992-01-01

    This second part of a report on European multimedia producers focuses on evaluation criteria and methodologies and the European market for educational and training multimedia materials, including production costs, subcontracting, the production hierarchy, the rationalization of production, and trends in the educational and training multimedia…

  6. A serious game can be a valid method to train clinical decision-making in surgery.

    Science.gov (United States)

    Graafland, Maurits; Vollebergh, Maarten F; Lagarde, Sjoerd M; van Haperen, M; Bemelman, Willem A; Schijven, Marlies P

    2014-12-01

    A serious game was developed to train surgical residents in clinical decision-making regarding biliary tract disease. Serious or applied gaming is a novel educational approach to postgraduate training, combining training and assessment of clinical decision-making in a fun and challenging way. Although interest for serious games in medicine is rising, evidence on its validity is lacking. This study investigates face, content, and construct validity of this serious game. Experts structurally validated the game's medical content. Subsequently, 41 participants played the game. Decision scores and decision speed were compared among surgeons, surgical residents, interns, and medical students, determining the game's discriminatory ability between different levels of expertise. After playing, participants completed a questionnaire on the game's perceived realism and teaching ability. Surgeons solved more cases correctly (mean 77 %) than surgical residents (67 %), interns (60 %), master-degree students (50 %), and bachelor-degree students (39 % (p game both realistic and useful for surgical training. The majority perceived the game as fun (91.2 %), challenging (85.3 %), and would recommend the game to educate their colleagues (81.8 %). This serious game showed clear discriminatory ability between different levels of expertise in biliary tract disease management and clear teaching capability. It was perceived as appealing and realistic. Serious gaming has the potential to increase adherence to training programs in surgical residency training and medical school.

  7. Lapabot: a compact telesurgical robot system for minimally invasive surgery: part I. System description.

    Science.gov (United States)

    Choi, Jaesoon; Park, Jun Woo; Kim, Dong Jun; Shin, Jungwook; Park, Chan Young; Lee, Jung Chan; Jo, Yung Ho

    2012-05-01

    The applications of robotic minimally invasive surgery (MIS) have widened, providing new advantages such as augmented dexterity and telesurgery. However, current commercial robotic laparoscopic surgical systems still have aspects to be improved such as heavy and bulky systems not suitable for agile operations, large rotational radii of robot manipulator arms, limited remote control capacity, and absence of force feedback. We have developed a robotic laparoscopic surgical system that features compact slave manipulators. The system can simultaneously operate one laparoscope arm and up to four instrument arms. The slave robot is controlled remotely through an Ethernet network and is ready for telesurgery. The developed surgical robot has sufficient workspace to perform general MIS and has been shown to provide acceptable motion tracking control performance.

  8. Effects of preoperative inspiratory muscle training in obese women undergoing open bariatric surgery: respiratory muscle strength, lung volumes, and diaphragmatic excursion

    OpenAIRE

    Marcela Cangussu Barbalho-Moulim; Gustavo Peixoto Soares Miguel; Eli Maria Pazzianotto Forti; Flavio do Amaral Campos; Dirceu Costa

    2011-01-01

    OBJECTIVE: To determine whether preoperative inspiratory muscle training is able to attenuate the impact of surgical trauma on the respiratory muscle strength, in the lung volumes, and diaphragmatic excursion in obese women undergoing open bariatric surgery. DESIGN: Randomized controlled trial. SETTING: Meridional Hospital, Cariacica/ES, Brazil. SUBJECTS: Thirty-two obese women undergoing elective open bariatric surgery were randomly assigned to receive preoperative inspiratory muscle trainin...

  9. In search of work/life balance: trainee perspectives on part-time obstetrics and gynaecology specialist training

    Directory of Open Access Journals (Sweden)

    Henry Amanda

    2012-01-01

    Full Text Available Abstract Background Part-time training (PTT is accessed by approximately 10% of Australian obstetrics and gynaecology trainees, a small but increasing minority which reflects the growing demand for improved work/life balance amongst the Australian medical workforce. This survey reports the attitudes and experiences of both full-time and part-time trainees to PTT. Methods An email-based anonymous survey was sent to all Australian obstetrics and gynaecology trainees in April 2009, collecting demographic and training status data, data on personal experiences of PTT and/or trainees, and attitudes towards PTT. Results 105 responses were received (20% response rate. These indicated strong support (90% from both full-time (FT and part-time (PT trainees for the availability of PTT. PT trainees were significantly more likely than FT trainees to be female with children. Improved morale was seen as a particular advantage of PTT; decreased continuity of care as a disadvantage. Conclusions Although limited by poor response rate, both PT and FT Australian obstetric trainees were supportive of part-time training. Both groups recognised important advantages and disadvantages of this mode of training. Currently, part-time training is accessed primarily by female trainees with family responsibilities, with many more trainees considering part-time training than the number that access it.

  10. Comparison between Training Models to Teach Veterinary Medical Students Basic Laparoscopic Surgery Skills.

    Science.gov (United States)

    Levi, Ohad; Michelotti, Kurt; Schmidt, Peggy; Lagman, Minette; Fahie, Maria; Griffon, Dominique

    2016-01-01

    The objective of this study was to compare the effectiveness of two different laparoscopic training models in preparing veterinary students to perform basic laparoscopic skills. Sixteen first- and second-year veterinary students were randomly assigned to a box trainer (Group B) or tablet trainer (Group T). Training and assessment for both groups included two tasks, "peg transfer" and "pattern cutting," derived from the well-validated McGill University Inanimate System for Training and Evaluation of Laparoscopic Skills. Confidence levels were compared by evaluating pre- and post-training questionnaires. Performance of laparoscopic tasks was scored pre- and post-training using a rubric for precision and speed. Results revealed a significant improvement in student confidence for basic laparoscopic skills (p<.05) and significantly higher scores for both groups in both laparoscopic tasks (p<.05). No significant differences were found between the groups regarding their assessment of the video quality, lighting, and simplicity of setup (p=.34, p=.15, and p=.43, respectively). In conclusion, the low-cost tablet trainer and the more expensive box trainer were similarly effective in preparing pre-clinical veterinary students to perform basic laparoscopic skills on a model.

  11. Choosing surgery

    DEFF Research Database (Denmark)

    Thorstensson, Carina; Lohmander, L; Frobell, Richard

    2009-01-01

    ABSTRACT: BACKGROUND: The objective was to understand patients' views of treatment after acute anterior cruciate ligament (ACL) injury, and their reasons for deciding to request surgery despite consenting to participate in a randomised controlled trial (to 'cross-over'). METHODS: Thirty-four in......-depth qualitative interviews were conducted with young (aged 18-35), physically active individuals with ACL rupture who were participating in a RCT comparing training and surgical reconstruction with training only. 22/34 were randomised to training only but crossed over to surgery. Of these, 11 were interviewed...... before surgery, and 11 were interviewed at least 6 months after surgery. To provide additional information, 12 patients were interviewed before randomisation. Interviews were audio-recorded, transcribed and analysed using the Framework approach. RESULTS: Strong preference for surgery was commonplace...

  12. Multi-sensor integration using neural networks for predicting quality characteristics of end-milled parts. Part 2: Interaction effects in training parameters

    Energy Technology Data Exchange (ETDEWEB)

    Okafor, A.C.; Adetona, O. [Univ. of Missouri, Rolla, MO (United States). Dept. of Mechanical, Aerospace Engineering and Engineering Mechanics

    1994-12-31

    Artificial neural networks have been shown to have a lot of potential as a means of integrating multi-sensor signals for in-process real time monitoring of machining processes. However a lot of questions still remain to be answered on how to optimize the training parameters of neural networks during the training phase in order to optimize their subsequent performance, especially in view of the fact that the few published literature have made conflicting recommendations. This paper presents a systematic evaluation of the interaction effects of the training parameters: learning rate, momentum rate and number of hidden layer nodes on the performance of back propagation networks in predicting quality characteristics of end milled parts. Multi-sensor signatures (acoustic emission, spindle vibration, and components of the horizontal cutting force) acquired during end milling of 4140 steel and the corresponding measured quality characteristics (surface roughness and bore tolerance) were used to train the networks. The network performances were evaluated using four different criteria: maximum error, RMS error, mean error and number of training cycles. The results indicate that there are significant interaction effects between the training parameters that can adversely affect the networks performance. Optimum combinations of training parameters have been observed. The effects of various combinations of training parameters are presented.

  13. [The competent surgeon. Bridging the gap between undergraduate final year and postgraduate surgery training].

    Science.gov (United States)

    Kadmon, M; Ganschow, P; Gillen, S; Hofmann, H S; Braune, N; Johannink, J; Kühn, P; Buhr, H J; Berberat, P O

    2013-10-01

    Competency-based frameworks rely on relevant professional competency rather than formal regulations. The transitional phase between final year undergraduate and common trunk postgraduate medical training is characterized by an increase of professional responsibility whereby previously acquired knowledge, skills and abilities have to be merged and applied to patients. Undergraduate and postgraduate training programs should ensure a successive transfer of responsibility for medical practice to final year students and young residents depending on individual competence. The concept of entrustable professional activities (EPA) represents a curricular concept based on concrete medical tasks which may be assigned to the responsibility of the trainee.

  14. Team training to establish a safety culture in dialysis access surgery.

    Science.gov (United States)

    Davidson, Ingemar; Widmer, Matthias K; Nolen, Billy; Ross, John; Slakey, Douglas P

    2015-01-01

    Operating room (OR) team safety training and learning in the field of dialysis access is well suited for the use of simulators, simulated case learning and root cause analysis of adverse outcomes. The objectives of OR team training are to improve communication and leadership skills, to use checklists and to prevent errors. Other objectives are to promote a change in the attitudes towards vascular access from learning through mistakes in a nonpunitive environment, to positively impact the employee performance and to increase staff retention by making the workplace safer, more efficient and user friendly. © 2015 S. Karger AG, Basel

  15. Medical emergencies in the dental surgery. Part 1: Preparation of the office and basic management.

    Science.gov (United States)

    Malamed, Stanley F

    2015-12-01

    Medical emergencies can and do happen in the dental surgery. In the 20- to 30-year practice lifetime of the typical dentist, he/she will encounter between five and seven emergency situations. Being prepared in advance of the emergency increases the likelihood of a successful outcome. PURPOSE OF THE PAPER: To prepare members of the dental office staff to be able to promptly recognize and efficiently manage those medical emergency situations that can occur in the dental office environment. Preparation of the dental office to promptly recognize and efficiently manage medical emergencies is predicated on successful implementation of the following four steps: basic life support for ALL members of the dental office staff; creation of a dental office emergency team; activation of emergency medial services (EMS) when indicated; and basic emergency drugs and equipment. The basic emergency algorithm (P->C->A->B->D) is designed for implementation in all emergency situations. Prompt implementation of the basic emergency management protocol can significantly increase the likelihood of a successful result when medical emergencies occur in the dental office environment.

  16. Dye-enhanced cataract surgery. Part 2: learning critical steps of phacoemulsification.

    Science.gov (United States)

    Werner, L; Pandey, S K; Escobar-Gomez, M; Hoddinott, D S; Apple, D J

    2000-07-01

    To use capsule dyes to enhance visualization to learn and perform various critical steps of the phacoemulsification procedure in a laboratory setting using postmortem human eyes. Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. Indocyanine green 0.5% (ICG) and trypan blue 0.1% were used to enhance visualization for performing critical steps of phacoemulsification in 8 human eyes obtained postmortem. All eyes were prepared according to the Miyake-Apple posterior video technique. After a continuous curvilinear capsulorhexis (CCC) was made, the dyes were used to enhance visualization for hydrodissection, hydrodelineation, and various maneuvers for nuclear emulsification and cortical cleanup. In 8 eyes, all the aforementioned steps were performed without using dye (control group). Both dyes helped enhance visualization during the critical steps of phacoemulsification. The use of a dye solution instead of balanced salt solution (BSS) for hydrodissection/delineation helped localize the complete plane of cleavage between the capsule and cortex and the nucleus-epinucleus complex. During various nuclear sculpting maneuvers, the use of dye helped visualization of the position of the phaco tip and its relation to the posterior capsule. It also helped localize remaining cortical fibers, facilitating complete cleaning of the capsular bag. Dye-enhanced cataract surgery was useful in learning various critical steps of phacoemulsification in a wet laboratory setting.

  17. Development and validation of a sensor- and expert model-based training system for laparoscopic surgery: the iSurgeon.

    Science.gov (United States)

    Kowalewski, Karl-Friedrich; Hendrie, Jonathan D; Schmidt, Mona W; Garrow, Carly R; Bruckner, Thomas; Proctor, Tanja; Paul, Sai; Adigüzel, Davud; Bodenstedt, Sebastian; Erben, Andreas; Kenngott, Hannes; Erben, Young; Speidel, Stefanie; Müller-Stich, Beat P; Nickel, Felix

    2017-05-01

    Training and assessment outside of the operating room is crucial for minimally invasive surgery due to steep learning curves. Thus, we have developed and validated the sensor- and expert model-based laparoscopic training system, the iSurgeon. Participants of different experience levels (novice, intermediate, expert) performed four standardized laparoscopic knots. Instruments and surgeons' joint motions were tracked with an NDI Polaris camera and Microsoft Kinect v1. With frame-by-frame image analysis, the key steps of suturing and knot tying were identified and registered with motion data. Construct validity, concurrent validity, and test-retest reliability were analyzed. The Objective Structured Assessment of Technical Skills (OSATS) was used as the gold standard for concurrent validity. The system showed construct validity by discrimination between experience levels by parameters such as time (novice = 442.9 ± 238.5 s; intermediate = 190.1 ± 50.3 s; expert = 115.1 ± 29.1 s; p Concurrent validity of OSATS and iSurgeon parameters was established. Test-retest reliability was given for 7 out of 8 parameters. The key steps "wrapping the thread around the instrument" and "needle positioning" were most difficult to learn. Validity and reliability of the self-developed sensor-and expert model-based laparoscopic training system "iSurgeon" were established. Using multiple parameters proved more reliable than single metric parameters. Wrapping of the needle around the thread and needle positioning were identified as difficult key steps for laparoscopic suturing and knot tying. The iSurgeon could generate automated real-time feedback based on expert models which may result in shorter learning curves for laparoscopic tasks. Our next steps will be the implementation and evaluation of full procedural training in an experimental model.

  18. A comparative analysis of predictive models of morbidity in intensive care unit after cardiac surgeryPart II: an illustrative example

    Directory of Open Access Journals (Sweden)

    Giomarelli Pierpaolo

    2007-11-01

    Full Text Available Abstract Background Popular predictive models for estimating morbidity probability after heart surgery are compared critically in a unitary framework. The study is divided into two parts. In the first part modelling techniques and intrinsic strengths and weaknesses of different approaches were discussed from a theoretical point of view. In this second part the performances of the same models are evaluated in an illustrative example. Methods Eight models were developed: Bayes linear and quadratic models, k-nearest neighbour model, logistic regression model, Higgins and direct scoring systems and two feed-forward artificial neural networks with one and two layers. Cardiovascular, respiratory, neurological, renal, infectious and hemorrhagic complications were defined as morbidity. Training and testing sets each of 545 cases were used. The optimal set of predictors was chosen among a collection of 78 preoperative, intraoperative and postoperative variables by a stepwise procedure. Discrimination and calibration were evaluated by the area under the receiver operating characteristic curve and Hosmer-Lemeshow goodness-of-fit test, respectively. Results Scoring systems and the logistic regression model required the largest set of predictors, while Bayesian and k-nearest neighbour models were much more parsimonious. In testing data, all models showed acceptable discrimination capacities, however the Bayes quadratic model, using only three predictors, provided the best performance. All models showed satisfactory generalization ability: again the Bayes quadratic model exhibited the best generalization, while artificial neural networks and scoring systems gave the worst results. Finally, poor calibration was obtained when using scoring systems, k-nearest neighbour model and artificial neural networks, while Bayes (after recalibration and logistic regression models gave adequate results. Conclusion Although all the predictive models showed acceptable

  19. Effects of implementation of an urgent surgical care service on subspecialty general surgery training

    Science.gov (United States)

    Wood, Leanne; Buczkowski, Andrzej; Panton, Ormond M.N.; Sidhu, Ravi S.; Hameed, S. Morad

    2010-01-01

    Background In July 2007, a large Canadian teaching hospital realigned its general surgery services into elective general surgery subspecialty-based services (SUBS) and a new urgent surgical care (USC) service (also know in the literature as an acute care surgery service). The residents on SUBS had their number of on-call days reduced to enable them to focus on activities related to SUBS. Our aim was to examine the effect of the creation of the USC service on the educational experiences of SUBS residents. Methods We enrolled residents who were on SUBS for the 6 months before and after the introduction of the USC service. We collected data by use of a survey, WEB eVAL and recorded attendance at academic half days. Our 2 primary outcomes were residents’ attendance at ambulatory clinics and compliance with the reduction in the number of on-call days. Our secondary outcomes included residents’ time for independent study, attendance at academic half days, operative experience, attendance at multidisciplinary rounds and overall satisfaction with SUBS. Results Residents on SUBS had a decrease in the mean number of on-call days per resident per month from 6.28 to 1.84 (p = 0.006), an increase in mean attendance at academic half days from 65% to 87% (p = 0.028), at multidisciplinary rounds (p = 0.002) and at ambulatory clinics and an increase in independent reading time (p = 0.015), and they reported an improvement in their work environment. There was no change in the amount of time residents spent in the operating room or in their overall satisfaction with SUBS. Conclusion Residents’ education in the SUBS structure was positively affected by the creation of a USC service. Compliance with the readjustment of on-call duties was high and was identified as the single most significant factor in enabling residents to take full advantage of the unique educational opportunities available only while on SUBS. PMID:20334744

  20. Effect of Voice-Part Training and Music Complexity on Focus of Attention to Melody or Harmony

    Science.gov (United States)

    Williams, Lindsey R.

    2009-01-01

    The purpose of this study was to investigate the possible effects of choral voice-part training/experience and music complexity on focus of attention to melody or harmony. Participants (N = 150) were members of auditioned university choral ensembles divided by voice-part (sopranos, n = 44; altos, n = 33; tenors, n = 35; basses, n = 38). The music…

  1. Dental students’ perceptions of undergraduate clinical training in oral and maxillofacial surgery in an integrated curriculum in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mahmoud Al-Dajani

    2015-09-01

    Full Text Available Purpose: The aim was to understand dental students’ experiences with oral and maxillofacial surgery (OMS teaching, their confidence levels in performing routine dento-alveolar operations, and the relationship between the students’ confidence level and the number of teeth extracted during the clinical practice. Methods: The survey questionnaire was distributed to 32 students at Aljouf University College of Dentistry, Saudi Arabia during their fourth and fifth year in 2015. Respondents were asked to rate 19 items, which represent a student’s confidence in performing routine surgical interventions, using a four-point Likert scale (1=very little confidence, 4=very confident. A multivariate regression was computed between average confidence and the variables: weekly hours devoted to studying oral and maxillofacial surgery, college grade point average, and the total number of teeth extracted. Results: The response rate was 100%. Students revealed the highest level of confidence in giving local anesthesia (96.9%, understanding extraction indications (93.8%, and performing simple extractions (90.6%. Less confidence was shown with handling difficult extractions (50.0%, extracting molars with separation (50.0% or extracting third molars (56.3%. The average confidence in performing surgical procedures was 2.88 (SD=0.55, ranging from 1.79 to 3.89. A given student’s confidence increased with an increase in the total number of teeth extracted (P=0.003. Conclusion: It reveals a significant impact of undergraduate clinical training on students’ confidence in performing oral and maxillofacial surgery clinical procedures: The more clinical experience the students had, the more confidence they reported.

  2. Analysis of the pediatric orthopedic surgery questions on the Orthopaedic In-Training Examination, 2002 through 2006.

    Science.gov (United States)

    Papp, Derek F; Ting, Beverlie L; Sargent, M Catherine; Frassica, Frank J

    2010-01-01

    Pediatric orthopedics has been a frequently tested topic on the Orthopaedic In-Training Examination (OITE). Our goal was to provide direction for resident education efforts by: (1) analyzing the exam's number, topics, and types of pediatric orthopedic surgery questions; (2) examining references cited in the postexam answer packet supplied by the American Academy of Orthopaedic Surgeons; and (3) examining the efficacy of the Orthopaedic Knowledge Update (OKU): Pediatrics 3 book as a source for answers to the pediatric orthopedic questions. We reviewed 5 years (2002 through 2006) of OITEs and the associated American Academy of Orthopaedic Surgeons' answer packets and assessed the OKU: Pediatrics 3 book for topic relativity. Each question was classified into 1 of 6 categories and labeled with a cognitive taxonomy level: 1 (simple recall), 2 (interpretation of data), or 3 (advanced problem-solving). The 6 categories included: (1) pediatric orthopedic knowledge; (2) knowledge of treatment modalities; (3) diagnosis; (4) diagnosis with recognition of associated conditions; (5) diagnosis with further studies; and (6) diagnosis with treatment. The overall percentage of pediatric questions was 14.1%. The most commonly addressed were pediatric elbow fractures, osteomyelitis, and scoliosis. The most common question types were categories 1 (pediatric orthopedic knowledge) and 6 (diagnosis with treatment). The most frequently referenced textbooks were Lovell and Winter's Pediatric Orthopaedics (31%) and Tachdjian's Pediatric Orthopaedics (16%). The most frequently referenced journals were the Journal of Pediatric Orthopaedics (American) (29%) and the Journal of Bone and Joint Surgery (American) (19%). Using only the OKU: Pediatrics 3 review textbook, 65% of the questions could be answered. Knowledge of the topics more likely to be tested may help the orthopedic educator direct a didactic curriculum geared toward the OITE and American Board of Surgery examinations. Although the

  3. The effect of surgical training and hospital characteristics on patient outcomes after pediatric surgery: a systematic review.

    Science.gov (United States)

    Evans, Ceri; van Woerden, Hugo C

    2011-11-01

    A systematic review aimed to compare patient outcomes after (1) appendicectomy and (2) pyloromyotomy performed by different surgical specialties, surgeons with different annual volumes, and in different hospital types, to inform the debate surrounding children's surgery provision. Embase, Medline, Cochrane Library, and Health Management Information Consortium were searched from January 1990 to February 2010 to identify relevant articles. Further literature was sought by contacting experts, citation searching, and hand-searching appropriate journals. Seventeen relevant articles were identified. These showed that (1) rates of wrongly diagnosed appendicitis were higher among general surgeons, but there were little differences in other outcomes and (2) outcomes after pyloromyotomy were superior in patients treated by specialist surgeons. Surgical specialty was a better predictor of morbidity than hospital type, and surgeons with higher operative volumes had better results. Existing evidence is largely observational and potentially subject to selection bias, but general pediatric surgery outcomes were clearly dependent on operative volumes. Published evidence suggests that (1) pediatric appendicectomy should not be centralized because children can be managed effectively by general surgeons; (2) pyloromyotomy need not be centralized but should be carried out in children's units by appropriately trained surgeons who expect to see more than 4 cases per year. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. One or two trainees per workplace in a structured multimodality training curriculum for laparoscopic surgery?

    DEFF Research Database (Denmark)

    Nickel, Felix; Jede, Felix; Minassian, Andreas;

    2014-01-01

    different approaches for optimal training outcome. However, no standards currently exist for the number of trainees assigned per workplace. Methods. This is a monocentric, open, three-arm randomized controlled trial. The participants are laparoscopically-naive medical students from Heidelberg University....... After a standardized introduction to laparoscopic cholecystectomy (LC) with online learning modules, the participants perform a baseline test for basic skills and LC performance on a virtual reality (VR) trainer. A total of 100 students will be randomized into three study arms, in a 2:2:1 ratio...... training between tests. A post-test is performed to reassess basic skills and LC performance on the VR trainer. The performance of a cadaveric porcine LC is then measured as the primary outcome using standardized and validated ratings by blinded experts with the Objective Structured Assessment of Technical...

  5. [Current status of thoracoscopic surgery for thoracic and lumbar spine. Part 2: treatment of the thoracic disc hernia, spinal deformities, spinal tumors, infections and miscellaneous].

    Science.gov (United States)

    Verdú-López, Francisco; Beisse, Rudolf

    2014-01-01

    Thoracoscopic surgery or video-assisted thoracic surgery (VATS) of the thoracic and lumbar spine has evolved greatly since it appeared less than 20 years ago. It is currently used in a large number of processes and injuries. The aim of this article, in its two parts, is to review the current status of VATS of the thoracic and lumbar spine in its entire spectrum. After reviewing the current literature, we developed each of the large groups of indications where VATS takes place, one by one. This second part reviews and discusses the management, treatment and specific thoracoscopic technique in thoracic disc herniation, spinal deformities, tumour pathology, infections of the spine and other possible indications for VATS. Thoracoscopic surgery is in many cases an alternative to conventional open surgery. The transdiaphragmatic approach has made endoscopic treatment of many thoracolumbar junction processes possible, thus widening the spectrum of therapeutic indications. These include the treatment of spinal deformities, spinal tumours, infections and other pathological processes, as well as the reconstruction of injured spinal segments and decompression of the spinal canal if lesion placement is favourable to antero-lateral approach. Good clinical results of thoracoscopic surgery are supported by growing experience reflected in a large number of articles. The degree of complications in thoracoscopic surgery is comparable to open surgery, with benefits in regard to morbidity of the approach and subsequent patient recovery. Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  6. Evaluation of a Pilot Project to Introduce Simulation-Based Team Training to Pediatric Surgery Trauma Room Care

    Directory of Open Access Journals (Sweden)

    Markus Lehner

    2017-01-01

    Full Text Available Introduction. Several studies in pediatric trauma care have demonstrated substantial deficits in both prehospital and emergency department management. Methods. In February 2015 the PAEDSIM collaborative conducted a one and a half day interdisciplinary, simulation based team-training course in a simulated pediatric emergency department. 14 physicians from the medical fields of pediatric surgery, pediatric intensive care and emergency medicine, and anesthesia participated, as well as four pediatric nurses. After a theoretical introduction and familiarization with the simulator, course attendees alternately participated in six simulation scenarios and debriefings. Each scenario incorporated elements of pediatric trauma management as well as Crew Resource Management (CRM educational objectives. Participants completed anonymous pre- and postcourse questionnaires and rated the course itself as well as their own medical qualification and knowledge of CRM. Results. Participants found the course very realistic and selected scenarios highly relevant to their daily work. They reported a feeling of improved medical and nontechnical skills as well as no uncomfortable feeling during scenarios or debriefings. Conclusion. To our knowledge this pilot-project represents the first successful implementation of a simulation-based team-training course focused on pediatric trauma care in German-speaking countries with good acceptance.

  7. Postoperative outcomes following preoperative inspiratory muscle training in patients undergoing open cardiothoracic or upper abdominal surgery: protocol for a systematic review

    OpenAIRE

    Mans Christina M; Reeve Julie C; Gasparini Catherine A; Elkins Mark R

    2012-01-01

    Abstract Background In patients undergoing open cardiothoracic and upper abdominal surgery, postoperative pulmonary complications remain an important cause of postoperative morbidity and mortality, impacting upon hospital length of stay and health care resources. Adequate preoperative respiratory muscle strength may help protect against the development of postoperative pulmonary complications and therefore preoperative inspiratory muscle training has been suggested to be of potential value in...

  8. Program Factors That Influence American Board of Surgery In-Training Examination Performance: A Multi-Institutional Study.

    Science.gov (United States)

    Kim, Jerry J; Gifford, Edward D; Moazzez, Ashkan; Sidwell, Richard A; Reeves, Mark E; Hartranft, Thomas H; Inaba, Kenji; Jarman, Benjamin T; Are, Chandrakanth; Galante, Joseph M; Amersi, Farin; Smith, Brian R; Melcher, Marc L; Nelson, M Timothy; Donahue, Timothy; Jacobsen, Garth; Arnell, Tracey D; Lee, Steven; Neville, Angela; de Virgilio, Christian

    2015-01-01

    To determine the influence of program strategies, such as program directors' (PD) attitudes about the American Board of Surgery In-Training Examination (ABSITE) and approach to ABSITE preparation, on residents' ABSITE performance. A 17-item questionnaire was sent to PDs at surgical residency programs. The questions were designed to elicit information regarding the educational curriculum, remediation protocols, and opinions relating to the ABSITE. Main outcome measure was categorical resident ABSITE percentile scores from the January 2014 examination. Statistical analysis was performed using the Student t-test, analysis of variance, and linear regression as appropriate. The study was carried out at general surgery residency programs across the country. In total, 15 general surgery residency PDs participated in the study. The PD response rate was 100%. All 460 resident ABSITE scores from the 15 programs were obtained. In total, 10 programs (67%) identified as university affiliated, 4 programs (27%) as independent academic, and 1 program (7%) as hybrid. The mean number of residents per program was 30.7 (range: 15-57). In total, 14 PDs (93%) indicated that an ABSITE review curriculum was in place and 13 PDs (87%) indicated they had a remediation protocol for residents with low ABSITE scores (with differing thresholds of factors associated with higher ABSITE scores included tracking resident reading throughout the year (median 63rd percentile with tracking vs 59th percentile without, p = 0.040) and the type of remediation (by PD: 77th percentile, by PD and faculty: 57th percentile, faculty only: 64th percentile, with Surgical Education and Self-Assessment Program (SESAP): 63rd percentile, outside review course: 43rd percentile; p Factors not significantly associated with ABSITE performance included number of structured educational hours per week and frequency of ABSITE review sessions. Program factors appear to significantly influence ABSITE performance. Programs where

  9. Dermatologic Surgery and Dermatologic Oncology as an Essential Part of the Modern Dermatology in Bulgaria.

    Science.gov (United States)

    Tchernev, Georgi; Lozev, Ilia; Lotti, Torello; Wollina, Uwe; Gianfaldoni, Serena; Guarneri, Claudio; Lotti, Jacopo; França, Katlein; Batashki, Atanas; Chokoeva, Anastasiya

    2017-07-25

    Dermatosurgery and dermatooncology are an integral part of dermatology as a speciality, and this postulate is strictly respected in a high percentage of European dermatological units. Due to the fact that a number of other specialties interweave with the subject of therapy - the surgical treatment of the patient with skin tumors, the positioning of dermatosurgery as part of dermatology is generally controversial (according to some), and at the same time is often the subject of a number of debates and conflicts. These include maxillofacial surgeons, plastic surgeons, regenerative and reconstructive surgeons, surgical and medical oncologist, etc. The advantages of these specialities are mainly based on good medical practice and good surgical techniques that are applied. In contrast, their disadvantages are based on the lack of good awareness of the initial surgical approach as well as the need for time-adjusted and accurately performed additional surgical interventions which should befurthermore careful scheduled with the relevant oncology units. Losing this thread, in practice, it turns out that we are losing the patients themselves or, looking laconically, we are working with reduced efficiency and effectiveness. Although for the last 15 years the positions of these sub-sectors in Bulgaria had been underdeveloped, a certain ascent has been observed nowadays or from a couple of years ago. This advance is undoubtedly due to the influence of the German Dermatological School, presented by Prof. Dr. Uwe Wollina, Head of Department of Dermatology, Venereology and Allergology in Dresden, Germany, as well as due to other respected representative of the Italian Dermatological School - in the face of Prof. Dr. Torello Lotti, Head of the Dermatology Unit at G Marconi University of Rome, Italy.

  10. Resistance training in the early postoperative phase reduces hospitalization and leads to muscle hypertrophy in elderly hip surgery patients--a controlled, randomized study

    DEFF Research Database (Denmark)

    Suetta, Charlotte; Magnusson, S Peter; Rosted, Anna

    2004-01-01

    OBJECTIVES: To better understand how immobilization and surgery affect muscle size and function in the elderly and to identify effective training regimes. DESIGN: A prospective randomized, controlled study. SETTING: Bispebjerg University Hospital, Copenhagen, Denmark. PARTICIPANTS: Thirty...... resistance training of the operated side (3/wk x 12 weeks). MEASUREMENTS: Hospital length of stay (LOS), quadriceps muscle cross-sectional area (CSA), isokinetic muscle strength, and functional performance. Patients were tested presurgery and 5 and 12 weeks postsurgery. RESULTS: Mean+/-standard error LOS...... was shorter for the resistance training group (10.0+/-2.4 days, Pmuscle strength (22-28%, Pmuscle...

  11. Quality Improvement in Surgery Combining Lean Improvement Methods with Teamwork Training: A Controlled Before-After Study.

