Surgical training in your hands: organising a skills course.

Science.gov (United States)

Burnand, Henry; Mutimer, Jon

2012-12-01

The advent of simulated surgical skills courses has brought dynamic changes to the traditional approach to acquiring practical skills in surgery. Teaching is a core part of the surgical profession, and any trainee can be involved in the organisation of skills training courses. This paper outlines the importance of organising surgical skills courses for trainees, and provides a practical guide on how to do so within busy clinical environments. The paper examines how to plan a course, how to design the programme, and provides tips on faculty staff requirements, venue, finance and participants, with additional suggestions for assessment and evaluation. We recommend the organisation of skills courses to any trainee. By following key ground rules, the surgical trainee can enable the acquisition of advanced learning opportunities and the ability to demonstrate valuable organisational skills. © Blackwell Publishing Ltd 2012.

10 CFR 1046.15 - Training and qualification for security skills and knowledge.

Science.gov (United States)

2010-01-01

... knowledge. 1046.15 Section 1046.15 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) PHYSICAL PROTECTION OF... knowledge. (a) DOE contractors shall only employ as protective force personnel individuals who successfully... and Qualification for Security Skills and Knowledge,” to this subpart. The DOE contractor shall...

The impact of a surgical boot camp on early acquisition of technical and nontechnical skills by novice surgical trainees.

Science.gov (United States)

Heskin, Leonie; Mansour, Ehab; Lane, Brian; Kavanagh, Dara; Dicker, Pat; Ryan, Donncha; Gildea-Byrne, Kate; Pawlikowska, Teresa; Tierney, Sean; Traynor, Oscar

2015-09-01

Acquisition of skills early in surgical training represents a significant challenge at present because of training time constraints. The aim of this study was to investigate if an intensive surgical boot camp was effective in transferring skills at the beginning of a surgical training program. New core surgical trainees (n = 58) took part in a 5-day boot camp. There were pretest and posttest assessments of knowledge, technical skills, and confidence levels. The boot camp used simulation and senior surgical faculty to teach a defined range of technical and nontechnical skills. The scores for knowledge (53.8% vs 68.4%, P technical skills (35.9% to 60.6% vs 50.6% to 78.2%, P Skills improvements were still present a year later. The 5-day surgical boot camp proved to be an effective way to rapidly acquire surgical knowledge and skills while increasing the confidence levels of trainees. Copyright © 2015 Elsevier Inc. All rights reserved.

Porcine wet lab improves surgical skills in third year medical students.

Science.gov (United States)

Drosdeck, Joseph; Carraro, Ellen; Arnold, Mark; Perry, Kyle; Harzman, Alan; Nagel, Rollin; Sinclair, Lynnsay; Muscarella, Peter

2013-09-01

Medical students desire to become proficient in surgical techniques and believe their acquisition is important. However, the operating room is a challenging learning environment. Small group procedural workshops can improve confidence, participation, and performance. The use of fresh animal tissues has been rated highly among students and improves their surgical technique. Greater exposure to surgical procedures and staff could positively influence students' interest in surgical careers. We hypothesized that a porcine "wet lab" course for third year medical students would improve their surgical skills. Two skills labs were conducted for third year medical students during surgery clerkships in the fall of 2011. The students' surgical skills were first evaluated in the operating room across nine dimensions. Next, the students performed the following procedures during the skills lab: (1) laparotomy; (2) small bowel resection; (3) splenectomy; (4) partial hepatectomy; (5) cholecystectomy; (6) interrupted abdominal wall closure; (7) running abdominal wall closure; and (8) skin closure. After the skills lab, the students were re-evaluated in the operating room across the same nine dimensions. Student feedback was also recorded. Fifty-one participants provided pre- and post-lab data for use in the final analysis. The mean scores for all nine surgical skills improved significantly after participation in the skills lab (P ≤ 0.002). Cumulative post-test scores also showed significant improvement (P = 0.002). Finally, the student feedback was largely positive. The surgical skills of third year medical students improved significantly after participation in a porcine wet lab, and the students rated the experience as highly educational. Integration into the surgery clerkship curriculum would promote surgical skill proficiency and could elicit interest in surgical careers. Copyright © 2013 Elsevier Inc. All rights reserved.

Comprehensive Surgical Coaching Enhances Surgical Skill in the Operating Room: A Randomized Controlled Trial.

Science.gov (United States)

Bonrath, Esther M; Dedy, Nicolas J; Gordon, Lauren E; Grantcharov, Teodor P

2015-08-01

The aim of the study was to determine whether individualized coaching improved surgical technical skill in the operating room to a higher degree than current residency training. Clinical training in the operating room is a valuable opportunity for surgeons to acquire skill and knowledge; however, it often remains underutilized. Coaching has been successfully used in various industries to enhance performance, but its role in surgery has been insufficiently investigated. This randomized controlled trial was conducted at one surgical training program. Trainees undergoing a minimally invasive surgery rotation were randomized to either conventional training (CT) or comprehensive surgical coaching (CSC). CT included ward and operating room duties, and regular departmental teaching sessions. CSC comprised performance analysis, debriefing, feedback, and behavior modeling. Primary outcome measures were technical performance as measured on global and procedure-specific rating scales, and surgical safety parameters, measured by error count. Operative performance was assessed by blinded video analysis of the first and last cases recorded by the participants during their rotation. Twenty residents were randomized and 18 completed the study. At posttraining the CSC group (n = 9) scored significantly higher on a procedure-specific skill scale compared with the CT group (n = 9) [median, 3.90 (interquartile range, 3.68-4.30) vs 3.60 (2.98-3.70), P = 0.017], and made fewer technical errors [10 (7-13) vs 18 (13-21), P = 0.003]. Significant within-group improvements for all skill metrics were only noted in the CSC group. Comprehensive surgical coaching enhances surgical training and results in skill acquisition superior to conventional training.

The Sex Difference in Basic Surgical Skills Learning: A Comparative Study.

Science.gov (United States)

Lou, Zheng; Yan, Fei-Hu; Zhao, Zhi-Qing; Zhang, Wei; Shui, Xian-Qi; Liu, Jia; Zhuo, Dong-Lan; Li, Li; Yu, En-da

2016-01-01

Very little is known of sex-related differences among medical students in the acquisition of basic surgical skills at an undergraduate level. The aim of this study was to investigate the sex differences in basic surgical skills learning and the possible explanations for sex disparities within basic surgical skills education. A didactic description of 10 surgical skills was performed, including knot tying, basic suture I, basic suture II, sterile technique, preoperative preparation, phlebotomy, debridement, laparotomy, cecectomy, and small bowel resection with hand-sewn anastomosis. The students were rated on a 100-point scale for each basic surgical skill. Later during the same semester all the students took the final theoretical examination. A total of 342 (male = 317 and female = 25) medical students participated in a single skills laboratory as part of their third-year medical student clerkship. The mean scores for each of the 10 surgical skills were higher in female group. The difference in sterile technique, preoperative preparation, cecectomy, and small bowel resection with hand-sewn anastomosis reached the significant level. Compared with male medical students, the mean theory examination score was significantly higher in female medical students. Approximately 76% of the (19 of 25) female students expressed their interest in pursuing a surgical career, whereas only 65.5% (207 of 317) male students wanted to be surgical professionals (p = 0.381). Female medical students completed basic surgical skills training more efficiently and passed the theoretical examination with significantly higher scores than male medical students. In the future, studies should be done in other classes in our institution and perhaps other schools to see if these findings are reliable or valid or just a reflection of this 1 sample. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Video and accelerometer-based motion analysis for automated surgical skills assessment.

Science.gov (United States)

Zia, Aneeq; Sharma, Yachna; Bettadapura, Vinay; Sarin, Eric L; Essa, Irfan

2018-03-01

Basic surgical skills of suturing and knot tying are an essential part of medical training. Having an automated system for surgical skills assessment could help save experts time and improve training efficiency. There have been some recent attempts at automated surgical skills assessment using either video analysis or acceleration data. In this paper, we present a novel approach for automated assessment of OSATS-like surgical skills and provide an analysis of different features on multi-modal data (video and accelerometer data). We conduct a large study for basic surgical skill assessment on a dataset that contained video and accelerometer data for suturing and knot-tying tasks. We introduce "entropy-based" features-approximate entropy and cross-approximate entropy, which quantify the amount of predictability and regularity of fluctuations in time series data. The proposed features are compared to existing methods of Sequential Motion Texture, Discrete Cosine Transform and Discrete Fourier Transform, for surgical skills assessment. We report average performance of different features across all applicable OSATS-like criteria for suturing and knot-tying tasks. Our analysis shows that the proposed entropy-based features outperform previous state-of-the-art methods using video data, achieving average classification accuracies of 95.1 and 92.2% for suturing and knot tying, respectively. For accelerometer data, our method performs better for suturing achieving 86.8% average accuracy. We also show that fusion of video and acceleration features can improve overall performance for skill assessment. Automated surgical skills assessment can be achieved with high accuracy using the proposed entropy features. Such a system can significantly improve the efficiency of surgical training in medical schools and teaching hospitals.

Automated surgical skill assessment in RMIS training.

Science.gov (United States)

Zia, Aneeq; Essa, Irfan

2018-05-01

Manual feedback in basic robot-assisted minimally invasive surgery (RMIS) training can consume a significant amount of time from expert surgeons' schedule and is prone to subjectivity. In this paper, we explore the usage of different holistic features for automated skill assessment using only robot kinematic data and propose a weighted feature fusion technique for improving score prediction performance. Moreover, we also propose a method for generating 'task highlights' which can give surgeons a more directed feedback regarding which segments had the most effect on the final skill score. We perform our experiments on the publicly available JHU-ISI Gesture and Skill Assessment Working Set (JIGSAWS) and evaluate four different types of holistic features from robot kinematic data-sequential motion texture (SMT), discrete Fourier transform (DFT), discrete cosine transform (DCT) and approximate entropy (ApEn). The features are then used for skill classification and exact skill score prediction. Along with using these features individually, we also evaluate the performance using our proposed weighted combination technique. The task highlights are produced using DCT features. Our results demonstrate that these holistic features outperform all previous Hidden Markov Model (HMM)-based state-of-the-art methods for skill classification on the JIGSAWS dataset. Also, our proposed feature fusion strategy significantly improves performance for skill score predictions achieving up to 0.61 average spearman correlation coefficient. Moreover, we provide an analysis on how the proposed task highlights can relate to different surgical gestures within a task. Holistic features capturing global information from robot kinematic data can successfully be used for evaluating surgeon skill in basic surgical tasks on the da Vinci robot. Using the framework presented can potentially allow for real-time score feedback in RMIS training and help surgical trainees have more focused training.

Building Skills and Qualifications among SME Employees. Leonardo da Vinci Good Practices Series.

Science.gov (United States)

Commission of the European Communities, Brussels (Belgium). Directorate-General for Education and Culture.

This document profiles 10 European programs that exemplify good practice in building skills and qualifications among employees of small and medium enterprises (SMEs). The programs profiled are as follows: (1) TRICTSME (a program providing World Wide Web-based information and communication technologies training for SMEs in manufacturing); (2)…

Gender differences in the acquisition of surgical skills

DEFF Research Database (Denmark)

Ali, Amir; Subhi, Yousif; Ringsted, Charlotte

2015-01-01

BACKGROUND: Females are less attracted than males to surgical specialties, which may be due to differences in the acquisition of skills. The aim of this study was to systematically review studies that investigate gender differences in the acquisition of surgical skills. METHODS: We performed...... a comprehensive database search using relevant search phrases and MeSH terms. We included studies that investigated the role of gender in the acquisition of surgical skills. RESULTS: Our search yielded 247 studies, 18 of which were found to be eligible and were therefore included. These studies included a total...... of 2,106 study participants. The studies were qualitatively synthesized in five categories (studies on medical students, studies on both medical students and residents, studies on residents, studies on gender differences in needed physical strength, and studies on other gender-related training...

Cross-platform digital assessment forms for evaluating surgical skills

DEFF Research Database (Denmark)

Andersen, Steven Arild Wuyts

2015-01-01

developed for the rating of surgical skills. The database platform used in this study was reasonably priced, intuitive for the user, and flexible. The forms have been provided online as free downloads that may serve as the basis for further development or as inspiration for future efforts. In conclusion......A variety of structured assessment tools for use in surgical training have been reported, but extant assessment tools often employ paper-based rating forms. Digital assessment forms for evaluating surgical skills could potentially offer advantages over paper-based forms, especially in complex...... assessment situations. In this paper, we report on the development of cross-platform digital assessment forms for use with multiple raters in order to facilitate the automatic processing of surgical skills assessments that include structured ratings. The FileMaker 13 platform was used to create a database...

Teaching and testing basic surgical skills without using patients

Directory of Open Access Journals (Sweden)

Razavi M

2004-10-01

Full Text Available Background: Nowadays, clinical skills centers are important structural components of authentic universities in the world. These centers can be use for tuition of cognitive, affective and psychomotor skills. In this study we have designed a surgical course, consist of 19 theoretical knowledge (cognitive skills and 10 procedural skills. Purpose: teaching and testing the designed course. Methods: This study has been conducted on 678 medical students at clerkship stage. Pre and post-self assessment technique has been used to assess learning progress. A multivariate statistical comparison were adapted for Judgments of learning achievement, Hotelling’s T-square has been used to ascertain the differences between pre and post tests score. For measuring the reliability of the test items. Cronbach's Alpha has been used to measure the reliability of test item. Results: The reliability of the test was 0.84 for cognitive skills and 0.92 for procedural skills. The two tailed test for comparing each pairs of score of 19 cognitive items showed a significant statistical difference between 13 items (P=0.000. For procedural skills the differences between the mean score of 9 items were significant (P=0.000. These results indicate learning achievements by students. Conclusion: This study suggests that, the ability of trainees in both cognitive and psychomotor skills can be improved by tuition of basic surgical skills in skill Lab. (without use of patients. Key words: BASIC SURGICAL SKILLS, CSC, (CLINICAL SKILLS CENTER PRE AND POST SELF-ASSESSMENT

Validation of a virtual reality-based robotic surgical skills curriculum.

Science.gov (United States)

Connolly, Michael; Seligman, Johnathan; Kastenmeier, Andrew; Goldblatt, Matthew; Gould, Jon C

2014-05-01

The clinical application of robotic-assisted surgery (RAS) is rapidly increasing. The da Vinci Surgical System™ is currently the only commercially available RAS system. The skills necessary to perform robotic surgery are unique from those required for open and laparoscopic surgery. A validated laparoscopic surgical skills curriculum (fundamentals of laparoscopic surgery or FLS™) has transformed the way surgeons acquire laparoscopic skills. There is a need for a similar skills training and assessment tool specific for robotic surgery. Based on previously published data and expert opinion, we developed a robotic skills curriculum. We sought to evaluate this curriculum for evidence of construct validity (ability to discriminate between users of different skill levels). Four experienced surgeons (>20 RAS) and 20 novice surgeons (first-year medical students with no surgical or RAS experience) were evaluated. The curriculum comprised five tasks utilizing the da Vinci™ Skills Simulator (Pick and Place, Camera Targeting 2, Peg Board 2, Matchboard 2, and Suture Sponge 3). After an orientation to the robot and a period of acclimation in the simulator, all subjects completed three consecutive repetitions of each task. Computer-derived performance metrics included time, economy of motion, master work space, instrument collisions, excessive force, distance of instruments out of view, drops, missed targets, and overall scores (a composite of all metrics). Experienced surgeons significantly outperformed novice surgeons in most metrics. Statistically significant differences were detected for each task in regards to mean overall scores and mean time (seconds) to completion. The curriculum we propose is a valid method of assessing and distinguishing robotic surgical skill levels on the da Vinci Si™ Surgical System. Further study is needed to establish proficiency levels and to demonstrate that training on the simulator with the proposed curriculum leads to improved robotic

Communication Skills among Surgical Trainees: Perceptions of ...

African Journals Online (AJOL)

Objective Communication between the surgeon and the patient is a core clinical skill. The ability to communicate with patients and their family members is very important in the optimum care of the surgical patient. Few studies have assessed communication between surgical trainees and their patients in sub-Saharan Africa.

The Role of Crowdsourcing in Assessing Surgical Skills.

Science.gov (United States)

Katz, Andrew J

2016-08-01

Assessing surgical skill is critical in improving patient care while reducing medical errors, length of stay, and readmission rates. Crowdsourcing provides 1 potential method for accurately assessing this; only recently has crowdsourcing been studied as a valid way to provide feedback to surgeons. The results of such studies are explored. A systematic literature search was performed on PubMed to identify studies that have attempted to validate crowdsourcing as a method for assessing surgical skill. Through a combination of abstract screening and full-length review, 9 studies that met the inclusion criteria were reviewed. Crowdsourcing has been validated as an important way to provide feedback for surgical skill. It has been demonstrated to be effective in both dry-lab and live surgery, for a variety of tasks and methods. However, more studies must be performed to ensure that crowdsourcing can provide quality feedback in a wider variety of scenarios.

Module based training improves and sustains surgical skills

DEFF Research Database (Denmark)

Carlsen, C G; Lindorff-Larsen, K; Funch-Jensen, P

2015-01-01

PURPOSE: Traditional surgical training is challenged by factors such as patient safety issues, economic considerations and lack of exposure to surgical procedures due to short working hours. A module-based clinical training model promotes rapidly acquired and persistent surgical skills. METHODS...... hernia repair was preferable in both short and long-term compared with standard clinical training. The model will probably be applicable to other surgical training procedures....