    Directory of Open Access Journals (Sweden)

    Eleanor Robertson

    Full Text Available To investigate the effectiveness of combining teamwork training and lean process improvement, two distinct approaches to improving surgical safety. We conducted a controlled interrupted time series study in a specialist UK Orthopaedic hospital incorporating a plastic surgery team (which received the intervention and an Orthopaedic theatre team acting as a control.We used a 3 month intervention with 3 months data collection period before and after it. A combined teamwork training and lean process improvement intervention was delivered by an experienced specialist team. Before and after the intervention we evaluated team non-technical skills using NOTECHS II, technical performance using the glitch rate and WHO checklist compliance using a simple 3 point scale. We recorded complication rate, readmission rate and length of hospital stay data for 6 months before and after the intervention.In the active group, but not the control group, full compliance with WHO Time Out (T/O increased from 14 to 71% (p = 0.032, Sign Out attempt rate (S/O increased from 0% to 50% (p<0.001 and Oxford NOTECHS II scores increased after the intervention (P = 0.058. Glitch rate decreased in the active group and increased in the control group (p = 0.001. Complications and length of stay appeared to rise in the control group and fall in the active group.Combining teamwork training and systems improvement enhanced both technical and non-technical operating team process measures, and were associated with a trend to better safety outcome measures in a controlled study comparison. We suggest that approaches which address both system and culture dimensions of safety may prove valuable in reducing risks to patients.

  12. Implementation and evaluation of a training program as part of the Cooperative Biological Engagement Program in Azerbaijan

    Directory of Open Access Journals (Sweden)

    April eJohnson

    2015-10-01

    Full Text Available A training program for animal and human health professionals has been implemented in Azerbaijan through a joint agreement between the United States Defense Threat Reduction Agency and the Government of Azerbaijan. The training program is administered as part of the Cooperative Biological Engagement Program, and targets key employees in Azerbaijan’s disease surveillance system including physicians, veterinarians, epidemiologists, and laboratory personnel. Training is aimed at improving detection, diagnosis, and response to especially dangerous pathogens, although the techniques and methodologies can be applied to other pathogens and diseases of concern. Biosafety and biosecurity training is provided to all trainees within the program. Prior to 2014, a variety of international agencies and organizations provided training, which resulted in gaps related to lack of coordination of training materials and content. In 2014 a new training program was implemented in order to address those gaps. This paper provides an overview of the Cooperative Biological Engagement Program training program in Azerbaijan, a description of how the program fits into existing national training infrastructure, and an evaluation of the new program’s effectiveness to date. Long-term sustainability of the program is also discussed.

  13. A serious game for off-pump coronary artery bypass surgery procedure training.

    Science.gov (United States)

    Cowan, Brent; Sabri, Hamed; Kapralos, Bill; Moussa, Fuad; Cristancho, Sayra; Dubrowski, Adam

    2011-01-01

    We have begun development of an interactive, multi-player serious game for the purpose of training cardiac surgeons, fellows, and residents the series of steps comprising the Off-Pump Coronary Artery Bypass grafting (OPCAB) surgical procedure. It is hypothesized that by learning the OPCAB procedure in a "first-person-shooter gaming environment", trainees will have a much better understanding of the procedure than by traditional learning modalities. The serious game will allow for simulation parameters related to levels of fidelity to be easily adjusted so that the effect of fidelity on knowledge transfer can be examined.

  14. Applying Educational Theory to Simulation-Based Training and Assessment in Surgery.

    Science.gov (United States)

    Chauvin, Sheila W

    2015-08-01

    Considerable progress has been made regarding the range of simulator technologies and simulation formats. Similarly, results from research in human learning and behavior have facilitated the development of best practices in simulation-based training (SBT) and surgical education. Today, SBT is a common curriculum component in surgical education that can significantly complement clinical learning, performance, and patient care experiences. Beginning with important considerations for selecting appropriate forms of simulation, several relevant educational theories of learning are described. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Lapabot: a compact telesurgical robot system for minimally invasive surgery: part II. Telesurgery evaluation.

    Science.gov (United States)

    Park, Jun Woo; Lee, Duck Hee; Kim, Young Woo; Lee, Byeong Han; Jo, Yung Ho

    2012-05-01

    As described in Part I, the Lapabot was developed considering telesurgery from the initial design stage. The robot configuration is based on the master-slave structure in which the operator can be separated spatially from the patient. The distributed control architecture communicating through high-speed network enables remote control of surgical robot manipulators. In this work, we added network communication modules using user datagram protocol/internet protocol for implementation of the telesurgical system. For a stable network environment, a dedicated research network was adopted. To characterize the network environment, a data packet sender and a repeater whose packet length and packet structure are similar to those of the real data packet were developed. The developed system was evaluated through in-vitro and in-vivo experiments. With the developed system, we have successfully performed remote control of the Lapabot. The roundtrip time delay for the control signal ranged from 1.4 to 4.1 ms. The total time delay for the operator including image signal acquisition and transmission delays was under 333 ms. It did not impede surgical procedures. Initial evaluation results demonstrate the feasibility of the developed telesurgical system.

  16. The validity of sheep mandible model used in the simulation-based preclinical practice training of periodontal surgery%羊下颌模型在牙周手术教学中的应用研究

    Institute of Scientific and Technical Information of China (English)

    许杰; 杨俊; 吴天明; 冀虎圣; 聂晨阳; 张伟; 曹敏; 陈发明

    2016-01-01

    Sheep mandible model was used in periodontal surgery simulation operation.The array of experi-ments proved that the sheep mandible model can imitate human oral and periodontal condition.Differential parts of the model were suitable for implementation of periodontal flap surgery,gingivoectomy,apically repositioned flap surgery and other common periodontal surgery.Using of sheep mandible model in the simulation -based preclinical practice training of periodontal surgery,can improve students'operation skills,strengthen the study effect.The sheep model is feasible in the teaching of periodontal surgery for undergraduates and advanced trainees.%选用羊下颌模型探索牙周手术模拟操作的可行性。实验证明羊下颌模型能够较真实的模拟人类口腔牙周情况,可利用不同部位的解剖特点,选择进行牙周翻瓣术、龈切术、根向复位瓣术等多种常见牙周手术。采用羊下颌模型进行牙周手术模拟操作的临床前教学,可以提高学生操作技能,强化学习效果,值得在牙周病学本科生教学和各层次牙周病学继续教育学习班操作课程中进一步推广。

  17. [Further training in the faculty of orthopedics and trauma surgery. Outstanding, average or insufficient?].

    Science.gov (United States)

    Perl, M; Stange, R; Niethard, M; Münzberg, M

    2013-01-01

    A well structured and executed and practical residency program is important to secure a sufficient number of well trained orthopedic surgeons in the future. Some of the residents, however, see substantial shortcomings here. Additionally, orthopedic residency programs struggle to be a valid alternative for graduated medical students when comparing them to residency programs in other medical specialities or alternative job options. In improving the current situation program directors as well as residents must play a key role. A rapid improvement of structural shortcomings of German residency programs does not only provide an advantage in recruiting new residents now, but may also help to maintain the high quality in orthopedic health care in the future.

  18. Training in Laparoscopic Gastric Cancer Surgery in the Western World: Current Educational Practices, Challenges, and Potential Opportunities at a Large University Centre.

    Science.gov (United States)

    Fecso, Andras B; Bonrath, Esther M; Grantcharov, Teodor P

    2016-01-01

    The purpose of this study was to explore and understand how surgeons distribute tasks during a laparoscopic gastrectomy for gastric cancer in an academic teaching environment. An anonymous, cross-sectional, census survey was used to poll trainees' and staff members' opinions pertaining to laparoscopic gastrectomy. Academic and community tertiary teaching hospitals, affiliated with the University of Toronto. All surgeons, within the Department of General Surgery at the University of Toronto, who practice laparoscopic gastrectomy for gastric cancer, were invited to participate. All general surgery residents, postgraduate year 1-5, minimally invasive surgery and surgical oncology fellows at the University of Toronto were invited to participate. Overall response rate was 74.35% (n = 87/117). The results suggested that trainees do not routinely perform the major operative steps. Trainees agreed with faculty in this regard; however, there was a statistically significant difference in opinions, related to the degree of the perceived active operating of the trainees. There was also a difference in opinion, between trainees and faculty, regarding the common reasons for takeover. The present survey highlights that current level of active exposure of surgical trainees to laparoscopic gastric surgery might be insufficient. A lack of role clarity may further hinder an optimal educational experience during these cases. Adopting a stepwise approach, with task deconstruction, could optimize training. Additional training modalities may be required to ensure technical proficiency is acquired before independent practice. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. Smart Sensor-Based Motion Detection System for Hand Movement Training in Open Surgery.

    Science.gov (United States)

    Sun, Xinyao; Byrns, Simon; Cheng, Irene; Zheng, Bin; Basu, Anup

    2017-02-01

    We introduce a smart sensor-based motion detection technique for objective measurement and assessment of surgical dexterity among users at different experience levels. The goal is to allow trainees to evaluate their performance based on a reference model shared through communication technology, e.g., the Internet, without the physical presence of an evaluating surgeon. While in the current implementation we used a Leap Motion Controller to obtain motion data for analysis, our technique can be applied to motion data captured by other smart sensors, e.g., OptiTrack. To differentiate motions captured from different participants, measurement and assessment in our approach are achieved using two strategies: (1) low level descriptive statistical analysis, and (2) Hidden Markov Model (HMM) classification. Based on our surgical knot tying task experiment, we can conclude that finger motions generated from users with different surgical dexterity, e.g., expert and novice performers, display differences in path length, number of movements and task completion time. In order to validate the discriminatory ability of HMM for classifying different movement patterns, a non-surgical task was included in our analysis. Experimental results demonstrate that our approach had 100 % accuracy in discriminating between expert and novice performances. Our proposed motion analysis technique applied to open surgical procedures is a promising step towards the development of objective computer-assisted assessment and training systems.

  20. Postoperative outcomes following preoperative inspiratory muscle training in patients undergoing open cardiothoracic or upper abdominal surgery: protocol for a systematic review

    Directory of Open Access Journals (Sweden)

    Mans Christina M

    2012-12-01

    Full Text Available Abstract Background In patients undergoing open cardiothoracic and upper abdominal surgery, postoperative pulmonary complications remain an important cause of postoperative morbidity and mortality, impacting upon hospital length of stay and health care resources. Adequate preoperative respiratory muscle strength may help protect against the development of postoperative pulmonary complications and therefore preoperative inspiratory muscle training has been suggested to be of potential value in improving postoperative outcomes. Methods/Design A systematic search of electronic databases will be undertaken to identify randomized trials of preoperative inspiratory muscle training in patients undergoing elective open cardiothoracic and upper abdominal surgery. From these trials, we will extract available data for a list of predefined outcomes, including postoperative pulmonary complications, hospital length of stay and respiratory muscle strength. We will meta-analyze comparable results where possible, and report a summary of the available pool of evidence. Discussion This review will provide the most comprehensive answer available to the question of whether preoperative inspiratory muscle training is clinically useful in improving postoperative outcomes in patients undergoing cardiothoracic and upper abdominal surgery. It will help inform clinicians working in the surgical arena of the likely effectiveness of instituting preoperative inspiratory muscle training programs to improve postoperative outcomes.

  1. Effective part-task training as evidence of distinct adaptive processes with different time scales.

    Directory of Open Access Journals (Sweden)

    Sandra Sülzenbrück

    Full Text Available For some types of visuo-motor transformations like large visuo-motor rotations or the complex transformation of a sliding first-order lever, distinct adaptive processes have been hypothesized that produce a rapid, discrete approximation of the transformation and a slow, graded fine tuning, respectively. Here we investigate whether part-task training of only the second of these processes, namely the fine tuning, transfers to the subsequent performance in a condition with the full transformation of the sliding first-order lever. Therefore, we compared performance of three groups with different practice conditions during transfer to the full transformation. While two groups only practiced the fine tuning without the right-left inversion of the lever prior to transfer, a third group practiced the full lever transformation. Our results show a positive, but less than perfect transfer of the isolated practice of the fine tuning on performance with the full transformation. For the fine tuning itself, transfer was not reliably different from being perfect. The observation that the fine tuning can be acquired separately and added to the later adaptation to the left-right inversion of the lever supports the notion that these slow and fast processes progress rather independently. The additional finding that the preceding acquisition of the fine tuning also facilitates the subsequent rapid process could be due to generalized learning-to-learn or to a more precise assignment of movement errors to the process from which they originate.

  2. Objective assessment of surgical performance and its impact on a national selection programme of candidates for higher surgical training in plastic surgery.

    LENUS (Irish Health Repository)

    Carroll, Sean M

    2012-02-01

    OBJECTIVE: The objective of this study was to develop and validate a transparent, fair and objective assessment programme for the selection of surgical trainees into higher surgical training (HST) in plastic surgery in the Republic of Ireland. METHODS: Thirty-four individuals applied for HST in plastic surgery at the Royal College of Surgeons in Ireland (RCSI) in the academic years 2005-2006 and 2006-2007. Eighteen were short-listed for interview and further assessment. All applicants were required to report on their undergraduate educational performance and their postgraduate professional development. Short-listed applicants completed validated objective assessment simulations of surgical skills, an interview and assessment of their suitability for a career in surgery. RESULTS: When applicants\\' short-listing scores were combined with their interview scores and assessment of their suitability for a career in surgery, individuals who were selected for HST in plastic surgery performed significantly better than those who were not (P<0.002). However, when the assessment of technical skills scores were added the significance level of this difference increased further (P<0.0001) as did the statistical power of the difference to 99.9%, thus increasing the robustness of the selection package. CONCLUSION: The results from this study suggest that the assessment protocol we used to select individuals for HST in plastic surgery reliably and statistically significantly discriminated between the performances of candidates.

  3. Outcome of endodontic surgery: a meta-analysis of the literature--part 1: Comparison of traditional root-end surgery and endodontic microsurgery.

    Science.gov (United States)

    Setzer, Frank C; Shah, Sweta B; Kohli, Meetu R; Karabucak, Bekir; Kim, Syngcuk

    2010-11-01

    The aim of this study was to investigate the outcome of root-end surgery. The specific outcome of traditional root-end surgery (TRS) versus endodontic microsurgery (EMS) and the probability of success for comparison of the 2 techniques were determined by means of meta-analysis and systematic review of the literature. An intensive search of the literature was conducted to identify longitudinal studies evaluating the outcome of root-end surgery. Three electronic databases (Medline, Embase, and PubMed) were searched to identify human studies from 1966 to October 2009 in 5 different languages (English, French, German, Italian, and Spanish). Relevant articles and review papers were searched for cross-references. Five pertinent journals (Journal of Endodontics, International Endodontic Journal, Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontics, Journal of Oral and Maxillofacial Surgery, International Journal of Oral and Maxillofacial Surgery) were individually searched back to 1975. Three independent reviewers (S.S., M.K., and F.S.) assessed the abstracts of all articles that were found according to predefined inclusion and exclusion criteria. Relevant articles were acquired in full-text form, and raw data were extracted independently by each reviewer. Qualifying papers were assigned to group TRS or group EMS. Weighted pooled success rates and relative risk assessment between TRS and EMS were calculated. A comparison between the groups was made by using a random effects model. Ninety-eight articles were identified and obtained for final analysis. In total, 21 studies qualified (12 for TRS [n = 925] and 9 for EMS [n = 699]) according to the inclusion and exclusion criteria. Weighted pooled success rates calculated from extracted raw data showed 59% positive outcome for TRS (95% confidence interval, 0.55-0.6308) and 94% for EMS (95% confidence interval, 0.8889-0.9816). This difference was statistically significant (P < .0005). The relative risk ratio

  4. Effect of aerobic exercise and relaxation training on fatigue and physical performance of cancer patients after surgery. A randomised controlled trial.

    Science.gov (United States)

    Dimeo, Fernando C; Thomas, Frank; Raabe-Menssen, Cornelia; Pröpper, Felix; Mathias, Michael

    2004-11-01

    Fatigue is a frequent problem after surgical treatment of solid tumours. Aerobic exercise and psychosocial interventions have been shown to reduce the severity of this symptom in cancer patients. Therefore, we compared the effect of the two therapies on fatigue in a randomised controlled study. Seventy-two patients who underwent surgery for lung (n=27) or gastrointestinal tumours (n=42) were assigned to an aerobic exercise group (stationary biking 30 min five times weekly) or a progressive relaxation training group (45 min three times per week). Both interventions were carried out for 3 weeks. At the beginning and the end of the study, we evaluated physical, cognitive and emotional status and somatic complaints with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core Module (EORTC-QLQ-30) questionnaire, and maximal physical performance with an ergometric stress test. Physical performance of the training group improved significantly during the programme (9.4+/-20 watts, p=0.01) but remained unchanged in the relaxation group (1.5+/-14.8 watts, p=0.37). Fatigue and global health scores improved in both groups during the intervention (fatigue: training group 21%, relaxation group 19%; global health of both groups 19%, p for all training programme improves the physical performance of patients recovering from surgery for solid tumours. However, exercise is not better than progressive relaxation training for the treatment of fatigue in this setting.

  5. Mental distress and effort to engage an image-guided navigation system in the surgical training of endoscopic sinus surgery: a prospective, randomised clinical trial.

    Science.gov (United States)

    Theodoraki, M N; Ledderose, G J; Becker, S; Leunig, A; Arpe, S; Luz, M; Stelter, K

    2015-04-01

    The use of image-guided navigation systems in the training of FESS is discussed controversy. Many experienced sinus surgeons report a better spatial orientation and an improved situational awareness intraoperatively. But many fear that the navigation system could be a disadvantage in the surgical training because of a higher mental demand and a possible loss of surgical skills. This clinical field study investigates mental and physical demands during transnasal surgery with and without the aid of a navigation system at an early stage in FESS training. Thirty-two endonasal sinus surgeries done by eight different trainee surgeons were included. After randomization, one side of each patient was operated by use of a navigation system, the other side without. During the whole surgery, the surgeons were connected to a biofeedback device measuring the heart rate, the heart rate variability, the respiratory frequency and the masticator EMG. Stress situations could be identified by an increase of the heart rate frequency and a decrease of the heart rate variability. The mental workload during a FESS procedure is high compared to the baseline before and after surgery. The mental workload level when using the navigation did not significantly differ from the side without using the navigation. Residents with more than 30 FESS procedures already done, showed a slightly decreased mental workload when using the navigation. An additional workload shift toward the navigation system could not be observed in any surgeon. Remarkable other stressors could be identified during this study: the behavior of the supervisor or the use of the 45° endoscope, other colleagues or students entering the theatre, poor vision due to bleeding and the preoperative waiting when measuring the baseline. The mental load of young surgeons in FESS surgery is tremendous. The application of a navigation system did not cause a higher mental workload or distress. The device showed a positive effort to engage

  6. [Centralization of robotic surgery: better results and cost savings

    NARCIS (Netherlands)

    Sluis, P.C. van der; Schreuder, H.W.B.; Merks, B.T.; Kruger, A.E. Boeken; Verheijen, R.; Hillegersberg, R. van

    2013-01-01

    In the University Medical Center Utrecht, the Netherlands, robot-assisted surgical procedures are performed weekly within the departments of Surgery, Gynaecology and Urology. Training for robot-assisted minimally invasive surgical procedures can be divided into two parts: system training and procedu

  7. [Centralization of robotic surgery: better results and cost savings

    NARCIS (Netherlands)

    Sluis, P.C. van der; Schreuder, H.W.B.; Merks, B.T.; Kruger, A.E. Boeken; Verheijen, R.; Hillegersberg, R. van

    2013-01-01

    In the University Medical Center Utrecht, the Netherlands, robot-assisted surgical procedures are performed weekly within the departments of Surgery, Gynaecology and Urology. Training for robot-assisted minimally invasive surgical procedures can be divided into two parts: system training and

  8. Master's Training as a Part of Young Researcher's Professional Development: British and Ukrainian Experience

    Science.gov (United States)

    Bidyuk, Natalya

    2014-01-01

    The problem of the professional development of young researchers in terms of Master's training has been analyzed. The analysis of the literature references, documental and other sources gave grounds to state that the basic principle of Master's professional training is a research-oriented paradigm. The necessity of using the innovative ideas of…

  9. The Orthopaedic Training Study, Phase II 1968-1972. Final Report Supplement, Psychomotor Skills, Part B.

    Science.gov (United States)

    Olson, Carl J.; And Others

    This document, as a supplement to the final report of the Orthopaedic Training Study, presents a discussion of the rationale behind the implementation of a laboratory course in psychomotor skills development for medical students. Medical educators examined resident training in terms of 3 components of cognitive elements of learning: cognitive,…

  10. General surgery career resource.

    Science.gov (United States)

    Parsee, Ana M; Ross, Sharona B; Gantt, Nancy L; Kichler, Kandace; Hollands, Celeste

    2013-11-01

    General surgery residency training can lead to a rewarding career in general surgery and serve as the foundation for careers in several surgical subspecialties. It offers broad-based training with exposure to the cognitive and technical aspects of several surgical specialties and prepares graduating residents for a wide range of career paths. This career development resource discusses the training aspects of general surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Potential role for psychological skills training in emergency medicine: Part 1 - Introduction and background.

    Science.gov (United States)

    Lauria, Michael J; Rush, Stephen; Weingart, Scott D; Brooks, Jason; Gallo, Isabelle A

    2016-10-01

    Psychological skills training (PST) is the systematic acquisition and practice of different psychological techniques to improve cognitive and technical performance. This training consists of three phases: education, skills acquisition and practice. Some of the psychological skills developed in this training include relaxation techniques, focusing and concentration skills, positive 'self-suggestion' and visualisation exercises. Since the middle of the 20th century, PST has been successfully applied by athletes, performing artists, business executives, military personnel and other professionals in high-risk occupations. Research in these areas has demonstrated the breadth and depth of the training's effectiveness. Despite the benefits realised in other professions, medicine has only recently begun to explore certain elements of PST. The present paper reviews the history and evidence behind the concept of PST. In addition, it presents some aspects of PST that have already been incorporated into medical training as well as implications for developing more comprehensive programmes to improve delivery of emergency medical care.

  12. Nuclear material safeguards for enrichments plants: Part 4, Gas Centrifuge Enrichment Plant: Diversion scenarios and IAEA safeguards activities: Safeguards training course

    Energy Technology Data Exchange (ETDEWEB)

    1988-10-01

    This publication is Part 4 of a safeguards training course in Nuclear Material Safeguards for enrichment plants. This part of the course deals with diversion scenarios and safeguards activities at gas centrifuge enrichment plants.

  13. 医学生外科学临床技能培训的思考%Thinking of Medical Students Clinical Skills Training of Surgery

    Institute of Scientific and Technical Information of China (English)

    苏华斌

    2015-01-01

    外科学是一门实践性很强的学科,而临床实习又是最关键阶段,在实习过程中,对学生的临床基本操作能力进行大力培训,包括实习前的岗前培训与考核、实习过程中的临床指导及外科综合手术培训,通过系统技能培训为培养具有创新精神、操作规范、技能娴熟的高级医学人才奠定基础。有效利用医院现有的教学资源,充分发挥教师的指导作用以及学生的主观能动性,切实有效地提高了教师临床技能培训的教学水平和医学生的综合素质。%Surgery is a very practical subject, and clinical practice is the most critical stage in the training process, the student's ability to perform basic operations vigorously clinical training, including practice before the pre-job training and assessment, training clinical guidance during surgery and surgical comprehensive training, skil s training through the system to cultivate the spirit of innovation, standardize operations, senior medical personnel skil ed foundation. The ef ective use of hospital existing teaching resources, give ful play to the initiative of teachers guidance and students,Ef ectively improve the comprehensive quality of the teachers teaching level and clinical skil s training for medical students.

  14. Synergy between On-the-job Training and Academic Education in the Case of a Newly Created Part-time Engineering Curriculum.

    Science.gov (United States)

    Marchio, Dominique; Adnot, Jerome; Arditi, Irene

    1997-01-01

    Part-time vocational engineering curricula aim to transform experienced higher technicians into engineering managers. This is done by making use of previous experience in working positions and adding training in new situations. Job training is combined with academic training through courses and activities at an academic institution. Describes ways…

  15. Learning Together; part 2: training costs and health gain - a cost analysis.

    Science.gov (United States)

    Cullen, Katherine; Riches, Wendy; Macaulay, Chloe; Spicer, John

    2017-01-01

    Learning Together is a complex educational intervention aimed at improving health outcomes for children and young people. There is an additional cost as two doctors are seeing patients together for a longer appointment than a standard general practice (GP) appointment. Our approach combines the impact of the training clinics on activity in South London in 2014-15 with health gain, using NICE guidance and standards to allow comparison of training options. Activity data was collected from Training Practices hosting Learning Together. A computer based model was developed to analyse the costs of the Learning Together intervention compared to usual training in a partial economic evaluation. The results of the model were used to value the health gain required to make the intervention cost effective. Data were returned for 363 patients booked into 61 clinics across 16 Training Practices. Learning Together clinics resulted in an increase in costs of £37 per clinic. Threshold analysis illustrated one child with a common illness like constipation needs to be well for two weeks, in one Practice hosting four training clinics for the clinics to be considered cost effective. Learning Together is of minimal training cost. Our threshold analysis produced a rubric that can be used locally to test cost effectiveness at a Practice or Programme level.

  16. Looking at plastic surgery through Google Glass: part 1. Systematic review of Google Glass evidence and the first plastic surgical procedures.

    Science.gov (United States)

    Davis, Christopher R; Rosenfield, Lorne K

    2015-03-01

    Google Glass has the potential to become a ubiquitous and translational technological tool within clinical plastic surgery. Google Glass allows clinicians to remotely view patient notes, laboratory results, and imaging; training can be augmented via streamed expert master classes; and patient safety can be improved by remote advice from a senior colleague. This systematic review identified and appraised every Google Glass publication relevant to plastic surgery and describes the first plastic surgical procedures recorded using Google Glass. A systematic review was performed using PubMed National Center for Biotechnology Information, Ovid MEDLINE, and the Cochrane Central Register of Controlled Trials, following modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Key search terms "Google" and "Glass" identified mutually inclusive publications that were screened for inclusion. Eighty-two publications were identified, with 21 included for review. Google Glass publications were formal articles (n = 3), editorial/commentary articles (n = 7), conference proceedings (n = 1), news reports (n = 3), and online articles (n = 7). Data support Google Glass' positive impact on health care delivery, clinical training, medical documentation, and patient safety. Concerns exist regarding patient confidentiality, technical issues, and limited software. The first plastic surgical procedure performed using Google Glass was a blepharoplasty on October 29, 2013. Google Glass is an exciting translational technology with the potential to positively impact health care delivery, medical documentation, surgical training, and patient safety. Further high-quality scientific research is required to formally appraise Google Glass in the clinical setting.

  17. 14 CFR Appendix B to Part 63 - Flight Navigator Training Course Requirements

    Science.gov (United States)

    2010-01-01

    ... weather reports. Forecasting. International Morse code: Ability to receive code groups of letters and... maximum of 50 hours of the required flight training may be obtained in acceptable types of synthetic...

  18. Referral patterns and the referral system for oral surgery care. Part 2: The referral system and telemedicine.

    Science.gov (United States)

    Coulthard, P; Kazakou, I; Koran, R; Worthington, H V

    2000-04-08

    To investigate GDP opinions of the current referral system and to investigate the need and demand for telemedicine in oral surgery referrals. Postal questionnaire. 400 GDPs in Greater Manchester. 84% participation rate. 48% were not satisfied overall with the service of their current specialist oral surgery referral site. The principal reason was the length of the waiting time for consultation and treatment. Distance for patients to travel to the specialist unit was also of concern, even though most patients (89%) travelled short distances (return journey of twelve miles or less). 23% of respondents wished to improve their ability to communicate with the oral surgeon and 70% wanted involvement in the patient consultation. Both of these requirements were more likely in younger practitioners. There is a need and demand for change in the referral system for oral surgery specialist care. Telemedicine could conceivably be one way to improve access to specialist oral surgery care.

  19. Educating the Educator: Use of Advanced Bleeding Control Mechanisms in Athletic Training: A Shift in the Thought Process of Prehospital Care. Part 2: Hemostatic Agents

    Science.gov (United States)

    Payne, Ellen K.; Berry, David C.; Seitz, S. Robert

    2014-01-01

    In Part 1 of this series [see: EJ1044392], the concepts of hemorrhaging, shock, and controlling bleeding as they relate to athletic training and prehospital emergency care along with the use of tourniquets were presented for athletic training educators (ATEs) to teach the skill in the classroom. This article, Part 2 of advanced bleeding control,…

  20. Educating the Educator: Use of Advanced Bleeding Control Mechanisms in Athletic Training: A Shift in the Thought Process of Prehospital Care. Part 2: Hemostatic Agents

    Science.gov (United States)

    Payne, Ellen K.; Berry, David C.; Seitz, S. Robert

    2014-01-01

    In Part 1 of this series [see: EJ1044392], the concepts of hemorrhaging, shock, and controlling bleeding as they relate to athletic training and prehospital emergency care along with the use of tourniquets were presented for athletic training educators (ATEs) to teach the skill in the classroom. This article, Part 2 of advanced bleeding control,…

  1. Are there Differences in the Mandibular Morphometry in Patients who are Candidates for Orthognathic Surgery? Part 2: Influences of Gender

    OpenAIRE

    Olate, S; Pozzer, L; Sawazaki, R; Asprino, L; de Moraes, M

    2009-01-01

    Individual facial features are to be associated with genetic and environmental influences, it is possible to identify clear differences between the facial patterns of men and women, where dentofacial deformities (FDA) will influence the surgical indications, surgical techniques and the final aesthetic results. We performed a cohort study with patients who consulted for orthognathic surgery between 2002 and 2008 in the Division of Oral and Maxillofacial Surgery of the FOP-UNICAMP. Examined pan...

  2. Health-improving training of preschoolers' with respiratory diseases parents as an integral part of rehabilitation programs.

    Directory of Open Access Journals (Sweden)

    Areshina Ju.B.

    2011-04-01

    Full Text Available The necessity of health-improving training of preschoolers' with respiratory diseases parents is reasoned. The reasoning is held theoretically and practically. The list of lecture topics for this contingent of parents is created. It contains plans of lectures, designed for covers a hospital and a post- hospital periods of physical rehabilitation. In experiment took part 42 families of children aged 4-6 years old.

  3. Simulation Training at a Medical Institute: An integral Part of the Educational Process

    Directory of Open Access Journals (Sweden)

    P. V. Ligatyuk

    2015-01-01

    Full Text Available Objective: to master and practically execute cardiopulmonary resuscitation (CPR procedural techniques, to acquire skills to use state-of-art equipment, and to teach work in the team. Subjects and methods. Forty-six interns and residents took a simulation course of training in basic CPR and automatic external defibrillation. Three-four days before the course, its participants received the certified translation of the European Resuscitation Council (ERC information material and studied it. The course education program encompasses lectures, lessons on a medical care algorithm in sudden cardiac arrest, and practical works using models, including chest compression, ventilation, and automatic external defibrillator (AED training. The duration of the course is 6—7 hours. Results. All the interns and residents were motivated to learn: to acquire first aid skills to manage sudden cardiac arrest. The ERC algorithm and a 4-stepped model to have practical skills were used. The taken course met expectations in 100% of the participants; all the interns and residents adequately acquired practical CPR skills and successfully completed their training. A questionnaire survey at the end of the course showed the high efficiency of the course. The training enhanced motivation in 29 interns and residents; they obtained an ERC provider degree; 10 interns and residents continue to take a course of training as an ERC instructor. 

  4. GENERAL SURGERY

    African Journals Online (AJOL)

    Globally, the entry of female students into medical schools has ... how female registrars perceived the impact of gender on their training and practice of surgery. ... male-dominated specialty, their choice of mentors and the challenges that they encountered ..... Social Determinants of Health2007 (Accessed on 23 Sep 2016).