Skill accreditation system for laparoscopic gastroenterologic surgeons in Japan.

Science.gov (United States)

Mori, Toshiyuki; Kimura, Taizo; Kitajima, Masaki

2010-01-01

The Japan Society for Endoscopic Surgery (JSES) has established an Endoscopic Surgical Skill Qualification System and started examination in 2004. Non-edited videotapes were assessed by two judges in a double-blinded fashion with strict criteria. Two kinds of criteria, namely common and procedure-specific, were prepared. The common criteria were designed to evaluate set-ups, autonomy of the operator, display of the surgical field, recognition of surgical anatomy, co-operation of the surgical team. The procedure-specific criteria were made to assess the operation in a step-by-step fashion. In total, out of 1.114 surgeons who were assessed by this qualification system over a period of four years, 537 (48.2%) have been accredited. The qualification rate in each surgical field has remained at the same level of 40 to 50% to date. Inter-rater agreement of two judges was low at 0.31 in the first year, but improved with revision of the criteria and consensus meetings. Surgeons assessed by this system as qualified experienced less frequent complications when compared to those who failed. This system has impacted on the improvement and standardization of laparoscopic surgery in Japan.

Australian Qualifications Framework Lower-Level Qualifications: Pathways to Where for Young People?

Science.gov (United States)

Stanwick, John

2005-01-01

This study investigates where certificate I and II qualifications lead young people aged 15-24 years in terms of employment and further study. A prime motivation for young people undertaking these qualifications is to facilitate transition into the labour market. These qualifications are aimed at developing basic vocational skills or preparatory…

Cross-platform digital assessment forms for evaluating surgical skills

Directory of Open Access Journals (Sweden)

Steven Arild Wuyts Andersen

2015-04-01

Full Text Available A variety of structured assessment tools for use in surgical training have been reported, but extant assessment tools often employ paper-based rating forms. Digital assessment forms for evaluating surgical skills could potentially offer advantages over paper-based forms, especially in complex assessment situations. In this paper, we report on the development of cross-platform digital assessment forms for use with multiple raters in order to facilitate the automatic processing of surgical skills assessments that include structured ratings. The FileMaker 13 platform was used to create a database containing the digital assessment forms, because this software has cross-platform functionality on both desktop computers and handheld devices. The database is hosted online, and the rating forms can therefore also be accessed through most modern web browsers. Cross-platform digital assessment forms were developed for the rating of surgical skills. The database platform used in this study was reasonably priced, intuitive for the user, and flexible. The forms have been provided online as free downloads that may serve as the basis for further development or as inspiration for future efforts. In conclusion, digital assessment forms can be used for the structured rating of surgical skills and have the potential to be especially useful in complex assessment situations with multiple raters, repeated assessments in various times and locations, and situations requiring substantial subsequent data processing or complex score calculations.

Proficiency training on a virtual reality robotic surgical skills curriculum.

Science.gov (United States)

Bric, Justin; Connolly, Michael; Kastenmeier, Andrew; Goldblatt, Matthew; Gould, Jon C

2014-12-01

The clinical application of robotic surgery is increasing. The skills necessary to perform robotic surgery are unique from those required in open and laparoscopic surgery. A validated laparoscopic surgical skills curriculum (Fundamentals of Laparoscopic Surgery or FLS™) has transformed the way surgeons acquire laparoscopic skills. There is a need for a similar skills training and assessment tool for robotic surgery. Our research group previously developed and validated a robotic training curriculum in a virtual reality (VR) simulator. We hypothesized that novice robotic surgeons could achieve proficiency levels defined by more experienced robotic surgeons on the VR robotic curriculum, and that this would result in improved performance on the actual daVinci Surgical System™. 25 medical students with no prior robotic surgery experience were recruited. Prior to VR training, subjects performed 2 FLS tasks 3 times each (Peg Transfer, Intracorporeal Knot Tying) using the daVinci Surgical System™ docked to a video trainer box. Task performance for the FLS tasks was scored objectively. Subjects then practiced on the VR simulator (daVinci Skills Simulator) until proficiency levels on all 5 tasks were achieved before completing a post-training assessment of the 2 FLS tasks on the daVinci Surgical System™ in the video trainer box. All subjects to complete the study (1 dropped out) reached proficiency levels on all VR tasks in an average of 71 (± 21.7) attempts, accumulating 164.3 (± 55.7) minutes of console training time. There was a significant improvement in performance on the robotic FLS tasks following completion of the VR training curriculum. Novice robotic surgeons are able to attain proficiency levels on a VR simulator. This leads to improved performance in the daVinci surgical platform on simulated tasks. Training to proficiency on a VR robotic surgery simulator is an efficient and viable method for acquiring robotic surgical skills.

Visuospatial Aptitude Testing Differentially Predicts Simulated Surgical Skill.

Science.gov (United States)

Hinchcliff, Emily; Green, Isabel; Destephano, Christopher; Cox, Mary; Smink, Douglas; Kumar, Amanika; Hokenstad, Erik; Bengtson, Joan; Cohen, Sarah

2018-02-05

To determine if visuospatial perception (VSP) testing is correlated to simulated or intraoperative surgical performance as rated by the American College of Graduate Medical Education (ACGME) milestones. Classification II-2 SETTING: Two academic training institutions PARTICIPANTS: 41 residents, including 19 Brigham and Women's Hospital and 22 Mayo Clinic residents from three different specialties (OBGYN, general surgery, urology). Participants underwent three different tests: visuospatial perception testing (VSP), Fundamentals of Laparoscopic Surgery (FLS®) peg transfer, and DaVinci robotic simulation peg transfer. Surgical grading from the ACGME milestones tool was obtained for each participant. Demographic and subject background information was also collected including specialty, year of training, prior experience with simulated skills, and surgical interest. Standard statistical analysis using Student's t test were performed, and correlations were determined using adjusted linear regression models. In univariate analysis, BWH and Mayo training programs differed in both times and overall scores for both FLS® peg transfer and DaVinci robotic simulation peg transfer (p<0.05 for all). Additionally, type of residency training impacted time and overall score on robotic peg transfer. Familiarity with tasks correlated with higher score and faster task completion (p= 0.05 for all except VSP score). There was no difference in VSP scores by program, specialty, or year of training. In adjusted linear regression modeling, VSP testing was correlated only to robotic peg transfer skills (average time p=0.006, overall score p=0.001). Milestones did not correlate to either VSP or surgical simulation testing. VSP score was correlated with robotic simulation skills but not with FLS skills or ACGME milestones. This suggests that the ability of VSP score to predict competence differs between tasks. Therefore, further investigation is required into aptitude testing, especially prior

Medical Students Teaching Medical Students Surgical Skills: The Benefits of Peer-Assisted Learning.

Science.gov (United States)

Bennett, Samuel Robert; Morris, Simon Rhys; Mirza, Salman

2018-04-10

Teaching surgical skills is a labor intensive process, requiring a high tutor to student ratio for optimal success, and teaching for undergraduate students by consultant surgeons is not always feasible. A surgical skills course was developed, with the aim of assessing the effectiveness of undergraduate surgical peer-assisted learning. Five surgical skills courses were conducted looking at eight domains in surgery, led by foundation year doctors and senior medical students, with a tutor to student ratio of 1:4. Precourse and postcourse questionnaires (Likert scales 0-10) were completed. Mean scores were compared precourse and postcourse. Surgical skills courses took place within clinical skills rooms in the Queen Elizabeth Hospital Birmingham (UK). Seventy students (59 medical, 2 dental, and 9 physician associate students) from a range of academic institutions across the UK completed the course. There was an overall increase in mean scores across all eight domains. Mean improvement score precourse and postcourse in WHO surgical safety checklist (+3.94), scrubbing (+2.99), gowning/gloving (+3.34), knot tying (+5.53), interrupted sutures (+5.89), continuous sutures (+6.53), vertical mattress sutures (+6.46), and local anesthesia (+3.73). Peer-assisted learning is an effective and feasible method for teaching surgical skills in a controlled environment, subsequently improving confidence among healthcare undergraduates. Such teaching may provide the basis for feasibly mass-producing surgical skills courses for healthcare students. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Retention of fundamental surgical skills learned in robot-assisted surgery.

Science.gov (United States)

Suh, Irene H; Mukherjee, Mukul; Shah, Bhavin C; Oleynikov, Dmitry; Siu, Ka-Chun

2012-12-01

Evaluation of the learning curve for robotic surgery has shown reduced errors and decreased task completion and training times compared with regular laparoscopic surgery. However, most training evaluations of robotic surgery have only addressed short-term retention after the completion of training. Our goal was to investigate the amount of surgical skills retained after 3 months of training with the da Vinci™ Surgical System. Seven medical students without any surgical experience were recruited. Participants were trained with a 4-day training program of robotic surgical skills and underwent a series of retention tests at 1 day, 1 week, 1 month, and 3 months post-training. Data analysis included time to task completion, speed, distance traveled, and movement curvature by the instrument tip. Performance of the participants was graded using the modified Objective Structured Assessment of Technical Skills (OSATS) for robotic surgery. Participants filled out a survey after each training session by answering a set of questions. Time to task completion and the movement curvature was decreased from pre- to post-training and the performance was retained at all the corresponding retention periods: 1 day, 1 week, 1 month, and 3 months. The modified OSATS showed improvement from pre-test to post-test and this improvement was maintained during all the retention periods. Participants increased in self-confidence and mastery in performing robotic surgical tasks after training. Our novel comprehensive training program improved robot-assisted surgical performance and learning. All trainees retained their fundamental surgical skills for 3 months after receiving the training program.

The Basic Surgical Skills Course in Sub-Saharan Africa: An Observational Study of Effectiveness.

Science.gov (United States)

Fergusson, Stuart J; Sedgwick, David M; Ntakiyiruta, Georges; Ntirenganya, Faustin

2018-04-01

The Basic Surgical Skills (BSS) course is a common component of postgraduate surgical training programmes in sub-Saharan Africa, but was originally designed in a UK context, and its efficacy and relevance have not been formally assessed in Africa. An observational study was carried out during a BSS course delivered to early-stage surgical trainees from Rwanda and the Democratic Republic of the Congo. Technical skill in a basic wound closure task was assessed in a formal Objective Structured Assessment of Technical Skills (OSAT) before and after course completion. Participants completed a pre-course questionnaire documenting existing surgical experience and self-perceived confidence levels in surgical skills which were to be taught during the course. Participants repeated confidence ratings and completed course evaluation following course delivery. A cohort of 17 participants had completed a pre-course median of 150 Caesarean sections as primary operator. Performance on the OSAT improved from a mean of 10.5/17 pre-course to 14.2/17 post-course (mean of paired differences 3.7, p skills taught, and the course was assessed as highly relevant by trainees. The Basic Surgical Skills course is effective in improving the basic surgical technique of surgical trainees from sub-Saharan Africa and their confidence in key technical skills.

[Evaluation of technical skills in surgical training].

Science.gov (United States)

Kasparian, Andres C; Martinez, A C; JoverClos, R J; Chércoles, R A

2014-01-01

technical skills acquisition is considered to be of paramount importance in surgical training. Yet, formal assessment of technical skills is the weakest and less developed area. Currently available resources to evaluate technical skills are largely subjective, and lack of validity and reliability. Direct observation, one of the most frequently used methods, is largely biased by interpersonal subjectivity and personality traits. We propose the creation and use of a new procedure-specific tool for objective assessment of technical skills in surgery to evaluate validity and reliability. laparoscopic cholecystectomy and Lichstenstein's inguinal hernia repair were the chosen procedures. Three groups of comparison were defined according to surgical expertise: initial, intermediate, and experts. Surgeries were videorecorded in real time without identification of the patient or the surgeon. Tapes without any posterior edition were assigned to two expert surgeons in a blind and randomized sequence. A newly proposed procedure-specific rating scale was used for evaluation, as well as Reznick's OSATS global scale. Kruskal-Wallis non-parametric test was used to assess validity. p 0.8 granted reliability. from April 2010 to December 2012 36 laparoscopic cholecystectomies and 31 inguinal hernia repairs were recorded. Significant difference was found among groups of comparison for every item (ptechnical skills in surgery is feasible and useful. The tool we proposed showed construct validity and reliability. Video recording of surgical procedures grants durability over time to an ephemeral phenomenon. The objectivity is based on the explicit statements and quantification of every step to be evaluated, and the blind randomization and anonymous treatment of the sample. Sharing the same quality criteria between evaluators is of paramount importance to reach satisfactory results. The process of evaluation always implies a shortened view of the reality.

Hybrid Qualifications

DEFF Research Database (Denmark)

Against the background of increasing qualification needs there is a growing awareness of the challenge to widen participation in processes of skill formation and competence development. At the same time, the issue of permeability between vocational education and training (VET) and general education...... has turned out as a major focus of European education and training policies and certainly is a crucial principle underlying the European Qualifications Framework (EQF). In this context, «hybrid qualifications» (HQ) may be seen as an interesting approach to tackle these challenges as they serve «two...

Using peer-assisted learning to teach basic surgical skills: medical students’ experiences

Directory of Open Access Journals (Sweden)

Mahdi Saleh

2013-08-01

Full Text Available Standard medical curricula in the United Kingdom (UK typically provide basic surgical-skills teaching before medical students are introduced into the clinical environment. However, these sessions are often led by clinical teaching fellows and/or consultants. Depending on the roles undertaken (e.g., session organizers, peer tutors, a peer-assisted learning (PAL approach may afford many benefits to teaching surgical skills. At the University of Keele's School of Medicine, informal PAL is used by the Surgical Society to teach basic surgical skills to pre-clinical students. As medical students who assumed different roles within this peer-assisted model, we present our experiences and discuss the possible implications of incorporating such sessions into UK medical curricula. Our anecdotal evidence suggests that a combination of PAL sessions – used as an adjunct to faculty-led sessions – may provide optimal learning opportunities in delivering a basic surgical skills session for pre-clinical students.

Non-technical skills of surgical trainees and experienced surgeons.

Science.gov (United States)

Gostlow, H; Marlow, N; Thomas, M J W; Hewett, P J; Kiermeier, A; Babidge, W; Altree, M; Pena, G; Maddern, G

2017-05-01

In addition to technical expertise, surgical competence requires effective non-technical skills to ensure patient safety and maintenance of standards. Recently the Royal Australasian College of Surgeons implemented a new Surgical Education and Training (SET) curriculum that incorporated non-technical skills considered essential for a competent surgeon. This study sought to compare the non-technical skills of experienced surgeons who completed their training before the introduction of SET with the non-technical skills of more recent trainees. Surgical trainees and experienced surgeons undertook a simulated scenario designed to challenge their non-technical skills. Scenarios were video recorded and participants were assessed using the Non-Technical Skills for Surgeons (NOTSS) scoring system. Participants were divided into subgroups according to years of experience and their NOTSS scores were compared. For most NOTSS elements, mean scores increased initially, peaking around the time of Fellowship, before decreasing roughly linearly over time. There was a significant downward trend in score with increasing years since being awarded Fellowship for six of the 12 NOTSS elements: considering options (score -0·015 units per year), implementing and reviewing decisions (-0·020 per year), establishing a shared understanding (-0·014 per year), setting and maintaining standards (-0·024 per year), supporting others (-0·031 per year) and coping with pressure (-0·015 per year). The drop in NOTSS score was unexpected and highlights that even experienced surgeons are not immune to deficiencies in non-technical skills. Consideration should be given to continuing professional development programmes focusing on non-technical skills, regardless of the level of professional experience. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

Use of Performance Measures to Evaluate, Document Competence and Deterioration of Advanced Surgical Skills Exposure for Trauma (ASSET) Surgical Skills

Science.gov (United States)

2015-03-01

Sharon Henry1, Stacy Shackelford4. 1Shock Trauma Anesthesiology Research, University of Maryland Baltimore; 2The Alfred Hospital and Swinburne...Bethesda USA, The Alfred Hospital and Swinburne University, Melbourne, Australia • 6) THE ASSETS OF ASSET: IMPROVING SURGICAL PERFROMANCE...ACTIVITY 820 CHANDLER STREET FORT DETRICK MD 21702-5014 January 15, 2015 SUBJECT: BA 150077- "Refreshing Combat Surgical Skills for Vascular Control

Video Ratings of Surgical Skill and Late Outcomes of Bariatric Surgery

Science.gov (United States)

Scally, Christopher P.; Varban, Oliver A.; Carlin, Arthur M.; Birkmeyer, John D.; Dimick, Justin B.

2018-01-01

Importance Measures of surgeons’ skill have been associated with variations in short-term outcomes after laparoscopic gastric bypass. However, the impact of surgical skill on long-term outcomes after bariatric surgery is unknown. Objective To study the association between surgical skill and long-term outcomes of bariatric surgery Design Surgeons were ranked on their skill level through blinded peer video review, and sorted into quartiles of skill. Outcomes of bariatric surgery were then examined at the patient level across skill levels. Setting The Michigan Bariatric Surgical Collaborative, a prospective clinical registry of 40 hospitals performing bariatric surgery in the state of Michigan Participants 20 surgeons performing bariatric surgery who submitted videos for anonymous peer ratings; patients undergoing surgery with these surgeons for whom one year follow-up data postoperatively was available. Exposure Surgeon skill level. Main Outcome Measures Excess body weight loss at one year; resolution of medical comorbidities (hypertension, sleep apnea, diabetes, hyperlipidemia), functional status, patient satisfaction. Results Peer ratings of surgical skill varied from 2.6 to 4.8 on a 5-point scale. There was no difference between the best (top 25%) and worst (bottom 25%) performance quartiles when comparing excess body weight loss (67.2% excess body weight loss vs 68.5%, p=.89) at one year. There were no differences in resolution of sleep apnea (62.6% vs 62.0%, p=.77), hypertension (47.1% vs 45.4%, p=.73), or hyperlipidemia (52.3% vs 63.4%, p=.45). Surgeons with the lowest skill rating had patients with higher rates of diabetes resolution (78.8%) when compared to the high-skill group (72.8%, p=0.01). Conclusions and Relevance In contrast to its impact on early complications, surgical skill did not impact postoperative weight loss or resolution of medical comorbidities at one year after laparoscopic gastric bypass. These findings suggest that long-term outcomes

Surgical skill and complication rates after bariatric surgery.