  5. The content and development trend of acute care surgery in America and its enlightenment to the training of acute care surgeons in China%美国急诊外科的内涵和发展趋势及对我国创伤救治医师培养的启示

    Institute of Scientific and Technical Information of China (English)

    宗兆文

    2015-01-01

    Acute care surgery are both a emergency surgical care system and a training paradigm developed by American trauma care society.Its development is very helpful in improving the trauma care ability and efficiency in U.S.A.The training curriculum includes elective general surgery, emergency surgery, trauma surgery and surgi-cal critical care.Part of neurological surgery, orthopedics and interventional radiology skills are also included. These successful experiences are worth learning by the trauma care society in China.%美国急诊外科是其创伤学界为应对创伤医师短缺而创建的外科急症救治模式和培训模式,对提高美国的创伤救治水平和效率具有重要的积极意义。其课程设置包括选择性普通外科、急症普通外科、创伤外科和外科重症监护,同时还选择性加入部分神经外科、骨科和介入性放射学技能的培训。美国急诊外科的成功经验值得我国创伤学界借鉴。

  6. THE EFFECT OF PREEMPTIVE GABAPENTIN ON POSTOPERATIVE PAIN AND OPIOID REQUIREMENT FOLLOWING SURGERIES IN THE ANTERIOR PART OF THE NECK

    Directory of Open Access Journals (Sweden)

    Nikhil

    2016-05-01

    Full Text Available BACKGROUND Acute postoperative pain has resulted in physiological and psychological disturbances. In spite of the spectacular advances in pain relief during surgery, relief of pain in the postoperative period still remains a problem. Here, we decided to study the effect of pre-emptive oral gabapentin on postoperative pain and opioid requirement. AIMS To evaluate the effect of pre-emptive gabapentin on postoperative pain and opioid requirement following surgeries in the neck area. To observe for the change in heart rate and blood pressure following surgery for 24 hrs. post-operatively. To observe for the incidence of nausea and vomiting. MATERIALS AND METHODS The patients selected for elective surgical procedures were randomly allocated into two groups, a control Group C and a gabapentin Group G of 30 members each. Patients in Group C received B-complex capsule orally as placebo 2 hours prior to surgery and those in Group B received gabapentin 300 mg orally 2 hours before surgery. After surgery, pain scores were assessed by a blinded person using visual analogue scale hourly for first 24 hours. Pethidine 1 mg/kg slow IV was given if pain score was 4 or more. Also adverse effects in the form of nausea and vomiting were documented. Statistical analysis of all the quantitative data was done by using the ‘Student’s unpaired t-test’ (e.g.: Mean Age, Vas Scores, Heart Rate, Systolic Blood Pressure, Diastolic Blood Pressure. Statistical analysis of all the qualitative data was done by using Chi ( 2 square test (e.g.: Gender, Nausea, Vomiting. Inter-group comparison of pethidine requirement was done using Mann-Whitney ‘u’ test (Z. RESULTS Patients in the gabapentin group had significantly lower VAS scores at all-time intervals of 0-6, 7-12, 13-18, 19-24 hours than those in the control group and it was statistically significant. Total pethidine requirement after surgery in the first 24 hours in the gabapentin group was (47±23.51 when

  7. Training needs of general library workers:Part I (challenges facing educators in South African institutions of higher learning

    Directory of Open Access Journals (Sweden)

    Hester W.J. Meyer

    2010-01-01

    Full Text Available A recent survey by Meyer (2009 on the need for the training of general library workers revealed that employers in library services are often not aware of the conditions affecting the ability of library and information science (LIS educators at South African tertiary institutions to deliver ‘work ready’ general workers to the LIS industry. Simultaneously, LIS educators are not aware of the extent to which changes to learning programmes can affect the appointment and promotions of library staff in practice. The objectives of the study were to determine the need for a formal learning programme for general library workers and how existing study material can be adapted to develop a formal learning programme suitable for general library workers countrywide. Data was collected by means of a self-administered questionnaire directed at supervisory staff of provincial and municipal libraries in South Africa, interviews with supervisors, and consultation of relevant internal documentation on job descriptions and legislation. The findings revealed that there is a definite need for training general library workers, whether formally or informally. This article, the first of two parts, considers the challenges facing LIS educators of which employers in the LIS industry are seldom aware of. The discussion is based on a literature study regarding training of general library workers in South Africa, as well as personal experience of the impact of various conditions on the relevant learning programmes of the Department of Information Science, University of South Africa before and after merging with the former Technikon SA. It considers the implementation of legislation and policies with regard to LIS training and how LIS educators, involved in open distance learning (ODL cope with the specific challenges for delivering ‘work ready’ general library workers. Part two will deal with aspects concerning the types of task general workers perform, and the

  8. [Hernia surgery in urology: part 1: inguinal, femoral and umbilical hernias - fundamentals of clinical diagnostics and treatment].

    Science.gov (United States)

    Franz, T; Schwalenberg, T; Dietrich, A; Müller, J; Stolzenburg, J-U

    2013-05-01

    Hernias are a common occurrence with correspondingly huge clinical and economic impacts on the healthcare system. The most common forms of hernia which need to be diagnosed and treated in routine urological work are inguinal and umbilical hernias. With the objective of reconstructing and stabilizing the inguinal canal there are the possibilities of open and minimally invasive surgery and both methods can be performed with suture or mesh repair. Indications for surgery of umbilical hernias are infrequent although this is possible with little effort under local anesthesia. This article presents an overview of the epidemiology, pathogenesis, clinical symptoms, diagnostics and therapy of inguinal, femoral and umbilical hernias.

  9. Attractive points: new points with no moving parts could put an end to train delays

    NARCIS (Netherlands)

    Hartmann, L.

    2003-01-01

    Failing points are one of the main causes of train delays. The design of the current type of railway points dates back to pre-World War II days, and is in urgent need of replacement. Five Industrial Design students at TU Delft decided to forget about existing principles and came up with a set of poi

  10. Sonar Recognition Training: An Investigation of Whole VS. Part and Analytic VS. Synthetic Procedures.

    Science.gov (United States)

    Annett, John

    An experienced person, in such tasks as sonar detection and recognition, has a considerable superiority over a machine recognition system in auditory pattern recognition. However, people require extensive exposure to auditory patterns before achieving a high level of performance. In an attempt to discover a method of training people to recognize…

  11. 33 CFR Appendix D to Part 154 - Training Elements for Oil Spill Response Plans

    Science.gov (United States)

    2010-07-01

    .... Further, this section of the plan must work in harmony with those sections of the plan dealing with exercises, the spill management team, and the qualified individual. 1.3The material in this appendix D is... the elements that define the program as appropriate. 2.2An effective spill response training...

  12. Learning Associations between Action and Perception: Effects of Incompatible Training on Body Part and Spatial Priming

    Science.gov (United States)

    Wiggett, Alison J.; Hudson, Matt; Tipper, Steve P.; Downing, Paul E.

    2011-01-01

    Observation of another person executing an action primes the same action in the observer's motor system. Recent evidence has shown that these priming effects are flexible, where training of new associations, such as making a foot response when viewing a moving hand, can reduce standard action priming effects (Gillmeister, Catmur, Liepelt, Brass,…

  13. The Orthopaedic Training Study, Phase II 1968-1972. Final Report Supplement, Part A.

    Science.gov (United States)

    Olson, Carl J.; And Others

    This document, as a supplement to the final report of the Orthopaedic Training Study, contains the documents considered to be important in providing the background for the study. The materials are organized into four major areas: initial correspondence, instrumentation, special reports, and psychomotor skills. See also HE 003 275 and HE 003 276.…

  14. Aspects of geometric calculation of the planetary gear train with intermediate rollers. Part 1

    Science.gov (United States)

    I-Kan, An; Il'In, A. S.; Lazurkevich, A. V.

    2016-04-01

    The paper presents the geometric calculation of the planetary gear train with intermediate rollers, where the number of intermediate rollers is greater or less than that of the teeth in the annular gear by one, the profile surface of the annular gear teeth being the same. The gear ratio is changed by both a value and a sign.

  15. Aspects of geometric calculation of the planetary gear train with intermediate rollers. Part 1

    OpenAIRE

    An I-Kan; Ilin, A. S.; Lazurkevich, A. V.

    2016-01-01

    The paper presents the geometric calculation of the planetary gear train with intermediate rollers, where the number of intermediate rollers is greater or less than that of the teeth in the annular gear by one, the profile surface of the annular gear teeth being the same. The gear ratio is changed by both a value and a sign.

  16. Attractive points: new points with no moving parts could put an end to train delays

    NARCIS (Netherlands)

    Hartmann, L.

    2003-01-01

    Failing points are one of the main causes of train delays. The design of the current type of railway points dates back to pre-World War II days, and is in urgent need of replacement. Five Industrial Design students at TU Delft decided to forget about existing principles and came up with a set of poi

  17. Long-term prospective teaching effectivity of practical skills training and a first OSCE in cranio maxillofacial surgery for dental students.

    Science.gov (United States)

    Landes, Constantin A; Hoefer, Sebastian; Schuebel, Florian; Ballon, Alexander; Teiler, Anna; Tran, Andreas; Weber, Roxane; Walcher, Felix; Sader, Robert

    2014-07-01

    Basic skills in oral/CMF surgery should be taught effectively to dental students as surgical skills training is traditionally under-represented in the dental curriculum compared to its later need in daily clinical practice. Rigid curricular time frames and prospectively condensed professional education foster new effective teaching and examination formats. Transmitting and assessing clinical competence objectively (independent of subjective bias), reliably (repeatable, inter-rater consistency) and valid (representative, structured task selection) was intended and evaluated in oral/CMF surgery skills acquisition starting in summer 2009. A small-group practical skills training (PST) day initiated a one-week practical training course, covering previously formulated learning objectives. An objective structured clinical evaluation (OSCE) was held at the end of each semester. Theoretical background knowledge and clinical skills should have to be memorized within a representative number of practical tasks (test stations). A first semester (26 students) used classical practical training alone as controls, the following semesters (171 students) had PST, considered as a study group. All 197 students were assessed with OSCE's over a 3-year period. An instructor held PST based on presentations, videos and practical training, including mannequins, with pairs of students. This included history taking, communication and interpretation of laboratory/image diagnostics, structured clinical facial examination, fracture diagnosis, venipuncture, suturing, biopsy and wire loops on pig jaws for manual and clinical skills, which were later incorporated in OSCE stations. OSCE average results increased from 63.3 ± 9.7% before and to 75.5 ± 10% after the inclusion of PST (p skills as evaluated by OSCE.

  18. Effects of aerobic exercise training on variability and heart rate kinetic during submaximal exercise after gastric bypass surgery--a randomized controlled trial.

    Science.gov (United States)

    Castello-Simões, Viviane; Polaquini Simões, Rodrigo; Beltrame, Thomas; Bassi, Daniela; Maria Catai, Aparecida; Arena, Ross; Azambuja, Noé Carvalho; do Nascimento Ortega, João; Borghi-Silva, Audrey

    2013-02-01

    This study aimed to determine whether morbidly obese women have an alteration of heart rate (HR) kinetics and HR variability (HRV) during the 6-min walk test (6MWT) and if an aerobic exercise training can modify these indexes after gastric bypass surgery (GBS). Nineteen morbidly obese women were randomized to a trained (TG) or control group and 12 women of eutrophic group (EG) were also evaluated. The obese women were tested on two occasions: 1 week before and 4 months after GBS through record of HR and R-R intervals during 6MWT for analysis HR kinetics. The TG underwent an aerobic exercise training program on a treadmill (1-h session, totaling 36 sessions over 12-week). Both obese groups demonstrated a significant reduction of rMSSD and slower HR kinetics during the 6MWT when compared to the EG. In addition, only the TG demonstrated a significant improvement in HRV indexes, walking distance, faster time constant and mean response time of HR during 6MWT after training (p exercise. However, aerobic exercise training can produce beneficial adaptations in HRV and faster HR kinetics following GBS.

  19. Computer modeling and simulators as part of university training for NPP operating personnel

    Science.gov (United States)

    Volman, M.

    2017-01-01

    This paper considers aspects of a program for training future nuclear power plant personnel developed by the NPP Department of Ivanovo State Power Engineering University. Computer modeling is used for numerical experiments on the kinetics of nuclear reactors in Mathcad. Simulation modeling is carried out on the computer and full-scale simulator of water-cooled power reactor for the simulation of neutron-physical reactor measurements and the start-up - shutdown process.

  20. [Portfolios: a tool for the training and assessment of residents in dermatology, part 2].

    Science.gov (United States)

    Casanova, J M; Soria, X; Borrego, L; De Argila, D; Ribera, M; Pujol, R M

    2011-06-01

    A portfolio is a collection of material documenting reflection about practice. It contains documents (eg, case histories and questionnaires the resident has used), images, and video recordings that reveal that an individual has acquired the competencies needed for professional practice. This assessment tool simultaneously supports learning and provides evidence for certifying competence. The adoption of portfolio use by a dermatology department requires the support of both the training supervisor and the chief of department. The learning objectives defined by the National Board for Medical-Surgical Dermatology and Venereology must be taken into consideration so that ways to assess each objective can be included; this approach supports holistic ongoing education as well as the certification of competencies the resident finally achieves. Use of portfolios in medical residency training can improve on current assessment methods, which we believe lack precision. We propose that portfolios gradually begin to replace the resident's training log. We are currently developing an online software application that will facilitate the use of portfolios.

  1. Survey on Robot-Assisted Surgical Techniques Utilization in US Pediatric Surgery Fellowships.

    Science.gov (United States)

    Maizlin, Ilan I; Shroyer, Michelle C; Yu, David C; Martin, Colin A; Chen, Mike K; Russell, Robert T

    2017-02-01

    Robotic technology has transformed both practice and education in many adult surgical specialties; no standardized training guidelines in pediatric surgery currently exist. The purpose of our study was to assess the prevalence of robotic procedures and extent of robotic surgery education in US pediatric surgery fellowships. A deidentified survey measured utilization of the robot, perception on the utility of the robot, and its incorporation in training among the program directors of Accreditation Council for Graduate Medical Education (ACGME) pediatric surgery fellowships in the United States. Forty-one of the 47 fellowship programs (87%) responded to the survey. While 67% of respondents indicated the presence of a robot in their facility, only 26% reported its utilizing in their surgical practice. Among programs not utilizing the robot, most common reasons provided were lack of clear supportive evidence, increased intraoperative time, and incompatibility of instrument size to pediatric patients. While 58% of program directors believe that there is a future role for robotic surgery in children, only 18% indicated that robotic training should play a part in pediatric surgery education. Consequently, while over 66% of survey respondents received training in robot-assisted surgical technique, only 29% of fellows receive robot-assisted training during their fellowship. A majority of fellowships have access to a robot, but few utilize the technology in their current practice or as part of training. Further investigation is required into both the technology's potential benefits in the pediatric population and its role in pediatric surgery training.

  2. 整形外科住院医师医患沟通能力的培养%Experience of resident-patient communication training in plastic surgery

    Institute of Scientific and Technical Information of China (English)

    李杨; 马显杰; 宋保强; 郭树忠

    2016-01-01

    Objective To discuss the resident-patient communication training methods based on the problems of the residents in clinical work of plastic surgery .Methods According to the characteristics of plastic surgery , we analyzed the problems and reasons of the residents in the resident-patient communication.Based on the experience of the faculty in the department of plastic surgery , we proposed the methods of resident-patient communication training. Results Several dos and don'ts were proposed for the problems of the resident-patient communication.And a series of training methods were suggested from the aspects of residents , attending surgeons and the department programs . Conclusion It is vital of the ability of the resident-patient communication in the complicated modern medical environment in China.The discussion of the training methods in this paper is mainly based on the experience of the faculty in our department.A perfect resident-patient training program should be formulated with the experience of developed country and scientific methods.%目的:结合整形外科临床工作中住院医师在医患沟通中存在的问题,探讨医患沟通能力培养方案。方法根据整形外科的执业特点,分析目前住院医师在医患沟通中存在的问题及原因,结合本科室多年的经验,探讨医患沟通能力的培养方案。结果针对医患沟通的问题及原因,提出了注意事项,并从住院医师、上级医师及科室制度层面等多角度提出一系列培养方案。结论整形外科住院医师医患沟通能力在当代复杂的医疗环境下尤为重要,本文对培养方案的探讨是本科室多年经验的总结,为进一步完善培养方案的制定,需要借鉴发达国家的经验,并通过科学方法逐步建立一整套完善的医患沟通培养方案,以适应临床工作的需要。

  3. Chiari malformation Type I surgery in pediatric patients. Part 1: validation of an ICD-9-CM code search algorithm.

    Science.gov (United States)

    Ladner, Travis R; Greenberg, Jacob K; Guerrero, Nicole; Olsen, Margaret A; Shannon, Chevis N; Yarbrough, Chester K; Piccirillo, Jay F; Anderson, Richard C E; Feldstein, Neil A; Wellons, John C; Smyth, Matthew D; Park, Tae Sung; Limbrick, David D

    2016-05-01

    OBJECTIVE Administrative billing data may facilitate large-scale assessments of treatment outcomes for pediatric Chiari malformation Type I (CM-I). Validated International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code algorithms for identifying CM-I surgery are critical prerequisites for such studies but are currently only available for adults. The objective of this study was to validate two ICD-9-CM code algorithms using hospital billing data to identify pediatric patients undergoing CM-I decompression surgery. METHODS The authors retrospectively analyzed the validity of two ICD-9-CM code algorithms for identifying pediatric CM-I decompression surgery performed at 3 academic medical centers between 2001 and 2013. Algorithm 1 included any discharge diagnosis code of 348.4 (CM-I), as well as a procedure code of 01.24 (cranial decompression) or 03.09 (spinal decompression or laminectomy). Algorithm 2 restricted this group to the subset of patients with a primary discharge diagnosis of 348.4. The positive predictive value (PPV) and sensitivity of each algorithm were calculated. RESULTS Among 625 first-time admissions identified by Algorithm 1, the overall PPV for CM-I decompression was 92%. Among the 581 admissions identified by Algorithm 2, the PPV was 97%. The PPV for Algorithm 1 was lower in one center (84%) compared with the other centers (93%-94%), whereas the PPV of Algorithm 2 remained high (96%-98%) across all subgroups. The sensitivity of Algorithms 1 (91%) and 2 (89%) was very good and remained so across subgroups (82%-97%). CONCLUSIONS An ICD-9-CM algorithm requiring a primary diagnosis of CM-I has excellent PPV and very good sensitivity for identifying CM-I decompression surgery in pediatric patients. These results establish a basis for utilizing administrative billing data to assess pediatric CM-I treatment outcomes.

  4. Perioperatory antibiotic prophylaxis in Pediatric Surgery (Part II: non-abdominal surgery. Profilaxis antibiótica perioperatoria en Cirugía Pediátrica (Parte II: cirugía no abdominal.

    Directory of Open Access Journals (Sweden)

    Guillermo Cortiza Orbe

    Full Text Available The surgical wound infection is the biggest cause of infectious morbility in surgical patients. It is an important cause of morbility that causes lincreased hospital demurrages, increased cost of medical attention and serious inconveniences to the patients and their familiies. 25% of all nosocomial infections are surgical wound infection. One of the big advances of the surgery in the last three decades is an introduction of antibiotic prophylaxis in the surgical practice. Is considered that it has saved more lives than any other novel procedure in surgery in the last 20 years. We presented the Good Clinical Practices Guideline for Antibiotic prophylaxis in no-abdominal surgery, approved by consensus in the 1st National Good Clinical Practices Workshop in Pediatric Surgery (Cienfuegos, Cuba, March 7 – 9, 2002.

    La infección posoperatoria de la herida quirúrgica es la mayor causa de morbilidad infecciosa en el paciente quirúrgico. Ocasiona prolongadas estadías hospitalarias, incremento de los costos de la atención médica y serios inconvenientes a los pacientes y sus familiares. El 25 % de todas las infecciones nosocomiales son infecciones de la herida quirúrgica. Uno de los grandes avances que ha experimentado la cirugía en las tres últimas décadas, es la introducción de la profilaxis antibiótica perioperatoria en la práctica quirúrgica. Se considera que en los últimos 20 años ha salvado más vidas que cualquier otro procedimiento novedoso en cirugía. Se presenta la Guía de Buenas Prácticas Clínicas para profilaxis antibiótica perioperatoria en cirugía abdominal, aprobada por consenso en el 1er Taller Nacional de Buenas Prácticas Clínicas en Cirugía Pediátrica (Cienfuegos, 7 al 9 de marzo del 2002.

  5. Perioperatory antibiotic prophylaxis in Pediatric Surgery (Part I: abdominal surgery Profilaxis antibiótica perioperatoria en Cirugía Pediátrica (Parte I: cirugía abdominal.

    Directory of Open Access Journals (Sweden)

    Berta Fonseca Romero

    2005-12-01

    Full Text Available The surgical wound infection is the biggest cause of infectious morbility in surgical patients. It is an important cause of morbility that causes lincreased hospital demurrages, increased cost of medical attention and serious inconveniences to the patients and their familiies. 25% of all nosocomial infections are surgical wound infection. One of the big advances of the surgery in the last three decades is an introduction of antibiotic prophylaxis in the surgical practice. Is considered that it has saved more lives than any other novel procedure in surgery in the last 20 years. We presented the Good Clinical Practices Guideline for Antibiotic prophylaxis in abdominal surgery, approved by consensus in the 1st National Good Clinical Practices Workshop in Pediatric Surgery (Cienfuegos, Cuba, March 7 – 9, 2002.

    La infección posoperatoria de la herida quirúrgica es la mayor causa de morbilidad infecciosa en el paciente quirúrgico. Ocasiona prolongadas estadías hospitalarias, incremento de los costos de la atención médica y serios inconvenientes a los pacientes y sus familiares. El 25 % de todas las infecciones nosocomiales son infecciones de la herida quirúrgica. Uno de los grandes avances que ha experimentado la cirugía en las tres últimas décadas, es la introducción de la profilaxis antibiótica perioperatoria en la práctica quirúrgica. Se considera que en los últimos 20 años ha salvado más vidas que cualquier otro procedimiento novedoso en cirugía. Se presenta la Guía de Buenas Prácticas Clínicas para profilaxis antibiótica perioperatoria en cirugía abdominal, aprobada por consenso en el 1er Taller Nacional de Buenas Prácticas Clínicas en Cirugía Pediátrica (Cienfuegos, 7 al 9 de marzo del 2002.

  6. 胸外科进修医师教学的实践体会%Experience of Training Refresher Doctors in Thoracic Surgery

    Institute of Scientific and Technical Information of China (English)

    郭俊唐; 梁朝阳; 刘阳; 初向阳

    2014-01-01

    During training thoracic surgery refresher doctors ,the teachers instituted reasonable feasible training plans for every refresher doctor individually .Systematic employee orientation and “three bas-ic” training including basal knowledge and basal theories ,the basal skills are important foundations for clinical practice .At the same time ,the teachers paid much attention to improve their clinical intel-lection and clinical skills .During the operation ,the teachers also emphasized the idea of minimally in-vasive .Personal management should be brought forward ,so that refresher doctors can work happily . We also proposed some advices about refresher doctors training in the future .%针对胸外科进修医师特点,对其进行系统化的入职培训和个体化的三基训练,以培养其临床思维能力和临床技能,并对其灌输微创手术的理念,并进行人性化的管理。此外,作者也对未来胸外科进修医生的培养提出一些建议。

  7. [Portfolios: a tool for the training and assessment of residents in dermatology, part 1].

    Science.gov (United States)

    Casanova, J M; Soria, X; Borrego, L; de Argila, D; Ribera, M; Pujol, R

    2011-05-01

    The medical resident's portfolio is a collection of materials that show reflective learning in the context of clinical practice. A portfolio contains documents (such as case histories and questionnaires the resident has used), images, and video recordings that reveal that an individual has acquired the competencies needed for professional practice. A portfolio is an assessment tool that simultaneously supports learning and gives evidence for certifying competence. It encourages independent continuing professional development that is incremental and centered on answering questions about what one has learned, how it might be applied, what still needs to be learned, and what must be done to reach one's goal. Answering such questions provides evidence of competencies that have been acquired and what is still lacking, allowing the trainee to develop a plan for personal improvement and evaluate subsequent achievements. The first step in creating a portfolio is to list required skills and abilities, along with the actions that will allow the resident to acquire them during each year of residency training. The ultimate goal is to define the resident's professional competence. We describe a model on which to base a training and assessment portfolio for residents in dermatology.

  8. Resultados da cirurgia para otospongiose com dois tipos de prótese em procedimentos realizados por residentes Results of stapes surgery for otosclerosis with two kinds of prothesis in residency training

    Directory of Open Access Journals (Sweden)

    Celso Dall'Igna

    2008-12-01

    Full Text Available A cirurgia do estapédio é um dos tratamentos indicados para a melhora da surdez condutiva secundária à otospongiose. O procedimento requer habilidade e experiência do cirurgião e faz parte do treinamento durante a residência médica. OBJETIVOS: Avaliar qual tipo de prótese (teflon ou mista de metal e aço apresenta melhores os resultados auditivos em cirurgias realizadas por residentes e a incidência de complicações. MATERIAL E MÉTODOS: Foram avaliadas retrospectivamente 189 intervenções cirúrgicas que tiveram participação ativa de residentes, comparando-se os dois tipos de prótese utilizados. Os resultados audiométricos foram analisados conforme orientação do Committee on Hearing and Equilibrium e segundo o Amsterdam Hearing Evaluation Plots. RESULTADOS: O gap aéreo-ósseo diminuiu em média 21,90 dB (pStapes surgery is one of the approaches indicated to treat conductive hearing loss secondary to otosclerosis. The procedures requires skill and experience from the surgeon and is part of medical residency training. AIMS: To assess which type of prosthesis (Teflon or metal/steel presents the best results in surgeries performed by residents and the incidence of complications. MATERIALS AND METHODS: we retrospectively assessed 189 interventions that counted on the active participation of resident physicians, and we compared the two types of prosthesis used. Audiometric results were analyzed following the guidelines from the Committee on Hearing and Equilibrium and also according to the Amsterdam Hearing Evaluation Plots. RESULTS: Bone-air gap reduced in an average value of 21.90 dB (p<0.05 after the surgery in the group that received the Teflon prosthesis and 21.37 dB (p<0.05 in the group that received the mixed prosthesis, and gain in SRI was of 22.33 and 26.10 dB (p<0.05, and the air-bone gap was below 20 dB in 80.6% and 85.04%, respectively. CONCLUSIONS: We did not see differences in the audiometry and in the incidence of

  9. [Part-time medical specialist training; experiences with job-sharing for trainee internists

    NARCIS (Netherlands)

    Bevers, K.; Nauta, S.; Stuyt, P.M.J.

    2004-01-01

    Due to various factors such as social changes, an increasing number of couples with two incomes, and a growing proportion of female doctors, there has been a growing demand for part-time work in recent years. This is also true for resident physicians. Objections such as a discontinuity in care and

  10. Systematic review and meta-analysis of the role of mental training in the acquisition of technical skills in surgery.

    Science.gov (United States)

    Rao, Ahsan; Tait, Ian; Alijani, Afshin

    2015-09-01

    Mental training is rehearsal of mental imagery without physically performing the task. The aim of the study was to perform systematic review and meta-analysis on all the available data to evaluate the role of mental training in the acquisition of surgical technical skills. The following search databases were used: EMBASE, MEDLINE, Web of Science, Clinicaltrials.gov.uk, SIGN guidelines, NICE guidelines, and Cochrane review register. Meta-analysis was performed using Revman 5.2 statistical software. There were a total of 9 randomized controlled trials with 474 participants, of which 189 participants received mental training. Five randomized controlled trials concluded positive impact of mental training. Mental training group did not show any significant improvement in overall performance of the task carried in each study (P = .06). Mental training can be used as an important supplementary tool in learning surgical skills when run in parallel with physical training and applied to trainees with some experience of the skill. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Hydraulic analysis of river training cross-vanes as part of post-restoration monitoring

    Science.gov (United States)

    Endreny, T. A.; Soulman, M. M.

    2011-07-01

    River restoration design methods are incrementally improved by studying and learning from monitoring data in previous projects. In this paper we report post-restoration monitoring data and simulation analysis for a Natural Channel Design (NCD) restoration project along 1600 m of the Batavia Kill (14 km2 watershed) in the Catskill Mountains, NY. The restoration project was completed in 2002 with goals to reduce bank erosion and determine the efficacy of NCD approaches for restoring headwater streams in the Catskill Mountains, NY. The NCD approach used a reference-reach to determine channel form, empirical relations between the project site and reference site bankfull dimensions to size channel geometry, and hydraulic and sediment computations based on a bankfull (1.3 yr return interval) discharge to test channel capacity and sediment stability. The NCD project included 12 cross-vanes and 48 j-hook vanes as river training structures along 19 meander bends to protect against bank erosion and maintain scour pools for fish habitat. Monitoring data collected from 2002 to 2004 were used to identify aggradation of pools in meander bends and below some structures. Aggradation in pools was attributed to the meandering riffle-pool channel trending toward step-pool morphology and cross-vane arms not concentrating flow in the center of the channel. The aggradation subsequently caused flow splitting and 4 partial point bar avulsions during a spring 2005 flood with a 25-yr return interval. Processing the pre-flood monitoring data with hydraulic analysis software provided clues the reach was unstable and preventative maintenance was needed. River restoration and monitoring teams should be trained in robust hydraulic analytical methods that help them extend project restoration goals and structure stability.

  12. Hydraulic analysis of river training cross-vanes as part of post-restoration monitoring

    Directory of Open Access Journals (Sweden)

    T. A. Endreny

    2011-07-01

    Full Text Available River restoration design methods are incrementally improved by studying and learning from monitoring data in previous projects. In this paper we report post-restoration monitoring data and simulation analysis for a Natural Channel Design (NCD restoration project along 1600 m of the Batavia Kill (14 km2 watershed in the Catskill Mountains, NY. The restoration project was completed in 2002 with goals to reduce bank erosion and determine the efficacy of NCD approaches for restoring headwater streams in the Catskill Mountains, NY. The NCD approach used a reference-reach to determine channel form, empirical relations between the project site and reference site bankfull dimensions to size channel geometry, and hydraulic and sediment computations based on a bankfull (1.3 yr return interval discharge to test channel capacity and sediment stability. The NCD project included 12 cross-vanes and 48 j-hook vanes as river training structures along 19 meander bends to protect against bank erosion and maintain scour pools for fish habitat. Monitoring data collected from 2002 to 2004 were used to identify aggradation of pools in meander bends and below some structures. Aggradation in pools was attributed to the meandering riffle-pool channel trending toward step-pool morphology and cross-vane arms not concentrating flow in the center of the channel. The aggradation subsequently caused flow splitting and 4 partial point bar avulsions during a spring 2005 flood with a 25-yr return interval. Processing the pre-flood monitoring data with hydraulic analysis software provided clues the reach was unstable and preventative maintenance was needed. River restoration and monitoring teams should be trained in robust hydraulic analytical methods that help them extend project restoration goals and structure stability.

  13. The functional deformation of maxillary complete dentures in patients with flabby alveolar ridges. Part II: After surgery.

    Science.gov (United States)

    el Ghazali, S; Nilner, K; Wallenius, K

    1991-01-01

    Using strain-gauged maxillary complete dentures, the effects of the surgical removal of soft mobile tissue over the maxillary edentulous alveolar ridges--flabby ridges--on the deformation pattern and magnitude of functional strain were studied in five subjects. The results showed that a 20-90% reduction in denture deformation had taken place after surgery. Furthermore, a pre-operative shear-straining pattern of the buccal flanges and the lateral palatal slopes was not evident post-operatively. The results of this study point on the beneficial value of early surgical removal of flabby maxillary alveolar ridges.

  14. [General surgery under discussion. From the viewpoint of vascular surgery].

    Science.gov (United States)

    Debus, E S; Eckstein, H H; Böckler, D; Imig, H; Florek, A

    2008-03-01

    Vascular diseases are common and their frequency is rising. Statistics show that 15% of the German population over 65 display some kind of peripheral arterial pathology. Even aneurysmatic degeneration and cardiac and visceral perfusion disorders are being observed more frequently, while peak age is dropping. Therapeutic surgical options are accordingly being continually advanced and refined. Additionally the range of interventional therapies and new conservative options has substantially increased vascular surgeons' armamentarium. Updates in surgical training have responded to this increase in such disorders, and the diversification of therapeutic modalities has resulted in the elevation of vascular surgery from specialized techniques to a fully accredited specialty equal in standing to the other seven surgical disciplines. Controversy exists however about the new accredition, beginning with the question of advancement from basic surgical training while excluding important elements of general surgery. Since those training for this specialty will branch off immediately after 2 years of basic surgical training, their final accreditation in the new classification would exclude essential skills that remain part of the training as general surgeons.