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Birkmeyer, John D; Finks, Jonathan F; O'Reilly, Amanda; Oerline, Mary; Carlin, Arthur M; Nunn, Andre R; Dimick, Justin; Banerjee, Mousumi; Birkmeyer, Nancy J O

2013-10-10

Clinical outcomes after many complex surgical procedures vary widely across hospitals and surgeons. Although it has been assumed that the proficiency of the operating surgeon is an important factor underlying such variation, empirical data are lacking on the relationships between technical skill and postoperative outcomes. We conducted a study involving 20 bariatric surgeons in Michigan who participated in a statewide collaborative improvement program. Each surgeon submitted a single representative videotape of himself or herself performing a laparoscopic gastric bypass. Each videotape was rated in various domains of technical skill on a scale of 1 to 5 (with higher scores indicating more advanced skill) by at least 10 peer surgeons who were unaware of the identity of the operating surgeon. We then assessed relationships between these skill ratings and risk-adjusted complication rates, using data from a prospective, externally audited, clinical-outcomes registry involving 10,343 patients. Mean summary ratings of technical skill ranged from 2.6 to 4.8 across the 20 surgeons. The bottom quartile of surgical skill, as compared with the top quartile, was associated with higher complication rates (14.5% vs. 5.2%, Pbariatric surgeons varied widely, and greater skill was associated with fewer postoperative complications and lower rates of reoperation, readmission, and visits to the emergency department. Although these findings are preliminary, they suggest that peer rating of operative skill may be an effective strategy for assessing a surgeon's proficiency.

The role of multimedia in surgical skills training and assessment.

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Shariff, Umar; Seretis, Charalampos; Lee, Doreen; Balasubramanian, Saba P

2016-06-01

Multimedia is an educational resource that can be used to supplement surgical skills training. The aim of this review was to determine the role of multimedia in surgical training and assessment by performing a systematic review of the literature. A systematic review for published articles was conducted on the following databases: PubMed/MEDLINE (1992 to November 2014), SCOPUS (1992 to November 2014) and EMBASE (1992 to November 2014). For each study the educational content, study design, surgical skill assessed and outcomes were recorded. A standard data extraction form was created to ensure systematic retrieval of relevant information. 21 studies were included; 14 randomized controlled trials (RCTs) and 7 non-randomized controlled trials (Non-RCTs). Technical skills were assessed in 7 RCTs and 3 non-RCTs; cognitive skills were assessed in 9 RCTs and 4 non-RCTs. In controlled studies, multimedia was associated with significant improvement in technical skills (4 studies; 4 RCTs) and cognitive skills (7 studies; 6 RCTs). In two studies multimedia was inferior in comparison to conventional teaching. Evaluation of multimedia (9 studies) demonstrated strongly favourable results. This review suggests that multimedia effectively facilitates both technical and cognitive skills acquisition and is well accepted as an educational resource. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Development and validation of trauma surgical skills metrics: Preliminary assessment of performance after training.

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Shackelford, Stacy; Garofalo, Evan; Shalin, Valerie; Pugh, Kristy; Chen, Hegang; Pasley, Jason; Sarani, Babak; Henry, Sharon; Bowyer, Mark; Mackenzie, Colin F

2015-07-01

Maintaining trauma-specific surgical skills is an ongoing challenge for surgical training programs. An objective assessment of surgical skills is needed. We hypothesized that a validated surgical performance assessment tool could detect differences following a training intervention. We developed surgical performance assessment metrics based on discussion with expert trauma surgeons, video review of 10 experts and 10 novice surgeons performing three vascular exposure procedures and lower extremity fasciotomy on cadavers, and validated the metrics with interrater reliability testing by five reviewers blinded to level of expertise and a consensus conference. We tested these performance metrics in 12 surgical residents (Year 3-7) before and 2 weeks after vascular exposure skills training in the Advanced Surgical Skills for Exposure in Trauma (ASSET) course. Performance was assessed in three areas as follows: knowledge (anatomic, management), procedure steps, and technical skills. Time to completion of procedures was recorded, and these metrics were combined into a single performance score, the Trauma Readiness Index (TRI). Wilcoxon matched-pairs signed-ranks test compared pretraining/posttraining effects. Mean time to complete procedures decreased by 4.3 minutes (from 13.4 minutes to 9.1 minutes). The performance component most improved by the 1-day skills training was procedure steps, completion of which increased by 21%. Technical skill scores improved by 12%. Overall knowledge improved by 3%, with 18% improvement in anatomic knowledge. TRI increased significantly from 50% to 64% with ASSET training. Interrater reliability of the surgical performance assessment metrics was validated with single intraclass correlation coefficient of 0.7 to 0.98. A trauma-relevant surgical performance assessment detected improvements in specific procedure steps and anatomic knowledge taught during a 1-day course, quantified by the TRI. ASSET training reduced time to complete vascular

Identifying the nontechnical skills required of nurses in general surgical wards.

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Marshall, Dianne C; Finlayson, Mary P

2018-04-01

To identify the nontechnical skills (NTS) required of nurses in general surgical wards for safe and effective care. As the largest occupational group, nurses are in an ideal position to block the vulnerabilities of patient adverse events in a surgical ward. Previous studies in the surgical environment have identified the NTS required of nurses for safe care in operating rooms; however, these skills have not been identified for nurses in general surgical wards. A nonparticipant observational descriptive design was used. A purposive sample of 15 registered nurses was recruited from four surgical wards and observed for a full shift on a morning, afternoon or night shift. Nonparticipant observations were conducted using field notes to collect data. A coding frame was developed, and an inductive process was used to analyse the data. A taxonomy comprising seven NTS required of nurses in their roles in surgical ward teams emerged from the data analysis. They are communication, leadership and management, planning, decision-making, situation awareness, teamwork and patient advocacy. Patient care provided by general surgical nurses involved the seven identified key NTS. These particular NTS are an important component of safe nursing practice as they underpin the provision of safe and effective care for general surgical patients. Nurses block the trajectory of error by using NTS to address the vulnerabilities in the system that can lead to adverse patient events. Identifying general surgical nurses' NTS enables the development of teaching strategies that target the learning of those skills to achieve successful work outcomes and improve patient safety. © 2018 John Wiley & Sons Ltd.

Crowd-sourced assessment of surgical skills in cricothyrotomy procedure.

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Aghdasi, Nava; Bly, Randall; White, Lee W; Hannaford, Blake; Moe, Kris; Lendvay, Thomas S

2015-06-15

Objective assessment of surgical skills is resource intensive and requires valuable time of expert surgeons. The goal of this study was to assess the ability of a large group of laypersons using a crowd-sourcing tool to grade a surgical procedure (cricothyrotomy) performed on a simulator. The grading included an assessment of the entire procedure by completing an objective assessment of technical skills survey. Two groups of graders were recruited as follows: (1) Amazon Mechanical Turk users and (2) three expert surgeons from University of Washington Department of Otolaryngology. Graders were presented with a video of participants performing the procedure on the simulator and were asked to grade the video using the objective assessment of technical skills questions. Mechanical Turk users were paid $0.50 for each completed survey. It took 10 h to obtain all responses from 30 Mechanical Turk users for 26 training participants (26 videos/tasks), whereas it took 60 d for three expert surgeons to complete the same 26 tasks. The assessment of surgical performance by a group (n = 30) of laypersons matched the assessment by a group (n = 3) of expert surgeons with a good level of agreement determined by Cronbach alpha coefficient = 0.83. We found crowd sourcing was an efficient, accurate, and inexpensive method for skills assessment with a good level of agreement to experts' grading. Copyright © 2015 Elsevier Inc. All rights reserved.

Impact of video game genre on surgical skills development: a feasibility study.

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de Araujo, Thiago Bozzi; Silveira, Filipe Rodrigues; Souza, Dante Lucas Santos; Strey, Yuri Thomé Machado; Flores, Cecilia Dias; Webster, Ronaldo Scholze

2016-03-01

The playing of video games (VGs) was previously shown to improve surgical skills. This is the first randomized, controlled study to assess the impact of VG genre on the development of basic surgical skills. Twenty first-year, surgically inexperienced medical students attended a practical course on surgical knots, suturing, and skin-flap technique. Later, they were randomized into four groups: control and/or nongaming (ContG), first-person-shooter game (ShotG), racing game (RaceG), and surgery game (SurgG). All participants had 3 wk of Nintendo Wii training. Surgical and VG performances were assessed by two independent, blinded surgeons who evaluated basal performance (time 0) and performance after 1 wk (time 1) and 3 wk (time 2) of training. The training time of RaceG was longer than that of ShotG and SurgG (P = 0.045). Compared to SurgG and RaceG, VG scores for ShotG improved less between times 0 and 1 (P = 0.010) but more between times 1 and 2 (P = 0.004). Improvement in mean surgical performance scores versus time differed in each VG group (P = 0.011). At time 2, surgical performance scores were significantly higher in ShotG (P = 0.002) and SurgG (P = 0.022) than in ContG. The surgical performance scores of RaceG were not significantly different from the score achieved by ContG (P = 0.279). Different VG genres may differentially impact the development of surgical skills by medical students. More complex games seem to improve performance even if played less. Although further studies are needed, surgery-related VGs with sufficient complexity and playability could be a feasible adjuvant to improving surgical skills. Copyright © 2016 Elsevier Inc. All rights reserved.

Improving Surgical Skills of OBGYN Residents through Partnership ...

African Journals Online (AJOL)

Improving Surgical Skills of OBGYN Residents through Partnership with Rural Hospitals: Experience from Southeast Nigeria. Odidika Ugochukwu Joannes Umeora, Azubuike Kanario Onyebuchi, Nkechi Bridget Emma-Echiegu, Justus Ndulue Eze, Paul Olisaemeka Ezeonu ...

Relationships among video gaming proficiency and spatial orientation, laparoscopic, and traditional surgical skills of third-year veterinary students.

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Millard, Heather A Towle; Millard, Ralph P; Constable, Peter D; Freeman, Lyn J

2014-02-01

To determine the relationships among traditional and laparoscopic surgical skills, spatial analysis skills, and video gaming proficiency of third-year veterinary students. Prospective, randomized, controlled study. A convenience sample of 29 third-year veterinary students. The students had completed basic surgical skills training with inanimate objects but had no experience with soft tissue, orthopedic, or laparoscopic surgery; the spatial analysis test; or the video games that were used in the study. Scores for traditional surgical, laparoscopic, spatial analysis, and video gaming skills were determined, and associations among these were analyzed by means of Spearman's rank order correlation coefficient (rs). A significant positive association (rs = 0.40) was detected between summary scores for video game performance and laparoscopic skills, but not between video game performance and traditional surgical skills scores. Spatial analysis scores were positively (rs = 0.30) associated with video game performance scores; however, that result was not significant. Spatial analysis scores were not significantly associated with laparoscopic surgical skills scores. Traditional surgical skills scores were not significantly associated with laparoscopic skills or spatial analysis scores. Results of this study indicated video game performance of third-year veterinary students was predictive of laparoscopic but not traditional surgical skills, suggesting that laparoscopic performance may be improved with video gaming experience. Additional studies would be required to identify methods for improvement of traditional surgical skills.

The assessment of surgical skills as a complement to the training method. Revision.

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Sánchez-Fernández, J; Bachiller-Burgos, J; Serrano-Pascual, Á; Cózar-Olmo, J M; Díaz-Güemes Martín-Portugués, I; Pérez-Duarte, F J; Hernández-Hurtado, L; Álvarez-Ossorio, J L; Sánchez-Margallo, F M

2016-01-01

The acquisition and improvement of surgical skills constitute a fundamental element in the training of any practitioner. At present, however, the assessment of these skills is a scarcely developed area of research. The aim of this study was to analyse the peculiarities of the various assessment systems and establish the minimum criteria that a skills and knowledge assessment system should meet as a method for assessing surgical skills in urological surgery. Scientific literature review aimed at the various currently available assessment systems for skills and competencies (technical and nontechnical), with a special focus on the systematic reviews and prospective studies. After conducting the review, we found that the various assessment systems for surgical competence have, in our opinion, a number of shortcomings. There is a certain degree of subjectivity in the assessment of surgeons by the evaluators. The assessment of nontechnical competencies is not formally recorded. There is no description of a follow-up assessment or any basic parameters associated with healthcare quality. There is no registration of associated competencies associated with the various surgical techniques. There is also no ranking of these competencies and the specific peculiarities for their application. We believe that the development of a new assessment system for surgical competencies (technical and nontechnical) aimed at assessing urologists in the various surgical techniques is necessary. To this end, our team has worked on developing the Evaluation System for Surgical Competencies on Laparoscopy, which is based on the definition, ranking and assessment of competencies demonstrated by surgeons. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Surgical ergonomics. Analysis of technical skills, simulation models and assessment methods.

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Papaspyros, Sotiris C; Kar, Ashok; O'Regan, David

2015-06-01

Over the past two centuries the surgical profession has undergone a profound evolution in terms of efficiency and outcomes. Societal concerns in relation to quality assurance, patient safety and cost reduction have highlighted the issue of training expert surgeons. The core elements of a training model build on the basic foundations of gross and fine motor skills. In this paper we provide an analysis of the ergonomic principles involved and propose relevant training techniques. We have endeavored to provide both the trainer and trainee perspectives. This paper is structured into four sections: 1) Pre-operative preparation issues, 2) technical skills and instrument handling, 3) low fidelity simulation models and 4) discussion of current concepts in crew resource management, deliberate practice and assessment. Rehearsal, warm-up and motivation-enhancing techniques aid concentration and focus. Appropriate posture, comprehension of ergonomic principles in relation to surgical instruments and utilisation of the non-dominant hand are essential skills to master. Low fidelity models can be used to achieve significant progress through the early stages of the learning curve. Deliberate practice and innate ability are complementary to each other and may be considered useful adjuncts to surgical skills development. Safe medical care requires that complex patient interventions be performed by highly skilled operators supported by reliable teams. Surgical ergonomics lie at the heart of any training model that aims to produce professionals able to function as leaders of a patient safety oriented culture. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Crowd-sourced assessment of technical skills: an opportunity for improvement in the assessment of laparoscopic surgical skills.

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Deal, Shanley B; Lendvay, Thomas S; Haque, Mohamad I; Brand, Timothy; Comstock, Bryan; Warren, Justin; Alseidi, Adnan

2016-02-01

Objective, unbiased assessment of surgical skills remains a challenge in surgical education. We sought to evaluate the feasibility and reliability of Crowd-Sourced Assessment of Technical Skills. Seven volunteer general surgery interns were given time for training and then testing, on laparoscopic peg transfer, precision cutting, and intracorporeal knot-tying. Six faculty experts (FEs) and 203 Amazon.com Mechanical Turk crowd workers (CWs) evaluated 21 deidentified video clips using the Global Objective Assessment of Laparoscopic Skills validated rating instrument. Within 19 hours and 15 minutes we received 662 eligible ratings from 203 CWs and 126 ratings from 6 FEs over 10 days. FE video ratings were of borderline internal consistency (Krippendorff's alpha = .55). FE ratings were highly correlated with CW ratings (Pearson's correlation coefficient = .78, P Assessment of Technical Skills as a reliable, basic tool to standardize the evaluation of technical skills in general surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

Improving Surgical Safety and Nontechnical Skills in Variable-Resource Contexts: A Novel Educational Curriculum.

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Lin, Yihan; Scott, John W; Yi, Sojung; Taylor, Kathryn K; Ntakiyiruta, Georges; Ntirenganya, Faustin; Banguti, Paulin; Yule, Steven; Riviello, Robert

2017-10-23

A substantial proportion of adverse intraoperative events are attributed to failures in nontechnical skills. To strengthen these skills and improve surgical safety, the Non-Technical Skills for Surgeons (NOTSS) taxonomy was developed as a common framework. The NOTSS taxonomy was adapted for low- and middle-income countries, where variable resources pose a significant challenge to safe surgery. The NOTSS for variable-resource contexts (VRC) curriculum was developed and implemented in Rwanda, with the aim of enhancing knowledge and attitudes about nontechnical skills and promoting surgical safety. The NOTSS-VRC curriculum was developed through a rigorous process of integrating contextually appropriate values. It was implemented as a 1-day training course for surgical and anesthesia postgraduate trainees. The curriculum comprises lectures, videos, and group discussions. A pretraining and posttraining questionnaire was administered to compare knowledge and attitudes regarding nontechnical skills, and their potential to improve surgical safety. The setting of this study was in the tertiary teaching hospital of Kigali, Rwanda. Participants were residents of the University of Kigali. A total of 55 residents participated from general surgery (31.4%), obstetrics (25.5%), anesthesia (17.6%), and other surgical specialties (25.5%). In a paired analysis, understanding of NOTSS improved significantly (55.6% precourse, 80.9% postcourse, pskills would improve patient outcomes. Nontechnical skills must be highlighted in surgical training in low- and middle-income countries. The NOTSS-VRC curriculum can be implemented without additional technology or significant financial cost. Its deliberate design for resource-constrained settings allows it to be used both as an educational course and a quality improvement strategy. Our research demonstrates it is feasible to improve knowledge and attitudes about NOTSS through a 1-day course, and represents a novel approach to improving global

Nontechnical skill training and the use of scenarios in modern surgical education.

Science.gov (United States)

Brunckhorst, Oliver; Khan, Muhammad S; Dasgupta, Prokar; Ahmed, Kamran

2017-07-01

Nontechnical skills are being increasingly recognized as a core reason of surgical errors. Combined with the changing nature of surgical training, there has therefore been an increase in nontechnical skill research in the literature. This review therefore aims to: define nontechnical skillsets, assess current training methods, explore assessment modalities and suggest future research aims. The literature demonstrates an increasing understanding of the components of nontechnical skills within surgery. This has led to a greater availability of validated training methods for its training, including the use of didactic teaching, e-learning and simulation-based scenarios. In addition, there are now various extensively validated assessment tools for nontechnical skills including NOTSS, the Oxford NOTECHS and OTAS. Finally, there is now more focus on the development of tools which target individual nontechnical skill components and an attempt to understand which of these play a greater role in specific procedures such as laparoscopic or robotic surgery. Current evidence demonstrates various training methods and tools for the training of nontechnical skills. Future research is likely to focus increasingly on individual nontechnical skill components and procedure-specific skills.

Approaching time is important for assessment of endoscopic surgical skills.

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Tokunaga, Masakazu; Egi, Hiroyuki; Hattori, Minoru; Yoshimitsu, Masanori; Sumitani, Daisuke; Kawahara, Tomohiro; Okajima, Masazumi; Ohdan, Hideki

2012-05-01

This study aimed to verify whether the approaching time (the time taken to reach the target point from another point, a short distance apart, during point-to-point movement in endoscopic surgery), assessed using the Hiroshima University Endoscopic Surgical Assessment Device (HUESAD), could distinguish the skill level of surgeons. Expert surgeons (who had performed more than 50 endoscopic surgeries) and novice surgeons (who had no experience in performing endoscopic surgery) were tested using the HUESAD. The approaching time, total time, and intermediate time (total time--approaching time) were measured and analyzed using the trajectory of the tip of the instrument. The approaching time and total time were significantly shorter in the expert group than in the novice group (p time did not significantly differ between the groups (p > 0.05). The approaching time, which is a component of the total time, is very mportant in the measurement of the total time to assess endoscopic surgical skills. Further, the approaching time was useful for skill assessment by the HUESAD for evaluating the skill of surgeons performing endoscopic surgery.

Effect of music on surgical skill during simulated intraocular surgery.

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Kyrillos, Ralph; Caissie, Mathieu

2017-12-01

To evaluate the effect of Mozart music compared to silence on anterior segment surgical skill in the context of simulated intraocular surgery. Prospective stratified and randomized noninferiority trial. Fourteen ophthalmologists and 12 residents in ophthalmology. All participants were asked to perform 4 sets of predetermined tasks on the EyeSI surgical simulator (VRmagic, Mannheim, Germany). The participants completed 1 Capsulorhexis task and 1 Anti-Tremor task during 3 separate visits. The first 2 sets determined the basic level on day 1. Then, the participants were stratified by surgical experience and randomized to be exposed to music (Mozart sonata for 2 pianos in D-K448) during either the third or the fourth set of tasks (day 2 or 3). Surgical skill was evaluated using the parameters recorded by the simulator such as "Total score" and "Time" for both tasks and task-specific parameters such as "Out of tolerance percentage" for the Anti-Tremor task and "Deviation of rhexis radius from 2.5 mm," "Roundness," and "Centering" for the Capsulorhexis task. The data were analyzed using the Wilcoxon signed-rank test. No statistically significant differences were noted between exposure and nonexposure for all the Anti-Tremor task parameters as well as most parameters for the Capsulorhexis task. Two parameters for the Capsulorhexis task showed a strong trend for improvement with exposure to music ("Total score" +23.3%, p = 0.025; "Roundness" +33.0%, p = 0.037). Exposure to music did not negatively impact surgical skills. Moreover, a trend for improvement was shown while listening to Mozart music. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Can a teaching assistant experience in a surgical anatomy course influence the learning curve for nontechnical skill development for surgical residents?

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Heidenreich, Mark J; Musonza, Tashinga; Pawlina, Wojciech; Lachman, Nirusha

2016-01-01

The foundation upon which surgical residents are trained to work comprises more than just critical cognitive, clinical, and technical skill. In an environment where the synchronous application of expertise is vital to patient outcomes, the expectation for optimal functioning within a multidisciplinary team is extremely high. Studies have shown that for most residents, one of the most difficult milestones in the path to achieving professional expertise in a surgical career is overcoming the learning curve. This view point commentary provides a reflection from the two senior medical students who have participated in the Student-as-Teacher program developed by the Department of Anatomy at Mayo Clinic, designed to prepare students for their teaching assistant (TA) role in anatomy courses. Both students participated as TAs in a six week surgical anatomy course for surgical first assistant students offered by the School of Health Sciences at Mayo Clinic. Development of teaching skills, nontechnical leadership, communication, and assessment skills, are discussed in relation to their benefits in preparing senior medical students for surgical residency. © 2015 American Association of Anatomists.

Surgeon-tool force/torque signatures--evaluation of surgical skills in minimally invasive surgery.

Science.gov (United States)

Rosen, J; MacFarlane, M; Richards, C; Hannaford, B; Sinanan, M

1999-01-01

The best method of training for laparoscopic surgical skills is controversial. Some advocate observation in the operating room, while others promote animal and simulated models or a combination of surgical related tasks. The mode of proficiency evaluation common to all of these methods has been subjective evaluation by a skilled surgeon. In order to define an objective means of evaluating performance, an instrumented laparoscopic grasper was developed measuring the force/torque at the surgeon hand/tool interface. The measured database demonstrated substantial differences between experienced and novice surgeon groups. Analyzing forces and torques combined with the state transition during surgical procedures allows an objective measurement of skill in MIS. Teaching the novice surgeon to limit excessive loads and improve movement efficiency during surgical procedures can potentially result in less injury to soft tissues and less wasted time during laparoscopic surgery. Moreover the force/torque database measured in this study may be used for developing realistic virtual reality simulators and optimization of medical robots performance.

More than a camera holder: teaching surgical skills to medical students.

Science.gov (United States)

Abbas, Paulette; Holder-Haynes, Juliet; Taylor, Deborah J; Scott, Bradford G; Brandt, Mary L; Naik-Mathuria, Bindi

2015-05-15

Students often experience passive learning in their surgical rotations as they are delegated to holding the camera during laparoscopic cases. We introduced a laparoscopic skills course to medical students to provide hands-on experience. We hypothesized that the course will improve basic laparoscopic skills and increase interest in a surgical career. All students on the core surgery rotation attended two sessions in the surgical simulation laboratory lead by Department of Surgery faculty members. Surveys were used before and after the course to assess video game (VG) use and interest in a surgical career. Course effectiveness was assessed with a laparoscopic peg transfer exercise. One hundred one students participated with 82 students documenting preinstruction and postinstruction peg transfer times. There was an overall improvement in median transfer times after instruction (before 63 s [interquartile range {IQR} 46-84.5] versus after 50.5 s [IQR 39-65.2], P men (n = 40) had faster median preintervention peg transfer times than women (n = 61; 65 s [IQR 51-88]) versus 81 s [IQR 65-98] (P = 0.030). However, both genders had equivalent postinstruction transfer times (men 48 s [IQR 36-61] versus women 51.3 s [IQR 43.2-68.3], P = 0.478). A similar trend was observed between students with and without prior VG use. Of the 50 students who completed both surveys, there was no significant increase (pre-24% versus post-34%, P = 0.29) or decrease (pre-32% versus post-22%, P = 0.13) in interest in a surgical career after the course. A laparoscopic course for medical students is effective in improving laparoscopic skills. Although male gender and VG use may be associated with better intrinsic skills, instruction and practice allow female students and non-VG users to "catch up." A longer follow-up study is warranted to determine true interest in a surgical career. Copyright © 2015 Elsevier Inc. All rights reserved.

American College of Surgeons/Association for Surgical Education medical student simulation-based surgical skills curriculum needs assessment.

Science.gov (United States)

Glass, Charity C; Acton, Robert D; Blair, Patrice G; Campbell, Andre R; Deutsch, Ellen S; Jones, Daniel B; Liscum, Kathleen R; Sachdeva, Ajit K; Scott, Daniel J; Yang, Stephen C

2014-02-01

Simulation can enhance learning effectiveness, efficiency, and patient safety and is engaging for learners. A survey was conducted of surgical clerkship directors nationally and medical students at 5 medical schools to rank and stratify simulation-based educational topics. Students applying to surgery were compared with others using Wilcoxon's rank-sum tests. Seventy-three of 163 clerkship directors (45%) and 231 of 872 students (26.5%) completed the survey. Of students, 28.6% were applying for surgical residency training. Clerkship directors and students generally agreed on the importance and timing of specific educational topics. Clerkship directors tended to rank basic skills, such as examination skills, higher than medical students. Students ranked procedural skills, such as lumbar puncture, more highly than clerkship directors. Surgery clerkship directors and 4th-year medical students agree substantially about the content of a simulation-based curriculum, although 4th-year medical students recommended that some topics be taught earlier than the clerkship directors recommended. Students planning to apply to surgical residencies did not differ significantly in their scoring from students pursuing nonsurgical specialties. Copyright © 2014 Elsevier Inc. All rights reserved.

Assessment of communication, professionalism, and surgical skills in an objective structured performance-related examination (OSPRE): a psychometric study.

Science.gov (United States)

Ponton-Carss, Alicia; Hutchison, Carol; Violato, Claudio

2011-10-01

The purpose of this study was to investigate the reliability and validity of a performance assessment of communication, professionalism, and surgical skills competencies for surgery residents. Fourteen residents from the general surgery program of the University of Calgary were assessed in 7 surgical simulation stations that included communication and professionalism skills. The internal consistency reliability of the checklists and global rating scales combined was adequate for communication (α = .75-.92) and surgical skills (α = .86-.96), but not for professionalism (α = 0). There was evidence of validity as surgical skills performance improved as a function of postgraduate year level but not for the professionalism checklist. Surgical skills and communication correlated in the 2 stations assessed (r = .55 and .57; P communication skills. Further instrument development is required to assess professionalism in a structured examination context. Copyright © 2011 Elsevier Inc. All rights reserved.

Measuring Error Identification and Recovery Skills in Surgical Residents.

Science.gov (United States)

Sternbach, Joel M; Wang, Kevin; El Khoury, Rym; Teitelbaum, Ezra N; Meyerson, Shari L

2017-02-01

Although error identification and recovery skills are essential for the safe practice of surgery, they have not traditionally been taught or evaluated in residency training. This study validates a method for assessing error identification and recovery skills in surgical residents using a thoracoscopic lobectomy simulator. We developed a 5-station, simulator-based examination containing the most commonly encountered cognitive and technical errors occurring during division of the superior pulmonary vein for left upper lobectomy. Successful completion of each station requires identification and correction of these errors. Examinations were video recorded and scored in a blinded fashion using an examination-specific rating instrument evaluating task performance as well as error identification and recovery skills. Evidence of validity was collected in the categories of content, response process, internal structure, and relationship to other variables. Fifteen general surgical residents (9 interns and 6 third-year residents) completed the examination. Interrater reliability was high, with an intraclass correlation coefficient of 0.78 between 4 trained raters. Station scores ranged from 64% to 84% correct. All stations adequately discriminated between high- and low-performing residents, with discrimination ranging from 0.35 to 0.65. The overall examination score was significantly higher for intermediate residents than for interns (mean, 74 versus 64 of 90 possible; p = 0.03). The described simulator-based examination with embedded errors and its accompanying assessment tool can be used to measure error identification and recovery skills in surgical residents. This examination provides a valid method for comparing teaching strategies designed to improve error recognition and recovery to enhance patient safety. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Avoiding Surgical Skill Decay: A Systematic Review on the Spacing of Training Sessions.

Science.gov (United States)

Cecilio-Fernandes, Dario; Cnossen, Fokie; Jaarsma, Debbie A D C; Tio, René A

Spreading training sessions over time instead of training in just 1 session leads to an improvement of long-term retention for factual knowledge. However, it is not clear whether this would also apply to surgical skills. Thus, we performed a systematic review to find out whether spacing training sessions would also improve long-term retention of surgical skills. We searched the Medline, PsycINFO, Embase, Eric, and Web of Science online databases. We only included articles that were randomized trials with a sample of medical trainees acquiring surgical motor skills in which the spacing effect was reported. The quality and bias of the articles were assessed using the Cochrane Collaboration's risk of bias assessment tool. With respect to the spacing effect, 1955 articles were retrieved. After removing duplicates and articles that did not meet the inclusion criteria, 11 articles remained. The overall quality of the experiments was "moderate." Trainees in the spaced condition scored higher in a retention test than students in the massed condition. Our systematic review showed evidence that spacing training sessions improves long-term surgical skills retention when compared to massed practice. However, the optimal gap between the re-study sessions is unclear. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Evaluation of distributed practice schedules on retention of a newly acquired surgical skill: a randomized trial.

Science.gov (United States)

Mitchell, Erica L; Lee, Dae Y; Sevdalis, Nick; Partsafas, Aaron W; Landry, Gregory J; Liem, Timothy K; Moneta, Gregory L

2011-01-01

practice influences new skill acquisition. The aim of this study was to prospectively investigate the impact of practice distribution (weekly vs monthly) on complex motor skill (end-side vascular anastomosis) acquisition and 4-month retention. twenty-four surgical interns were randomly assigned to weekly training for 4 weeks or monthly training for 4 months, with equal total training times. Performance was assessed before training, immediately after training, after the completion of distributed training, and 4 months later. there was no statistical difference in surgical skill acquisition and retention between the weekly and monthly scheduled groups, as measured by procedural checklist scores, global rating scores of operative performance, final product analysis, and overall performance or assessment of operative "competence." distributed practice results in improvement and retention of a newly acquired surgical skill independent of weekly or monthly practice schedules. Flexibility in a surgical skills laboratory curriculum is possible without adversely affecting training. 2011 Elsevier Inc. All rights reserved.

Battle of the bots: a comparison of the standard da Vinci and the da Vinci Surgical Skills Simulator in surgical skills acquisition.

Science.gov (United States)

Brown, Kevin; Mosley, Natalie; Tierney, James

2017-06-01

Virtual reality simulators are increasingly used to gain robotic surgical skills. This study compared use of the da Vinci Surgical Skills Simulator (dVSSS) to the standard da Vinci (SdV) robot for skills acquisition in a prospective randomized study. Residents from urology, gynecology, and general surgery programs performed three virtual reality tasks (thread the ring, ring rail, and tubes) on the dvSSS. Participants were then randomized to one of the two study groups (dVSSS and SdV). Each participant then practiced on either the dVSSS or the SdV (depending on randomization) for 30 min per week over a 4-week time period. The dVSSS arm was not permitted to practice ring rail (due to no similar practice scenario available for the SdV group). Following 4 weeks of practice, participants performed the same three virtual reality tasks and the results were recorded and compared to baseline. Overall and percent improvement were recorded for all participants from pre-test to post-test. Two-way ANOVA analyses were used to compare the dVSSS and SdV groups and three tasks. Initially, 30 participants were identified and enrolled in the study. Randomization resulted in 15 participants in each arm. During the course of the study, four participants were unable to complete all tasks and practice sessions and were, therefore, excluded. This resulted in a total of 26 participants (15 in the dVSSS group and 11 in the SdV group) who completed the study. Overall total improvement score was found to be 23.23 and 23.48 for the SdV and dVSSS groups, respectively (p = 0.9245). The percent improvement was 60 and 47 % for the SdV and dVSSS groups respectively, which was a statistically significant difference between the two groups and three tasks. Practicing on the standard da Vinci is comparable to practicing on the da Vinci simulator for acquiring robotic surgical skills. In spite of several potential advantages, the dVSSS arm performed no better than the SdV arm in the final

Qualifications and Skills: The Organisational Perspective

Science.gov (United States)

Dafou, Efthimia

2009-01-01

This paper portrays the inferences that employers in Greece draw from particular aspects of study programmes, as recorded on educational qualifications. Based on semi-structured interviews with human resource managers in 37 industrial and service organisations and general directors of careers offices in eight higher education institutions, and…

MOJECT: MOTION ANALYSIS TO SUPPORT ASSESSMENT OF SURGICAL SKILLS

NARCIS (Netherlands)

Uineken, Ruben; Groot Jebbink, Erik; Halfwerk, F.R.; Bulten, Anne; Knoben, Peter; Roux, Moritz; Wicik, Ola; Groenier, Marleen

2018-01-01

Assessment of surgical skills is usually performed through direct observation by experts. This is subjective, expensive and requires assessor training. Motion analysis can support objective and cost-effective assessment. The aim of the current study is to design a low-cost, unobtrusive system for

Primary School Teachers' Understanding of Science Process Skills in Relation to Their Teaching Qualifications and Teaching Experience

Science.gov (United States)

Shahali, Edy H. M.; Halim, Lilia; Treagust, David F.; Won, Mihye; Chandrasegaran, A. L.