  15. Superior subconjunctival anesthesia versus retrobulbar anesthesia for manual small-incision cataract surgery in a residency training program: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kongsap P

    2012-11-01

    Full Text Available Pipat KongsapDepartment of Ophthalmology, Prapokklao Hospital, Chanthaburi, Thailand; Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandPurpose: To evaluate the effectiveness of subconjunctival anesthesia as compared to retrobulbar anesthesia for pain control during manual small-incision cataract surgery (MSICS performed by third-year residents.Design: A randomized, controlled trial.Patients and methods: A total of 150 patients undergoing routine cataract surgery were randomly assigned to receive either subconjunctival anesthesia (group 1, n = 75 or retrobulbar anesthesia (group 2, n = 75. Third-year residents performed MSICS using the modified Blumenthal technique. Subconjunctival anesthesia was administered by injecting 2% xylocaine with adrenalin into the superior conjunctiva, and retrobulbar anesthesia by injecting 2 mL of 2% xylocaine with adrenalin into the retrobulbar space. We studied the following variables: intraoperative pain score rated on a 100-point visual analog scale (VAS, operative time, and injection and operative complications.Results: A mean age of 69 vs 70 years, an operative time of 47.1 (SD, 9.9 min vs 47.7 (10.9 min, and a median (interquartile range pain score of 40 (range, 20–70 vs 40 (range, 20–50 were observed in the subconjunctival and the retrobulbar groups, respectively. The injection complication of subconjunctival hemorrhage was significantly higher in the subconjunctival group (25.3% compared to the retrobulbar group (1.3%. The operative complication rate between groups was not different (P > 0.05.Conclusion: Both, superior subconjunctival anesthesia and retrobulbar anesthesia were effective during MSICS when used in a residency training program.Keywords: subconjunctival anesthesia, retrobulbar anesthesia, cataract surgery, small-incision cataract surgery, visual analog scale, pain score

  16. Whole greater than the parts: integrated esophageal centers (IEC) and advanced training in esophageal diseases.

    Science.gov (United States)

    Triadafilopoulos, G; Clarke, J; Hawn, M

    2017-10-01

    An integrated esophageal center (IEC) is a multidisciplinary team with expertise, skill, range, and facilities necessary to achieve optimal outcomes in patients with esophageal diseases efficiently and expeditiously. Within IEC, patients presenting with esophageal symptoms undergo a detailed clinical, functional and structural evaluation of their esophagus prior to implementation of tailored medical, endoscopic or surgical therapy. Serving as a core, the IEC clinical practice also supports research and innovation in esophageal diseases as well as public and physician education. Referrals to the unit may be primary, either from primary care or self-initiated, or secondary from other specialty practices, to reassess patients who have previously failed therapies and to manage complex or complicated cases. The fundamental goals of the IEC are to provide value for patients with esophageal diseases, streamlining complex diagnostic investigations and expediting therapies aiming at reducing costs while improving clinical outcomes, and to accelerate knowledge generation through robust interaction and cross-training across disciplines. The organization of the IEC goes beyond traditional academic and clinical silos and involves a director and administrative team coordinating faculty and fellows from both medical and surgical disciplines and supported by other clinical lines, such as radiology, pathology, etc., while it interfaces with physicians, the public, basic, translational and clinical research groups, and related industry partners. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Lipids and bariatric procedures part 1 of 2: Scientific statement from the National Lipid Association, American Society for Metabolic and Bariatric Surgery, and Obesity Medicine Association: FULL REPORT.

    Science.gov (United States)

    Bays, Harold E; Jones, Peter H; Jacobson, Terry A; Cohen, David E; Orringer, Carl E; Kothari, Shanu; Azagury, Dan E; Morton, John; Nguyen, Ninh T; Westman, Eric C; Horn, Deborah B; Scinta, Wendy; Primack, Craig

    2016-01-01

    Bariatric procedures often improve lipid levels in patients with obesity. This 2 part scientific statement examines the potential lipid benefits of bariatric procedures and represents the contributions from authors representing the National Lipid Association, American Society for Metabolic and Bariatric Surgery, and the Obesity Medicine Association. The foundation for this scientific statement was based on published data through June 2015. Part 1 of this 2 part scientific statement provides an overview of: (1) adipose tissue, cholesterol metabolism, and lipids; (2) bariatric procedures, cholesterol metabolism, and lipids; (3) endocrine factors relevant to lipid influx, synthesis, metabolism, and efflux; (4) immune factors relevant to lipid influx, synthesis, metabolism, and efflux; (5) bariatric procedures, bile acid metabolism, and lipids; and (6) bariatric procedures, intestinal microbiota, and lipids, with specific emphasis on how the alterations in the microbiome by bariatric procedures influence obesity, bile acids, and inflammation, which in turn, may all affect lipid levels. Included in part 2 of this comprehensive scientific statement will be a review of (1) the importance of nutrients (fats, carbohydrates, and proteins) and their absorption on lipid levels; (2) the effects of bariatric procedures on gut hormones and lipid levels; (3) the effects of bariatric procedures on nonlipid cardiovascular disease (CVD) risk factors; (4) the effects of bariatric procedures on lipid levels; (5) effects of bariatric procedures on CVD; and finally, (6) the potential lipid effects of vitamin, mineral, and trace element deficiencies that may occur after bariatric procedures. This document represents the full report of part 1.

  18. Lipids and bariatric procedures part 1 of 2: Scientific statement from the National Lipid Association, American Society for Metabolic and Bariatric Surgery, and Obesity Medicine Association: EXECUTIVE SUMMARY.

    Science.gov (United States)

    Bays, Harold E; Jones, Peter H; Jacobson, Terry A; Cohen, David E; Orringer, Carl E; Kothari, Shanu; Azagury, Dan E; Morton, John; Nguyen, Ninh T; Westman, Eric C; Horn, Deborah B; Scinta, Wendy; Primack, Craig

    2016-01-01

    Bariatric procedures often improve lipid levels in patients with obesity. This 2-part scientific statement examines the potential lipid benefits of bariatric procedures and represents contributions from authors representing the National Lipid Association, American Society for Metabolic and Bariatric Surgery, and the Obesity Medicine Association. The foundation for this scientific statement was based on data published through June 2015. Part 1 of this 2-part scientific statement provides an overview of: (1) adipose tissue, cholesterol metabolism, and lipids; (2) bariatric procedures, cholesterol metabolism, and lipids; (3) endocrine factors relevant to lipid influx, synthesis, metabolism, and efflux; (4) immune factors relevant to lipid influx, synthesis, metabolism, and efflux; (5) bariatric procedures, bile acid metabolism, and lipids; and (6) bariatric procedures, intestinal microbiota, and lipids, with specific emphasis on how the alterations in the microbiome by bariatric procedures influence obesity, bile acids, and inflammation, which in turn, may all affect lipid levels. Included in part 2 of this comprehensive scientific statement will be a review of: (1) the importance of nutrients (fats, carbohydrates, and proteins) and their absorption on lipid levels; (2) the effects of bariatric procedures on gut hormones and lipid levels; (3) the effects of bariatric procedures on nonlipid cardiovascular disease risk factors; (4) the effects of bariatric procedures on lipid levels; (5) effects of bariatric procedures on cardiovascular disease; and finally (6) the potential lipid effects of vitamin, mineral, and trace element deficiencies that may occur after bariatric procedures. This document represents the executive summary of part 1.

  19. Additive manufacturing technology in reconstructive surgery.

    Science.gov (United States)

    Fuller, Scott C; Moore, Michael G

    2016-10-01

    Technological advances have been part and parcel of modern reconstructive surgery, in that practitioners of this discipline are continually looking for innovative ways to perfect their craft and improve patient outcomes. We are currently in a technological climate wherein advances in computers, imaging, and science have coalesced with resulting innovative breakthroughs that are not merely limited to improved outcomes and enhanced patient care, but may provide novel approaches to training the next generation of reconstructive surgeons. New developments in software and modeling platforms, imaging modalities, tissue engineering, additive manufacturing, and customization of implants are poised to revolutionize the field of reconstructive surgery. The interface between technological advances and reconstructive surgery continues to expand. Additive manufacturing techniques continue to evolve in an effort to improve patient outcomes, decrease operative time, and serve as instructional tools for the training of reconstructive surgeons.

  20. [Hernia surgery in urology. Part 2: parastomal, trocar and incisional hernias - fundamentals of clinical diagnostics and treatment].

    Science.gov (United States)

    Franz, T; Schwalenberg, T; Dietrich, A; Müller, J; Stolzenburg, J-U

    2013-06-01

    Hernias are a common occurrence with a correspondingly huge clinical and economic impact on the healthcare system. Parastomal and trocar hernias are rare in routine urological work. The therapy of parastomal hernias remains problematic but basically the surgeon is able to use conventional techniques with suture repair or procedures with mesh implantation. The conventional parastomal hernia repair with mesh can be classified into sublay, onlay and intraperitoneal techniques. Furthermore, a relocation of the stoma is possible. Trocar hernias represent a rare but hazardous complication. Due to the increase in keyhole surgery there is also the danger of a rise in their occurrence. Incisional hernias occur frequently in patients who have undergone laparotomy and for repair different surgical techniques and types of meshes are available. This article presents an overview of the epidemiology, pathogenesis, clinical symptoms, diagnostic and therapy of parastomal, trocar and incisional hernias.

  1. What to Expect After Breast Reconstruction Surgery

    Science.gov (United States)

    ... En Español Category Cancer A-Z Breast Cancer Breast Reconstruction Surgery Women who have surgery as part of ... and after your surgery. Deciding Whether To Have Breast Reconstruction Many women choose to have reconstruction surgery, but ...

  2. Heart Surgery Experience in Hitit University Faculty of Medicine Corum Research and Training Hospital: First Year Results

    Directory of Open Access Journals (Sweden)

    Adem Diken

    2014-03-01

    Full Text Available Aim: We aimed to assess the clinical outcomes of our department of cardiac surgery which was newly introduced in Hitit University Corum Education and Research Hospital. Material and Method: Between November 2012 and November 2013, a total of 110 open-heart surgeries were performed. Ten out of these (9.1% were emergency operations for acute ST elevation myocardial infarction Off-pump technique was used in 31 (29.2% patients and cardiopulmonary bypass was used in 75 (70.8%. A total of 106 patients received coronary artery bypass grafting, 1 received mitral reconstruction, 1 received Bentall procedure, 1 received tricuspid valve repair, 1 received mitral valve replacement, 1 received aortic valve replacement with aortic root enlargement and 1 received aortic supracoronary graft replacement. Results: Hospital mortality occurred in 1 (0.9% patient. Four patients (3.6% who were on dual antiaggregants underwent a revision for bleeding on the day of the operation. Morbidities occurred in 3 (2.7% patients. Atrial fibrillation occurred in 11 (10% patients and the normal sinus rhythm was achieved by amiodarone. Intraaortic balloon counterpulsation was used in 5 (4.5% patients. Discussion: The newly introduced cardiac surgery department of the Hitit University Corum Education and Research Hospital, which provides tertiary care to a wide rural community, serves with low morbidity and mortality.

  3. Robotic surgery.

    Science.gov (United States)

    Diana, M; Marescaux, J

    2015-01-01

    Proficiency in minimally invasive surgery requires intensive and continuous training, as it is technically challenging for unnatural visual and haptic perceptions. Robotic and computer sciences are producing innovations to augment the surgeon's skills to achieve accuracy and high precision during complex surgery. This article reviews the current use of robotically assisted surgery, focusing on technology as well as main applications in digestive surgery, and future perspectives. The PubMed database was interrogated to retrieve evidence-based data on surgical applications. Internal and external consulting with key opinion leaders, renowned robotics laboratories and robotic platform manufacturers was used to produce state-of-the art business intelligence around robotically assisted surgery. Selected digestive procedures (oesophagectomy, gastric bypass, pancreatic and liver resections, rectal resection for cancer) might benefit from robotic assistance, although the current level of evidence is insufficient to support widespread adoption. The surgical robotic market is growing, and a variety of projects have recently been launched at both academic and corporate levels to develop lightweight, miniaturized surgical robotic prototypes. The magnified view, and improved ergonomics and dexterity offered by robotic platforms, might facilitate the uptake of minimally invasive procedures. Image guidance to complement robotically assisted procedures, through the concepts of augmented reality, could well represent a major revolution to increase safety and deal with difficulties associated with the new minimally invasive approaches. © 2015 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  4. Outcome of endodontic surgery: a meta-analysis of the literature--Part 2: Comparison of endodontic microsurgical techniques with and without the use of higher magnification.

    Science.gov (United States)

    Setzer, Frank C; Kohli, Meetu R; Shah, Sweta B; Karabucak, Bekir; Kim, Syngcuk

    2012-01-01

    The aim of this study was to investigate the outcome of root-end surgery. It identifies the effect of the surgical operating microscope or the endoscope on the prognosis of endodontic surgery. The specific outcomes of contemporary root-end surgery techniques with microinstruments but only loupes or no visualization aids (contemporary root-end surgery [CRS]) were compared with endodontic microsurgery using the same instruments and materials but with high-power magnification as provided by the surgical operating microscope or the endoscope (endodontic microsurgery [EMS]). The probabilities of success for a comparison of the 2 techniques were determined by means of a meta-analysis and systematic review of the literature. The influence of the tooth type on the outcome was investigated. A comprehensive literature search for longitudinal studies on the outcome of root-end surgery was conducted. Three electronic databases (ie, Medline, Embase, and PubMed) were searched to identify human studies from 1966 up to October 2009 in 5 different languages (ie, English, French, German, Italian, and Spanish). Review articles and relevant articles were searched for cross-references. In addition, 5 dental and medical journals (ie, Journal of Endodontics, International Endodontic Journal, Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontics, Journal of Oral and Maxillofacial Surgery, and International Journal of Oral and Maxillofacial Surgery) dating back to 1975 were hand searched. Following predefined inclusion and exclusion criteria, all articles were screened by 3 independent reviewers (S.B.S., M.R.K., and F.C.S.). Relevant articles were obtained in full-text form, and raw data were extracted independently by each reviewer. After agreement among the reviewers, articles that qualified were assigned to group CRS. Articles belonging to group EMS had already been obtained for part 1 of this meta-analysis. Weighted pooled success rates and a relative risk assessment

  5. A systematic review on soft-to-hard tissue ratios in orthognathic surgery part II: Chin procedures.

    Science.gov (United States)

    San Miguel Moragas, Joan; Oth, Olivier; Büttner, Michael; Mommaerts, Maurice Y

    2015-10-01

    evidence level IIIb, three were evidence level IIb, and the rest were evidence level IV. Three studies were prospective in nature. A high variability of soft-to-hard tissue ratios regarding genioplasty seemed to disappear if data were stratified according to confounding factors. With the available data, a soft-to-hard pogonion ratio of 0.9:1 and 0.55:1 could be used for chin advancement and chin setback surgery, respectively. Advancement and extrusion movements of the chin segment show respectively a 0.9:1 of sPg:Pg horizontally and 0.95:1 of sMe:Me vertically. Setback and impaction movements show respectively a -0.52:1 of sPg:Pg horizontally and -0.43:1 of sMe:Me vertically. Prospective studies are needed that stratify by confounding factors such as type of osteotomy technique, magnitude of the movement, age, sex, race/ethnicity, and quantity and quality of the soft tissues. More specifically, studies are needed regarding soft-to-hard tissue changes after chin extrusion ("downgrafting"), intrusion ("impaction"), and widening and narrowing surgery. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  6. [Aesthetic surgery].

    Science.gov (United States)

    Bruck, Johannes C

    2006-01-01

    The WHO describes health as physical, mental and social well being. Ever since the establishment of plastic surgery aesthetic surgery has been an integral part of this medical specialty. It aims at reconstructing subjective well-being by employing plastic surgical procedures as described in the educational code and regulations for specialists of plastic surgery. This code confirms that plastic surgery comprises cosmetic procedures for the entire body that have to be applied in respect of psychological exploration and selection criteria. A wide variety of opinions resulting from very different motivations shows how difficult it is to differentiate aesthetic surgery as a therapeutic procedure from beauty surgery as a primarily economic service. Jurisdiction, guidelines for professional conduct and ethical codes have tried to solve this question. Regardless of the intention and ability of the health insurances, it has currently been established that the moral and legal evaluation of advertisements for medical procedures depends on their purpose: advertising with the intent of luring patients into cosmetic procedures that do not aim to reconstruct a subjective physical disorder does not comply with a medical indication. If, however, the initiative originates with the patient requesting the amelioration of a subjective disorder of his body, a medical indication can be assumed.

  7. Documenting a learning curve and test-retest reliability of two tasks on a virtual reality training simulator in laparoscopic surgery.

    Science.gov (United States)

    Hogle, Nancy J; Briggs, William M; Fowler, Dennis L

    2007-01-01

    Virtual reality simulators are a component of the armamentarium for training surgical residents. No one knows exactly how to incorporate virtual reality simulators into a curriculum. The purpose of this study was to document and show the learning curve and test-retest reliability of 2 tasks on a virtual reality-training simulator (LapSim; Surgical Science, Göteborg, Sweden) in laparoscopic surgery. Twenty-nine medical students participated in 8 iterations of 7 virtual reality tasks ("camera navigation" (CN), "instrument navigation," "coordination," "grasping," "lifting and grasping" (LG), "cutting," and "clip applying") Learning curves for each outcome variable of the CN and LG tasks were generated. Using ANOVA, we evaluated the differences between each score from attempt number 7 to attempt number 8 to document test-retest reliability. A plateau in the learning curve occurred within 8 sessions for CN misses, CN tissue damage, CN maximum damage, and LG maximum damage. Over the course of 8 sessions, a plateau in the learning curve was nearly reached for CN time, CN drift, CN path, CN angular path, and LG left and right path. The following variables had a downward trend to the mean learning curve over 8 sessions, but they did not reach a plateau: LG time, LG left and right miss, LG left and right angular path, and LG tissue damage. Using the LapSim virtual reality simulator, we documented a learning curve and test-retest reliability for each outcome variable for CN and LG for rank novices. The modeling of the general learning curve is useful in designing training program. These results may be important in developing standards for technical evaluation in a surgical training curriculum.

  8. Evaluation of Procedural Simulation as a Training and Assessment Tool in General Surgery-Simulating a Laparoscopic Appendectomy

    DEFF Research Database (Denmark)

    Bjerrum, Flemming; Strandbygaard, Jeanett; Rosthøj, Susanne

    2016-01-01

    BACKGROUND: Laparoscopic appendectomy is a commonly performed surgical procedure, but few training models have been described for it. We examined a virtual reality module for practising a laparoscopic appendectomy. METHODS: A prospective cohort study with the following 3 groups of surgeons (n = 45...

  9. Global Health Values of a Multidirectional Near Peer Training Program in Surgery, Pathology, Anatomy, Research Methodology, and Medical Education for Haitian, Rwandan, and Canadian Medical Students.

    Science.gov (United States)

    Elharram, Malik; Dinh, Trish; Lalande, Annie; Ge, Susan; Gao, Sophie; Noël, Geoffroy

    As health care delivery increasingly requires providers to cross international borders, medical students at McGill University, Canada, developed a multidirectional exchange program with Haiti and Rwanda. The program integrates surgery, pathology, anatomy, research methodology, and medical education. The aim of the present study was to explore the global health value of this international training program to improve medical education within the environment of developing countries, such as Haiti and Rwanda, while improving sociocultural learning of Canadian students. Students from the University of Kigali, Rwanda and Université Quisqueya, Haiti, participated in a 3-week program at McGill University. The students spanned from the first to sixth year of their respective medical training. The program consisted of anatomy dissections, surgical simulations, clinical pathology shadowing, and interactive sessions in research methodology and medical education. To evaluate the program, a survey was administered to students using a mixed methodology approach. Common benefits pointed out by the participants included personal and professional growth. The exchange improved career development, sense of responsibility toward one's own community, teaching skills, and sociocultural awareness. The participants all agreed that the anatomy dissections improved their knowledge of anatomy and would make them more comfortable teaching the material when the returned to their university. The clinical simulation activities and shadowing experiences allowed them to integrate the different disciplines. However, the students all felt the research component had too little time devoted to it and that the knowledge presented was beyond their educational level. The development of an integrated international program in surgery, pathology, anatomy, research methodology, and medical education provided medical students with an opportunity to learn about differences in health care and medical education

  10. Using your shoulder after replacement surgery

    Science.gov (United States)

    Joint replacement surgery - using your shoulder; Shoulder replacement surgery - after ... You have had shoulder replacement surgery to replace the bones of your shoulder joint with artificial parts. The parts include a stem made of metal and a ...

  11. Assessment of intraoperative tube thoracostomy after diaphragmatic resection as part of debulking surgery for primary advanced-stage Müllerian cancer.

    Science.gov (United States)

    Kato, Kazuyoshi; Tate, Shinichi; Nishikimi, Kyoko; Shozu, Makio

    2013-10-01

    The present study assessed the use of an intraoperative tube thoracostomy for patients with primary advanced-stage ovarian, fallopian tube, or peritoneal cancer who underwent a diaphragmatic resection as part of debulking surgery and to define which patients are more likely to benefit from an intraoperative tube thoracostomy. All consecutive patients with stage IIIC-IV Müllerian cancer who underwent diaphragmatic resection at our institution between April 2008 and March 2013 were retrospectively reviewed. When a full-thickness resection of the diaphragm was performed and the thoracic cavity was opened, a chest tube was routinely placed during surgery. Patient-, disease-, and surgery-related data were collected from the patients' medical records. The data were evaluated with particular attention directed at pleural effusion after diaphragmatic resection. A total of 37 patients were included in this study. No complications associated with the intraoperative tube thoracostomy procedures occurred. An infection of the thoracic cavity occurred in one patient, following the presence of intra-abdominal abscess. The total volume of pleural drainage ranged from 88 to 2826 mL (median, 965 mL). The estimated blood loss, intraoperative blood transfusion, and area of the diaphragmatic opening were significantly associated with the total volume of pleural drainage in univariate analyses. In a multivariate analysis, the estimated blood loss was the only factor to be significantly associated with the total volume of pleural drainage. A prophylactic tube thoracostomy might be considered if the volume of the estimated blood loss is higher than usual. © 2013.

  12. Comparison of ultrasound and nerve stimulation techniques for interscalene brachial plexus block for shoulder surgery in a residency training environment: a randomized, controlled, observer-blinded trial.

    Science.gov (United States)

    Thomas, Leslie C; Graham, Sean K; Osteen, Kristie D; Porter, Heather Scuderi; Nossaman, Bobby D

    2011-01-01

    The ability to provide adequate intraoperative anesthesia and postoperative analgesia for orthopedic shoulder surgery continues to be a procedural challenge. Anesthesiology training programs constantly balance the time needed for procedural education versus associated costs. The administration of brachial plexus anesthesia can be facilitated through nerve stimulation or by ultrasound guidance. The benefits of using a nerve stimulator include a high incidence of success and less cost when compared to ultrasonography. Recent studies with ultrasonography suggest high success rates and decreased procedural times, but less is known about the comparison of these procedural times in training programs. We conducted a prospective, randomized, observer-blinded study with inexperienced clinical anesthesia (CA) residents-CA-1 to CA-3-to compare differences in these 2 guidance techniques in patients undergoing interscalene brachial plexus block for orthopedic surgery. In this study, 41 patients scheduled for orthopedic shoulder surgery were randomly assigned to receive an interscalene brachial plexus block guided by either ultrasound (US group) or nerve stimulation (NS group). Preoperative analgesics and sedatives were controlled in both groups. The US group required significantly less time to conduct the block (4.3 ± 1.5 minutes) than the NS group (10 ± 1.5 minutes), P  =  .009. Moreover, the US group achieved a significantly faster onset of sensory block (US group, 12 ± 2 minutes; NS group, 19 ± 2 minutes; P  =  .02) and motor block (US group, 13.5 ± 2.3 minutes; NS group, 20.2 ± 2.1 minutes; P  =  .03). Success rates were high for both techniques and were not statistically different (US group, 95%; NS group, 91%). No differences were found in operative times, postoperative pain scores, need for rescue analgesics, or incidences of perioperative or postdischarge side effects. On the basis of our results with inexperienced residents, we

  13. Simulation-based mastery learning for endoscopy using the endoscopy training system: a strategy to improve endoscopic skills and prepare for the fundamentals of endoscopic surgery (FES) manual skills exam.

    Science.gov (United States)

    Ritter, E Matthew; Taylor, Zachary A; Wolf, Kathryn R; Franklin, Brenton R; Placek, Sarah B; Korndorffer, James R; Gardner, Aimee K

    2017-07-11

    The fundamentals of endoscopic surgery (FES) program has considerable validity evidence for its use in measuring the knowledge, skills, and abilities required for competency in endoscopy. Beginning in 2018, the American Board of Surgery will require all candidates to have taken and passed the written and performance exams in the FES program. Recent work has shown that the current ACGME/ABS required case volume may not be enough to ensure trainees pass the FES skills exam. The aim of this study was to investigate the feasibility of a simulation-based mastery-learning curriculum delivered on a novel physical simulation platform to prepare trainees to pass the FES manual skills exam. The newly developed endoscopy training system (ETS) was used as the training platform. Seventeen PGY 1 (10) and PGY 2 (7) general surgery residents completed a pre-training assessment consisting of all 5 FES tasks on the GI Mentor II. Subjects then trained to previously determined expert performance benchmarks on each of 5 ETS tasks. Once training benchmarks were reached for all tasks, a post-training assessment was performed with all 5 FES tasks. Two subjects were lost to follow-up and never returned for training or post-training assessment. One additional subject failed to complete any portion of the curriculum, but did return for post-training assessment. The group had minimal endoscopy experience (median 0, range 0-67) and minimal prior simulation experience. Three trainees (17.6%) achieved a passing score on the pre-training FES assessment. Training consisted of an average of 48 ± 26 repetitions on the ETS platform distributed over 5.1 ± 2 training sessions. Seventy-one percent achieved proficiency on all 5 ETS tasks. There was dramatic improvement demonstrated on the mean post-training FES assessment when compared to pre-training (74.0 ± 8 vs. 50.4 ± 16, p skills exam. This simulation-based mastery learning curriculum using the ETS is feasible for training novices and

  14. 基于流动医院的白内障超声乳化手术培训模式的探索%Exploration of cataract phacoemulsification surgery training models based upon mobile hospital

    Institute of Scientific and Technical Information of China (English)

    王凯; 鲍永珍; 李明武; 黎晓新

    2011-01-01

    In mobile hospitals, numerous cataract patients have recovered visual acuity after cataract surgeries, during which a lot of eligible cataract surgeons have been trained.During the process of training, Department of Ophthalmology, Peking University People' s Hospital explored two new cataract surgery training models and gained good training results.Combination of these two models has significantly elevated completion rate of independently performed cataract surgeries, and lowered incidence of surgery complications.%基于流动医院的白内障复明手术给无数白内障患者带来了光明,同时也培养了一批合格的白内障手术医师。在实施复明手术的过程中,北京大学人民医院眼科中心探索了2种新的白内障手术培训模式,取得了良好的手术培训效果。通过2种模式的有机结合,显著提高了受训眼科医师的白内障手术独立完成率,并降低了手术并发症的发生率。

  15. Simulation-based training for thoracoscopy

    DEFF Research Database (Denmark)

    Bjurström, Johanna Margareta; Konge, Lars; Lehnert, Per;

    2013-01-01

    An increasing proportion of thoracic procedures are performed using video-assisted thoracic surgery. This minimally invasive technique places special demands on the surgeons. Using simulation-based training on artificial models or animals has been proposed to overcome the initial part of the lear......An increasing proportion of thoracic procedures are performed using video-assisted thoracic surgery. This minimally invasive technique places special demands on the surgeons. Using simulation-based training on artificial models or animals has been proposed to overcome the initial part...... of the learning curve. This study aimed to investigate the effect of simulation-based training and to compare self-guided and educator-guided training....

  16. Part II. Work hardening for warriors: Training military Occupational Therapy professionals in the management of combat stress casualties.

    Science.gov (United States)

    Rice, Valerie J.; Gerardi, Steve M.

    1999-01-01

    The purpose of this article is to describe the training of military occupational therapy personnel in a unique application of their professional skills. Ergonomic principles of training for stressful environments were implemented to ensure training effectiveness and transfer of skills to combat situations. Training schedules, casualty role-play scenarios, critical incident stress debriefing principles and scenarios, unit survey guidelines, and premises for training persons to function under stressful conditions are provided. Comparisons with civilian applications are drawn, and suggestions for future roles and training for Occupational Therapy professionals are given.

  17. Bariatric Surgery

    Science.gov (United States)

    ... Metabolic and Bariatric Surgery MedlinePlus What is bariatric surgery? Bariatric surgery helps people who are very obese to ... What are the endocrine-related benefits of bariatric surgery? Bariatric surgery and the weight loss that results can: ...

  18. The General Surgery Chief Resident Operative Experience

    Science.gov (United States)

    Drake, Frederick Thurston; Horvath, Karen D.; Goldin, Adam B.; Gow, Kenneth W.

    2014-01-01

    IMPORTANCE The chief resident (CR) year is a pivotal experience in surgical training. Changes in case volume and diversity may impact the educational quality of this important year. OBJECTIVE To evaluate changes in operative experience for general surgery CRs. DESIGN, SETTING, AND PARTICIPANTS Review of Accreditation Council for Graduate Medical Education case logs from 1989–1990 through 2011–2012 divided into 5 periods. Graduates in period 3 were the last to train with unrestricted work hours; those in period 4 were part of a transition period and trained under both systems; and those in period 5 trained fully under the 80-hour work week. Diversity of cases was assessed based on Accreditation Council for Graduate Medical Education defined categories. MAIN OUTCOMES AND MEASURES Total cases and defined categories were evaluated for changes over time. RESULTS The average total CR case numbers have fallen (271 in period 1 vs 242 in period 5, P surgery training may be jeopardized by reduced case diversity. Chief resident cases are crucial in surgical training and educators should consider these findings as surgical training evolves. PMID:23864049

  19. Validation of an inanimate low cost model for training minimal invasive surgery (MIS) of esophageal atresia with tracheoesophageal fistula (AE/TEF) repair.

    Science.gov (United States)

    Maricic, Maximiliano Alejo; Bailez, María Marcela; Rodriguez, Susana P

    2016-09-01

    We present the results of the validation of an inanimate model created for training thoracoscopic treatment of esophageal atresia with lower tracheoesophageal fistula (EA/TEF). We used different domestic materials such as a piece of wood (support), corrugated plastic tubes (PVC) of different sizes to simulate ribs, intercostal spaces, trachea and spine and tubular latex balloons to simulate the esophagus and lungs to make the basic model. This device was inserted into the thoracic cavity of a rubber dummy simulating a 3kg newborn with a work area volume of 50ml. The model was designed taking into account the experience of doing this procedure in neonates. The cost of the materials used was 50 US$. Regular video endoscopic equipment and 3mm instruments were used. Thirty-nine international faculty or pediatric surgeons attending hands on courses with different levels of training in minimal invasive surgery (MIS) repair of EA/TEF performed the procedure in the model. We compared the performance of the practitioners with their experience in thoracoscopic repair of EA. A Likert-type scale was used to evaluate results. Previous experience in MIS, anatomical appearance of the model, surgical anatomy compared to a real patient, and utility as a training method were analyzed. We also used a checklist to assess performance. We evaluated: number of errors and types of injuries, quality of the anastomosis, and duration of procedure. To analyze the results we used a T-test, chi-square test and Excel® database to match up some results. Thirty-nine questionnaires were completed. Seven surgeons were experts (≥30 TEF/EA repairs as surgeon), 10 had intermediate level of experience (5 to 29 repairs as surgeon) and 22 were beginners (less than 5 repairs). To simplify the analysis we divided the respondents into low experience LE (MIS operative room setting and team work. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. The functional deformation of maxillary complete dentures in patients with flabby alveolar ridges. Part I: Before surgery.

    Science.gov (United States)

    el Ghazali, S; Nilner, K; Wallenius, K

    1991-01-01

    Using strain-guaged duplicate maxillary dentures, the deformation patterns and magnitude of functional strain were studied on five complete denture wearing subjects who had varying amounts of soft mobile tissue over their maxillary edentulous alveolar ridge so called flabby ridges. The thickness of mobile tissue--expressed as depth--was measured by a sharpened periodontal probe with aid of a plastic base plate as a locator. The functional test included maximum biting, and the chewing of three test food samples. The results did not point on any direct relationship between the thickness of the soft tissue and the midline deformation pattern and/or magnitude of functional strain. It seems, however, as if the main influence of mobile tissue is on the strain behaviour in the lateral part of the denture.

  1. 29 CFR (non - mandatory) Appendix D to Subpart L of Part 1926-List of Training Topics for Scaffold Erectors and...

    Science.gov (United States)

    2010-07-01

    ... Training Topics for Scaffold Erectors and Dismantlers (Non Labor Regulations Relating to Labor (Continued... 1926—List of Training Topics for Scaffold Erectors and Dismantlers This Appendix D is provided to serve... be trained in the following topics: • General Overview of Scaffolding • regulations and standards...