2017-04-01

This study investigated the understanding of science process skills (SPS) of 329 science teachers from 52 primary schools selected by random sampling. The understanding of SPS was measured in terms of conceptual and operational aspects of SPS using an instrument called the Science Process Skills Questionnaire (SPSQ) with a Cronbach's alpha reliability of 0.88. The findings showed that the teachers' conceptual understanding of SPS was much weaker than their practical application of SPS. The teachers' understanding of SPS differed by their teaching qualifications but not so much by their teaching experience. Emphasis needs to be given to both conceptual and operational understanding of SPS during pre-service and in-service teacher education to enable science teachers to use the skills and implement inquiry-based lessons in schools.

Toward an objective assessment of technical skills: a national survey of surgical program directors in Saudi Arabia.

Science.gov (United States)

Alkhayal, Abdullah; Aldhukair, Shahla; Alselaim, Nahar; Aldekhayel, Salah; Alhabdan, Sultan; Altaweel, Waleed; Magzoub, Mohi Elden; Zamakhshary, Mohammed

2012-01-01

After almost a decade of implementing competency-based programs in postgraduate training programs, the assessment of technical skills remains more subjective than objective. National data on the assessment of technical skills during surgical training are lacking. We conducted this study to document the assessment tools for technical skills currently used in different surgical specialties, their relationship with remediation, the recommended tools from the program directors' perspective, and program directors' attitudes toward the available objective tools to assess technical skills. This study was a cross-sectional survey of surgical program directors (PDs). The survey was initially developed using a focus group and was then sent to 116 PDs. The survey contains demographic information about the program, the objective assessment tools used, and the reason for not using assessment tools. The last section discusses the recommended tools to be used from the PDs' perspective and the PDs' attitude and motivation to apply these tools in each program. The associations between the responses to the assessment questions and remediation were statistically evaluated. Seventy-one (61%) participants responded. Of the respondents, 59% mentioned using only nonstandardized, subjective, direct observation for technical skills assessment. Sixty percent use only summative evaluation, whereas 15% perform only formative evaluations of their residents, and the remaining 22% conduct both summative and formative evaluations of their residents' technical skills. Operative portfolios are kept by 53% of programs. The percentage of programs with mechanisms for remediation is 29% (19 of 65). The survey showed that surgical training programs use different tools to assess surgical skills competency. Having a clear remediation mechanism was highly associated with reporting remediation, which reflects the capability to detect struggling residents. Surgical training leadership should invest more in

Automated robot-assisted surgical skill evaluation: Predictive analytics approach.

Science.gov (United States)

Fard, Mahtab J; Ameri, Sattar; Darin Ellis, R; Chinnam, Ratna B; Pandya, Abhilash K; Klein, Michael D

2018-02-01

Surgical skill assessment has predominantly been a subjective task. Recently, technological advances such as robot-assisted surgery have created great opportunities for objective surgical evaluation. In this paper, we introduce a predictive framework for objective skill assessment based on movement trajectory data. Our aim is to build a classification framework to automatically evaluate the performance of surgeons with different levels of expertise. Eight global movement features are extracted from movement trajectory data captured by a da Vinci robot for surgeons with two levels of expertise - novice and expert. Three classification methods - k-nearest neighbours, logistic regression and support vector machines - are applied. The result shows that the proposed framework can classify surgeons' expertise as novice or expert with an accuracy of 82.3% for knot tying and 89.9% for a suturing task. This study demonstrates and evaluates the ability of machine learning methods to automatically classify expert and novice surgeons using global movement features. Copyright © 2017 John Wiley & Sons, Ltd.

Evaluation of surgical skill of uvulopalato pharyngo plasty (UPPP)

International Nuclear Information System (INIS)

Takashima, Masayuki; Oda, Makoto; Itoi, Aya; Tomoda, Kouichi

2006-01-01

We evaluated the surgical skill of uvulopalato pharyngo plasty (UPPP) done in 35 cases in our hospital and discussed its efficacy. Our method of UPPP has three characteristics. First, a mattress suture was applied in the tonsillar bed. As a result there was no failure of the suture. Second, we made a raw surface at a little upper part of the root of the uvula and applied the mattress suture to it. This suture has efficacy of soft palate upword to the oral side. Third, no continuous suture has advantage to present scar formation. We also examined the dynamic MRI for obstructive site and images were divided some morphological obstructive pattern, and assess about efficacy of improvement rate of AHI. The efficacy was over 80% in tonsillar type. But there was 31% efficacy not only soft palate but also tongue rotation type. We concluded that the important factor to have good result of UPPP are surgical skill and adequate indication. (author)

Communication skills among surgical trainees: Perceptions of residents in a teaching hospital in Northern Nigeria

Directory of Open Access Journals (Sweden)

A Ibrahim

2011-01-01

Full Text Available Objective Communication between the surgeon and the patient is a core clinical skill. The ability to communicate with patients and their family members is very important in the optimum care of the surgical patient. Few studies have assessed communication between surgical trainees and their patients in sub-Saharan Africa. In response to this, the communication skills of residents in the department of surgery were evaluated to determine their perception of competency and perceived need for training in communication skills as a basis for developing an effective education programme. Method A survey of patient care - related communication skills among surgery residents and assessment of competence, rating the importance and perceived need for training in communication skills. Results Most residents rated their skills as either fairly or extremely competent in all areas except in providing bereavement counseling. They found all skills important and indicated a need for training in them. Senior registrars rated their competence and the importance higher in skills relating to breaking bad news, educating and preparing patients and families for surgery and encouraging them to express their anxieties. (p 0.05. Conclusion Residents face difficult communication challenges with patients and their families. There is a dire need for improved education in communication skills. Understanding the surgical trainees perceptions of patient care related communication skills is the first step in designing an effective education programme.

Developing an indigenous surgical workforce for Australasia.

Science.gov (United States)

Aramoana, Jaclyn; Alley, Patrick; Koea, Jonathan B

2013-12-01

Progress has been made in Australia and New Zealand to increase the numbers of indigenous students (Aboriginal, Torres Strait Islander and Maori) entering primary medical qualification courses. In New Zealand, up to 20 Maori are graduating annually, with similar numbers possible in Australia, creating a potential opportunity to develop an indigenous surgical workforce. A literature review identified factors utilized by medical schools to attract indigenous students into medical careers and the interventions necessary to ensure successful graduation. A further search identified those factors important in encouraging indigenous medical graduates to enter specialist training programmes and achieve faculty appointments. All medical schools have utilized elements of a 'pipeline approach' encompassing contact with students at secondary school level to encourage aspirational goals and assist with suitable subject selection. Bridging courses can ensure students leaving school have appropriate skill sets before entering medical degree courses. Extensive practical help is available during primary medical qualification study. The elements necessary for primary medical qualification success - dedicated and focused study, developing appropriate skill sets, mentoring, support, and an institutional and collegial commitment to success - are also the elements required for postgraduate achievement. The Royal Australasian College of Surgeons (RACS) is primarily involved in training rather than service provision. The increasing numbers of indigenous medical graduates in both Australia and New Zealand represent an opportunity for the College to contribute to improving indigenous health status by implementing specific measures to increase numbers of indigenous surgeons. © 2013 Royal Australasian College of Surgeons.

Validating a Methodology for Establishing a Criteria and Proficiency Levels in Surgical Skills Simulators

National Research Council Canada - National Science Library

Heinrichs, LeRoy; Lukoff, Brian; Youngblood, Patricia; Dev, Parvati; Shavelson, Richard

2006-01-01

.... To establish training criteria, we have assessed the performance of 18 experienced laparoscopic surgeons basic technical surgical skills of recorded electronically in 26 basic skills modules selected...

Cognitive learning and its future in urology: surgical skills teaching and assessment.

Science.gov (United States)

Shafiei, Somayeh B; Hussein, Ahmed A; Guru, Khurshid A

2017-07-01

The aim of this study is to provide an overview of the current status of novel cognitive training approaches in surgery and to investigate the potential role of cognitive training in surgical education. Kinematics of end-effector trajectories, as well as cognitive state features of surgeon trainees and mentors have recently been studied as modalities to objectively evaluate the expertise level of trainees and to shorten the learning process. Virtual reality and haptics also have shown promising in research results in improving the surgical learning process by providing feedback to the trainee. 'Cognitive training' is a novel approach to enhance training and surgical performance. The utility of cognitive training in improving motor skills in other fields, including sports and rehabilitation, is promising enough to justify its utilization to improve surgical performance. However, some surgical procedures, especially ones performed during human-robot interaction in robot-assisted surgery, are much more complicated than sport and rehabilitation. Cognitive training has shown promising results in surgical skills-acquisition in complicated environments such as surgery. However, these methods are mostly developed in research groups using limited individuals. Transferring this research into the clinical applications is a demanding challenge. The aim of this review is to provide an overview of the current status of these novel cognitive training approaches in surgery and to investigate the potential role of cognitive training in surgical education.

Extended score interval in the assessment of basic surgical skills.

Science.gov (United States)

Acosta, Stefan; Sevonius, Dan; Beckman, Anders

2015-01-01

The Basic Surgical Skills course uses an assessment score interval of 0-3. An extended score interval, 1-6, was proposed by the Swedish steering committee of the course. The aim of this study was to analyze the trainee scores in the current 0-3 scored version compared to a proposed 1-6 scored version. Sixteen participants, seven females and nine males, were evaluated in the current and proposed assessment forms by instructors, observers, and learners themselves during the first and second day. In each assessment form, 17 tasks were assessed. The inter-rater reliability between the current and the proposed score sheets were evaluated with intraclass correlation (ICC) with 95% confidence intervals (CI). The distribution of scores for 'knot tying' at the last time point and 'bowel anastomosis side to side' given by the instructors in the current assessment form showed that the highest score was given in 31 and 62%, respectively. No ceiling effects were found in the proposed assessment form. The overall ICC between the current and proposed score sheets after assessment by the instructors increased from 0.38 (95% CI 0.77-0.78) on Day 1 to 0.83 (95% CI 0.51-0.94) on Day 2. A clear ceiling effect of scores was demonstrated in the current assessment form, questioning its validity. The proposed score sheet provides more accurate scores and seems to be a better feedback instrument for learning technical surgical skills in the Basic Surgical Skills course.

Can virtual reality be used to measure and train surgical skills?

Science.gov (United States)

Arnold, Paul; Farrell, Martin J

2002-04-15

The quantitative literature on the use of virtual environments to measure and train a variety of surgical skills is critically reviewed. We selected works from the years 1995-2000. Theoretical perspectives, such as those of Saltzman (1979), Bernstein (1967) and Schmidt (1975) and techniques, such as hierarchical task analysis, are presented and contrasted with the largely atheoretical approach of the practitioners of virtual surgery. It is concluded that the quantitative work discussed provides few findings of value to practising surgeons. This may be due in part to the lack of consideration paid to fundamental issues in the learning of motor skills, such as whether motor skills learning is most effective with varying training conditions and the distinction between purely motoric aspects and knowledge of procedures. Possible ways forward for surgical training are outlined. It is suggested that the theoretical perspectives and techniques available in the area of motor behaviour should be incorporated into future experimental studies of surgery in virtual environments.

Toward an objective assessment of technical skills: a national survey of surgical program directors in Saudi Arabia

Directory of Open Access Journals (Sweden)

Alkhayal A

2012-10-01

Full Text Available Abdullah Alkhayal,1 Shahla Aldhukair,2 Nahar Alselaim,1 Salah Aldekhayel,1 Sultan Alhabdan,1 Waleed Altaweel,3 Mohi Elden Magzoub,4 Mohammed Zamakhshary1,21Department of Surgery, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2Public Health Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 3Urology Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; 4Department of Medical Education, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaBackground: After almost a decade of implementing competency-based programs in postgraduate training programs, the assessment of technical skills remains more subjective than objective. National data on the assessment of technical skills during surgical training are lacking. We conducted this study to document the assessment tools for technical skills currently used in different surgical specialties, their relationship with remediation, the recommended tools from the program directors’ perspective, and program directors’ attitudes toward the available objective tools to assess technical skills.Methods: This study was a cross-sectional survey of surgical program directors (PDs. The survey was initially developed using a focus group and was then sent to 116 PDs. The survey contains demographic information about the program, the objective assessment tools used, and the reason for not using assessment tools. The last section discusses the recommended tools to be used from the PDs’ perspective and the PDs’ attitude and motivation to apply these tools in each program. The associations between the responses to the assessment questions and remediation were statistically evaluated.Results: Seventy-one (61% participants responded. Of the respondents, 59% mentioned using only nonstandardized, subjective, direct observation for technical skills assessment. Sixty percent use only summative

Surgical resident technical skill self-evaluation: increased precision with training progression.

Science.gov (United States)

Quick, Jacob A; Kudav, Vishal; Doty, Jennifer; Crane, Megan; Bukoski, Alex D; Bennett, Bethany J; Barnes, Stephen L

2017-10-01

Surgical resident ability to accurately evaluate one's own skill level is an important part of educational growth. We aimed to determine if differences exist between self and observer technical skill evaluation of surgical residents performing a single procedure. We prospectively enrolled 14 categorical general surgery residents (six post-graduate year [PGY] 1-2, three PGY 3, and five PGY 4-5). Over a 6-month period, following each laparoscopic cholecystectomy, residents and seven faculty each completed the Objective Structured Assessment of Technical Skills (OSATS). Spearman's coefficient was calculated for three groups: senior (PGY 4-5), PGY3, and junior (PGY 1-2). Rho (ρ) values greater than 0.8 were considered well correlated. Of the 125 paired assessments (resident-faculty each evaluating the same case), 58 were completed for senior residents, 54 for PGY3 residents, and 13 for junior residents. Using the mean from all OSATS categories, trainee self-evaluations correlated well to faculty (senior ρ 0.97, PGY3 ρ 0.9, junior ρ 0.9). When specific OSATS categories were analyzed, junior residents exhibited poor correlation in categories of respect for tissue (ρ -0.5), instrument handling (ρ 0.71), operative flow (ρ 0.41), use of assistants (ρ 0.05), procedural knowledge (ρ 0.32), and overall comfort with the procedure (ρ 0.73). PGY3 residents lacked correlation in two OSATS categories, operative flow (ρ 0.7) and procedural knowledge (ρ 0.2). Senior resident self-evaluations exhibited strong correlations to observers in all areas. Surgical residents improve technical skill self-awareness with progressive training. Less-experienced trainees have a tendency to over-or-underestimate technical skill. Copyright © 2017 Elsevier Inc. All rights reserved.

Should surgical novices trade their retractors for joysticks? Videogame experience decreases the time needed to acquire surgical skills.

Science.gov (United States)

Shane, Matthew D; Pettitt, Barbara J; Morgenthal, Craig B; Smith, C Daniel

2008-05-01

Video game experience (VGE) has been identified as a possible predictive factor for surgical skill. We hypothesized that surgical novices with previous VGE would acquire new surgical skills faster than those without. Fourth-year medical students (M4) and first-year surgical residents (PG-1) completed a survey asking about standard demographic data and previous VGE. Gamers had high VGE, defined as more than 3 h per week of videogame playing. Nongamers had little or no VGE. Both groups trained to proficiency on two tasks (AcquirePlace and Traversal) of the MIST-VR simulator, with proficiency defined as meeting previously validated criteria on two consecutive trials. The number of trials required to achieve proficiency for each task was recorded. The 26 participants included 11 M4s and 15 PG-1s: 17 males (8 gamers/9 nongamers) and 9 females (3 gamers/6 nongamers), mean age 27.8 years. There were no differences in time to proficiency between the M4 and PG-1 residents, and there were no significant differences in the relative number of gamers per gender. All participants eventually met proficiency criteria. The 11 gamers reached proficiency more quickly than the 15 nongamers (median 0 trials versus 6 trials, p = 0.01). Gamers scored lower than nongamers on their initial attempts. Women overall took longer to reach proficiency than did men (median 10 trials versus 0 trials, p = 0.002). When stratified according to VGE, female nongamers took longer to reach proficiency than male nongamers (median 11 trials versus 1 trial, p = 0.006) but among gamers, there was no difference between females and males (median 0 trials versus 0.5 trials, NS). Previous VGE shortens time to achieve proficiency on two tasks on a validated surgical simulator. The possibility that VGE may ameliorate gender differences in length of time required to acquire surgical skills should be explored further.

Do soft skills predict surgical performance?: a single-center randomized controlled trial evaluating predictors of skill acquisition in virtual reality laparoscopy.

Science.gov (United States)

Maschuw, K; Schlosser, K; Kupietz, E; Slater, E P; Weyers, P; Hassan, I

2011-03-01

Virtual reality (VR) training in minimal invasive surgery (MIS) is feasible in surgical residency and beneficial for the performance of MIS by surgical trainees. Research on stress-coping of surgical trainees indicates the additional impact of soft skills on VR performance in the surgical curriculum. The aim of this study was to evaluate the impact of structured VR training and soft skills on VR performance of trainees. The study was designed as a single-center randomized controlled trial. Fifty first-year surgical residents with limited experience in MIS ("camera navigation" in laparoscopic cholecystectomy only) were randomized for either 3 months of VR training or no training. Basic VR performance and defined soft skills (self-efficacy, stress-coping, and motivation) were assessed prior to randomization using basic modules of the VR simulator LapSim(®) and standardized psychological questionnaires. Three months after randomization VR performance was reassessed. Outcome measurement was based on the results derived from the most complex of the basic VR modules ("diathermy cutting") as the primary end point. A correlation analysis of the VR end-point performance and the psychological scores was done in both groups. Structured VR training enhanced VR performance of surgical trainees. An additional correlation to high motivational states (P 0.05). Low self-efficacy and negative stress-coping strategies seem to predict poor VR performance. However, structured training along with high motivational states is likely to balance out this impairment.

The effectiveness of and satisfaction with high-fidelity simulation to teach cardiac surgical resuscitation skills to nurses.

Science.gov (United States)

McRae, Marion E; Chan, Alice; Hulett, Renee; Lee, Ai Jin; Coleman, Bernice

2017-06-01

There are few reports of the effectiveness or satisfaction with simulation to learn cardiac surgical resuscitation skills. To test the effect of simulation on the self-confidence of nurses to perform cardiac surgical resuscitation simulation and nurses' satisfaction with the simulation experience. A convenience sample of sixty nurses rated their self-confidence to perform cardiac surgical resuscitation skills before and after two simulations. Simulation performance was assessed. Subjects completed the Satisfaction with Simulation Experience scale and demographics. Self-confidence scores to perform all cardiac surgical skills as measured by paired t-tests were significantly increased after the simulation (d=-0.50 to 1.78). Self-confidence and cardiac surgical work experience were not correlated with time to performance. Total satisfaction scores were high (mean 80.2, SD 1.06) indicating satisfaction with the simulation. There was no correlation of the satisfaction scores with cardiac surgical work experience (τ=-0.05, ns). Self-confidence scores to perform cardiac surgical resuscitation procedures were higher after the simulation. Nurses were highly satisfied with the simulation experience. Copyright © 2016 Elsevier Ltd. All rights reserved.

"Reflection-Before-Practice" Improves Self-Assessment and End-Performance in Laparoscopic Surgical Skills Training.

Science.gov (United States)

Ganni, Sandeep; Botden, Sanne M B I; Schaap, Dennis P; Verhoeven, Bas H; Goossens, Richard H M; Jakimowicz, Jack J

To establish whether a systematized approach to self-assessment in a laparoscopic surgical skills course improves accordance between expert- and self-assessment. A systematic training course in self-assessment using Competency Assessment Tool was introduced into the normal course of evaluation within a Laparoscopic Surgical Skills training course for the test group (n = 30). Differences between these and a control group (n = 30) who did not receive the additional training were assessed. Catharina Hospital, Eindhoven, The Netherlands (n = 27), and GSL Medical College, Rajahmundry, India (n = 33). Sixty postgraduate year 2 and 3 surgical residents who attended the 2-day Laparoscopic Surgical Skills grade 1 level 1 curriculum were invited to participate. The test group (n = 30) showed better accordance between expert- and self-assessment (difference of 1.5, standard deviation [SD] = 0.2 versus 3.83, SD = 0.6, p = 0.009) as well as half the number (7 versus 14) of cases of overreporting. Furthermore, the test group also showed higher overall mean performance (mean = 38.1, SD = 0.7 versus mean = 31.8, SD = 1.0, p assessment can be viewed as responsible for this and can be seen as "reflection-before-practice" within the framework of reflective practice as defined by Donald Schon. Our results suggest that "reflection-before-practice" in implementing self-assessment is an important step in the development of surgical skills, yielding both better understanding of one's strengths and weaknesses and also improving overall performance. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Computer-enhanced visual learning method: a paradigm to teach and document surgical skills.

Science.gov (United States)

Maizels, Max; Mickelson, Jennie; Yerkes, Elizabeth; Maizels, Evelyn; Stork, Rachel; Young, Christine; Corcoran, Julia; Holl, Jane; Kaplan, William E

2009-09-01

Changes in health care are stimulating residency training programs to develop new methods for teaching surgical skills. We developed Computer-Enhanced Visual Learning (CEVL) as an innovative Internet-based learning and assessment tool. The CEVL method uses the educational procedures of deliberate practice and performance to teach and learn surgery in a stylized manner. CEVL is a learning and assessment tool that can provide students and educators with quantitative feedback on learning a specific surgical procedure. Methods involved examine quantitative data of improvement in surgical skills. Herein, we qualitatively describe the method and show how program directors (PDs) may implement this technique in their residencies. CEVL allows an operation to be broken down into teachable components. The process relies on feedback and remediation to improve performance, with a focus on learning that is applicable to the next case being performed. CEVL has been shown to be effective for teaching pediatric orchiopexy and is being adapted to additional adult and pediatric procedures and to office examination skills. The CEVL method is available to other residency training programs.

14 CFR 121.909 - Approval of Advanced Qualification Program.

Science.gov (United States)

2010-01-01

... criteria. Each AQP must have separate curriculums for indoctrination, qualification, and continuing... the training and evaluation of CRM and technical skills and knowledge. An application for approval of... must meet all the requirements of this subpart. (2) Each indoctrination, qualification, and continuing...

Surgical simulation: Current practices and future perspectives for technical skills training.

Science.gov (United States)

Bjerrum, Flemming; Thomsen, Ann Sofia Skou; Nayahangan, Leizl Joy; Konge, Lars

2018-06-17

Simulation-based training (SBT) has become a standard component of modern surgical education, yet successful implementation of evidence-based training programs remains challenging. In this narrative review, we use Kern's framework for curriculum development to describe where we are now and what lies ahead for SBT within surgery with a focus on technical skills in operative procedures. Despite principles for optimal SBT (proficiency-based, distributed, and deliberate practice) having been identified, massed training with fixed time intervals or a fixed number of repetitions is still being extensively used, and simulators are generally underutilized. SBT should be part of surgical training curricula, including theoretical, technical, and non-technical skills, and be based on relevant needs assessments. Furthermore, training should follow evidence-based theoretical principles for optimal training, and the effect of training needs to be evaluated using relevant outcomes. There is a larger, still unrealized potential of surgical SBT, which may be realized in the near future as simulator technologies evolve, more evidence-based training programs are implemented, and cost-effectiveness and impact on patient safety is clearly demonstrated.

Surgical skills simulation in trauma and orthopaedic training.

Science.gov (United States)

Stirling, Euan R B; Lewis, Thomas L; Ferran, Nicholas A

2014-12-19

Changing patterns of health care delivery and the rapid evolution of orthopaedic surgical techniques have made it increasingly difficult for trainees to develop expertise in their craft. Working hour restrictions and a drive towards senior led care demands that proficiency be gained in a shorter period of time whilst requiring a greater skill set than that in the past. The resulting conflict between service provision and training has necessitated the development of alternative methods in order to compensate for the reduction in 'hands-on' experience. Simulation training provides the opportunity to develop surgical skills in a controlled environment whilst minimising risks to patient safety, operating theatre usage and financial expenditure. Many options for simulation exist within orthopaedics from cadaveric or prosthetic models, to arthroscopic simulators, to advanced virtual reality and three-dimensional software tools. There are limitations to this form of training, but it has significant potential for trainees to achieve competence in procedures prior to real-life practice. The evidence for its direct transferability to operating theatre performance is limited but there are clear benefits such as increasing trainee confidence and familiarity with equipment. With progressively improving methods of simulation available, it is likely to become more important in the ongoing and future training and assessment of orthopaedic surgeons.

Communication skills among surgical trainees: Perceptions of residents in a teaching hospital in Northern Nigeria

OpenAIRE

A Ibrahim; Z I Delia; M E Asuku; T Dahiru

2011-01-01

Objective Communication between the surgeon and the patient is a core clinical skill. The ability to communicate with patients and their family members is very important in the optimum care of the surgical patient. Few studies have assessed communication between surgical trainees and their patients in sub-Saharan Africa. In response to this, the communication skills of residents in the department of surgery were evaluated to determine their perception of competency and perceived need for ...

Crowd-sourced assessment of technical skills: an adjunct to urology resident surgical simulation training.

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Holst, Daniel; Kowalewski, Timothy M; White, Lee W; Brand, Timothy C; Harper, Jonathan D; Sorenson, Mathew D; Kirsch, Sarah; Lendvay, Thomas S

2015-05-01

Crowdsourcing is the practice of obtaining services from a large group of people, typically an online community. Validated methods of evaluating surgical video are time-intensive, expensive, and involve participation of multiple expert surgeons. We sought to obtain valid performance scores of urologic trainees and faculty on a dry-laboratory robotic surgery task module by using crowdsourcing through a web-based grading tool called Crowd Sourced Assessment of Technical Skill (CSATS). IRB approval was granted to test the technical skills grading accuracy of Amazon.com Mechanical Turk™ crowd-workers compared to three expert faculty surgeon graders. The two groups assessed dry-laboratory robotic surgical suturing performances of three urology residents (PGY-2, -4, -5) and two faculty using three performance domains from the validated Global Evaluative Assessment of Robotic Skills assessment tool. After an average of 2 hours 50 minutes, each of the five videos received 50 crowd-worker assessments. The inter-rater reliability (IRR) between the surgeons and crowd was 0.91 using Cronbach's alpha statistic (confidence intervals=0.20-0.92), indicating an agreement level between the two groups of "excellent." The crowds were able to discriminate the surgical level, and both the crowds and the expert faculty surgeon graders scored one senior trainee's performance above a faculty's performance. Surgery-naive crowd-workers can rapidly assess varying levels of surgical skill accurately relative to a panel of faculty raters. The crowds provided rapid feedback and were inexpensive. CSATS may be a valuable adjunct to surgical simulation training as requirements for more granular and iterative performance tracking of trainees become mandated and commonplace.

Assessing the Nontechnical Skills of Surgical Trainees: Views of the Theater Team.

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Al-Jundi, Wissam; Wild, Jonathan; Ritchie, Judith; Daniels, Sarah; Robertson, Eleanor; Beard, Jonathan

2016-01-01

This study aims to explore the views of members of theater teams regarding the proposed introduction of a workplace-based assessment of nontechnical skills of surgeons (NOTSS) into the Intercollegiate Surgical Curriculum Programme in the United Kingdom. In addition, the previous training and familiarity of the members of the surgical theater team with the concept and assessment of NOTSS would be evaluated. A regional survey of members of theater teams (consultant surgeons, anesthetists, scrub nurses, and trainees) was performed at 1 teaching and 2 district general hospitals in South Yorkshire. There were 160 respondents corresponding to a response rate of 81%. The majority (77%) were not aware of the NOTSS assessment tool with only 9% of respondents reporting to have previously used the NOTSS tool and just 3% having received training in NOTSS assessment. Overall, 81% stated that assessing NOTSS was as important as assessing technical skills. Trainees attributed less importance to nontechnical skills than the other groups (p ≤ 0.016). Although opinion appears divided as to whether the presence of a consultant surgeon in theater could potentially make it difficult to assess a trainee's leadership skills and decision-making capabilities, overall 60% agree that the routine use of NOTSS assessment would enhance safety in the operating theater and 80% agree that the NOTSS tool should be introduced to assess the nontechnical skills of trainees in theater. However, a significantly lower proportion of trainees (45%) agreed on the latter compared with the other groups (p = 0.001). Our survey demonstrates acceptability among the theater team for the introduction of the NOTSS tool into the surgical curriculum. However, lack of familiarity highlights the importance of faculty training for assessors before such an introduction. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Surgical skills simulation in trauma and orthopaedic training

OpenAIRE

Stirling, Euan RB; Lewis, Thomas L; Ferran, Nicholas A

2014-01-01

Changing patterns of health care delivery and the rapid evolution of orthopaedic surgical techniques have made it increasingly difficult for trainees to develop expertise in their craft. Working hour restrictions and a drive towards senior led care demands that proficiency be gained in a shorter period of time whilst requiring a greater skill set than that in the past. The resulting conflict between service provision and training has necessitated the development of alternative methods in orde...

Basic airway skills acquisition using the American College of Surgeons/Association for Surgical Education medical student simulation-based surgical skills curriculum: Initial results.

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Muratore, Sydne; Kim, Michael; Olasky, Jaisa; Campbell, Andre; Acton, Robert

2017-02-01

The ACS/ASE Medical Student Simulation-Based Skills Curriculum was developed to standardize medical student training. This study aims to evaluate the feasibility and validity of implementing the basic airway curriculum. This single-center, prospective study of medical students participating in the basic airway module from 12/2014-3/2016 consisted of didactics, small-group practice, and testing in a simulated clinical scenario. Proficiency was determined by a checklist of skills (1-15), global score (1-5), and letter grade (NR-needs review, PS-proficient in simulation scenario, CP-proficient in clinical scenario). A proportion of students completed pre/post-test surveys regarding experience, satisfaction, comfort, and self-perceived proficiency. Over 16 months, 240 students were enrolled with 98% deemed proficient in a simulated or clinical scenario. Pre/post-test surveys (n = 126) indicated improvement in self-perceived proficiency by 99% of learners. All students felt moderately to very comfortable performing basic airway skills and 94% had moderate to considerable satisfaction after completing the module. The ACS/ASE Surgical Skills Curriculum is a feasible and effective way to teach medical students basic airway skills using simulation. Copyright © 2016 Elsevier Inc. All rights reserved.

The Effect of a Surgical Skills Course on Confidence Levels of Rural General Practitioners: An Observational Study.

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Byrd, Pippa; Ward, Olga; Hamdorf, Jeffrey

2016-10-01

Objective  To investigate the effect of a short surgical skills course on general practitioners' confidence levels to perform procedural skills. Design  Prospective observational study. Setting  The Clinical Evaluation and Training Centre, a practical skills-based educational facility, at The University of Western Australia. Participants  Medical practitioners who participated in these courses. Nurses, physiotherapists, and medical students were excluded. The response rate was 61% with 61 participants providing 788 responses for pre- and postcourse confidence levels regarding various surgical skills. Intervention  One- to two-day surgical skills courses consisting of presentations, demonstrations, and practical stations, facilitated by specialists. Main Outcome Measures  A two-page precourse and postcourse questionnaire was administered to medical practitioners on the day. Participants rated their confidence levels to perform skills addressed during the course on a 4-point Likert scale. Results  Of the 788 responses regarding confidence levels, 621 were rated as improved postcourse, 163 were rated as no change, and 4 were rated as lower postcourse. Seven of the courses showed a 25% median increase in confidence levels, and one course demonstrated a 50% median increase. All courses showed statistically significant results ( p  skills course resulted in a statistically significant improvement in the confidence levels of rural general practitioners to perform these skills.

Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training.

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Gallagher, Anthony G; Ritter, E Matt; Champion, Howard; Higgins, Gerald; Fried, Marvin P; Moses, Gerald; Smith, C Daniel; Satava, Richard M

2005-02-01

To inform surgeons about the practical issues to be considered for successful integration of virtual reality simulation into a surgical training program. The learning and practice of minimally invasive surgery (MIS) makes unique demands on surgical training programs. A decade ago Satava proposed virtual reality (VR) surgical simulation as a solution for this problem. Only recently have robust scientific studies supported that vision A review of the surgical education, human-factor, and psychology literature to identify important factors which will impinge on the successful integration of VR training into a surgical training program. VR is more likely to be successful if it is systematically integrated into a well-thought-out education and training program which objectively assesses technical skills improvement proximate to the learning experience. Validated performance metrics should be relevant to the surgical task being trained but in general will require trainees to reach an objectively determined proficiency criterion, based on tightly defined metrics and perform at this level consistently. VR training is more likely to be successful if the training schedule takes place on an interval basis rather than massed into a short period of extensive practice. High-fidelity VR simulations will confer the greatest skills transfer to the in vivo surgical situation, but less expensive VR trainers will also lead to considerably improved skills generalizations. VR for improved performance of MIS is now a reality. However, VR is only a training tool that must be thoughtfully introduced into a surgical training curriculum for it to successfully improve surgical technical skills.

Virtual reality simulators: current status in acquisition and assessment of surgical skills.

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Cosman, Peter H; Cregan, Patrick C; Martin, Christopher J; Cartmill, John A

2002-01-01

Medical technology is currently evolving so rapidly that its impact cannot be analysed. Robotics and telesurgery loom on the horizon, and the technology used to drive these advances has serendipitous side-effects for the education and training arena. The graphical and haptic interfaces used to provide remote feedback to the operator--by passing control to a computer--may be used to generate simulations of the operative environment that are useful for training candidates in surgical procedures. One additional advantage is that the metrics calculated inherently in the controlling software in order to run the simulation may be used to provide performance feedback to individual trainees and mentors. New interfaces will be required to undergo evaluation of the simulation fidelity before being deemed acceptable. The potential benefits fall into one of two general categories: those benefits related to skill acquisition, and those related to skill assessment. The educational value of the simulation will require assessment, and comparison to currently available methods of training in any given procedure. It is also necessary to determine--by repeated trials--whether a given simulation actually measures the performance parameters it purports to measure. This trains the spotlight on what constitutes good surgical skill, and how it is to be objectively measured. Early results suggest that virtual reality simulators have an important role to play in this aspect of surgical training.

Human-robot skills transfer interfaces for a flexible surgical robot.