  2. Arthroscopic skills assessment and use of box model for training in arthroscopic surgery using Sawbones – “FAST” workstation

    Science.gov (United States)

    Goyal, Saumitra; Radi, Mohamed Abdel; Ramadan, Islam Karam-allah; Said, Hatem Galal

    2016-01-01

    Purpose: Arthroscopic skills training outside the operative room may decrease risks and errors by trainee surgeons. There is a need of simple objective method for evaluating proficiency and skill of arthroscopy trainees using simple bench model of arthroscopic simulator. The aim of this study is to correlate motor task performance to level of prior arthroscopic experience and establish benchmarks for training modules. Methods: Twenty orthopaedic surgeons performed a set of tasks to assess a) arthroscopic triangulation, b) navigation, c) object handling and d) meniscus trimming using SAWBONES “FAST” arthroscopy skills workstation. Time to completion and the errors were computed. The subjects were divided into four levels; “Novice”, “Beginner”, “Intermediate” and “Advanced” based on previous arthroscopy experience, for analyses of performance. Results: The task performance under transparent dome was not related to experience of the surgeon unlike opaque dome, highlighting the importance of hand-eye co-ordination required in arthroscopy. Median time to completion for each task improved as the level of experience increased and this was found to be statistically significant (p 85%) of subjects across all the levels reported improvement in performance with sequential tasks. Conclusion: Use of the arthroscope requires visuo-spatial coordination which is a skill that develops with practice. This simple box model can reliably differentiate the arthroscopic skills based on experience and can be used to monitor progression of skills of trainees in institutions. PMID:27801643

  3. The Medical Mission and Modern Core Competency Training: A 10-Year Follow-Up of Resident Experiences in Global Plastic Surgery.

    Science.gov (United States)

    Yao, Caroline A; Swanson, Jordan; McCullough, Meghan; Taro, Trisa B; Gutierrez, Ricardo; Bradshaw, Allison; Campbell, Alex; Magee, William P; Magee, William P

    2016-09-01

    The emphasis on cultural competency for physicians and surgeons is increasingly important, as communication with both patients and other providers significantly affects individual and system-wide outcomes. International surgical training has been shown to improve leadership skills, cultural competency, and technical proficiency of participants in short-term follow-up. This study explores the long-term impact of international surgical mission experiences on developing participants' core competencies, professional outcomes, and commitment to global health. All 208 plastic and reconstructive surgeons who completed the Operation Smile Regan/Stryker fellowship programs between 2006 and 2015 were surveyed electronically. One hundred sixty-five surveys were returned, for an overall response rate of 79.3 percent. The majority of participants reported that the fellowship positively impacted all six Accreditation Council for Graduate Medical Education core competencies. Most participants who were attending physicians at the time of the survey were practicing general plastic surgery, with 42 percent in an academic/teaching environment, 32 percent in assistant/associate professor positions, and 6 percent in either a program director or department chairman position. The majority currently volunteer on local or international missions, and all respondents would consider volunteering again. Carefully structured and rigorously proctored programs such as the Regan/Stryker Fellowship offer plastic surgery residents the opportunity to gain valuable professional and personal experiences that benefit them long after their service experience. Programs of this nature can not only effectively improve cultural competency of physicians, but also positively influence their attitudes toward leadership and direct that potential to meet the growing need for surgical care in low- and middle-income countries.

  4. Reduction in pulmonary complications in high risk patients undergoing surgery for total hip replacement under general anesthesia by preoperative intensive inspiratory muscle training:A randomized controlled clinical trial

    Institute of Scientific and Technical Information of China (English)

    Bingqiang Ma; Hongguang Bao

    2009-01-01

    Objective: To evaluate the effects of preoperative inspiratory muscle training (IMT) on the incidence of atelectasis in patients at high risk of postoperative pulmonary complications scheduled for elective total hip replacement surgery under general anesthesia. Methods: Thirty two high-risk paticnts undergoing elective total hip replacement surgery under general anesthesia were chosen from Nanjing Medical University, Affiliated Nanjing First Hospital. In this single-blind randomized controlled clinical trial, patients were randomly assigned to receive preoperative inspiratory muscle training or conventional treatment (CT). The major effectiveness outcome variables were atelectasis and duration of postoperative hospitalization. Results: Both groups were comparable prior to surgery. Seven patients in the CT group and 3 in the IMT group developed atelectasis (P = 0.25). Median duration of postoperative hospitalization was 13 days (range, 10~17 days) in the IMT group versus 16 days (range, 11~23 days) in the CT group (Mann-Whitney U statistics, Z =-2.22, P = 0.03). Mean postoperative inspiratory pressure was 5% higher in the IMT group. Conclusion: Preoperative intensive inspiratory muscle training appears to reduce the incidence of atelectasis and duration of postoperative hospitalization in patients at high risk of developing postoperative pulmonary complications who were scheduled for elective total hip replacement surgery under general anesthesia.

  5. A new possibility in thoracoscopic virtual reality simulation training: development and testing of a novel virtual reality simulator for video-assisted thoracoscopic surgery lobectomy.

    Science.gov (United States)

    Jensen, Katrine; Bjerrum, Flemming; Hansen, Henrik Jessen; Petersen, René Horsleben; Pedersen, Jesper Holst; Konge, Lars

    2015-10-01

    The aims of this study were to develop virtual reality simulation software for video-assisted thoracic surgery (VATS) lobectomy, to explore the opinions of thoracic surgeons concerning the VATS lobectomy simulator and to test the validity of the simulator metrics. Experienced VATS surgeons worked with computer specialists to develop a VATS lobectomy software for a virtual reality simulator. Thoracic surgeons with different degrees of experience in VATS were enrolled at the 22nd meeting of the European Society of Thoracic Surgeons (ESTS) held in Copenhagen in June 2014. The surgeons were divided according to the number of performed VATS lobectomies: novices (0 VATS lobectomies), intermediates (1-49 VATS lobectomies) and experienced (>50 VATS lobectomies). The participants all performed a lobectomy of a right upper lobe on the simulator and answered a questionnaire regarding content validity. Metrics were compared between the three groups. We succeeded in developing the first version of a virtual reality VATS lobectomy simulator. A total of 103 thoracic surgeons completed the simulated lobectomy and were distributed as follows: novices n = 32, intermediates n = 45 and experienced n = 26. All groups rated the overall user realism of the VATS lobectomy scenario to a median of 5 on a scale 1-7, with 7 being the best score. The experienced surgeons found the graphics and movements realistic and rated the scenario high in terms of usefulness as a training tool for novice and intermediate experienced thoracic surgeons, but not very useful as a training tool for experienced surgeons. The metric scores were not statistically significant between groups. This is the first study to describe a commercially available virtual reality simulator for a VATS lobectomy. More than 100 thoracic surgeons found the simulator realistic, and hence it showed good content validity. However, none of the built-in simulator metrics could significantly distinguish between novice, intermediate

  6. Current trends in robot assisted surgery: a survey of gynecologic oncologists.

    Science.gov (United States)

    duPont, Nefertiti C; Chandrasekhar, Rameela; Wilding, Gregory; Guru, Khurshid A

    2010-12-01

    To evaluate the perceptions of the importance and utility of robot assisted surgery in gynecologic oncology. A 39 question web-based survey was sent to members of the Society of Gynecologic Oncologists. The survey response rate was 28%, with 277 surveys completed. Nearly 40% of respondents felt robotic surgical training was required as a part of their career goals, and 73% of respondents have performed a robotic hysterectomy. Among respondents, 39% felt that robotic surgery was as good as laparoscopic surgery but 23% thought robot assisted surgery should be the gold standard for the treatment of endometrial cancer. Robot assisted surgery is gaining widespread acceptance and is perceived to be as good as laparoscopic surgery for the treatment of early stage endometrial and cervical cancers. Among respondents the greatest benefit of robot assisted surgery was its ease of use and perceived improvement in a patient's quality of life. Copyright © 2010 John Wiley & Sons, Ltd.

  7. Effect observation about eye movement training to cataract patients before surgery%白内障患者术前眼球运动训练的效果观察

    Institute of Scientific and Technical Information of China (English)

    马新荣

    2016-01-01

    目的:探讨术前眼球运动训练在白内障手术效果的支持。方法:对161名白内障患者进行有效的术前眼球运动训练。结果:161例患者经过术前眼球运动训练,手术效果良好未见明显并发症。结论:白内障患者手术前进行眼球运动训练,可使患者术中很好的配合手术,提高手术成功率。%Objective:Discuss the support of effects about eye movement training to cataract surgery.Method:By giving 161 preoperative cataract patients effective eye movement training.Result:after 161 cataract patients received preoperative eye movement training,they had good operation effects without apparent complications.Conclusion:If cataract patients receive eye movement training before surgery,they can cooperate more positively during operation,and the success rate of surgery will be improved greatly.

  8. Graduate Education and Simulation Training for CBRNE Disasters Using a Multimodal Approach to Learning. Part 2: Education and Training from the Perspectives of Educators and Students

    Science.gov (United States)

    2013-08-01

    develop new operating protocols and upgraded components. In addition, the center uses M256-A1 chemical-agent detector kits, ten robotic manikins, and... complications better because of the experience. Reading is a poor substitute. Videos are better than reading but as 2D presentations, fail to result...Factors and Safety in Surgery , research sponsored by the Federal Aviation Administration. Department of Psychology, University of Texas Human Research

  9. Thyroid Surgery

    Science.gov (United States)

    ... Fax/Phone Home » Thyroid Surgery Leer en Español Thyroid Surgery GENERAL INFORMATION Your doctor may recommend that ... made in conjunction with your endocrinologist and surgeon. Thyroid Surgery FAQs QUESTIONS AND CONSIDERATIONS When thyroid surgery ...

  10. Plastic Surgery

    Science.gov (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Plastic Surgery KidsHealth > For Teens > Plastic Surgery Print A A ... forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word "plastic" ...

  11. Quality of Documentation as a Surrogate Marker for Awareness and Training Effectiveness of PHTLS-Courses. Part of the Prospective Longitudinal Mixed-Methods EPPTC-Trial

    Science.gov (United States)

    Beckers, Stefan K.; Hofmann, Marzellus; Lefering, Rolf; Gliwitzky, Bernhard; Wölfl, Christoph C.; Grützner, Paul; Stöckle, Ulrich; Dieroff, Marc; Münzberg, Matthias

    2017-01-01

    Objective Care for severely injured patients requires multidisciplinary teamwork. A decrease in the number of accident victims ultimately affects the routine and skills. PHTLS (“Pre-Hospital Trauma Life Support”) courses are established two-day courses for medical and non-medical rescue service personnel, aimed at improving the pre-hospital care of trauma patients worldwide. The study aims the examination of the quality of documentation before and after PHTLS courses as a surrogate endpoint of training effectiveness and awareness. Methods This was a prospective pre-post intervention trial and was part of the mixed-method longitudinal EPPTC (Effect of Paramedic Training on Pre-Hospital Trauma Care) study, evaluating subjective and objective changes among participants and real patient care, as a result of PHTLS courses. The courses provide an overview of the SAMPLE approach for interrogation of anamnestic information, which is believed to be responsible for patient safety as relevant, among others, “Allergies,” “Medication,” and “Patient History” (AMP). The focus of the course is not the documentation. Results In total, 320 protocols were analyzed before and after the training. The PHTLS course led to a significant increase (p effectiveness and awareness. In this regard, we demonstrated that participants use certain parts of training in real life, thereby suggesting that the learning methods of PHTLS training are effective. These results, however, do not indicate whether patient care has changed. PMID:28107394

  12. An analytical drilling force model and GPU-accelerated haptics-based simulation framework of the pilot drilling procedure for micro-implants surgery training.

    Science.gov (United States)

    Zheng, Fei; Lu, Wen Feng; Wong, Yoke San; Foong, Kelvin Weng Chiong

    2012-12-01

    The placement of micro-implants is a common but relatively new surgical procedure in clinical dentistry. This paper presents a haptics-based simulation framework for the pilot drilling of micro-implants surgery to train orthodontists to successfully perform this essential procedure by tactile sensation, without damaging tooth roots. A voxel-based approach was employed to model the inhomogeneous oral tissues. A preprocessing pipeline was designed to reduce imaging noise, smooth segmentation results and construct an anatomically correct oral model from patient-specific data. In order to provide a physically based haptic feedback, an analytical drilling force model based on metal cutting principles was developed and adapted for the voxel-based approach. To improve the real-time response, the parallel computing power of Graphics Processing Units is exploited through extra efforts for data structure design, algorithms parallelization, and graphic memory utilization. A prototype system has been developed based on the proposed framework. Preliminary results show that, by using this framework, proper drilling force can be rendered at different tissue layers with reduced cycle time, while the visual display has also been enhanced.

  13. Web-Based Simulation in Psychiatry Residency Training: A Pilot Study

    Science.gov (United States)

    Gorrindo, Tristan; Baer, Lee; Sanders, Kathy M.; Birnbaum, Robert J.; Fromson, John A.; Sutton-Skinner, Kelly M.; Romeo, Sarah A.; Beresin, Eugene V.

    2011-01-01

    Background: Medical specialties, including surgery, obstetrics, anesthesia, critical care, and trauma, have adopted simulation technology for measuring clinical competency as a routine part of their residency training programs; yet, simulation technologies have rarely been adapted or used for psychiatry training. Objective: The authors describe…

  14. Hearing loss prevention for carpenters: part 1 - using health communication and health promotion models to develop training that works.

    Science.gov (United States)

    Stephenson, Carol Merry; Stephenson, Mark R

    2011-01-01

    In phase 1 of a large multiyear effort, health communication and health promotion models were used to develop a comprehensive hearing loss prevention training program for carpenters. Additionally, a survey was designed to be used as an evaluation instrument. The models informed an iterative research process in which the authors used key informant interviews, focus groups, and early versions of the survey tool to identify critical issues expected to be relevant to the success of the hearing loss prevention training. Commonly held attitudes and beliefs associated with occupational noise exposure and hearing losses, as well as issues associated with the use or non-use of hearing protectors, were identified. The training program was then specifically constructed to positively shape attitudes, beliefs, and behavioral intentions associated with healthy hearing behaviors - especially those associated with appropriate hearing protector use. The goal was to directly address the key issues and overcome the barriers identified during the formative research phase. The survey was finalized using factor analysis methods and repeated pilot testing. It was designed to be used with the training as an evaluation tool and thus could indicate changes over time in attitudes, beliefs, and behavioral intentions regarding hearing loss prevention. Finally, the training program was fine tuned with industry participation so that its delivery would integrate seamlessly into the existing health and safety training provided to apprentice carpenters. In phase 2, reported elsewhere in this volume, the training program and the survey were tested through a demonstration project at two sites.

  15. Hearing loss prevention for carpenters: Part 1 - Using health communication and health promotion models to develop training that works

    Directory of Open Access Journals (Sweden)

    Carol Merry Stephenson

    2011-01-01

    Full Text Available In phase 1 of a large multiyear effort, health communication and health promotion models were used to develop a comprehensive hearing loss prevention training program for carpenters. Additionally, a survey was designed to be used as an evaluation instrument. The models informed an iterative research process in which the authors used key informant interviews, focus groups, and early versions of the survey tool to identify critical issues expected to be relevant to the success of the hearing loss prevention training. Commonly held attitudes and beliefs associated with occupational noise exposure and hearing losses, as well as issues associated with the use or non-use of hearing protectors, were identified. The training program was then specifically constructed to positively shape attitudes, beliefs, and behavioral intentions associated with healthy hearing behaviors - especially those associated with appropriate hearing protector use. The goal was to directly address the key issues and overcome the barriers identified during the formative research phase. The survey was finalized using factor analysis methods and repeated pilot testing. It was designed to be used with the training as an evaluation tool and thus could indicate changes over time in attitudes, beliefs, and behavioral intentions regarding hearing loss prevention. Finally, the training program was fine tuned with industry participation so that its delivery would integrate seamlessly into the existing health and safety training provided to apprentice carpenters. In phase 2, reported elsewhere in this volume, the training program and the survey were tested through a demonstration project at two sites.

  16. 数字化三维手术模拟在正颌外科专科医师培训中的应用%Application of digital three-dimensional surgical simulation system in specialist training of orthognathic surgery

    Institute of Scientific and Technical Information of China (English)

    沈末伦; 王旭东

    2016-01-01

    牙颌面畸形患者面部形态异常和咬合功能障碍常较严重,需要采用正颌—正畸联合治疗的方法进行矫正。治疗牙颌面畸形的正颌手术术野狭小、操作复杂、风险较大,其手术教学和操作培训手段有限,限制了此类技术的推广应用。文章介绍了将数字化三维手术设计与模拟系统应用于正颌外科专科医师培训,可取得良好的手术教学效果。实践表明,通过手术虚拟操作,可使受训医师加深对牙颌面畸形和正颌外科手术的理解。%Patients with dento-maxillofacial deformities often suffer relatively severe facial anomalies and occlusal dysfunction, which need to be corrected with combined orthodontic and orthognathic treatment.Orthognathic surgery is very complicated with narrow operative field and relatively high risk.The means of orthognathic surgery teaching and operation training are limited,which restricts the promotion of orthognathic surgical technology.In this study,a digital three-dimensional surgical design and simulation system was applied to specialist training of orthognathic surgery with satisfactory results.Practice proves that through virtual operation training,the trained surgeons obtained a deeper understanding of dento-maxillofacial deformities and orthognathic surgery.

  17. Construction of Teaching Practical Training System for Chinese Medicine Acupuncture Surgery%中医针灸外科学实训教学体系的构建

    Institute of Scientific and Technical Information of China (English)

    董宝强; 王树东

    2011-01-01

    高等中医院校中医针灸外科学教学多以理论讲授为主,并受到教学资源的限制,学生实践操作能力较差.作者多年来通过丰富实训教学内容、尝试PBL等多元化教学模式、实施阶段性实践培训和多站式技能考核方法、加强教师临床技能等手段,不断完善中医针灸外科学实训教学体系,全面提高了学生的思维创新能力及中医外科临床技能.%The Theory teaching is the main way in the Chinese medicine acupuncture Surgery in Higher TCM Colleges, and the students' practical operating abilities were poor because of the teaching resources limitation.The author has been perfected the Teaching Practical Training System of Chinese medicine acupuncture Surgery for years, by rich the Training Teaching content, try to use the multiple teaching such as PBL, carry out the practice training by stage and multistate skill examination method, as well as enhance the teachers' clinical skills, which make overall improvement in students' thinking innovative ability and the clinical skills of TCM Surgery innovative ability.

  18. Quality of Documentation as a Surrogate Marker for Awareness and Training Effectiveness of PHTLS-Courses. Part of the Prospective Longitudinal Mixed-Methods EPPTC-Trial.

    Science.gov (United States)

    Häske, David; Beckers, Stefan K; Hofmann, Marzellus; Lefering, Rolf; Gliwitzky, Bernhard; Wölfl, Christoph C; Grützner, Paul; Stöckle, Ulrich; Dieroff, Marc; Münzberg, Matthias

    2017-01-01

    Care for severely injured patients requires multidisciplinary teamwork. A decrease in the number of accident victims ultimately affects the routine and skills. PHTLS ("Pre-Hospital Trauma Life Support") courses are established two-day courses for medical and non-medical rescue service personnel, aimed at improving the pre-hospital care of trauma patients worldwide. The study aims the examination of the quality of documentation before and after PHTLS courses as a surrogate endpoint of training effectiveness and awareness. This was a prospective pre-post intervention trial and was part of the mixed-method longitudinal EPPTC (Effect of Paramedic Training on Pre-Hospital Trauma Care) study, evaluating subjective and objective changes among participants and real patient care, as a result of PHTLS courses. The courses provide an overview of the SAMPLE approach for interrogation of anamnestic information, which is believed to be responsible for patient safety as relevant, among others, "Allergies," "Medication," and "Patient History" (AMP). The focus of the course is not the documentation. In total, 320 protocols were analyzed before and after the training. The PHTLS course led to a significant increase (p PHTLS course showed a significant increase in the information content. In summary, we showed that PHTLS training improves documentation quality, which we used as a surrogate endpoint for learning effectiveness and awareness. In this regard, we demonstrated that participants use certain parts of training in real life, thereby suggesting that the learning methods of PHTLS training are effective. These results, however, do not indicate whether patient care has changed.

  19. Construction of a valid online training model from the point of view of the student as part of their study discipline

    Directory of Open Access Journals (Sweden)

    Itziar Portillo Morales

    2007-05-01

    Full Text Available Since the virtual training modality first came into being, there has been a growing interest in identifying the factors that determine the success of an online training system. Technological, economic and pedagogical approaches have provided information about what, from each field, has been considered to be the key factors of success.However, and as this new training modality becomes established, it is essential to know the student's opinion with regard to what, from the user's point of view, is considered to be efficient or valid and determinant of the success of a virtual teaching-learning system. If the virtual student becomes the protagonist in the learning process, acting according to operating guidelines based on maturity and autonomy (Bautista et al., p. 34, shouldn't they also take part in designing the teaching system?Without losing sight of each training experience being conditioned by a series of factors that determine the structure of what would be a specific virtual training model, we meet as many types of models as specific needs of each student. However, these models will necessarily have to share a series of common elements that will make up the framework of a virtual teaching-learning system, on which will have to be added the didactic and technological element in the exact measure so that they provide the student with exactly what they ask for.

  20. Development of plastic surgery

    Directory of Open Access Journals (Sweden)

    Pećanac Marija Đ.

    2015-01-01

    Full Text Available Introduction. Plastic surgery is a medical specialty dealing with corrections of defects, improvements in appearance and restoration of lost function. Ancient Times. The first recorded account of reconstructive plastic surgery was found in ancient Indian Sanskrit texts, which described reconstructive surgeries of the nose and ears. In ancient Greece and Rome, many medicine men performed simple plastic cosmetic surgeries to repair damaged parts of the body caused by war mutilation, punishment or humiliation. In the Middle Ages, the development of all medical braches, including plastic surgery was hindered. New age. The interest in surgical reconstruction of mutilated body parts was renewed in the XVIII century by a great number of enthusiastic and charismatic surgeons, who mastered surgical disciplines and became true artists that created new forms. Modern Era. In the XX century, plastic surgery developed as a modern branch in medicine including many types of reconstructive surgery, hand, head and neck surgery, microsurgery and replantation, treatment of burns and their sequelae, and esthetic surgery. Contemporary and future plastic surgery will continue to evolve and improve with regenerative medicine and tissue engineering resulting in a lot of benefits to be gained by patients in reconstruction after body trauma, oncology amputation, and for congenital disfigurement and dysfunction.

  1. Evaluation of JSAF EM Propagation Prediction Methods for Navy Continuous Training Environment/Fleet Synthetic Training Results and Recommendations: Part 1 - Evaluation of Current JSAF EM Propagation Modeling

    Science.gov (United States)

    2012-12-01

    FFACTR” which is a part of the Engineers Refractive Index Prediction System (EREPS) Tactical Decision Aid ( TDA ) developed by what is now SPAWARS SSC San...currently used in JSAF is “FFACTR” which is a part of the Engineers Refractive Index Prediction System (EREPS) Tactical Decision Aid ( TDA ) developed by what...Decision Aid ( TDA ) developed by what is now SPAWARS SSC San Diego in 1988. This model is no longer supported by SPAWARS or any other group and has been

  2. Survey of the patients with cleft lip and palate in China who were funded for surgery by the Smile Train Program from 2000 to 2002

    Institute of Scientific and Technical Information of China (English)

    ZHOU Qiao-juan; SHI Bing; SHI Zong-dao; ZHENG Qian; WANG Yan

    2006-01-01

    Background Cleft lip (CL) and cleft palate (CP) are two of the most frequent congenital malformations.Many epidemiologic studies on this deformity have been conducted worldwide, often producing inconsistent results. This study assessed epidemiology and some genetic aspects of cleft lip and palate in a Chinese sample from the Smile Train Program and to compare with other methodologically sound surveys.Methods The general information, family history, classification of cleft and associated malformations of 8000CL and CP surgery patients were analyzed.Results Of the 8000 cases, 7812 had complete data. The distribution of cleft types is 17.04% with CP, 23.39%with CL and 59.58% with cleft lip and palate (CLP). Unilateral clefts were more common than bilateral, with involved 29 CP cases, 41 CL and 156 CLP. The frequency of associated malformations in CLP (3.35%) was higher than CL (2.24%) and CP (2.22%) (P<0.05). Patients with CP or CLP were born less often in the winter than in the summer (P<0.05). A history of family members having clefts occurred in 6.84% of patients. The proportion of CLP cases (7.56%) was significantly higher than that of CL cases (5.64%) (P<0.05).Conclusions The different types of clefts appeared in the highest proportion in CLP and lowest proportion in CP. Males are more common with CL and CLP and less common with CP. These characteristics are the same as those of other Chinese surveys but different from some European reports.

  3. Training for MIS in pediatric urology: proposition of a structured training curriculum.

    Science.gov (United States)

    Escolino, Maria; Turrà, Francesco; Settimi, Alessandro; Esposito, Ciro

    2016-10-01

    In Europe there are a lot of training centers for minimally invasive surgery (MIS) but a standardized MIS training program in pediatric urology doesn't exist at the moment. We performed a literature review with the last goals to propose a structured training curriculum in MIS urology for pediatric surgeons. Pediatric urologists have to obtain a valid MIS training curriculum completing the following 4 steps: (I) Theoretical part (theoretical courses, masterclass) to acquire theoretical knowledge; (II) experimental training (simulation on pelvic trainer, virtual reality simulators, animal models, 3-D ex-vivo models) to acquire basic laparoscopic skills; (III) stages in European centers of reference for pediatric MIS urology to learn all surgery aspects; (IV) personal operative experience. At the end of the training period, the trainee would be expected to perform several MIS urological procedures independently, under supervision of an expert tutor. At the end of the training program, each center will analyze the candidate training booklet and release for each applicant a certification after an exam. We think that this MIS training program in pediatric urology may assure an integrated acquisition of basic and advanced laparoscopic skills during residency training in pediatric urology. Each European country should adopt this program so as to secure a standardized technical qualification in MIS urology for all future pediatric urologists.

  4. Master’s Training as a Part of Young Researcher’S Professional Development: British and Ukrainian Experience

    Directory of Open Access Journals (Sweden)

    Bidyuk Natalya

    2014-09-01

    Full Text Available The problem of the professional development of young researchers in terms of Master’s training has been analyzed. The analysis of the literature references, documental and other sources gave grounds to state that the basic principle of Master’s professional training is a research-oriented paradigm. The necessity of using the innovative ideas of foreign experience for improving the quality of Master's education due to European approaches has been proved. It has been stressed that the main task of Master’s programs is the preparation of young researchers for the next stage of their career both in research activities and success achievement in various fields of employment, assistance and creation of opportunities as well as optimal conditions for their contribution to the research of a particular scientific field or discipline. An important source for defining strategic priorities of solving the problems of Master’s professional training is studying and analyzing theoretical and practical experience of leading countries (USA, Australia and UK. The features of Masters’ research training in the British experience and the ways of supporting and developing the research activities and fostering Master's professional development in UK and Ukraine have been studied. It has been considered that Master’s training should be realized on the basis of such theories as social, human, intellectual and cultural capital, career orientation, constructive and cognitive concepts, continuing education and adult education, learner-centered education, comparative studies.

  5. Training a cataract surgeon

    Directory of Open Access Journals (Sweden)

    M Babar Qureshi

    2014-07-01

    Full Text Available Training in cataract surgery is one of the key factors needed to ensure high quality cataract surgery with good visual outcomes and patient satisfaction. The training has to impart the right skills to the right person by the right trainer and in the right environment.

  6. Functional outcomes of cleft lip surgery. Part I: Study design and surgeon ratings of lip disability and need for lip revision

    National Research Council Canada - National Science Library

    Trotman, Carroll-Ann; Phillips, Ceib; Essick, Greg K; Faraway, Julian J; Barlow, Steven M; Losken, H Wolfgang; van Aalst, John; Rogers, Lyna

    2007-01-01

    .... In this article, the design of the clinical trial is described and results of a study on subjective evaluations of facial form by surgeons for or against the need for lip revision surgery are presented...

  7. Lung surgery

    Science.gov (United States)

    ... Pneumonectomy; Lobectomy; Lung biopsy; Thoracoscopy; Video-assisted thoracoscopic surgery; VATS ... You will have general anesthesia before surgery. You will be asleep and unable to feel pain. Two common ways to do surgery on your lungs are thoracotomy and video- ...

  8. Turbinate surgery

    Science.gov (United States)

    Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery; Nasal obstruction - turbinate surgery ... There are several types of turbinate surgery: Turbinectomy: All or ... This can be done in several different ways, but sometimes a ...

  9. Cataract Surgery

    Science.gov (United States)

    ... and Videos: What Do Cataracts Look Like? Cataract Surgery Written By: Kierstan Boyd Reviewed By: Elena M ... how they work. What to expect with cataract surgery Before surgery: Your ophthalmologist will measure your eye ...

  10. Simulation Training in Hysteroscopic Surgery

    NARCIS (Netherlands)

    Janse, J.A.

    2014-01-01

    Hysteroscopy detects uterine cavity pathology by direct visualisation of the endometrial lining, making use of a vaginally inserted endoscope. The additional insertion of an instrument through the endoscope provides the opportunity for obtainment of histology and treatment of pathologies, and for st

  11. [Crohn's disease surgery].

    Science.gov (United States)

    Kala, Zdeněk; Marek, Filip; Válek, Vlastimil A; Bartušek, Daniel

    2014-01-01

    Surgery of Crohns disease is an important part of the general treatment algorithm. The role of surgery is changing with the development of conservative procedures. The recent years have seen the return to early treatment of patients with Crohns disease. Given the character of the disease and its intestinal symptoms, a specific approach to these patients is necessary, especially regarding the correct choice of surgery. The paper focuses on the luminal damage of the small and large intestine including complications of the disease. We describe the individual indications for a surgical solution, including the choice of anastomosis or multiple / repeated surgeries.

  12. The Computer in Education and Training. Report of the Main Committee of the HSRC Education Research Programme. Part 1.

    Science.gov (United States)

    Human Sciences Research Council, Pretoria (South Africa).

    This report presents findings and recommendations of an investigation that surveyed and evaluated the current educational situation in South Africa and offered recommendations on the use of computers in education and training. The following concerns are discussed: computers in formal and nonformal education; strategies for the introduction of…

  13. Survey Instrument Validity Part I: Principles of Survey Instrument Development and Validation in Athletic Training Education Research

    Science.gov (United States)

    Burton, Laura J.; Mazerolle, Stephanie M.

    2011-01-01

    Context: Instrument validation is an important facet of survey research methods and athletic trainers must be aware of the important underlying principles. Objective: To discuss the process of survey development and validation, specifically the process of construct validation. Background: Athletic training researchers frequently employ the use of…

  14. Collegiate Aviation Maintenance Training Programs Certified under 14CFR Part 147 that Are Members of the Aviation Technician Education Council

    Science.gov (United States)

    Hunt, Terry Lile

    2010-01-01

    Scope and method of study: The purpose of this study was to construct a descriptive analysis of aviation maintenance training programs that confer the Bachelor of Science degree and who are members of the Aviation Technician Education Council. The sample was comprised of the 11 educational programs within the population that met these criteria.…

  15. Collegiate Aviation Maintenance Training Programs Certified under 14CFR Part 147 that Are Members of the Aviation Technician Education Council

    Science.gov (United States)

    Hunt, Terry Lile

    2010-01-01

    Scope and method of study: The purpose of this study was to construct a descriptive analysis of aviation maintenance training programs that confer the Bachelor of Science degree and who are members of the Aviation Technician Education Council. The sample was comprised of the 11 educational programs within the population that met these criteria.…

  16. Technical Vocational Education and Training for Micro-Enterprise Development in Ethiopia: A Solution or Part of the Problem?

    Science.gov (United States)

    Gondo, Tendayi; Dafuleya, Gift

    2010-01-01

    Technical vocational education and training (TVET) programmes have recently received increased attention as an area of priority for stimulating growth in developed and developing countries. This paper considers the situation in Ethiopia where the promotion of micro and small-sized enterprises (MSEs) has been central to the development and…

  17. Technical Vocational Education and Training for Micro-Enterprise Development in Ethiopia: A Solution or Part of the Problem?

    Science.gov (United States)

    Gondo, Tendayi; Dafuleya, Gift

    2010-01-01

    Technical vocational education and training (TVET) programmes have recently received increased attention as an area of priority for stimulating growth in developed and developing countries. This paper considers the situation in Ethiopia where the promotion of micro and small-sized enterprises (MSEs) has been central to the development and…

  18. Multimedia and Training: Practice and Skills of European Producers, (Part 1) Results of the European Project "START-UP."