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Calinon, Sylvain; Bruno, Danilo; Malekzadeh, Milad S; Nanayakkara, Thrishantha; Caldwell, Darwin G

2014-09-01

In minimally invasive surgery, tools go through narrow openings and manipulate soft organs to perform surgical tasks. There are limitations in current robot-assisted surgical systems due to the rigidity of robot tools. The aim of the STIFF-FLOP European project is to develop a soft robotic arm to perform surgical tasks. The flexibility of the robot allows the surgeon to move within organs to reach remote areas inside the body and perform challenging procedures in laparoscopy. This article addresses the problem of designing learning interfaces enabling the transfer of skills from human demonstration. Robot programming by demonstration encompasses a wide range of learning strategies, from simple mimicking of the demonstrator's actions to the higher level imitation of the underlying intent extracted from the demonstrations. By focusing on this last form, we study the problem of extracting an objective function explaining the demonstrations from an over-specified set of candidate reward functions, and using this information for self-refinement of the skill. In contrast to inverse reinforcement learning strategies that attempt to explain the observations with reward functions defined for the entire task (or a set of pre-defined reward profiles active for different parts of the task), the proposed approach is based on context-dependent reward-weighted learning, where the robot can learn the relevance of candidate objective functions with respect to the current phase of the task or encountered situation. The robot then exploits this information for skills refinement in the policy parameters space. The proposed approach is tested in simulation with a cutting task performed by the STIFF-FLOP flexible robot, using kinesthetic demonstrations from a Barrett WAM manipulator. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Virtual Reality Training System for Anytime/Anywhere Acquisition of Surgical Skills: A Pilot Study.

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Zahiri, Mohsen; Booton, Ryan; Nelson, Carl A; Oleynikov, Dmitry; Siu, Ka-Chun

2018-03-01

This article presents a hardware/software simulation environment suitable for anytime/anywhere surgical skills training. It blends the advantages of physical hardware and task analogs with the flexibility of virtual environments. This is further enhanced by a web-based implementation of training feedback accessible to both trainees and trainers. Our training system provides a self-paced and interactive means to attain proficiency in basic tasks that could potentially be applied across a spectrum of trainees from first responder field medical personnel to physicians. This results in a powerful training tool for surgical skills acquisition relevant to helping injured warfighters.

The consequences of using advanced physical assessment skills in medical and surgical nursing: A hermeneutic pragmatic study.

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Zambas, Shelaine I; Smythe, Elizabeth A; Koziol-Mclain, Jane

2016-01-01

The aim of this study was to explore the consequences of the nurse's use of advanced assessment skills on medical and surgical wards. Appropriate, accurate, and timely assessment by nurses is the cornerstone of maintaining patient safety in hospitals. The inclusion of "advanced" physical assessment skills such as auscultation, palpation, and percussion is thought to better prepare nurses for complex patient presentations within a wide range of clinical situations. This qualitative study used a hermeneutic pragmatic approach. Unstructured interviews were conducted with five experienced medical and surgical nurses to obtain 13 detailed narratives of assessment practice. Narratives were analyzed using Van Manen's six-step approach to identify the consequences of the nurse's use of advanced assessment skills. The consequences of using advanced assessment skills include looking for more, challenging interpretations, and perseverance. The use of advanced assessment skills directs what the nurse looks for, what she sees, interpretation of the findings, and her response. It is the interpretation of what is seen, heard, or felt within the full context of the patient situation, which is the advanced skill. Advanced assessment skill is the means to an accurate interpretation of the clinical situation and contributes to appropriate diagnosis and medical management in complex patient situations. The nurse's use of advanced assessment skills enables her to contribute to diagnostic reasoning within the acute medical and surgical setting.

Personnel Officers: Judging Their Qualifications.

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Webb, Gisela

1988-01-01

Discusses the backgrounds and qualifications appropriate for a library personnel administrator, including (1) a master's degree in library science; (2) library work experience; (3) additional training in administration, personnel management, organizational development, and psychology; and (4) personal attributes such as good communication skills,…

Coaching Non-technical Skills Improves Surgical Residents' Performance in a Simulated Operating Room.

Science.gov (United States)

Yule, Steven; Parker, Sarah Henrickson; Wilkinson, Jill; McKinley, Aileen; MacDonald, Jamie; Neill, Adrian; McAdam, Tim

2015-01-01

To investigate the effect of coaching on non-technical skills and performance during laparoscopic cholecystectomy in a simulated operating room (OR). Non-technical skills (situation awareness, decision making, teamwork, and leadership) underpin technical ability and are critical to the success of operations and the safety of patients in the OR. The rate of developing assessment tools in this area has outpaced development of workable interventions to improve non-technical skills in surgical training and beyond. A randomized trial was conducted with senior surgical residents (n = 16). Participants were randomized to receive either non-technical skills coaching (intervention) or to self-reflect (control) after each of 5 simulated operations. Coaching was based on the Non-Technical Skills For Surgeons (NOTSS) behavior observation system. Surgeon-coaches trained in this method coached participants in the intervention group for 10 minutes after each simulation. Primary outcome measure was non-technical skills, assessed from video by a surgeon using the NOTSS system. Secondary outcomes were time to call for help during bleeding, operative time, and path length of laparoscopic instruments. Non-technical skills improved in the intervention group from scenario 1 to scenario 5 compared with those in the control group (p = 0.04). The intervention group was faster to call for help when faced with unstoppable bleeding in the final scenario (no. 5; p = 0.03). Coaching improved residents' non-technical skills in the simulated OR compared with those in the control group. Important next steps are to implement non-technical skills coaching in the real OR and assess effect on clinically important process measures and patient outcomes. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Description and evaluation of a bench porcine model for teaching surgical residents vascular anastomosis skills

Directory of Open Access Journals (Sweden)

Jauch Karl-Walter

2010-07-01

Full Text Available Abstract Background Numerous models, of variable quality, exist to impart the complex skills required to perform vascular anastomosis. These models differ with regard to the kinds of materials used, as well as their sizes, the time needed for their preparation, their availability, and the associated costs. The present study describes a bench model that uses formalin-fixed porcine aorta, and its evaluation by young surgical residents during a recent skills course. Findings The aortic segments used were a by-product of slaughtering. They were fixed and stored after harvesting for eventual use. Ten young surgical residents participated, and each performed one end-to-side vascular anastomosis. The evaluation was a questionnaire maintaining anonymity of the participant containing questions addressing particular aspects of the model and the experiences of the trainee, along with their ratings concerning the need for a training course to learn vascular anastomosis techniques. The scoring on the survey was done using a global 6-point rating scale (Likert Scale. In addition, we ranked the present model by reviewing the current literature for models that address vascular anastomosis skills. The trainees who participated were within their first two years of training (1.25 ± 0.46. A strong agreement in terms of the necessity of training for vascular anastomosis techniques was evident among the participating trainees (5.90 ± 0.32, who had only few prior manual experiences (total number 1.50 ± 0.53. The query revealed a strong agreement that porcine aorta is a suitable model that fits the needs for training vascular anastomosis skills (5.70 ± 0.48. Only a few bench models designed to teach surgical residents vascular anastomosis techniques were available in the literature. Conclusions The preparatory and financial resources needed to perform anastomosis skills training using porcine aorta are few. The presented bench model appears to be appropriate for

Advanced Surgical Skills for Exposure in Trauma (ASSET): the first 25 courses.

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Bowyer, Mark W; Kuhls, Deborah A; Haskin, Danielle; Sallee, Richard A; Henry, Sharon M; Garcia, George D; Luchette, Frederick A

2013-08-01

The Advanced Surgical Skills for Exposure in Trauma (ASSET) course was developed to address limited experience of residents and practicing surgeons (PS) in rapid exposure of major blood vessels for trauma. This one day, case based, scenario driven, fresh cadaver dissection course emphasizes rapid surgical exposure of the vasculature of the neck, chest, abdomen, pelvis and extremities with additional focus on fasciotomies and pelvic packing. Contained herein are the results of the first 25 courses. Data collected from 25 ASSET courses conducted between September 2010 and February 2012 included self-reported comfort level (5 point Likert scale) with each of 25 specific skills before and upon completion of the course, and evaluation of the course content. Statistical analysis was accomplished using the Student t-test with α set at P ASSET sites. Self-assessed comfort levels for all 25 queried skills and exposures improved significantly over baseline with P values ranging from 1.6 × 10(-7) to 3.9 × 10(-41). Participants gained new knowledge (4.83 on 5 point scale); learned new techniques (4.83), felt better prepared to expose traumatically injured vessels (4.88), and would recommend the course to a colleague (4.92). The ASSET course was well received and significantly improved self-reported confidence in the exposures needed to care for trauma in both surgical trainees and PS. Ongoing experience with this course will enable more comprehensive psychometric analysis and further validation of this curriculum. Published by Elsevier Inc.

Self-confidence of medical students in performing clinical skills acquired during their surgical rotation. Assessing clinical skills education in Kuwait.

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Karim, Jumanah A; Marwan, Yousef A; Dawas, Ahmed M; Akhtar, Saeed

2012-12-01

To assess the self-confidence of clinical years` medical students in performing clinical skills/procedures. A cross-sectional study was conducted in April 2011 at the Department of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, Safat, Kuwait. A questionnaire was used to collect data from students who had completed their surgical rotation of their first clinical year. The students reported their level of self-confidence in performing specific skills/procedures related to that rotation. Data were presented using frequencies and percentages. A total score of confidence was calculated for each student. The Mann-Whitney and Kruskal-Wallis tests were used to assess the association between the students` sociodemographic characteristics and confidence score. Of the 122 students invited to participate in the study, only 15 (12.3%) declined to comply. Most students reported high confidence level (more than 75%) in performing 7 of the 13 history taking/physical examination skills, and 2 of the 39 diagnostic/treatment procedure skills. The highest confidence level was in performing abdominal examination, while the lowest level was in care of Jackson-Pratt drain site and emptying the drain bulb. The total confidence score was significantly higher among males (p=0.021), and students with higher monthly income (p=0.002). Medical students appeared to have poor self-confidence in performing clinical skills/procedures. Curriculum planners should explore potential reasons, and methods for the improvement of confidence level among medical students in performing skills/procedures they were expected to learn during their surgical rotation.

The Humanitarian Action Qualifications Framework: a quality assurance tool for the Humanitarian Sector

Directory of Open Access Journals (Sweden)

Bastiaan L. Aardema

2014-07-01

Full Text Available The article presents the European Universities on Professionalisation on Humanitarian Action (EUPRHA Project as an initiative that seeks to contribute to the professionalisation and quality assurance of the humanitarian sector. Its purpose is to explain the approach and the process leading to the development of the Humanitarian Action Qualifications Framework as an example of good practice for other sectors aiming at improving the recognition of qualifications as a precondition of academic and professional mobility. With this aim, it introduces the educational and humanitarian trends that led to this project: the move from transnational qualifications frameworks of which the European Qualifications Framework for Lifelong Learning (EQF is the best example to sectoral qualifications frameworks and the increasing demand from the sector seeking to determine the competencies and required skills of a professional humanitarian aid worker. Based on the EQF and the Tuning methodology the framework will act as a translating device to make national and sectoral qualifications more readable and promote humanitarian workers’ and learners’ mobility between countries and organisations. It will facilitate inter-system transparency and recognition of (non-formal and informal learning by linking occupations, skills, competences, and qualifications, thus benefiting the Humanitarian Sector as a whole.

An electronic portfolio for quantitative assessment of surgical skills in undergraduate medical education.

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Sánchez Gómez, Serafín; Ostos, Elisa María Cabot; Solano, Juan Manuel Maza; Salado, Tomás Francisco Herrero

2013-05-06

We evaluated a newly designed electronic portfolio (e-Portfolio) that provided quantitative evaluation of surgical skills. Medical students at the University of Seville used the e-Portfolio on a voluntary basis for evaluation of their performance in undergraduate surgical subjects. Our new web-based e-Portfolio was designed to evaluate surgical practical knowledge and skills targets. Students recorded each activity on a form, attached evidence, and added their reflections. Students self-assessed their practical knowledge using qualitative criteria (yes/no), and graded their skills according to complexity (basic/advanced) and participation (observer/assistant/independent). A numerical value was assigned to each activity, and the values of all activities were summated to obtain the total score. The application automatically displayed quantitative feedback. We performed qualitative evaluation of the perceived usefulness of the e-Portfolio and quantitative evaluation of the targets achieved. Thirty-seven of 112 students (33%) used the e-Portfolio, of which 87% reported that they understood the methodology of the portfolio. All students reported an improved understanding of their learning objectives resulting from the numerical visualization of progress, all students reported that the quantitative feedback encouraged their learning, and 79% of students felt that their teachers were more available because they were using the e-Portfolio. Only 51.3% of students reported that the reflective aspects of learning were useful. Individual students achieved a maximum of 65% of the total targets and 87% of the skills targets. The mean total score was 345 ± 38 points. For basic skills, 92% of students achieved the maximum score for participation as an independent operator, and all achieved the maximum scores for participation as an observer and assistant. For complex skills, 62% of students achieved the maximum score for participation as an independent operator, and 98% achieved

Core trainee boot camp-A method for improving technical and non-technical skills of novice surgical trainees. A before and after study.

Science.gov (United States)

Bamford, R; Langdon, L; Rodd, C A; Eastaugh-Waring, S; Coulston, J E

2018-04-10

The transition to surgical training can be a stressful time for trainees and is most evident during national handover periods where new graduates start and senior trainees rotate to new programmes. During this time, patient mortality can increase and Hospital efficiency reduces. This influence is compounded by the impact of working time directives. Intensive, simulation rich training programmes or "Boot Camps" have been postulated as a solution. This article highlights the development of a surgical boot camp for novice surgical trainees and the impact this can have on training. A novel surgical boot camp was developed for all trainees within a surgical training region including nine acute NHS trusts. Participating cohort of trainees completed pre and post course questionnaires to assess technical and non-technical skills. 25 trainees attended and completed the pre and post boot camp questionnaire. Significant improvements were seen with technical skills (p = 0.0429), overall non-technical skills (p skills (p = 0.005) and outpatient skill (p = 0.002). Trainees reported significantly increased ability to assess and manage a critically unwell patient (p = 0.001) and a trauma patient (p = 0.001). 96% of trainees have utilised the skills they learnt on Boot Camp and all trainees would recommend it as an induction programme. Surgical Boot Camps offer a timely chance to develop technical and non-technical skills whilst enhancing a trainee's confidence and knowledge and reduce the patient safety impact of the handover period. Copyright © 2018. Published by Elsevier Ltd.

Retention of robot-assisted surgical skills in urological surgeons acquired using Mimic dV-Trainer.

Science.gov (United States)

Teishima, Jun; Hattori, Minoru; Inoue, Shogo; Ikeda, Kenichiro; Hieda, Keisuke; Ohara, Shinya; Egi, Hiroyuki; Ohdan, Hideki; Matsubara, Akio

2014-07-01

We assess the retention of robot-assisted surgical skills among urologic surgeons. The robot-assisted surgery skills of 20 urologic surgeons were assessed using a Mimic dV-Trainer program (Mimic Technologies, Inc., Seattle, WA) consisting of 6 tasks. These 20 surgeons had no previous experience either using the Mimic dV-Trainer or acting as the main surgeon in robot-assisted surgery. The surgeons completed the program 4 times in a row; after 1 year, they completed it again for a fifth time. Performance scores were recorded using the Mimic dV-Trainer's built-in algorithm. For all 6 tasks, there were significant improvements to the scores in the fourth trials compared with those in the first trials. The scores in the fifth trials did not significantly decline compared with those in the fourth trials. There was no significant difference between the fifth trial scores of surgeons with laparoscopic surgery skills/experience and those without. Our results indicate that fundamental robot-assisted surgical skills can be retained in the long-term after they are acquired.

Round table discussion " Development of qualification framework in meteorology (TEMPUS QUALIMET)"

Science.gov (United States)

Bashmakova, I.; Belotserkovsky, A.; Karlin, L.; Petrosyan, A.; Serditova, N.; Zilitinkevich, S.

2010-09-01

The international consortium has started implementing a project aimed at the development of unified framework of qualifications in meteorology (QualiMet), setting a system of recognition and award of qualifications up to Doctoral level based on standards of knowledge, skill and competence acquired by learners is underway. The QualiMet has the following specific objectives: 1. To develop standards of knowledge, skills and competence for all qualifications up to Doctoral level needed in all possible occupations meteorology learner can undertake, by July 2011 2. To develop reciprocally recognized rubrics, criteria, methods and tools for assessing the compliance with the developed standards (quality assurance), by July 2012 3. To set the network of Centers of Excellence as the primary designer of sample education programs and learning experiences, both in brick-and-mortar and distant setting of delivery, leading to achievement of the developed standards, by December 2012 4. To set a system of mutual international recognition and award of qualifications in meteorology based on the developed procedures and establishment of self-regulatory public organization, by December 2012 The main beneficiaries of the project are: 1. Meteorology learners from the consortium countries. They will be able to make informed decisions about available qualification choices and progression options and provided an opportunity for students and graduates to participate in the system of international continuous education. 2. Meteorology employers from the consortium countries, They will be able to specify the level of knowledge, skill and competence required for occupational roles, evaluate qualifications presented, connect training and development with business needs. 3. Students and academic staff of all the consortium members, who will gain the increased mobility and exchange the fluxes of culturally and institutionally diversified lecturers and qualified specialists

Evaluating Robotic Surgical Skills Performance Under Distractive Environment Using Objective and Subjective Measures.