    Science.gov (United States)

    Gutierrez, Christine Gardiol; Boder, Andre

    1992-01-01

    Describes the START-UP project developed by the European Community to identify educational and training multimedia producers in European countries and to define the methodologies that these producers use in developing their products. Highlights include production stages, multimedia skills, teamwork, decision making, learning processes, learner…

  19. 临床护理兼职教师培训模式的研究%Study on the training model of clinical nursing part-time teachers

    Institute of Scientific and Technical Information of China (English)

    汪建国; 鲁娟; 曾友燕

    2010-01-01

    本文介绍了教学医院临床护理兼职教师培训模式的实践过程,探讨了临床护理兼职教师的聘任条件、选聘程序、教学培训、绩效考评等师资队伍建设关键环节的举措.强调要提高临床护理教学质量,必须树立以学生为中心的教育观,建立兼职教师准入制度、设立有效的竞争激励机制和科学、公正的兼职教师教学评价体系,稳定和促进临床护理兼职教师队伍的可持续发展.%An effective training model of clinical part-time nursing teachers was introduced in this article, and its key measures including the part-time teachers' qualification, the procedure to engage, teaching skill training plan, performance review were defined.It emphasize that the students-centered educational view, scientific part-time nursing teachers' admittance system, effective competition mechanism and fair teaching evaluation system are not only helpful for the stability and continual development of clinical part-time nursing staff but also improving the quality of clinical nursing education.

  20. Relaxation strategies for patients during dermatologic surgery.

    Science.gov (United States)

    Shenefelt, Philip D

    2010-07-01

    Patient stress and anxiety are common preoperatively and during dermatologic procedures and surgeries. Stress and anxiety can occasionally interfere with performance of procedures or surgery and can induce hemodynamic instability, such as elevated blood pressure or syncope, as well as producing considerable discomfort for some patients. Detection of excess stress and anxiety in patients can allow the opportunity for corrective or palliative measures. Slower breathing, biofeedback, progressive muscular relaxation, guided imagery, hypnosis, meditation and music can help calm and rebalance the patient's autonomic nervous system and immune functioning. Handheld miniaturized heart rate variability biofeedback devices are now available. The relaxation response can easily be taught. Guided imagery can be recorded or live. Live rapid induction hypnosis followed by deepening and then self-guided imagery requires no experience on the part of the patient but does require training and experience on the part of a provider. Recorded hypnosis inductions may also be used. Meditation generally requires more prior experience and training, but is useful when the patient already is skilled in it. Live, guided meditation or meditation recordings may be used. Relaxing recorded music from speakers or headphones or live performance music may also be employed to ease discomfort and improve the patient's attitude for dermatologic procedures and surgeries.

  1. Surgery Risk Assessment (SRA) Database

    Data.gov (United States)

    Department of Veterans Affairs — The Surgery Risk Assessment (SRA) database is part of the VA Surgical Quality Improvement Program (VASQIP). This database contains assessments of selected surgical...

  2. Weight Loss Surgery (Bariatric Surgery) (For Parents)

    Science.gov (United States)

    ... to Be Smart About Social Media Weight Loss Surgery (Bariatric Surgery) KidsHealth > For Parents > Weight Loss Surgery (Bariatric Surgery) ... bariatric surgery might be an option. About Bariatric Surgery Bariatric surgery had its beginnings in the 1960s, ...

  3. The non-medical workforce and its role in surgical training: Consensus recommendations by the Association of Surgeons in Training.

    Science.gov (United States)

    Gokani, Vimal J; Peckham-Cooper, Adam; Bunting, David; Beamish, Andrew J; Williams, Adam; Harries, Rhiannon L

    2016-11-01

    Changes in the delivery of the healthcare structure have led to the expansion of the non-medical workforce (NMW). The non-medical practitioner in surgery (a healthcare professional without a medical degree who undertakes specialist training) is a valuable addition to a surgical firm. However, there are a number of challenges regarding the successful widespread implementation of this role. This paper outlines a number of these concerns, and makes recommendations to aid the realisation of the non-medical practitioner as a normal part of the surgical team. In summary, the Association of Surgeons in Training welcomes the development of the non-medical workforce as part of the surgical team in order to promote enhanced patient care and improved surgical training opportunities. However, establishing a workforce of independent/semi-independent practitioners who compete for the same training opportunities as surgeons in training may threaten the UK surgical training system, and therefore the care of our future patients.

  4. [Robotic surgery in gynecology].

    Science.gov (United States)

    Csorba, Roland

    2012-06-24

    Minimally invasive surgery has revolutionized gynecological interventions over the past 30 years. The introduction of the da Vinci robotic surgery in 2005 has resulted in large changes in surgical management. The robotic platform allows less experienced laparoscopic surgeons to perform more complex procedures. It can be utilized mainly in general gynecology and reproductive gynecology. The robot is being increasingly used for procedures such as hysterectomy, myomectomy, adnexal surgery, and tubal anastomosis. In urogynecology, the robot is being utilized for sacrocolopexy as well. In the field of gynecologic oncology, the robot is being increasingly used for hysterectomy and lymphadenectomy in oncologic diseases. Despite the rapid and widespread adaption of robotic surgery in gynecology, there are no randomized trials comparing its efficacy and safety to other traditional surgical approaches. This article presents the development, technical aspects and indications of robotic surgery in gynecology, based on the previously published reviews. Robotic surgery can be highly advantageous with the right amount of training, along with appropriate patient selection. Patients will have less blood loss, less post-operative pain, faster recovery, and fewer complications compared to open surgery and laparoscopy. However, until larger randomized control trials are completed which report long-term outcomes, robotic surgery cannot be stated to have priority over other surgical methods.

  5. Algorithm for planning a double-jaw orthognathic surgery using a computer-aided surgical simulation (CASS) protocol. Part 1: planning sequence.

    Science.gov (United States)

    Xia, J J; Gateno, J; Teichgraeber, J F; Yuan, P; Chen, K-C; Li, J; Zhang, X; Tang, Z; Alfi, D M

    2015-12-01

    The success of craniomaxillofacial (CMF) surgery depends not only on the surgical techniques, but also on an accurate surgical plan. The adoption of computer-aided surgical simulation (CASS) has created a paradigm shift in surgical planning. However, planning an orthognathic operation using CASS differs fundamentally from planning using traditional methods. With this in mind, the Surgical Planning Laboratory of Houston Methodist Research Institute has developed a CASS protocol designed specifically for orthognathic surgery. The purpose of this article is to present an algorithm using virtual tools for planning a double-jaw orthognathic operation. This paper will serve as an operation manual for surgeons wanting to incorporate CASS into their clinical practice.

  6. Design of Virtual Surgery Training Platform System for Navy Medical Team%海上医疗队虚拟手术训练平台系统的设计

    Institute of Scientific and Technical Information of China (English)

    罗晶; 王海威; 王德利; 丁宇; 王全玉; 王宏

    2012-01-01

    Objective To design a surgical training platform system suitable for sea swing, heave, and bumpy environment for the navy medical team of different surgical specialties. Methods The virtual surgery training platform system was designed to solve the problems including mobile portability and environmental adaptability by utilization of truckle with brake, fixing with magnetic materials and bracket, etc. The virtual surgery training platform system integrated force -feedback device, graphic workstation as well as three-dimensional display device to build a software-hardware combination system in order to simulate and imitate various martial circumstances. Results During the "Harmonious Mission2011", the medical team used this system to do the simulation training for the tibia and fibula fracture fixation. The system achieved the design requirements and could be used to do virtual surgery training in different maritime environment. Conclusion The application of the system can improve the availability and pertinence of the treatment skills training for the medical team, so as to promote the ability of martial medical treatment.%目的:研制一种适用于海上摇摆、垂荡、颠簸环境下,海上医疗队进行跨学科专业的手术训练平台系统.方法:为解决移动便携和海上舰船环境适应性问题,采取带刹车滚轮、磁性材料固定、支架固定等措施,以集成力反馈设备、图形工作站、三维立体显示等设备建立该系统,设计能够模拟不同海况环境条件的移动虚拟手术训练平台系统.结果:在海军执行和谐使命系列任务中,医疗队员使用该系统进行胫腓骨骨折内固定术的模拟训练.经实际检验,该系统实现了设计要求,可在不同海上环境下提供虚拟手术训练.结论:该系统的应用,能提高海上医疗队员海战救治技能训练的针对性和有效性,从而有利于提高海上医疗救治能力.

  7. [Haemorrhage after thyroid surgery].

    Science.gov (United States)

    Swirta, Jarosław S; Barczyński, Marcin

    2014-01-01

    Haemorrhage after thyroid surgery is rare, but if it occurs it is a life-threatening condition necessitating emergency surgery. The aim of this study was to evaluate prevalence and risk factors of haemorrhage after thyroid surgery. A retrospective analysis was undertaken in a group of 8931 consecutive patients with various thyroid diseases treated in 2004-2013 at our institution. Potential risk factors for postoperative haemorrhage after thyroid surgery were analysed using logistic regression model. Haemorrhage after thyroid operation necessitating emergency surgery occurred in 40 (0.45%) of 8931 patients. None of the patients died within the perioperative period. Bleeding occurred within first 24 hours following surgery in 38 (95%) patients, and in the remaining 2 (5%) patients in more than 24 hours after initial surgery. The following risk factors for bleeding after thyroid operation were identified: male sex (OR 3.618; 1.762-7.430; p or = 70 years (OR 3.052; 1.275-7.304; p = 0.012), surgery for hyperthyroidism (OR 2.873; 1.511-5.462; p = 0.001), smoking (OR 2.855; 1.502-5.428; p = 0.001), subtotal thyroidectomy in contrast to total thyroidectomy or lobectomy (OR 2.853; 1.356-6.004; p=0.006), and thyroid operation undertaken by resident in training in general surgery (OR 2.596; 1.393-4.837; p = 0.003). Haemorrhage after thyroid operation necessitating emergency surgical intervention occurs most frequently within first 24 hour following surgery. Hence, for safety reasons a minimum of 24-hour hospital stay is recommended in all patients with risk factors for postoperative bleeding after thyroid operation. Quality monitoring of thyroid surgery should include also risk factors for postoperative bleeding.

  8. Encuesta de opinión sobre la cirugía mayor ambulatoria en la formación del residente de especialidades quirúrgicas Opinion survey of the effect of major ambulatory surgery on the training of surgical residents

    Directory of Open Access Journals (Sweden)

    Carlos Martínez Ramos

    2004-12-01

    Full Text Available Introducción: La progresiva implantación en nuestro pais de la Cirugía Mayor Ambulatoria (CMA puede afectar a la enseñanza de la cirugía, si consideramos el desplazamiento presente y futuro hacia las Unidades de CMA de intervenciones quirúrgicas muy frecuentes, de riesgo medio y bajo, que constituyen la base del aprendizaje quirúrgico. El objetivo del presente trabajo es 1º conocer la opinión de los residentes de especialidades quirúrgicas sobre la repercusión que la CMA puede tener en su formación quirúrgica y 2º conocer las posibles soluciones que aportan en este sentido. Material y Métodos: Se ha realizado una encuesta de 17 preguntas (13 cerradas, 2 abiertas y 1 mixta a 72 residentes pertenecientes a 7 de las especialidades quirúrgicas que participan en la Unidad de CMA del Hospital Clínico San Carlos de Madrid. Resultados: La encuesta ha sido cumplimentada por el 36,1% de los residentes. De ellos, el 100% considera que: 1 es importante conocer y formarse en este tipo de cirugía. 2 las técnicas quirúrgicas que se realizan en la UCMA del Hospital son fundamentales para la formación del residente. 3 la Cirugía Mayor Ambulatoria debe incluirse en la formación de su especialidad durante el periodo de residencia. El 80,8% considera que tener formación en CMA contribuye a mejorar las expectativas laborales una vez finalizada la residencia. Conclusiones: Los residentes consideran que es necesaria su participación en la actividad de las Unidades de CMA, necesitándose, en este sentido, la creación de programas bien estructurados, elaborados y coordinados. Estos han de estar consensuados por todas las partes afectadas y se han de adaptar a las características de cada especialidad.Introduction: The progressive introduction in our country of Major Ambulatory Surgery (MAS may affect the training of surgical residents. The type of operations that may now be performed at MAS Units (frequent medium and low risk operations

  9. Real-Time Augmented Reality for Robotic-Assisted Surgery

    DEFF Research Database (Denmark)

    Jørgensen, Martin Kibsgaard; Kraus, Martin

    2015-01-01

    Training in robotic-assisted minimally invasive surgery is crucial, but the training with actual surgery robots is relatively expensive. Therefore, improving the efficiency of this training is of great interest in robotic surgical education. One of the current limitations of this training is the ...

  10. Application of operation robot in standardization training for resident docto rs in general surgery%机器人手术教学在普通外科住院医师规范化培训中的应用

    Institute of Scientific and Technical Information of China (English)

    程鹏; 李丽; 胡先贵; 张浩; 赵志青

    2015-01-01

    目的:为了提高普通外科住院医师规范化培训中的临床教学效果。方法我们将基于机器人手术的教学模式有针对性地初步应用到普外科临床教学中,将107名规范化培训的住院医师分两组:传统方法手术教学组(51人)和手术机器人教学组(56人)。将两组相关教学效果用SPSS软件统计对比分析。结果发现该教学模式在普通外科住院医师规范化培训的中具有其独特的优势,能使培训的住院医师更仔细观察腹部的解剖,普外科疾病特征和手术操作的细节,提升他们的学习腹部手术的兴趣,优化临床教学效果。结论运用该教学模式可提升普通外科的住院医师规范化培训的临床教学的实际效果。%Objective To improve the teaching of general surgery effect of standardization training of residents.Methods We apllied the robot operation mode of teaching into clinical teaching of department of general surgery, the 107 resident doctors of standardized training is divided into two groups:the traditional method of teaching operation group and operation robot teaching group . Comparative analysis of two groups of related teaching effect was done by using the SPSS software. Results We found that it had its unique advantages in surgery teaching:making the resident doctors successfully observe the abdominal anatomy and operation details, improving their learning interest and confidence of abdominal surgery, optimizing the learning effect. Conclusion So the teaching mode with operation robotic can improve teaching effect of the resident standardization training in general surgery.

  11. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  12. Dental Implant Surgery

    Science.gov (United States)

    ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  13. Influences on Faculty Willingness to Mentor Undergraduate Students from Another University as Part of an Interinstitutional Research Training Program.

    Science.gov (United States)

    Morales, Danielle X; Grineski, Sara E; Collins, Timothy W

    2016-01-01

    In 2014, the National Institutes of Health invested $31 million in 10 primary institutions across the United States through the Building Undergraduate Infrastructure Leading to Diversity (BUILD) program; one requirement of BUILD is sending undergraduate trainees from those primary institutions to partner institutions for research experiences. Mechanisms like BUILD are designed to broaden research opportunities for students, especially those from underrepresented backgrounds. However, to our knowledge, no studies have examined faculty willingness to mentor undergraduates from other institutions through structured training programs. Survey data from 536 faculty members at 13 institutions were collected in Fall 2013 and analyzed using multiple statistical techniques. Results show that faculty who valued the opportunity to increase diversity in the academy and those who believed that mentoring undergraduates benefited their own research expressed greater willingness to serve as research mentors to visiting undergraduates, and faculty who perceived that they did not have the ability to accommodate additional students expressed less willingness to do so. Most respondents viewed student and faculty incentives as motivating factors in their willingness to mentor, but their perspectives on different types of incentives varied based on faculty career stage, discipline, and research funding status. Results have important implications for designing multi-institutional undergraduate research training programs.

  14. [Endovascular surgery in the war].

    Science.gov (United States)

    Reva, V A; Samokhvalov, I M

    2015-01-01

    Rapid growth of medical technologies has led to implementation of endovascular methods of diagnosis and treatment into rapidly developing battlefield surgery. This work based on analysing all available current publications generalizes the data on using endovascular surgery in combat vascular injury. During the Korean war (1950-1953) American surgeons for the first time performed endovascular balloon occlusion of the aorta - the first intravascular intervention carried out in a zone of combat operations. Half a century thereafter, with the beginning of the war in Afghanistan (2001) and in Iraq (2003) surgeons of central hospitals of the USA Armed Forces began performing delayed endovascular operations to the wounded. The development of technologies, advent of mobile angiographs made it possible to later on implement high-tech endovascular interventions in a zone of combat operations. At first, more often they performed implantation of cava filters, somewhat afterward - angioembolization of damaged accessory vessels, stenting and endovascular repair of major arteries. The first in the theatre of war endovascular prosthetic repair of the thoracic aorta for severe closed injury was performed in 2008. Russian experience of using endovascular surgery in combat injuries is limited to diagnostic angiography and regional intraarterial perfusion. Despite the advent of stationary angiographs in large hospitals of the RF Ministry of Defence in the early 1990s, endovascular operations for combat vascular injury are casuistic. Foreign experience in active implementation of endovascular technologies to treatment of war-time injuries has substantiated feasibility of using intravascular interventions in tertiary care military hospitals. Carrying out basic training courses on endovascular surgery should become an organic part of preparing multimodality general battlefield surgeons rendering care on the theatre of combat operations.

  15. Training Out-of-School Time Staff. Part 2 in a Series on Implementing Evidence-Based Practices in Out-of-School Time Programs: The Role of Frontline Staff. Research-to-Results Brief. Publication #2009-05

    Science.gov (United States)

    Metz, Allison J. R.; Burkhauser; Mary; Bowie, Lillian

    2009-01-01

    A skilled and sustainable workforce is one of the most important markers of high-quality out-of-school time programs. Given the links between skilled staff, high-quality programs, and better youth outcomes, staff training has become an essential part of program implementation. To expand what is known about staff training, Child Trends recently…

  16. Aerobic interval training partly reverse contractile dysfunction and impaired Ca2+ handling in atrial myocytes from rats with post infarction heart failure.

    Directory of Open Access Journals (Sweden)

    Anne Berit Johnsen

    Full Text Available BACKGROUND: There is limited knowledge about atrial myocyte Ca(2+ handling in the failing hearts. The aim of this study was to examine atrial myocyte contractile function and Ca(2+ handling in rats with post-infarction heart failure (HF and to examine whether aerobic interval training could reverse a potential dysfunction. METHODS AND RESULTS: Post-infarction HF was induced in Sprague Dawley rats by ligation of the left descending coronary artery. Atrial myocyte shortening was depressed (p<0.01 and time to relaxation was prolonged (p<0.01 in sedentary HF-rats compared to healthy controls. This was associated with decreased Ca(2+ amplitude, decreased SR Ca(2+ content, and slower Ca(2+ transient decay. Atrial myocytes from HF-rats had reduced sarcoplasmic reticulum Ca(2+ ATPase activity, increased Na(+/Ca(2+-exchanger activity and increased diastolic Ca(2+ leak through ryanodine receptors. High intensity aerobic interval training in HF-rats restored atrial myocyte contractile function and reversed changes in atrial Ca(2+ handling in HF. CONCLUSION: Post infarction HF in rats causes profound impairment in atrial myocyte contractile function and Ca(2+ handling. The observed dysfunction in atrial myocytes was partly reversed after aerobic interval training.

  17. Barriers to Neurosurgical Training in Sub-Saharan Africa: The Need for a Phased Approach to Global Surgery Efforts to Improve Neurosurgical Care.

    Science.gov (United States)

    Sader, Elie; Yee, Philip; Hodaie, Mojgan

    2017-02-01

    Neurosurgery in low-income countries is faced with multiple challenges. Although the most common challenges include infrastructure and physical resource deficits, an underemphasized barrier relates to the methods and components of surgical training. The role of important aspects, including didactic surgical training, surgical decision-making, workshops, conferences, and assessment methods, has not been duly studied. Knowledge of these issues is a crucial step to move closer to strengthening surgical capacity in low-income countries. We designed an online survey to assess self-perceived and objectively measured barriers to neurosurgical training in various Sub-Saharan African countries. Key outcomes included perception toward adequacy of neurosurgery training and barriers to neurosurgical training at each individual site. Only 37% of responders felt that their training program adequately prepared them for handling incoming neurosurgical cases. Top perceived limitations of neurosurgery training included lack of physical resources (25% of all responses), lack of practical workshops (22%), lack of program structure (18%), and lack of topic-specific lectures (10%). Our results show that most responders believe their training program is inadequate and are interested in improving it through international collaborations. This implies that activities directed at strengthening surgical capacity must address this important necessity. One important strategy is the use of online educational tools. In consideration of the observed limitations in care, resources, and training, we recommend a phased approach to neurosurgical growth in low-income settings. Copyright © 2016. Published by Elsevier Inc.

  18. Evaluation of Systemic On-the-job Training Effects in Nurses of Pediatric Surgery%小儿外科护理人员系统岗位培训及效果评价

    Institute of Scientific and Technical Information of China (English)

    郑琼; 胡丽君

    2012-01-01

    Objective To explore the training methods and effects of systemic on-the-job training on the nurses of pediatric surgery.Methods From January 2010 to February 2011,26 selected nurses from department of pediatric surgery were involved in the 10-month-training.The effects were evaluated by comparing the scores of the theory and skills assessment before and after the training and their self-evaluation.Results Compared to the scores oi nurses' specialise knowledge, nursing skills and comprehensive abilities before training,the data showed significant differences after the training(P<0.01), The satisfactions oi training contents, training methods, the training teachers and time arrangement were 87.50%, 91.67 % ,85.83 % and 87.50% respectivley.'The top five effects of nurse-self-evaluation were improving job confidence( 100%) , improving communication skills(95.83 %),improving learning skills(91.67%),improving culture attainments(91.67%) ,and improving job-promoting capacity(83.33%).Conclusion The systemic on-the-job training on the nurses oi pediatric surgery is an effective way to improve the specialist knowledge,nursing skills and comprehensive abilities, which contributes to more confidence and better practice ability for nurses.%目的 探讨小儿外科护理人员系统岗位培训的方法及其效果.方法 选择2010年1月至2011年2月重庆医科大学附属儿童医院小儿外科在岗的26名小儿外科护理人员为研究对象,进行为期10个月培训.比较培训前后理论及技能操作考核成绩,并通过培训后参训人员自评对岗位培训进行效果评价.结果 培训后,参训人员的理论和技能操作考核成绩均有提高,差异有统计学意义(P<0.01).在自评中,对培训满意度方面排名前四位为"培训内容"、"培训方式"、"授课教师"、" 时间安排",其满意度分别为87.50%、91.67%、85.83%和 87.50%.在自评中,培训对参训人员自身帮助与否方面的排名前五位为"培训可以提

  19. Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 2: Bone graft, implant and reconstructive surgery.

    Science.gov (United States)

    Simonpieri, Alain; Del Corso, Marco; Vervelle, Alain; Jimbo, Ryo; Inchingolo, Francesco; Sammartino, Gilberto; Dohan Ehrenfest, David M

    2012-06-01

    Platelet concentrates for surgical use are innovative tools of regenerative medicine, and were widely tested in oral and maxillofacial surgery. Unfortunately, the literature on the topic is contradictory and the published data are difficult to sort and interpret. In bone graft, implant and reconstructive surgery, the literature is particularly dense about the use of the various forms of Platelet-Rich Plasma (PRP) - Pure Platelet-Rich Plasma (P-PRP) or Leukocyte- and Platelet-Rich Plasma (L-PRP) - but still limited about Platelet-Rich Fibrin (PRF) subfamilies. In this second article, we describe and discuss the current published knowledge about the use of PRP and PRF during implant placement (particularly as surface treatment for the stimulation of osseointegration), the treatment of peri-implant bone defects (after peri-implantitis, during implantation in an insufficient bone volume or during immediate post-extraction or post-avulsion implantation), the sinuslift procedures and various complex implant-supported treatments. Other potential applications of the platelet concentrates are also highlighted in maxillofacial reconstructive surgery, for the treatment of patients using bisphosphonates, anticoagulants or with post-tumoral irradiated maxilla. Finally, we particularly insist on the perspectives in this field, through the description and illustration of the use of L-PRF (Leukocyte- and Platelet-Rich Fibrin) clots and membranes during the regeneration of peri-implant bone defects, during the sinus-lift procedure and during complex implant-supported rehabilitations. The use of L-PRF allowed to define a new therapeutic concept called the Natural Bone Regeneration (NBR) for the reconstruction of the alveolar ridges at the gingival and bone levels. As it is illustrated in this article, the NBR principles allow to push away some technical limits of global implant-supported rehabilitations, particularly when combined with other powerful biotechnological tools

  20. The Basics of Boiler Operation and Maintenance. Part 2, Air Pollution Training Institute Self-Instructional Course SI-466.

    Science.gov (United States)

    Environmental Protection Agency, Research Triangle Park, NC. Air Pollution Training Inst.

    This workbook is part two of a self-instructional course prepared for the United States Environmental Protection Agency. The student proceeds at his own pace and when questions are asked, after answering, he either turns to the next page to check his response or refers to the previously covered material. The purpose of this course is to prepare…

  1. 42 CFR Appendix B to Part 75 - Standards for Accreditation of Dental Radiography Training for Dental Hygienists

    Science.gov (United States)

    2010-10-01

    ... scatter; X-ray beam quality and quantity; factors influencing radiographic density, contrast, definition... EDUCATIONAL PROGRAMS FOR AND THE CREDENTIALING OF RADIOLOGIC PERSONNEL Pt. 75, App. B Appendix B to Part 75..., and protection; X-ray films and radiographic film quality; radiographic techniques; darkroom and...

  2. 42 CFR Appendix C to Part 75 - Standards for Accreditation of Dental Radiography Training for Dental Assistants

    Science.gov (United States)

    2010-10-01

    ... should include: X-radiation production and scatter; X-ray beam quality and quantity; factors influencing... EDUCATIONAL PROGRAMS FOR AND THE CREDENTIALING OF RADIOLOGIC PERSONNEL Pt. 75, App. C Appendix C to Part 75... educational program in dental assisting. Such dental assisting education programs may be accredited by an...

  3. Troubleshooting, Section One, Boilers: Correcting Oil Temperature. Part 3, Air Pollution Training Institute Self-Instructional Course SI-466.

    Science.gov (United States)

    Environmental Protection Agency, Research Triangle Park, NC. Air Pollution Training Inst.

    This workbook is part three of a self-instructional course prepared for the United States Environmental Protection Agency. The student proceeds at his own pace and when questions are asked, after answering, he either turns to the next page to check his response or refers to the previously covered material. The purpose of this course is to prepare…

  4. Global cancer surgery: delivering safe, affordable, and timely cancer surgery.

    Science.gov (United States)

    Sullivan, Richard; Alatise, Olusegun Isaac; Anderson, Benjamin O; Audisio, Riccardo; Autier, Philippe; Aggarwal, Ajay; Balch, Charles; Brennan, Murray F; Dare, Anna; D'Cruz, Anil; Eggermont, Alexander M M; Fleming, Kenneth; Gueye, Serigne Magueye; Hagander, Lars; Herrera, Cristian A; Holmer, Hampus; Ilbawi, André M; Jarnheimer, Anton; Ji, Jia-Fu; Kingham, T Peter; Liberman, Jonathan; Leather, Andrew J M; Meara, John G; Mukhopadhyay, Swagoto; Murthy, Shilpa S; Omar, Sherif; Parham, Groesbeck P; Pramesh, C S; Riviello, Robert; Rodin, Danielle; Santini, Luiz; Shrikhande, Shailesh V; Shrime, Mark; Thomas, Robert; Tsunoda, Audrey T; van de Velde, Cornelis; Veronesi, Umberto; Vijaykumar, Dehannathparambil Kottarathil; Watters, David; Wang, Shan; Wu, Yi-Long; Zeiton, Moez; Purushotham, Arnie

    2015-09-01

    Surgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery--e.g., pathology and imaging--are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.

  5. Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 1: Periodontal and dentoalveolar surgery.

    Science.gov (United States)

    Del Corso, Marco; Vervelle, Alain; Simonpieri, Alain; Jimbo, Ryo; Inchingolo, Francesco; Sammartino, Gilberto; Dohan Ehrenfest, David M

    2012-06-01

    Platelet concentrates for surgical use are innovative tools of regenerative medicine, and were widely tested in oral and maxillofacial surgery. Unfortunately, the literature on the topic is contradictory and the published data are difficult to sort and interpret. In periodontology and dentoalveolar surgery, the literature is particularly dense about the use of the various forms of Platelet-Rich Plasma (PRP) - Pure Platelet-Rich Plasma (P-PRP) or Leukocyte- and Platelet-Rich Plasma (L-PRP) - but still limited about Platelet-Rich Fibrin (PRF) subfamilies. In this first article, we describe and discuss the current published knowledge about the use of PRP and PRF during tooth avulsion or extraction, mucogingival surgery, Guided Tissue Regeneration (GTR) or bone filling of periodontal intrabony defects, and regeneration of alveolar ridges using Guided Bone Regeneration (GBR), in a comprehensive way and in order to avoid the traps of a confusing literature and to highlight the underlying universal mechanisms of these products. Finally, we particularly insist on the perspectives in this field, through the description and illustration of the systematic use of L-PRF (Leukocyte- and Platelet- Rich Fibrin) clots and membranes during tooth avulsion, cyst exeresis or the treatment of gingival recessions by root coverage. The use of L-PRF also allowed to define new therapeutic principles: NTR (Natural Tissue Regeneration) for the treatment of periodontal intrabony lesions and Natural Bone Regeneration (NBR) for the reconstruction of the alveolar ridges. In periodontology, this field of research will soon find his golden age by the development of user-friendly platelet concentrate procedures, and the definition of new efficient concepts and clinical protocols.

  6. Trainee Perceptions of the Canadian Cardiac Surgery Workforce: A Survey of Canadian Cardiac Surgery Trainees.

    Science.gov (United States)

    Mewhort, Holly E M; Quantz, Mackenzie A; Hassan, Ansar; Rubens, Fraser D; Pozeg, Zlatko I; Perrault, Louis P; Feindel, Christopher M; Ouzounian, Maral

    2017-04-01

    Management of cardiac surgery health human resources (HHR) has been challenging, with recent graduates struggling to secure employment and a shortage of cardiac surgeons predicted as early as 2020. The length of cardiac surgery training prevents HHR supply from adapting in a timely fashion to changes in demand, resulting in a critical need for active workforce management. This study details the results of the 2015 Canadian Society of Cardiac Surgeons (CSCS) workforce survey undertaken as part of the CSCS strategy for active workforce management. The 38-question survey was administered electronically to all 96 trainees identified as being registered in a Canadian cardiac surgery residency program for the 2015-2016 academic year. Eighty-four of 96 (88%) trainees responded. The majority of participants were satisfied with their training experience. However, 29% stated that their clinical and operative exposure needed improvement, and 57% of graduating trainees did not believe that they would be competent to practice independently at the conclusion of their training. Although 51% of participants believe the job market is improving, 94% of senior trainees found it competitive or extremely difficult to secure an attending staff position. Participants highlighted a need for improved career counselling and formal mentorship. Although the job market is perceived to be improving, a mismatch in the cardiac surgery workforce supply and demand remains because current trainees continue to experience difficulty securing employment after the completion of residency training. Trainees have identified improved career counselling and mentorship as potential strategies to aid graduates in securing employment. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  7. Integrated training for aphasia: an application of part-whole learning to treat lexical retrieval, sentence production, and discourse-level communications in three cases of nonfluent aphasia.

    Science.gov (United States)

    Milman, Lisa; Vega-Mendoza, Mariana; Clendenen, Deanna

    2014-05-01

    The purpose of this study was to evaluate integrated training for aphasia (ITA), a multicomponent language-production treatment based on part-whole learning that systematically trains lexical retrieval, sentence production, and discourse-level communications. Specific research objectives were to evaluate acquisition of target structures, statistical parameters associated with learning variables, treatment generalization, and the efficacy of individual treatment components. ITA was administered to 3 individuals with nonfluent aphasia following a multiple-baseline, across-behaviors design. Effect size and correlational coefficients were computed to assess acquisition, generalization, and maintenance of target structures. Standardized tests and a treatment efficacy questionnaire were also completed. A significant treatment effect was found in 2 of the 3 participants. In addition, as is seen in normal skill acquisition, practice time and error rate were significantly correlated. All participants demonstrated evidence of generalization on standardized language measures. Only 1 participant improved, however, on the communication measures. Results of the treatment component analysis revealed significant differences in the perceived efficacy of individual therapy tasks. Findings add to the evidence supporting multicomponent aphasia treatments, provide preliminary support for ITA and the application of a part-whole learning approach, and suggest that specific treatment components may contribute differentially to outcomes and generalization effects.

  8. PHTLS ® (Prehospital Trauma Life Support) provider courses in Germany - who takes part and what do participants think about prehospital trauma care training?

    Science.gov (United States)

    Frank, Christian B; Wölfl, Christoph G; Hogan, Aidan; Suda, Arnold J; Gühring, Thorsten; Gliwitzky, Bernhard; Münzberg, Matthias

    2014-01-01

    The goal of this study was to examine PHTLS Provider courses in Germany and to proof the assumption that formation of physicians and paramedics in prehospital trauma care can be optimized. PHTLS participants were asked to fill out standardized questionnaires during their course preparation and directly after the course. There were some open questions regarding their professional background and closed questions concerning PHTLS itself. Further questions were to be answered on an analog scale in order to quantify subjective impressions of confidence, knowledge and also to describe individual levels of education and training. 247 questionnaires could be analyzed. Physicians noted significant (p PHTLS (p = 0.005), didn't benefit as much as the rest (p = 0.004) and stated more often, that the course was of less value for their daily work (p = 0.03). After the course confidence increased remarkably and reached higher rates than before the course (p PHTLS both groups showed similar ratings concerning the course concept indicating that PHTLS could equalize some training deficits and help to gain confidence and assurance in prehospital trauma situations. 90% of the paramedics and 100% of the physicians would recommend PHTLS. Physicians and especially anesthetists revised their opinions with regard to providing PHTLS at Medical School after having taken part in a PHTLS course. The evaluation of PHTLS courses in Germany indicates the necessity for special prehospital trauma care training. Paramedics and physicians criticize deficits in their professional training, which can be compensated by PHTLS. With respect to relevant items like confidence and knowledge PHTLS leads to a statistically significant increase in ratings on a visual analogue scale. PHTLS should be integrated into the curriculum at Medical School.

  9. PHTLS ® (Prehospital Trauma Life Support) provider courses in Germany – who takes part and what do participants think about prehospital trauma care training?

    Science.gov (United States)

    2014-01-01

    Background The goal of this study was to examine PHTLS Provider courses in Germany and to proof the assumption that formation of physicians and paramedics in prehospital trauma care can be optimized. Methods PHTLS participants were asked to fill out standardized questionnaires during their course preparation and directly after the course. There were some open questions regarding their professional background and closed questions concerning PHTLS itself. Further questions were to be answered on an analog scale in order to quantify subjective impressions of confidence, knowledge and also to describe individual levels of education and training. Results 247 questionnaires could be analyzed. Physicians noted significant (p PHTLS (p = 0.005), didn’t benefit as much as the rest (p = 0.004) and stated more often, that the course was of less value for their daily work (p = 0.03). After the course confidence increased remarkably and reached higher rates than before the course (p PHTLS both groups showed similar ratings concerning the course concept indicating that PHTLS could equalize some training deficits and help to gain confidence and assurance in prehospital trauma situations. 90% of the paramedics and 100% of the physicians would recommend PHTLS. Physicians and especially anesthetists revised their opinions with regard to providing PHTLS at Medical School after having taken part in a PHTLS course. Conclusion The evaluation of PHTLS courses in Germany indicates the necessity for special prehospital trauma care training. Paramedics and physicians criticize deficits in their professional training, which can be compensated by PHTLS. With respect to relevant items like confidence and knowledge PHTLS leads to a statistically significant increase in ratings on a visual analogue scale. PHTLS should be integrated into the curriculum at Medical School. PMID:25050135

  10. Algorithm for planning a double-jaw orthognathic surgery using a computer-aided surgical simulation (CASS) protocol. Part 1: planning sequence

    Science.gov (United States)

    Xia, J. J.; Gateno, J.; Teichgraeber, J. F.; Yuan, P.; Chen, K.-C.; Li, J.; Zhang, X.; Tang, Z.; Alfi, D. M.

    2015-01-01

    The success of craniomaxillofacial (CMF) surgery depends not only on the surgical techniques, but also on an accurate surgical plan. The adoption of computer-aided surgical simulation (CASS) has created a paradigm shift in surgical planning. However, planning an orthognathic operation using CASS differs fundamentally from planning using traditional methods. With this in mind, the Surgical Planning Laboratory of Houston Methodist Research Institute has developed a CASS protocol designed specifically for orthognathic surgery. The purpose of this article is to present an algorithm using virtual tools for planning a double-jaw orthognathic operation. This paper will serve as an operation manual for surgeons wanting to incorporate CASS into their clinical practice. PMID:26573562

  11. A standardized resident training program in endoscopic surgery in general and in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair in particular

    DEFF Research Database (Denmark)

    Miserez, Marc; Arregui, Maurice; Bisgaard, Thue

    2009-01-01

    The need for acquisition of specific laparoscopic skills has emphasized the role of a preclinical laboratory-training program. However, for laparoscopic inguinal hernia repair with a steep learning curve, especially for totally extraperitoneal repair, preclinical skill training remains a challeng...

  12. A piezo surgery with corticotomies and implant placement as part of a multidisciplinary approach to treat malocclusion disorder in an adult patient: clinical report

    OpenAIRE

    Gelpi, Federico; De Santis, Daniele; Marconcini, Simone; Briguglio, Francesco; Finotti, Marco

    2015-01-01

    This clinical report illustrates a multidisciplinary approach for the rehabilitation of a young adult patient affected by a bilateral edentulous space and an anterior deep bite. The patient required orthodontics and surgical corticotomy and implantology (both performed with a piezo device). A multidisciplinary planning approach, including orthodontics, oral and periodontic surgery, and restorative dentistry, has an important role in the final outcome of treatment. In fact a dental class I occ...

  13. Are there Differences in the Mandibular Morphometry in Patients who are Candidates for Orthognathic Surgery? Part 1: Influences of Facial Class

    OpenAIRE

    Pozzer, L; Olate, S; Asprino, L; de Moraes, M

    2009-01-01

    Dentofacial deformities (FDA) facial alterations are well known. These disorders can present clinically with subsequent anterior, vertical, horizontal alterations that can be isolated or combining some of them. The surgical approach of these alterations has been extensive study in the last 50 years, where the bone morphometric characteristics have a crucial role. It was developed in a cohort study of patients who consulted for orthognathic surgery between 2002 and 2008 in the Division of Oral...

  14. Evaluation of the Army Physical Training and Weight Control Programs. Part 2. The Army Medical Department Advanced NCOES Course

    Science.gov (United States)

    1983-09-01

    Inspecion Specialist 91S - Environmental Specialist 91T - Animal Care Specialist 91W - Nuclear Lab Specialist 92B - Medical Lab Specialist 94F... Corporations have achieved excellent success with individual programs when they are supervised and receive adequate institutional backirg (Health and Fitness...The Corporate View, 1980). A safe and effective physical fitness program which is supported by the organization is an integral part of successful stress

  15. The Effect of early physiotherapy on the recovery of mandibular function after orthognathic surgery for Class III correction: part I--jaw-motion analysis.

    Science.gov (United States)

    Teng, Terry Te-Yi; Ko, Ellen Wen-Ching; Huang, Chiung Shing; Chen, Yu-Ray

    2015-01-01

    The aim of this prospective study was to compare the mandibular range of motion in Class III patients with and without early physiotherapy after orthognathic surgery (OGS). This study consisted of 63 Class III patients who underwent 2-jaw OGS. The experimental group comprised 31 patients who received early systematic physical rehabilitation. The control group consisted of 32 patients who did not have physical rehabilitation. Twelve variables of 3-dimensional (3D) jaw-motion analysis (JMA) were recorded before surgery (T1) and 6 weeks (T2) and 6 months (T3) after surgery. A 2-sample t test was conducted to compare the JMA results between the two groups at different time points. At T2, the JMA data were measured to be 77.5%-145.7% of presurgical values in the experimental group, and 60.3%-90.6% in the control group. At T3, the measurements were 112.2%-179.2% of presurgical values in the experimental group, and 77.6%-157.2% in the control group. The patients in the experimental group exhibited more favorable recovery than did those in the control group, from T1 to T2 and T1 to T3. However, after termination of physiotherapy, no significant difference in the extent of recovery was observed between groups up to 6 months after OGS.

  16. Nose Surgery

    Science.gov (United States)

    ... Patient Health Home Copyright © 2017 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2017. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

  17. After Surgery

    Science.gov (United States)

    ... side effects. There is usually some pain with surgery. There may also be swelling and soreness around ... the first few days, weeks, or months after surgery. Some other questions to ask are How long ...

  18. One or two trainees per workplace in a structured multimodality training curriculum for laparoscopic surgery? Study protocol for a randomized controlled trial - DRKS00004675.

    Science.gov (United States)

    Nickel, Felix; Jede, Felix; Minassian, Andreas; Gondan, Matthias; Hendrie, Jonathan D; Gehrig, Tobias; Linke, Georg R; Kadmon, Martina; Fischer, Lars; Müller-Stich, Beat P

    2014-04-23

    Laparoscopy training courses have been established in many centers worldwide to ensure adequate skill learning before performing operations on patients. Different training modalities and their combinations have been compared regarding training effects. Multimodality training combines different approaches for optimal training outcome. However, no standards currently exist for the number of trainees assigned per workplace. This is a monocentric, open, three-arm randomized controlled trial. The participants are laparoscopically-naive medical students from Heidelberg University. After a standardized introduction to laparoscopic cholecystectomy (LC) with online learning modules, the participants perform a baseline test for basic skills and LC performance on a virtual reality (VR) trainer. A total of 100 students will be randomized into three study arms, in a 2:2:1 ratio. The intervention groups participate individually (Group 1) or in pairs (Group 2) in a standardized and structured multimodality training curriculum. Basic skills are trained on the box and VR trainers. Procedural skills and LC modules are trained on the VR trainer. The control group (Group C) does not receive training between tests. A post-test is performed to reassess basic skills and LC performance on the VR trainer. The performance of a cadaveric porcine LC is then measured as the primary outcome using standardized and validated ratings by blinded experts with the Objective Structured Assessment of Technical Skills. The Global Operative Assessment of Laparoscopic Surgical skills score and the time taken for completion are used as secondary outcome measures as well as the improvement of skills and VR LC performance between baseline and post-test. Cognitive tests and questionnaires are used to identify individual factors that might exert influence on training outcome. This study aims to assess whether workplaces in laparoscopy training courses for beginners should be used by one trainee or two trainees

  19. Medical theses as part of the scientific training in basic medical and dental education: experiences from Finland

    Directory of Open Access Journals (Sweden)

    Takkinen Hanna-Mari

    2007-12-01

    Full Text Available Abstract Background Teaching the principles of scientific research in a comprehensive way is important at medical and dental schools. In many countries medical and dental training is not complete until the candidate has presented a diploma thesis. The objective of this study was to evaluate the nature, quality, publication pattern and visibility of Finnish medical diploma theses. Methods A total of 256 diploma theses presented at the University of Oulu from 2001 to 2003 were analysed. Using a standardised questionnaire, we extracted several characteristics from each thesis. We used the name of the student to assess whether the thesis resulted in a scientific publication indexed in medical article databases. The number of citations received by each published thesis was also recorded. Results A high proportion of the theses (69.5% were essentially statistical in character, often combined with an extensive literature review or the development of a laboratory method. Most of them were supervised by clinical departments (55.9%. Only 61 theses (23.8% had been published in indexed scientific journals. Theses in the fields of biomedicine and diagnostics were published in more widely cited journals. The median number of citations received per year was 2.7 and the range from 0 to 14.7. Conclusion The theses were seldom written according to the principles of scientific communication and the proportion of actually published was small. The visibility of these theses and their dissemination to the scientific community should be improved.

  20. Medical theses as part of the scientific training in basic medical and dental education: experiences from Finland.

    Science.gov (United States)

    Nieminen, Pentti; Sipilä, Kirsi; Takkinen, Hanna-Mari; Renko, Marjo; Risteli, Leila

    2007-12-05

    Teaching the principles of scientific research in a comprehensive way is important at medical and dental schools. In many countries medical and dental training is not complete until the candidate has presented a diploma thesis. The objective of this study was to evaluate the nature, quality, publication pattern and visibility of Finnish medical diploma theses. A total of 256 diploma theses presented at the University of Oulu from 2001 to 2003 were analysed. Using a standardised questionnaire, we extracted several characteristics from each thesis. We used the name of the student to assess whether the thesis resulted in a scientific publication indexed in medical article databases. The number of citations received by each published thesis was also recorded. A high proportion of the theses (69.5%) were essentially statistical in character, often combined with an extensive literature review or the development of a laboratory method. Most of them were supervised by clinical departments (55.9%). Only 61 theses (23.8%) had been published in indexed scientific journals. Theses in the fields of biomedicine and diagnostics were published in more widely cited journals. The median number of citations received per year was 2.7 and the range from 0 to 14.7. The theses were seldom written according to the principles of scientific communication and the proportion of actually published was small. The visibility of these theses and their dissemination to the scientific community should be improved.

  1. Robotic surgery in gynecology.

    Science.gov (United States)

    Alkatout, Ibrahim; Mettler, Liselotte; Maass, Nicolai; Ackermann, Johannes

    2016-01-01

    Robotic surgery is the most dynamic development in the sector of minimally invasive operations currently. It should not be viewed as an alternative to laparoscopy, but as the next step in a process of technological evolution. The advancement of robotic surgery, in terms of the introduction of the Da Vinci Xi, permits the variable use of optical devices in all four trocars. Due to the new geometry of the "patient cart," an operation can be performed in all spatial directions without re-docking. Longer instruments and the markedly narrower mechanical elements of the "patient cart" provide greater flexibility as well as access similar to those of traditional laparoscopy. Currently, robotic surgery is used for a variety of indications in the treatment of benign gynecological diseases as well as malignant ones. Interdisciplinary cooperation and cooperation over large geographical distances have been rendered possible by telemedicine, and will ensure comprehensive patient care in the future by highly specialized surgery teams. In addition, the second operation console and the operation simulator constitute a new dimension in advanced surgical training. The disadvantages of robotic surgery remain the high costs of acquisition and maintenance as well as the laborious training of medical personnel before they are confident with using the technology.

  2. [25 years of laparoscopic surgery in Spain].

    Science.gov (United States)

    Moreno-Sanz, Carlos; Tenías-Burillo, Jose María; Morales-Conde, Salvador; Balague-Ponz, Carmen; Díaz-Luis, Hermógenes; Enriquez-Valens, Pablo; Manuel-Palazuelos, Juan Carlos; Martínez-Cortijo, Sagrario; Olsina-Kissler, Jorge; Socas-Macias, María; Toledano-Trincado, Miguel; Vidal-Pérez, Oscar; Noguera-Aguilar, Juan Francisco; Salvador-Sanchís, José Luis; Feliu-Pala, Xavier; Targarona-Soler, Eduard M

    2014-04-01

    The introduction of laparoscopic surgery (LS) can be considered the most important advancement in our specialty in the past 25 years. Despite its advantages, implementation and consolidation has not been homogenous, especially for advanced techniques. The aim of this study was to analyse the level of development and use of laparoscopic surgery in Spain at the present time and its evolution in recent years. During the second half of 2012 a survey was developed to evaluate different aspects of the implementation and development of LS in our country. The survey was performed using an electronic questionnaire. The global response rate was 16% and 103 heads of Department answered the survey. A total of 92% worked in the public system. A total of 99% perform basic laparoscopic surgery and 85,2% advanced LS. Most of the responders (79%) consider that the instruments they have available for LS are adequate and 71% consider that LS is in the right stage of development in their environment. Basic laparoscopic surgery has developed in our country to be considered the standard performed by most surgeons, and forms part of the basic surgical training of residents. With regards to advanced LS, although it is frequently used, there are still remaining areas of deficit, and therefore, opportunities for improvement. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  3. Strength Training

    Science.gov (United States)

    ... en español Entrenamiento de la fuerza muscular Strength training is a vital part of a balanced exercise routine that includes aerobic activity and flexibility exercises. Regular aerobic exercise, such as running or ...

  4. Entrenamiento físico y educación como parte de la rehabilitación pulmonar en pacientes con EPOC Exercise training and education as part of pulmonary rehabilitation for COPD patients

    Directory of Open Access Journals (Sweden)

    KATHERINE MARÍN D

    2008-12-01

    Full Text Available La rehabilitación pulmonar es un recurso terapéutico no farmacológico dirigido a pacientes con EPOC, sus principales objetivos son: reducir los síntomas, mejorar la calidad de vida y aumentar la participación física y emocional de los pacientes en las actividades cotidianas. Los pacientes con EPOC en todos los estadios de la enfermedad se benefician con los programas de entrenamiento, que mejoran tanto la tolerancia al ejercicio como la sensación de disnea y fatiga. La educación al paciente se incluye con el objetivo de optimizar sus habilidades, su capacidad de sobrellevar la enfermedad y para mejorar su estado de salud, además de la cesación del hábito tabáquico. A continuación se presenta una revisión bibliográfica acerca del entrenamiento físico y la educación como parte de un programa de rehabilitación pulmonar.Pulmonary rehabilitation is a non-pharmacological therapeutic resort for COPD patients. Its main goals are to reduce symptoms, improve quality of life, and increase physical and emotional involvement in everyday activities. COPD patients at all stages ofthe disease benefit from exercise training programs, as ihey improve both exercise tolerance and symptoms of dyspnea and fatigue. Patient 's education is included so that it helps improving skills, ability to cope with illness, and health status, as well as smoking cessation. We present a bibliographical review about exercise training and education as part of a pulmonary rehabilitation program.

  5. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws and ... Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by ...

  6. [Safety culture in orthopedics and trauma surgery : Course concept: interpersonal competence by the German Society for Orthopaedics and Trauma (DGOU) and Lufthansa Aviation Training].

    Science.gov (United States)

    Doepfer, A-K; Seemann, R; Merschin, D; Stange, R; Egerth, M; Münzberg, M; Mutschler, M; Bouillon, B; Hoffmann, R

    2017-06-22

    Patient safety has become a central and measurable key factor in the routine daily medical practice. The human factor plays a decisive role in safety culture and has moved into focus regarding the reduction of treatment errors and undesired critical incidents. Nonetheless, the systematic training in communication and interpersonal competences has so far only played a minor role. The German Society of Orthopaedics and Trauma (DGOU) in cooperation with the Lufthansa Aviation Training initiated a course system for interpersonal competence. Several studies confirmed the reduction of critical incidents and costs after implementation of a regular and targeted human factor training. The interpersonal competence should be an essential component of specialist training within the framework of a 3‑column model.

  7. An analysis from the Quality Outcomes Database, Part 2. Predictive model for return to work after elective surgery for lumbar degenerative disease.

    Science.gov (United States)

    Asher, Anthony L; Devin, Clinton J; Archer, Kristin R; Chotai, Silky; Parker, Scott L; Bydon, Mohamad; Nian, Hui; Harrell, Frank E; Speroff, Theodore; Dittus, Robert S; Philips, Sharon E; Shaffrey, Christopher I; Foley, Kevin T; McGirt, Matthew J

    2017-10-01

    OBJECTIVE Current costs associated with spine care are unsustainable. Productivity loss and time away from work for patients who were once gainfully employed contributes greatly to the financial burden experienced by individuals and, more broadly, society. Therefore, it is vital to identify the factors associated with return to work (RTW) after lumbar spine surgery. In this analysis, the authors used data from a national prospective outcomes registry to create a predictive model of patients' ability to RTW after undergoing lumbar spine surgery for degenerative spine disease. METHODS Data from 4694 patients who underwent elective spine surgery for degenerative lumbar disease, who had been employed preoperatively, and who had completed a 3-month follow-up evaluation, were entered into a prospective, multicenter registry. Patient-reported outcomes-Oswestry Disability Index (ODI), numeric rating scale (NRS) for back pain (BP) and leg pain (LP), and EQ-5D scores-were recorded at baseline and at 3 months postoperatively. The time to RTW was defined as the period between operation and date of returning to work. A multivariable Cox proportional hazards regression model, including an array of preoperative factors, was fitted for RTW. The model performance was measured using the concordance index (c-index). RESULTS Eighty-two percent of patients (n = 3855) returned to work within 3 months postoperatively. The risk-adjusted predictors of a lower likelihood of RTW were being preoperatively employed but not working at the time of presentation, manual labor as an occupation, worker's compensation, liability insurance for disability, higher preoperative ODI score, higher preoperative NRS-BP score, and demographic factors such as female sex, African American race, history of diabetes, and higher American Society of Anesthesiologists score. The likelihood of a RTW within 3 months was higher in patients with higher education level than in those with less than high school

  8. Simulation-based training for thoracoscopic lobectomy

    DEFF Research Database (Denmark)

    Jensen, Katrine; Ringsted, Charlotte; Hansen, Henrik Jessen;

    2014-01-01

    BACKGROUND: Video-assisted thoracic surgery is gradually replacing conventional open thoracotomy as the method of choice for the treatment of early-stage non-small cell lung cancers, and thoracic surgical trainees must learn and master this technique. Simulation-based training could help trainees...... overcome the first part of the learning curve, but no virtual-reality simulators for thoracoscopy are commercially available. This study aimed to investigate whether training on a laparoscopic simulator enables trainees to perform a thoracoscopic lobectomy. METHODS: Twenty-eight surgical residents were...... randomized to either virtual-reality training on a nephrectomy module or traditional black-box simulator training. After a retention period they performed a thoracoscopic lobectomy on a porcine model and their performance was scored using a previously validated assessment tool. RESULTS: The groups did...

  9. Nursing home staffing and training recommendations for promoting older adults' quality of care and life: Part 1. Deficits in the quality of care due to understaffing and undertraining.

    Science.gov (United States)

    Maas, Meridean L; Specht, Janet P; Buckwalter, Kathleen C; Gittler, Josephine; Bechen, Kate

    2008-04-01

    Caught between the inability or unwillingness of nursing home corporations and owners to redistribute revenue and the reluctance of federal and state agencies to increase payments to nursing homes, the nation's most vulnerable older adults are not receiving the care they deserve. Widespread recognition of substandard care and quality of life of older adults in nursing homes has existed for decades. In addition, there is substantial evidence that poor quality of care is related to inadequate numbers and training of nursing staff. Still, policy makers and nursing home owners have failed to take needed action. In the first article of this two-part series, major deficits in the care of older adult nursing home residents are reviewed, and research documenting the relationship between nursing home staffing and the quality of care and life of residents is summarized.

  10. Robotic Surgery in Gynecologic Oncology

    Directory of Open Access Journals (Sweden)

    Robert DeBernardo

    2011-01-01

    Full Text Available Robotic surgery for the management of gynecologic cancers allows for minimally invasive surgical removal of cancer-bearing organs and tissues using sophisticated surgeon-manipulated, robotic surgical instrumentation. Early on, gynecologic oncologists recognized that minimally invasive surgery was associated with less surgical morbidity and that it shortened postoperative recovery. Now, robotic surgery represents an effective alternative to conventional laparotomy. Since its widespread adoption, minimally invasive surgery has become an option not only for the morbidly obese but for women with gynecologic malignancy where conventional laparotomy has been associated with significant morbidity. As such, this paper considers indications for robotic surgery, reflects on outcomes from initial robotic surgical outcomes data, reviews cost efficacy and implications in surgical training, and discusses new roles for robotic surgery in gynecologic cancer management.

  11. 3D 打印技术在脊柱外科手术教学和训练中的应用%Application of 3D printing technology in the teaching and training of spine surgery

    Institute of Scientific and Technical Information of China (English)

    赵波; 刘颖; 邱晓文; 贺西京

    2015-01-01

    Spinal disorders show an increasing trend in these years.However,the training of young doctors in spine surgery still follows the old pattern.On the basis of introducing 3D printer to make 3D model to guide operation,our hospital further used the 3D printing equal proportion model to train young doctors in surgical techniques.The training consists of explanation of the model,teaching of key points,and young trainees'operation on the equal proportion model and result analysis so as to help them grasp the key points as soon as possible.Results show that after the one-year training with the new method,the young doctors became familiar with and skillful in inserting pedicle screws in the full-length spine.Therefore,applying the 3D printing equal proportion model into spine surgery training is feasible with obvious effects.%脊柱疾病呈现出逐年上升的趋势,而脊柱外科青年医师的培训却还是依照旧的模式。西安交通大学医学部第二附属医院在引进3D 打印机制作3D 模型指导手术的前提下,更进一步运用3D 打印等比例模型对青年医师的手术技巧进行训练。经过模型讲解、要点传授以及青年医师亲手在等比例模型上进行操作和分析得失,使其能够尽快掌握技术要领。结果显示,青年医师接受新的方法培训后,能够在1年内熟悉和精通脊柱全长的椎弓根螺钉的置入技巧。因此,将3D 打印等比例模型运用于脊柱外科手术训练是切实可行且效果比较明显的训练方法。

  12. virtX - evaluation of a computer-based training system for mobile C-arm systems in trauma and orthopedic surgery.

    Science.gov (United States)

    Bott, O J; Teistler, M; Duwenkamp, C; Wagner, M; Marschollek, M; Plischke, M; Raab, B W; Stürmer, K M; Pretschner, D P; Dresing, K

    2008-01-01

    Operating room personnel (ORP) operating mobile image intensifier systems (C-arms) need training to produce high quality radiographs with a minimum of time and X-ray exposure. Our study aims at evaluating acceptance, usability and learning effect of the CBT system virtX that simulates C-arm based X-ray imaging in the context of surgical case scenarios. Prospective, interventional study conducted during an ORP course with three groups: intervention group 1 (training on a PC using virtX), and 2 (virtX with a C-arm as input device), and a control group (training without virtX) - IV1, IV2 and CG. All participants finished training with the same exercise. Time needed to produce an image of sufficient quality was recorded and analyzed using One-Way-ANOVA and Dunnett post hoc test (alpha = .05). Acceptance and usability of virtX have been evaluated using a questionnaire. CG members (n = 21) needed more time for the exercise than those of IV2 (n = 20): 133 +/- 55 vs. 101 +/- 37 sec. (p = .03). IV1 (n = 12) also performed better than CG (128 +/- 48 sec.), but this was not statistically significant. Seventy-nine participants returned a questionnaire (81% female, age 34 +/- 9 years, professional experience 8.3 +/- 7.6 years; 77% regularly used a C-arm). 83% considered virtX a useful addition to conventional C-arm training. 91% assessed virtual radiography as helpful for understanding C-arm operation. Trainees experienced virtX as substantial enhancement of C-arm training. Training with virtX can reduce the time needed to perform an imaging task.

  13. Procedural Portfolio Planning in Plastic Surgery, Part 1: Strategic Changes in Clinical Practice to Increase Physician Revenue, Improve Operative Throughput, and Maintain Patient Satisfaction.

    Science.gov (United States)

    Hultman, Charles Scott

    2016-06-01

    Portfolio planning in health care represents the strategic prioritization of services that permits an organization to better achieve its goals of margin and mission. Because of recent volatility in the economy, declining reimbursement, and rising costs of providing care, such strategic planning has become increasingly important if physicians want to remain leaders in health care. This project assesses the financial impact of procedural portfolio planning on an academic plastic surgery practice from the physician's perspective. We tracked the top 50 procedures, defined as total charges per CPT code, that were performed in our baseline year, for 6 providers in a stable plastic surgery practice. At the end of the first year, we implemented 3 types of strategic changes: growth of areas with high contribution margin (laser resurfacing of burn scars), curtailment of high-risk procedures with negative contribution margin (panniculectomy in smokers), and improved efficiency of mission-critical services with high resource consumption (free-flap breast reconstruction). During the 2-year study period, we had no turnover in faculty, did not pursue any formal marketing, did not change our surgical fees or billing system, provided care independent of payer mix, and maintained our commitment to indigent care. Outcome measures included procedural charges and revenue, collection rates, work relative value units, operating room times, idle times (room time less case time), receipts/minute in operating room, uncompensated charity care, and patient satisfaction (Press-Gainey scores). Before the study period, annual incremental growth in our practice was 1% to 2%, in terms of charges and receipts. After implementation of the portfolio planning project, the financial position of our division improved significantly, with patient satisfaction rates increasing from 85.5% to 94.1% and charity care remaining constant at US $400,000 per year. Encounters, work relative value units, charges

  14. The use of mixed-method, part-body pre-cooling procedures for team-sport athletes training in the heat.

    Science.gov (United States)

    Duffield, Rob; Steinbacher, Geoff; Fairchild, Timothy J

    2009-12-01

    The current study investigated the effects of a pre-cooling intervention on physiological and performance responses to team-sport training in the heat. Seven male lacrosse players performed a familiarization session and 2 randomized, counterbalanced sessions consisting of a 30-minute intermittent-sprint conditioning session. Prior to the sessions, players performed a 20-minute mixed-method, part-body cooling intervention (consisting of cooling vests, cold towels to the neck, and ice packs to the quadriceps) or no cooling intervention. Performance was determined from collection of 1 Hz global positioning system (GPS) data and analyzed for distance and speed. Prior to, during, and following the sessions, core temperature, heart rate, rating of perceived exertion (RPE), and thermal sensation scale (TSS) were measured; additionally, a venous blood sample was collected before and after each session for measurement of interleukin-6 (IL-6), insulin-like growth factor (IGF-1) and insulin-like growth factor-binding protein3 (IGF-BP3). Results indicated that a greater distance was covered during the pre-cooling condition (3.35 +/- 0.20 vs. 3.11 +/- 0.13 km; p = 0.05). Further, most of this improvement was evident from a greater distance covered during moderate intensities of 7 to 14 km/h (2.28 +/- 0.18 vs. 2.00 +/- 0.24 km; p = 0.05). Peak speeds and very-high-intensity efforts (20 km/h +/-) were not different between conditions (p > 0.05). The increase in core temperature was blunted following cooling, with a lower core temperature throughout the cooling session (38.8 +/- 0.3 vs. 39.3 +/- 0.4 degrees C; p 0.05). Accordingly, the use of a mixed-method, part-body cooling intervention prior to an intermittent-sprint training session in the heat can assist in reducing thermoregulatory load and improve aspects of training performance for team sports.

  15. The climb to break the glass ceiling in surgery: trends in women progressing from medical school to surgical training and academic leadership from 1994 to 2015.

    Science.gov (United States)

    Abelson, Jonathan S; Chartrand, Genevieve; Moo, Tracy-Ann; Moore, Maureen; Yeo, Heather

    2016-10-01

    There have been many efforts to increase the number of women surgeons. We provide an update of women surgeon representation along the pathway to surgical academia. Data was extracted from Association of American Medical Colleges FACTS and Faculty Administrative Management Online User System as well as GME annual reports starting in 1994 until the last year available for each. The proportion of graduating women medical students has increased on average .5% per year from 1994 to 2014. Women general surgery trainees have more than doubled in number over the same period but represented 38.3% of all general surgery trainees in 2014. Women Full Professors increased on average .3% from 1994 to 2015 but still make up less than 10% of all Full Professors. Despite improvements over the past 20 years, there are still large gender gaps in surgery for trainees and academic leadership. At the current rate of increase, women Full Professors will not achieve gender parity until in 2136. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Rectal prolapse associated with a healed pelvic fracture in a pregnant free-ranging African black rhinoceros (Diceros bicornis. Part 2 : surgery and necropsy : case report

    Directory of Open Access Journals (Sweden)

    A. Olivier

    2001-07-01

    Full Text Available The oedematous and traumatised protruding section of the rectal tissue of an adult free-ranging female African black rhinoceros (Diceros bicornis was surgically amputated. Immediately before completion of surgery, the rhinoceros died of anaesthetic-related cardiac arrest. At necropsy a deformed pelvis and sacrum associated with a healed fracture of the left ileal wing were noted. New bone formation in and around the left ventral sacral foramina may have resulted in neuropathy of particularly the 3rd and 4th left ventral sacral nerves, which (in the horse supply the majority of the nerve fibres innervating the caudal rectum and anus. The cause of the injury is not known, although back injuries, presumably sustained during mating by bulls, have been recorded in white rhinoceros. An encounter with elephants could also have been responsible for the injury in this case.

  17. Complications in neonatal surgery.

    Science.gov (United States)

    Escobar, Mauricio A; Caty, Michael G

    2016-12-01

    Neonatal surgery is recognized as an independent discipline in general surgery, requiring the expertise of pediatric surgeons to optimize outcomes in infants with surgical conditions. Survival following neonatal surgery has improved dramatically in the past 60 years. Improvements in pediatric surgical outcomes are in part attributable to improved understanding of neonatal physiology, specialized pediatric anesthesia, neonatal critical care including sophisticated cardiopulmonary support, utilization of parenteral nutrition and adjustments in fluid management, refinement of surgical technique, and advances in surgical technology including minimally invasive options. Nevertheless, short and long-term complications following neonatal surgery continue to have profound and sometimes lasting effects on individual patients, families, and society. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Endodontic surgery.

    Science.gov (United States)

    Chong, B S; Rhodes, J S

    2014-03-01

    A better understanding of endodontic disease and the causes of treatment failure has refined the role of surgery in endodontics. The advent of newer materials, advances in surgical armamentarium and techniques have also led to an improved endodontic surgical outcome. The aim of this article is to provide a contemporary and up-to-date overview of endodontic surgery. It will focus primarily on the procedures most commonly performed in endodontic surgery.

  19. Pre-prosthetic surgery: Mandible

    Science.gov (United States)

    Devaki, Veeramalai Nadu; Balu, Kandasamy; Ramesh, Sadashiva Balakrishnapillai; Arvind, Ramraj Jayabalan; Venkatesan

    2012-01-01

    Pre-prosthetic surgery is that part of oral and maxillofacial surgery which restores oral function and facial form. This is concerned with surgical modification of the alveolar process and its surrounding structures to enable the fabrication of a well-fitting, comfortable, and esthetic dental prosthesis. The ultimate goal of pre-prosthetic surgery is to prepare a mouth to receive a dental prosthesis by redesigning and smoothening bony edges. PMID:23066301

  20. Pre-prosthetic surgery: Mandible

    Directory of Open Access Journals (Sweden)

    Veeramalai Naidu Devaki

    2012-01-01

    Full Text Available Pre-prosthetic surgery is that part of oral and maxillofacial surgery which restores oral function and facial form. This is concerned with surgical modification of the alveolar process and its surrounding structures to enable the fabrication of a well-fitting, comfortable, and esthetic dental prosthesis. The ultimate goal of pre-prosthetic surgery is to prepare a mouth to receive a dental prosthesis by redesigning and smoothening bony edges.

  1. The Impact of Patient Safety Training on Oral and Maxillofacial Surgery Residents' Attitudes and Knowledge: A Mixed Method Case Study

    Science.gov (United States)

    Buhrow, Suzanne

    2013-01-01

    It is estimated that in the United States, more than 40,000 patients are injured each day because of preventable medical errors. Patient safety experts and graduate medical education accreditation leaders recognize that medical education reform must include the integration of safety training focused on error causation, system engineering, and…

  2. Improving qualified rate of rehabilitation training for patients with shoulder arthroscopy surgeries%提高肩关节镜术后患者康复功能锻炼达标率的实践

    Institute of Scientific and Technical Information of China (English)

    真启云; 王辉; 费文勇

    2015-01-01

    运用持续质量改进,提高肩关节镜术后患者康复功能锻炼达标率,促进患者关节功能康复。对影响达标率的原因进行调查分析,制订计划和改进措施,实施并评价效果。运用PDCA从支具佩戴、用具创新、康复器材、锻炼场所、训练图谱、健教形式、评估反馈等方面进行持续质量改进,使肩关节镜术后康复功能锻炼达标率由49.66%提高至70.83%。科学的质量持续改进减轻了患者疼痛,提高了关节功能,减轻了护士工作量,激发了护士工作热情,有效提高了肩关节镜术后患者康复功能锻炼达标率。%Continuous Quality Improvements were used to increase qualiifed rate of rehabilitation training for patients with shoulder arthroscopy surgeries, and to improve the recovery of patients' shoulder functions. In this study, the authors investigated and analyzed factors affecting the qualiifed rate, made plans and improvement measures, then carried out plans and evaluated the effects ifnally. By using PDCA cycle, they implemented Continuous Quality Improvements on every aspect including brace wearing, innovation of the appliance, rehabilitation equipment, exercise places, training graphics, health education methods, evaluation and feedback. They increased the qualiifed rate of rehabilitation training from 49.66% to 70.83%. Through scientiifcally and consistently improving process, they alleviated patients' pain, improved joint functions, reduced the nurses' workload, stimulated nurses' passion, and then increased qualified rate of rehabilitation training for patients with shoulder arthroscopy surgeries effectively.

  3. American Academy of Otolaryngology--Head and Neck Surgery

    Science.gov (United States)

    ... Neck Mass in Adults is now available in Otolaryngology–Head and Neck Surgery. The guideline addresses the ... Interested in systematic review training? SAGE, publisher of Otolaryngology—Head and Neck Surgery , will offer three grants ...

  4. The effect of early physiotherapy on the recovery of mandibular function after orthognathic surgery for class III correction. Part II: electromyographic activity of masticatory muscles.

    Science.gov (United States)

    Ko, Ellen Wen-Ching; Teng, Terry Te-Yi; Huang, Chiung Shing; Chen, Yu-Ray

    2015-01-01

    The study was conducted to evaluate the effect of early physical rehabilitation by comparing the differences of surface electromyographic (sEMG) activity in the masseter and anterior temporalis muscles after surgical correction of skeletal class III malocclusion. The prospective study included 63 patients; the experimental groups contained 31 patients who received early systematic physical rehabilitation; the control group (32 patients) did not receive physiotherapy. The amplitude of sEMG in the masticatory muscles reached 72.6-121.3% and 37.5-64.6% of pre-surgical values in the experimental and control groups respectively at 6 weeks after orthognathic surgery (OGS). At 6 months after OGS, the sEMG reached 135.1-233.4% and 89.6-122.5% of pre-surgical values in the experimental and control groups respectively. Most variables in the sEMG examination indicated that recovery of the masticatory muscles in the experimental group was better than the control group as estimated in the early phase (T1 to T2) and the total phase (T1 to T3); there were no significant differences between the mean recovery percentages in the later phase (T2 to T3). Early physical rehabilitative therapy is helpful for early recovery of muscle activity in masticatory muscles after OGS. After termination of physical therapy, no significant difference in recovery was indicated in patients with or without early physiotherapy.

  5. Bone transplantation and tissue engineering, part IV. Mesenchymal stem cells: history in orthopedic surgery from Cohnheim and Goujon to the Nobel Prize of Yamanaka.

    Science.gov (United States)

    Hernigou, Philippe

    2015-04-01

    In 1867 the German pathologist Cohnheim hypothesized that non-hematopoietic, bone marrow-derived cells could migrate through the blood stream to distant sites of injury and participate in tissue regeneration. In 1868, the French physiologist Goujon studied the osteogenic potential of bone marrow on rabbits. Friedenstein demonstrated the existence of a nonhematopoietic stem cell within bone marrow more than a hundred years later. Since this discovery, the research on mesenchymal stem cell (MSC) has explored their therapeutic potential. The prevalent view during the second century was that mature cells were permanently locked into the differentiated state and could not return to a fully immature, pluripotent stem-cell state. Recently, Japanese scientist (first orthopaedist) Shinya Yamanaka proved that introduction of a small set of transcription factors into a differentiated cell was sufficient to revert the cell to a pluripotent state. Yamanaka shared the Nobel Prize in Physiology or Medicine and opened a new door for potential applications of MSCs. This manuscript describes the concept of MSCs from the period when it was relegated to the imagination to the beginning of the twenty-first century and their application in orthopaedic surgery.

  6. A piezo surgery with corticotomies and implant placement as part of a multidisciplinary approach to treat malocclusion disorder in an adult patient: clinical report.

    Science.gov (United States)

    Gelpi, Federico; De Santis, Daniele; Marconcini, Simone; Briguglio, Francesco; Finotti, Marco

    2015-12-01

    This clinical report illustrates a multidisciplinary approach for the rehabilitation of a young adult patient affected by a bilateral edentulous space and an anterior deep bite. The patient required orthodontics and surgical corticotomy and implantology (both performed with a piezo device). A multidisciplinary planning approach, including orthodontics, oral and periodontic surgery, and restorative dentistry, has an important role in the final outcome of treatment. In fact a dental class I occlusion has been established only on the right side. The left side could not be restored to an ideal class I relationship due to the pontic prosthesis. The original collapsed right posterior occlusion was corrected. A stable posterior occlusion was established, and the balancing interference was eliminated. Centric relation and centric occlusion were established at the same vertical dimension of occlusion. The cephalometric analysis and clinical aspect at the end of treatment showed that the patient had improvements in overbite and overjet.Multidisciplinary management, including endodontic and restorative dentistry, periodontics, corticotomy-assisted orthodontics, implants, and prosthetics, was used for a young female patient with multiple missing teeth, anterior deep bite, and a malocclusion with cant of the occlusal plane. The interaction of interdisciplinary specialties and careful treatment planning were required. The patient also benefited esthetically from our effort.

  7. Heart bypass surgery incision (image)

    Science.gov (United States)

    ... the left part of the chest between the ribs. This incision is much less traumatic than the traditional heart bypass surgery incision which separates the breast bone. Minimally invasive heart bypass surgery allows the patient less pain and a faster recovery.

  8. Thyroid Surgery

    Science.gov (United States)

    ... etc.). Surgery is also an option for the treatment of hyperthyroidism (Grave’s disease or a “toxic nodule” (see Hyperthyroidism brochure ), for large and multinodular goiters and for any goiter that may be causing ... MEANS OF TREATMENT? Surgery is definitely indicated to remove nodules suspicious ...

  9. Low-Cost Simulation of Robotic Surgery

    DEFF Research Database (Denmark)

    Grande, Kasper; Jensen, Rasmus Steen; Kraus, Martin

    2013-01-01

    The high expenses associated with acquiring and maintaining robotic surgical equipment for minimally invasive surgery entail that training on this equipment is also expensive. Virtual reality (VR) training simulators can reduce this training time; however, the current simulators are also quite...... expensive. Therefore, we propose a low-cost simulation of minimally invasive surgery and evaluate its feasibility. Using off-the-shelf hardware and a commercial game engine, a prototype simulation was developed and evaluated against the use of a surgical robot. The participants of the evaluation were given...... suitable option for a low-cost simulation of robotic surgery....

  10. Low-Cost Simulation of Robotic Surgery

    DEFF Research Database (Denmark)

    Grande, Kasper; Jensen, Rasmus Steen; Kraus, Martin

    2013-01-01

    The high expenses associated with acquiring and maintaining robotic surgical equipment for minimally invasive surgery entail that training on this equipment is also expensive. Virtual reality (VR) training simulators can reduce this training time; however, the current simulators are also quite...... expensive. Therefore, we propose a low-cost simulation of minimally invasive surgery and evaluate its feasibility. Using off-the-shelf hardware and a commercial game engine, a prototype simulation was developed and evaluated against the use of a surgical robot. The participants of the evaluation were given...... suitable option for a low-cost simulation of robotic surgery....

  11. Nutrition & Pancreatic Surgery

    NARCIS (Netherlands)

    Gerritsen, A.

    2015-01-01

    The aim of the first part of this thesis was to determine the optimal feeding strategy after pancreatoduodenectomy. The available nutritional guidelines give conflicting recommendations and are all based on studies after major gastrointestinal surgery for cancer in general. We systematically reviewe

  12. Restructuring of advanced instruction and training programs in order to increase the number of flight hours for military pilots. Part II

    National Research Council Canada - National Science Library

    Ioan STEFANESCU

    2011-01-01

    Converting the DC school jet aircraft into SC advanced training aircraft - and use them for the combat training of military pilots from the operational units, has become a necessity due to the budget...

  13. The production of audiovisual teaching tools in minimally invasive surgery.

    Science.gov (United States)

    Tolerton, Sarah K; Hugh, Thomas J; Cosman, Peter H

    2012-01-01

    Audiovisual learning resources have become valuable adjuncts to formal teaching in surgical training. This report discusses the process and challenges of preparing an audiovisual teaching tool for laparoscopic cholecystectomy. The relative value in surgical education and training, for both the creator and viewer are addressed. This audiovisual teaching resource was prepared as part of the Master of Surgery program at the University of Sydney, Australia. The different methods of video production used to create operative teaching tools are discussed. Collating and editing material for an audiovisual teaching resource can be a time-consuming and technically challenging process. However, quality learning resources can now be produced even with limited prior video editing experience. With minimal cost and suitable guidance to ensure clinically relevant content, most surgeons should be able to produce short, high-quality education videos of both open and minimally invasive surgery. Despite the challenges faced during production of audiovisual teaching tools, these resources are now relatively easy to produce using readily available software. These resources are particularly attractive to surgical trainees when real time operative footage is used. They serve as valuable adjuncts to formal teaching, particularly in the setting of minimally invasive surgery. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  14. Photobiomodulation in laser surgery

    Science.gov (United States)

    Liu, Timon Cheng-Yi; Rong, Dong-Liang; Huang, Jin; Deng, Xiao-Yuan; Liu, Song-Hao

    2006-01-01

    Laser surgery provides good exposure with clear operating fields and satisfactory preliminary functional results. In contrast to conventional excision, it was found that matrix metalloproteinases and the tissue inhibitors of metalloproteinases -1 mRNA expression is higher, myofibroblasts appeared and disappeared slower in laser excision wounds. It has been suggested that the better anatomical and functional results achieved following laser cordectomy may be explained by the fact that such procedures result in better, more rapid healing processes to recover vocal cord for early glottic tumors and better. In this paper, the role of photobiomodulation in laser surgery will be discussed by the cultured monolayer normal human skin fibroblast model of the photobiomodulation of marginal irradiation of high intensity laser beam, the photobiomodulation related to the irradiated tissue, the biological information model of photobiomodulation and the animal models of laser surgery. Although high intensity laser beam is so intense that it destroys the irradiated cells or tissue, its marginal irradiation intensity is so low that there is photobiomodulation on non-damage cells to modulate the regeneration of partly damaged tissue so that the surgery of laser of different parameters results in different post-surgical recovery. It was concluded that photobiomodulation might play an important role in the long-term effects of laser surgery, which might be used to design laser surgery.

  15. Generic Training Materials.

    Science.gov (United States)

    National Paralegal Inst., Washington, DC.

    Part of the National Paralegal Institute's curriculum for short-term intensive training sessions for paralegals, or legal assistants, the document outlines the format for training sessions concerning: (1) initial training to examine the functions of the paralegal and stimulate commitment to the entire training program, (2) legal research, (3)…

  16. Colorectal Surgeons Teaching General Surgery Residents: Current Challenges and Opportunities

    National Research Council Canada - National Science Library

    Schmitz, Connie; Chow, Christopher; Rothenberger, David

    2012-01-01

    Effective teaching for general surgery residents requires that faculty members with colorectal expertise actively engage in the education process and fully understand the current context for residency training...

  17. Medical students' achievement on the Bachelor of Medicine, Bachelor of Surgery/Chirurgery Final Part I and II licensing examination: a comparison of students in problem-based learning, community-based education and service, and conventional curricula in Ghana.

    Science.gov (United States)

    Mogre, Victor; Amalba, Anthony; Saaka, Mark; Kyei-Aboagye, Kwabena

    2014-05-08

    Problem-based learning is an established method of teaching and learning in medical education. However, its impact on students' achievement on examinations is varied and inconsistent. We compared the levels of achievement on the Bachelor of Medicine, Bachelor of Surgery/Chirurgery (MB ChB) Part I and II licensing examination of students in problem-based learning, community-based education and service (PBL/COBES), and conventional curricula. In 2014, we analyzed the MB ChB Final Part I and II licensing examination results of students in three classes (2004, 2005, and 2006) of the School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana. Ninety-three students in the 2004 and 2005 cohorts followed a conventional curriculum, and 82 students in the 2006 cohort followed a PBL/COBES curriculum. Using appropriate statistical tools, the analysis compared individual discipline scores and the proportions of students who received distinction/credit/pass grades among the classes. The PBL students had significantly higher mean and median scores than the conventional students in Obstetrics and Gynecology, Internal Medicine, Community Health and Family Medicine, Surgery, and Psychiatry, but not in Child Health and Pediatrics. Also, a significantly (P=0.0010) higher percentage, 95.1% (n=78), of the PBL students passed all the disciplines, compared to 79.6% (n=74) of the conventional students. The PBL students significantly performed better in all the disciplines except child health and pediatrics, where the conventional students scored higher. These findings demonstrate that the benefits of the PBL/COBES curriculum are tangible and should be fostered.

  18. Take-Home Training in Laparoscopy.

    Science.gov (United States)

    Thinggaard, Ebbe

    2017-04-01

    When laparoscopy was first introduced, skills were primarily taught using the apprenticeship model. A limitation of this method when compared to open surgery, was that it requires more time to practise and more frequent learning opportunities in clinical practice. The unique set of skills required in laparoscopy highlighted the need for new training methods that reduce the need for supervision and do not put the patient at risk. Simulation training was developed to meet this need. The overall purpose of this thesis was to explore simulation-based laparoscopic training at home. The thesis consists of five papers: a review, a validation study, a study of methodology, a randomised controlled trial and a mixed-methods study. Our aims were to review the current knowledge on training off-site, to develop and explore validity for a training and assessment system, to investigate the effect of take-home training in a simulation-based laparoscopic training programme, and to explore the use of take-home training. The first paper in this thesis is a scoping review. The aim of the review was to explore the current knowledge on off-site laparoscopic skills training. We found that off-site training was feasible but that changes were required in order for it to become an effective method of training. Furthermore, the select-ed instructional design varied and training programmes were designed using a variety of educational theories. Based on our findings, we recommended that courses and training curricula should follow established education theories such as proficiency-based learning and deliberate practice. Principles of directed self-regulated learning could be used to improve off-site laparoscopic training programmes. In the second study, we set out to develop and explore validity evidence of the TABLT test. The TABLT test was developed for basic laparoscopic skills training in a cross-specialty curriculum. We found validity evidence to support the TABLT test as a summative test

  19. Biomechanical Evaluation of Different Fixation Methods for Mandibular Anterior Segmental Osteotomy Using Finite Element Analysis, Part Two: Superior Repositioning Surgery With Bone Allograft.

    Science.gov (United States)

    Kilinç, Yeliz; Erkmen, Erkan; Kurt, Ahmet

    2016-01-01

    In this study, the biomechanical behavior of different fixation methods used to fix the mandibular anterior segment following various amounts of superior repositioning was evaluated by using Finite Element Analysis (FEA). The three-dimensional finite element models representing 3 and 5 mm superior repositioning were generated. The gap in between segments was assumed to be filled by block bone allograft and resignated to be in perfect contact with the mandible and segmented bone. Six different finite element models with 2 distinct mobilization rate including 3 different fixation configurations, double right L (DRL), double left L (DLL), or double I (DI) miniplates with monocortical screws, correspondingly were created. A comparative evaluation has been made under vertical, horizontal and oblique loads. The von Mises and principal maximum stress (Pmax) values were calculated by finite element solver programme. The first part of our ongoing Finite Element Analysis research has been addressed to the mechanical behavior of the same fixation configurations in nongrafted models. In comparison with the findings of the first part of the study, it was concluded that bone graft offers superior mechanical stability without any limitation of mobilization and less stress on the fixative appliances as well as in the bone.

  20. The effect of teamwork training on team performance and clinical outcome in elective orthopaedic surgery: a controlled interrupted time series study.

    Science.gov (United States)

    Morgan, Lauren; Hadi, Mohammed; Pickering, Sharon; Robertson, Eleanor; Griffin, Damian; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; McCulloch, Peter; New, Steve

    2015-04-20

    To evaluate the effectiveness of aviation-style teamwork training in improving operating theatre team performance and clinical outcomes. 3 operating theatres in a UK district general hospital, 1 acting as a control group and the other 2 as the intervention group. 72 operations (37 intervention, 35 control) were observed in full by 2 trained observers during two 3-month observation periods, before and after the intervention period. A 1-day teamwork training course for all staff, followed by 6 weeks of weekly in-service coaching to embed learning. We measured team non-technical skills using Oxford NOTECHS II, (evaluating the whole team and the surgical, anaesthetic and nursing subteams, and evaluated technical performance using the Glitch count. We evaluated compliance with the WHO checklist by recording whether time-out (T/O) and sign-out (S/O) were attempted, and whether T/O was fully complied with. We recorded complications, re-admissions and duration of hospital stay using hospital administrative data. We compared the before-after change in the intervention and control groups using 2-way analysis of variance (ANOVA) and regression modelling. Mean NOTECHS II score increased significantly from 71.6 to 75.4 in the active group but remained static in the control group (p=0.047). Among staff subgroups, the nursing score increased significantly (p=0.006), but the anaesthetic and surgical scores did not. The attempt rate for WHO T/O procedures increased significantly in both active and control groups, but full compliance with T/O improved only in the active group (p=0.003). Mean glitch rate was unchanged in the control group but increased significantly (7.2-10.2/h, p=0.002) in the active group. Teamwork training was associated with improved non-technical skills in theatre teams but also with a rise in operative glitches. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Ophthalmic plastic and orbital surgery in Taiwan.

    Science.gov (United States)

    Hsu, Chi-Hsin; Lin, I-Chan; Shen, Yun-Dun; Hsu, Wen-Ming

    2014-06-01

    We describe in this paper the current status of ophthalmic plastic and orbital surgery in Taiwan. Data were collected from the Bureau of National Health Insurance of Taiwan, the Bulletin of the Taiwan Ophthalmic Plastic and Reconstructive Society, and the Statistics Yearbook of Practicing Physicians and Health Care Organizations in Taiwan by the Taiwan Medical Association. We ascertained that 94 ophthalmologists were oculoplastic surgeons and accounted for 5.8% of 1621 ophthalmologists in Taiwan. They had their fellowship training abroad (most ophthalmologists trained in the United States of America) or in Taiwan. All ophthalmologists were well trained and capable of performing major oculoplastic surgeries. The payment rates by our National Health Insurance for oculoplastic and orbital surgeries are relatively low, compared to Medicare payments in the United States. Ophthalmologists should promote the concept that oculoplastic surgeons specialize in periorbital plastic and aesthetic surgeries. However, general ophthalmologists should receive more educational courses on oculoplastic and cosmetic surgery.

  2. Implantation of 3D-Printed Patient-Specific Aneurysm Models into Cadaveric Specimens: A New Training Paradigm to Allow for Improvements in Cerebrovascular Surgery and Research

    Directory of Open Access Journals (Sweden)

    Arnau Benet

    2015-01-01

    Full Text Available Aim. To evaluate the feasibility of implanting 3D-printed brain aneurysm model in human cadavers and to assess their utility in neurosurgical research, complex case management/planning, and operative training. Methods. Two 3D-printed aneurysm models, basilar apex and middle cerebral artery, were generated and implanted in four cadaveric specimens. The aneurysms were implanted at the same anatomical region as the modeled patient. Pterional and orbitozygomatic approaches were done on each specimen. The aneurysm implant, manipulation capabilities, and surgical clipping were evaluated. Results. The 3D aneurysm models were successfully implanted to the cadaveric specimens’ arterial circulation in all cases. The features of the neck in terms of flexibility and its relationship with other arterial branches allowed for the practice of surgical maneuvering characteristic to aneurysm clipping. Furthermore, the relationship of the aneurysm dome with the surrounding structures allowed for better understanding of the aneurysmal local mass effect. Noticeably, all of these observations were done in a realistic environment provided by our customized embalming model for neurosurgical simulation. Conclusion. 3D aneurysms models implanted in cadaveric specimens may represent an untapped training method for replicating clip technique; for practicing certain approaches to aneurysms specific to a particular patient; and for improving neurosurgical research.

  3. CARDIOTHORACIC SURGERY

    African Journals Online (AJOL)

    lbadan, Nigeria. Reprint requests to: Dr. V. O. Adegboye, Department Of Surgery, University College Hospital, Iberian,. Nigeria. ... been shown to be related to the rate of bleeding. .... patients after an interval of conservative/medical treatment.

  4. General Surgery

    African Journals Online (AJOL)

    bbshehu

    underwent major colonic restorative resection between July 1997 and September 199 in order to ... factors, the level of anastomosis and the experience of the surgeon are perhaps the ... indications for surgery and cancer stage were similar.

  5. Brain surgery

    Science.gov (United States)

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  6. Hemorrhoid surgery

    Science.gov (United States)

    ... and hemorrhoidectomy. In: Delaney CP, ed. Netter's Surgical Anatomy and Approaches . Philadelphia, PA: Elsevier Saunders; 2014:chap 26. Review Date 4/5/2015 Updated by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason ...

  7. GENERAL SURGERY

    African Journals Online (AJOL)

    The traditional operative approach is an open surgical one to drain the cysts and ... early outcomes of laparoscopic treatment of liver hydatid cysts at our institution. .... O. Radical vs. conservative surgery for hydatid liver cysts: Experience from ...

  8. Outpatient Surgery

    Science.gov (United States)

    ... thirds of all operations are performed in outpatient facilities, according to the Centers for Disease Control and Prevention. Outpatient surgery provides patients with the convenience of recovering at home, and can cost less. ...

  9. Laparoscopic Surgery

    Science.gov (United States)

    ... surgeon’s perspective, laparoscopic surgery may allow for easier dissection of abdominal scar tissue (adhesions), less surgical trauma, ... on Facebook About ACG ACG Store ACG Patient Education & Resource Center Home GI Health and Disease Recursos ...

  10. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N

    2014-01-01

    National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...

  11. Effects of relaxation training combined music therapy on patients undergoing surgery with local anesthesia%放松训练联合音乐疗法在局麻手术病人中的应用研究

    Institute of Scientific and Technical Information of China (English)

    温秀芬; 陈云超; 张晖; 高虹; 张雪燕; 徐光芸; 骆如香

    2014-01-01

    Objective To investigate the effects of relaxation training combined music therapy on postoperative psychological ,pain sensitivity ,and hemodynamic of patients undergoing surgery with local anesthesia .Method 120 patients were randomly divided into 2 group:experimental group and control group ,60 cases in each group .Pa-tients in group experimental received routine care and relaxation training combined with music therapy ,in the anoth-er hand ,patients in group control only received routine care .The changes of pain sensitivity and anxiety levels were observed before surgery and postoperative .changes of heart rate and blood pressure of both group were observed in the day before surgery ,before entering the operating room ,during the surgery and postoperative .Result The SAS and postoperative VAS score of group experimental was significantly lower than that of group control and systolic blood pressure ,diastolic blood pressure and heart rate in postoperative 30 min of group experimental were lower those in group control ether (P 0 .05) .systolic pressure ,diastolic blood pressure and heart rate of patients in both group before entering the operating room were higher than those in the day before sur-gery (P0 .05) .In group control , compared with the data before entering the operating room ,there were there were no significant differences of sys-tolic blood pressure ,diastolic blood pressure ,heart rate among the data before entering the operating room ,during and after the surgery (P> 0 .05) .Conclusion The therapy of relaxation training combined with music could reduce anxiety and pain sensitivity and helps to maintain stable vital signs of anesthesia during and after the surgery in pa-tients with local anesthesia .%目的:探讨放松训练联合音乐疗法对局麻手术患者术中、术后的心理、疼痛敏感度及血流动力学的影响。方法将120例患者按手术安排顺序单双数分为实验组与对照组,每组各60

  12. Computer-assisted 3D design software for teaching neuro-ophthalmology of the oculomotor system and training new retinal surgery techniques

    Science.gov (United States)

    Glittenberg, Carl; Binder, Susanne

    2004-07-01

    Purpose: To create a more effective method of demonstrating complex subject matter in ophthalmology with the use of high end, 3-D, computer aided animation and interactive multimedia technologies. Specifically, to explore the possibilities of demonstrating the complex nature of the neuroophthalmological basics of the human oculomotor system in a clear and non confusing way, and to demonstrate new forms of retinal surgery in a manner that makes the procedures easier to understand for other retinal surgeons. Methods and Materials: Using Reflektions 4.3, Monzoom Pro 4.5, Cinema 4D XL 5.03, Cinema 4D XL 8 Studio Bundle, Mediator 4.0, Mediator Pro 5.03, Fujitsu-Siemens Pentium III and IV, Gericom Webgine laptop, M.G.I. Video Wave 1.0 and 5, Micrografix Picture Publisher 6.0 and 8, Amorphium 1.0, and Blobs for Windows, we created 3-D animations showing the origin, insertion, course, main direction of pull, and auxiliary direction of pull of the six extra-ocular eye muscles. We created 3-D animations that (a) show the intra-cranial path of the relevant oculomotor cranial nerves and which muscles are supplied by them, (b) show which muscles are active in each of the ten lines of sight, (c) demonstrate the various malfunctions of oculomotor systems, as well as (d) show the surgical techniques and the challenges in radial optic neurotomies and subretinal surgeries. Most of the 3-D animations were integrated in interactive multimedia teaching programs. Their effectiveness was compared to conventional teaching methods in a comparative study performed at the University of Vienna. We also performed a survey to examine the response of students being taught with the interactive programs. We are currently in the process of placing most of the animations in an interactive web site in order to make them freely available to everyone who is interested. Results: Although learning how to use complex 3-D computer animation and multimedia authoring software can be very time consuming and

  13. [Robotic surgery].

    Science.gov (United States)

    Moreno-Portillo, Mucio; Valenzuela-Salazar, Carlos; Quiroz-Guadarrama, César David; Pachecho-Gahbler, Carlos; Rojano-Rodríguez, Martín

    2014-12-01

    Medicine has experienced greater scientific and technological advances in the last 50 years than in the rest of human history. The article describes relevant events, revises concepts and advantages and clinical applications, summarizes published clinical results, and presents some personal reflections without giving dogmatic conclusions about robotic surgery. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) defines robotic surgery as a surgical procedure using technology to aid the interaction between surgeon and patient. The objective of the surgical robot is to correct human deficiencies and improve surgical skills. The capacity of repeating tasks with precision and reproducibility has been the base of the robot´s success. Robotic technology offers objective and measurable advantages: - Improving maneuverability and physical capacity during surgery. - Correcting bad postural habits and tremor. - Allowing depth perception (3D images). - Magnifying strength and movement limits. - Offering a platform for sensors, cameras, and instruments. Endoscopic surgery transformed conceptually the way of practicing surgery. Nevertheless in the last decade, robotic assisted surgery has become the next paradigm of our era.

  14. Viscoless microincision cataract surgery

    Directory of Open Access Journals (Sweden)

    Guy Sallet

    2008-06-01

    Full Text Available Guy SalletDepartment of Opthamology, Aalsters Stedelijk Ziekenhuis, BelgiumAbstract: A cataract surgery technique is described in which incisions, continuous circular capsulorhexis and hydrodissection are made without the use of any viscoelastics. Two small incisions are created through which the different parts of the procedure can take place, maintaining a stable anterior chamber under continuous irrigation. Subsequent bimanual phacoemulsification can be done through these microincisions. At the end of the procedure, an intraocular lens can be inserted through the self-sealing incision under continuous irrigation. 50 consecutive cataract patients were operated on without the use of viscoelastics and then compared with a group of 50 patients who had been helped with viscoelastics. No difference in outcome, endothelial cell count or pachymetry was noted between the two groups. No intraoperative complication was encountered. Viscoless cataract surgery was a safe procedure with potential advantages.Keywords: ophthalmic visco-surgical device, viscoless cataract surgery, microincision

  15. [IMSS in numbers. Surgeries].

    Science.gov (United States)

    2005-01-01

    Surgery occupies a priority place within the organization of health services. In the IMSS around 1.4 million surgeries are performed annually and 3934 take place each day. A great part of the resources goes to obstetric interventions, since 222,928 caesarean sections were performed in 2004, and along with curettages, tubal occlusions and hysterectomies, they sum 37.6% of the surgeries performed in 2004. Abdominal deliveries (caesarean sections) were done in 39% of the pregnancies delivered in the IMSS and 8.3% were done in adolescents. Simple surgical interventions were also important. Cholecystectomies were 6 times more frequent in women aged 20 to 59 years old than in men the same age. Among the main interventions we also describe hernioplasty, appendicectomies, amygdalectomies, rhinoplasties, biopsies and circumcisions. Scarce data on complications are registered and no data is available for infections of surgical wounds. Surgical procedures are more frequent in women and in certain specialities.

  16. PROGRAM SIXTY ONE. A BASIC TRAINING COURSE IN INVENTORY CONTROL. PART II. ESTABLISHING STOCK EQUILIBRIUM. ALLOCATIONS AND REALLOCATIONS. REDISTRIBUTIONS. SMALC AND FORCED DEGENERACY,

    Science.gov (United States)

    INVENTORY CONTROL , NAVAL TRAINING), WAREHOUSES, SUPPLY DEPOTS, INVENTORY CONTROL , REPLACEMENT THEORY, LINEAR PROGRAMMING, LOGISTICS, COST EFFECTIVENESS, DISTRIBUTION, TRANSPORTATION, SELECTION, SCHEDULING, OPTIMIZATION.

  17. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... find out more. Dental and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, ...

  18. Tennis elbow surgery

    Science.gov (United States)

    Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery ... Surgery to repair tennis elbow is usually an outpatient surgery. This means you will not stay in the hospital overnight. You will be given ...

  19. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

  20. Mohs micrographic surgery

    Science.gov (United States)

    Skin cancer - Mohs surgery; Basal cell skin cancer - Mohs surgery; Squamous cell skin cancer - Mohs surgery ... Mohs surgery usually takes place in the doctor's office. The surgery is started early in the morning and is ...