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Suh, Irene H; LaGrange, Chad A; Oleynikov, Dmitry; Siu, Ka-Chun

2016-02-01

Distractions are recognized as a significant factor affecting performance in safety critical domains. Although operating rooms are generally full of distractions, the effect of distractions on robot-assisted surgical (RAS) performance is unclear. Our aim was to investigate the effect of distractions on RAS performance using both objective and subjective measures. Fifteen participants performed a knot-tying task using the da Vinci Surgical System and were exposed to 3 distractions: (1) passive distraction entailed listening to noise with a constant heart rate, (2) active distraction included listening to noise and acknowledging a change of random heart rate from 60 to 120 bpm, and (3) interactive distraction consisted of answering math questions. The objective kinematics of the surgical instrument tips were used to evaluate performance. Electromyography (EMG) of the forearm and hand muscles of the participants were collected. The median EMG frequency (EMG(fmed)) and the EMG envelope (EMG(env)) were analyzed. NASA Task Load Index and Fundamentals of Laparoscopic Surgery score were used to evaluate the subjective performance. One-way repeated analysis of variance was applied to examine the effects of distraction on skills performance. Spearman's correlations were conducted to compare objective and subjective measures. Significant distraction effect was found for all objective kinematics measures (P < .05). There were significant distraction effects for EMG measures (EMG(env), P < .004; EMG(fmed), P = .031). Significant distraction effects were also found for subjective measurements. Distraction impairs surgical skills performance and increases muscle work. Understanding how the surgeons cope with distractions is important in developing surgical education. © The Author(s) 2015.

STEM Leadership Qualification: Tomorrow's Leaders Today

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Williams, Chris

2009-01-01

This article features the Science, Technology, Engineering and Mathematics (STEM) Leadership Qualification programme, developed by the Centre for Science Education (CSE) at Sheffield Hallam University in collaboration with Edexcel, which sets out to develop leadership skills and capabilities through contexts in STEM. With six units to complete…

Innovative approach using interprofessional simulation to educate surgical residents in technical and nontechnical skills in high-risk clinical scenarios.

Science.gov (United States)

Nicksa, Grace A; Anderson, Cristan; Fidler, Richard; Stewart, Lygia

2015-03-01

The Accreditation Council for Graduate Medical Education core competencies stress nontechnical skills that can be difficult to evaluate and teach to surgical residents. During emergencies, surgeons work in interprofessional teams and are required to perform certain procedures. To obtain proficiency in these skills, residents must be trained. To educate surgical residents in leadership, teamwork, effective communication, and infrequently performed emergency surgical procedures with the use of interprofessional simulations. SimMan 3GS was used to simulate high-risk clinical scenarios (15-20 minutes), followed by debriefings with real-time feedback (30 minutes). A modified Oxford Non-Technical Skills scale (score range, 1-4) was used to assess surgical resident performance during the first half of the academic year (July-December 2012) and the second half of the academic year (January-June 2013). Anonymous online surveys were used to solicit participant feedback. Simulations were conducted in the operating room, intensive care unit, emergency department, ward, and simulation center. A total of 43 surgical residents (postgraduate years [PGYs] 1 and 2) participated in interdisciplinary clinical scenarios, with other health care professionals (nursing, anesthesia, critical care, medicine, respiratory therapy, and pharmacy; mean number of nonsurgical participants/session: 4, range 0-9). Thirty seven surgical residents responded to the survey. Simulation of high-risk clinical scenarios: postoperative pulmonary embolus, pneumothorax, myocardial infarction, gastrointestinal bleeding, anaphylaxis with a difficult airway, and pulseless electrical activity arrest. Evaluation of resident skills: communication, leadership, teamwork, problem solving, situation awareness, and confidence in performing emergency procedures (eg, cricothyroidotomy). A total of 31 of 35 (89%) of the residents responding found the sessions useful. Additionally, 28 of 33 (85%) reported improved confidence

DOE handbook: Guide to good practices for training and qualification of maintenance personnel

International Nuclear Information System (INIS)

1996-03-01

The purpose of this Handbook is to provide contractor training organizations with information that can be used to verify the adequacy of and/or modify existing maintenance training programs, or to develop new training programs. This guide, used in conjunction with facility-specific job analyses, provides a framework for training and qualification programs for maintenance personnel at DOE reactor and nonreactor nuclear facilities. Recommendations for qualification are made in four areas: education, experience, physical attributes, and training. The functional positions of maintenance mechanic, electrician, and instrumentation and control technician are covered by this guide. Sufficient common knowledge and skills were found to include the three disciplines in one guide to good practices. Contents include: qualifications; on-the-job training; trainee evaluation; continuing training; training effectiveness evaluation; and program records. Appendices are included which relate to: administrative training; industrial safety training; fundamentals training; tools and equipment training; facility systems and component knowledge training; facility systems and component skills training; and specialized skills training

DOE handbook: Guide to good practices for training and qualification of maintenance personnel

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-03-01

The purpose of this Handbook is to provide contractor training organizations with information that can be used to verify the adequacy of and/or modify existing maintenance training programs, or to develop new training programs. This guide, used in conjunction with facility-specific job analyses, provides a framework for training and qualification programs for maintenance personnel at DOE reactor and nonreactor nuclear facilities. Recommendations for qualification are made in four areas: education, experience, physical attributes, and training. The functional positions of maintenance mechanic, electrician, and instrumentation and control technician are covered by this guide. Sufficient common knowledge and skills were found to include the three disciplines in one guide to good practices. Contents include: qualifications; on-the-job training; trainee evaluation; continuing training; training effectiveness evaluation; and program records. Appendices are included which relate to: administrative training; industrial safety training; fundamentals training; tools and equipment training; facility systems and component knowledge training; facility systems and component skills training; and specialized skills training.

Assessment of laparoscopic psychomotor skills in interns using the MIST Virtual Reality Simulator: a prerequisite for those considering surgical training?

Science.gov (United States)

Cope, Daron H; Fenton-Lee, Douglas

2008-04-01

Selection for surgical training in Australia is currently based on assessment of a structured curriculum vitae, referral reports from selected clinicians and an interview. The formal assessment of laparoscopic psychomotor skill and ability to attain skills is not currently a prerequisite for selection. The aim of this study was to assess the innate psychomotor skills of interns and also to compare interns with an interest in pursuing a surgical career to interns with those with no interest in pursuing a surgical career. Twenty-two interns were given the opportunity to carry out tasks on the Minimal Invasive Surgical Trainer, Virtual Reality (Mentice, Gothenburg, Sweden) Simulator. The candidates were required to complete six tasks, repeated six times each. Scores for each task were calculated objectively by the simulator software. Demographic data were similar between the two groups. Although some candidates who were interested in pursuing a surgical career performed poorly on the simulator, there was no significant difference when comparing the two groups. The Minimal Invasive Surgical Trainer, Virtual Reality (Mentice) Simulator provides an objective and comparable assessment of laparoscopic psychomotor skills. We can conclude that interns have varying inherent ability as judged by the simulator and this does not seem to have an influence on their career selection. There was no significant difference in the scores between the two groups. Interns with and without inherent abilities have aspirations to pursue surgical careers and their aptitude does not seem to influence this decision. Surgical colleges could use psychomotor ability assessments to recruit candidates to pursue a career in surgery. Trainees needing closer monitoring and additional training could be identified early and guided to achieve competency.

Arthroscopic Shoulder Surgical Simulation Training Curriculum: Transfer Reliability and Maintenance of Skill Over Time.

Science.gov (United States)

Dunn, John C; Belmont, Philip J; Lanzi, Joseph; Martin, Kevin; Bader, Julia; Owens, Brett; Waterman, Brian R

2015-01-01

Surgical education is evolving as work hour constraints limit the exposure of residents to the operating room. Potential consequences may include erosion of resident education and decreased quality of patient care. Surgical simulation training has become a focus of study in an effort to counter these challenges. Previous studies have validated the use of arthroscopic surgical simulation programs both in vitro and in vivo. However, no study has examined if the gains made by residents after a simulation program are retained after a period away from training. In all, 17 orthopedic surgery residents were randomized into simulation or standard practice groups. All subjects were oriented to the arthroscopic simulator, a 14-point anatomic checklist, and Arthroscopic Surgery Skill Evaluation Tool (ASSET). The experimental group received 1 hour of simulation training whereas the control group had no additional training. All subjects performed a recorded, diagnostic arthroscopy intraoperatively. These videos were scored by 2 blinded, fellowship-trained orthopedic surgeons and outcome measures were compared within and between the groups. After 1 year in which neither group had exposure to surgical simulation training, all residents were retested intraoperatively and scored in the exact same fashion. Individual surgical case logs were reviewed and surgical case volume was documented. There was no difference between the 2 groups after initial simulation testing and there was no correlation between case volume and initial scores. After training, the simulation group improved as compared with baseline in mean ASSET (p = 0.023) and mean time to completion (p = 0.01). After 1 year, there was no difference between the groups in any outcome measurements. Although individual technical skills can be cultivated with surgical simulation training, these advancements can be lost without continued education. It is imperative that residency programs implement a simulation curriculum and

Development and validation of a composite scoring system for robot-assisted surgical training--the Robotic Skills Assessment Score.

Science.gov (United States)

Chowriappa, Ashirwad J; Shi, Yi; Raza, Syed Johar; Ahmed, Kamran; Stegemann, Andrew; Wilding, Gregory; Kaouk, Jihad; Peabody, James O; Menon, Mani; Hassett, James M; Kesavadas, Thenkurussi; Guru, Khurshid A

2013-12-01

A standardized scoring system does not exist in virtual reality-based assessment metrics to describe safe and crucial surgical skills in robot-assisted surgery. This study aims to develop an assessment score along with its construct validation. All subjects performed key tasks on previously validated Fundamental Skills of Robotic Surgery curriculum, which were recorded, and metrics were stored. After an expert consensus for the purpose of content validation (Delphi), critical safety determining procedural steps were identified from the Fundamental Skills of Robotic Surgery curriculum and a hierarchical task decomposition of multiple parameters using a variety of metrics was used to develop Robotic Skills Assessment Score (RSA-Score). Robotic Skills Assessment mainly focuses on safety in operative field, critical error, economy, bimanual dexterity, and time. Following, the RSA-Score was further evaluated for construct validation and feasibility. Spearman correlation tests performed between tasks using the RSA-Scores indicate no cross correlation. Wilcoxon rank sum tests were performed between the two groups. The proposed RSA-Score was evaluated on non-robotic surgeons (n = 15) and on expert-robotic surgeons (n = 12). The expert group demonstrated significantly better performance on all four tasks in comparison to the novice group. Validation of the RSA-Score in this study was carried out on the Robotic Surgical Simulator. The RSA-Score is a valid scoring system that could be incorporated in any virtual reality-based surgical simulator to achieve standardized assessment of fundamental surgical tents during robot-assisted surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

[Chances and Potential of a Modern Surgical Skills Lab as Substantial Practical Part of the Study of Human Medicine - "The Magdeburg Model"].

Science.gov (United States)

Piatek, S; Altmann, S; Haß, H-J; Werwick, K; Winkler-Stuck, K; Zardo, P; von Daake, S; Baumann, B; Rahmanzadeh, A; Chiapponi, C; Reschke, K; Meyer, F

2017-02-01

Introduction: Surgical education of medical students within "skills labs" have not been standardised throughout Germany as yet; there is a substantial impact of available aspects such as personal and space at the various medical schools. Aim: The aim of this contribution is to illustrate the concept of a surgical skills lab in detail, including curricular teaching and integrated facultative courses at the Medical School, University of Magdeburg ("The Magdeburg Model") in the context of a new and reconstructed area for the skills lab at the Magdeburg's apprenticeship center for medical basic abilities (MAMBA). Method: We present an overview on the spectrum of curricular and facultative teaching activities within the surgical part of the skills lab. Student evaluation of this teaching concept is implemented using the programme "EvaSys" and evaluation forms adapted to the single courses. Results: By establishing MAMBA, the options for a practice-related surgical education have been substantially improved. Student evaluations of former courses presented within the skills lab and the chance of moving the skills lab into a more generous and reconstructed area led to a reorganisation of seminars and courses. New additional facultative courses held by student tutors have been introduced and have shown to be of great effect, in particular, because of their interdisciplinary character. Conclusion: Practice-related surgical education within a skills lab may have the potential to effectively prepare medical students for their professional life. In addition, it allows one to present and teach the most important basic skills in surgery, which need to be pursued by every student. An enthusiastic engagement of the Office for Student Affairs can be considered the crucial and indispensable link between clinical work and curricular as well as facultative teaching with regard to organisation and student evaluation. The practice-related teaching parts and contents at the surgical

Self-assessment in laparoscopic surgical skills training: Is it reliable?

Science.gov (United States)

Ganni, Sandeep; Chmarra, Magdalena K; Goossens, Richard H M; Jakimowicz, Jack J

2017-06-01

The concept of self-assessment has been widely acclaimed for its role in the professional development cycle and self-regulation. In the field of medical education, self-assessment has been most used to evaluate the cognitive knowledge of students. The complexity of training and evaluation in laparoscopic surgery has previously acted as a barrier in determining the benefits self-assessment has to offer in comparison with other fields of medical education. Thirty-five surgical residents who attended the 2-day Laparoscopic Surgical Skills Grade 1 Level 1 curriculum were invited to participate from The Netherlands, India and Romania. The competency assessment tool (CAT) for laparoscopic cholecystectomy was used for self- and expert-assessment and the resulting distributions assessed. A comparison between the expert- and self-assessed aggregates of scores from the CAT agreed with previous studies. Uniquely to this study, the aggregates of individual sub-categories-'use of instruments'; 'tissue handling'; and errors 'within the component tasks' and the 'end product' from both self- and expert-assessments-were investigated. There was strong positive correlation (r s  > 0.5; p assessment in all categories with only the 'tissue handling' having a weaker correlation (r s  = 0.3; p = 0.04). The distribution of the mean of the differences between self-assessment and expert-assessment suggested no significant difference between the scores of experts and the residents in all categories except the 'end product' evaluation where the difference was significant (W = 119, p = 0.03). Self-assessment using the CAT form gives results that are consistently not different from expert-assessment when assessing one's proficiency in surgical skills. Areas where there was less agreement could be explained by variations in the level of training and understanding of the assessment criteria.

Practical skills teaching in contemporary surgical education: how can educational theory be applied to promote effective learning?

Science.gov (United States)

Sadideen, Hazim; Kneebone, Roger

2012-09-01

Teaching practical skills is a core component of undergraduate and postgraduate surgical education. It is crucial to optimize our current learning and teaching models, particularly in a climate of decreased clinical exposure. This review explores the role of educational theory in promoting effective learning in practical skills teaching. Peer-reviewed publications, books, and online resources from national bodies (eg, the UK General Medical Council) were reviewed. This review highlights several aspects of surgical education, modeling them on current educational theory. These include the following: (1) acquisition and retention of motor skills (Miller's triangle; Fitts' and Posner's theory), (2) development of expertise after repeated practice and regular reinforcement (Ericsson's theory), (3) importance of the availability of expert assistance (Vygotsky's theory), (4) learning within communities of practice (Lave and Wenger's theory), (5) importance of feedback in learning practical skills (Boud, Schon, and Endes' theories), and (6) affective component of learning. It is hoped that new approaches to practical skills teaching are designed in light of our understanding of educational theory. Copyright © 2012 Elsevier Inc. All rights reserved.

[Simulation training in surgical education - application of virtual reality laparoscopic simulators in a surgical skills course].

Science.gov (United States)

Lehmann, K S; Gröne, J; Lauscher, J C; Ritz, J-P; Holmer, C; Pohlen, U; Buhr, H-J

2012-04-01

Training and simulation are gaining importance in surgical education. Today, virtual reality surgery simulators provide sophisticated laparoscopic training scenarios and offer detailed assessment methods. This also makes simulators interesting for the application in surgical skills courses. The aim of the current study was to assess the suitability of a virtual surgery simulator for training and assessment in an established surgical training course. The study was conducted during the annual "Practical Course for Visceral Surgery" (Warnemuende, Germany). 36 of 108 course participants were assigned at random for the study. Training was conducted in 15 sessions over 5 days with 4 identical virtual surgery simulators (LapSim) and 2 standardised training tasks. The simulator measured 16 individual parameters and calculated 2 scores. Questionnaires were used to assess the test persons' laparoscopic experience, their training situation and the acceptance of the simulator training. Data were analysed with non-parametric tests. A subgroup analysis for laparoscopic experience was conducted in order to assess the simulator's construct validity and assessment capabilities. Median age was 32 (27 - 41) years; median professional experience was 3 (1 - 11) years. Typical laparoscopic learning curves with initial significant improvements and a subsequent plateau phase were measured over 5 days. The individual training sessions exhibited a rhythmic variability in the training results. A shorter night's sleep led to a marked drop in performance. The participants' different experience levels could clearly be discriminated ( ≤ 20 vs. > 20 laparoscopic operations; p ≤ 0.001). The questionnaire showed that the majority of the participants had limited training opportunities in their hospitals. The simulator training was very well accepted. However, the participants severely misjudged the real costs of the simulators that were used. The learning curve on the

Avoiding Surgical Skill Decay : A Systematic Review on the Spacing of Training Sessions

NARCIS (Netherlands)

Cecilio-Fernandes, Dario; Cnossen, Fokie; Jaarsma, Debbie A D C; Tio, René A

OBJECTIVE: Spreading training sessions over time instead of training in just 1 session leads to an improvement of long-term retention for factual knowledge. However, it is not clear whether this would also apply to surgical skills. Thus, we performed a systematic review to find out whether spacing

Writing Stories, Telling Tales: National Vocational Qualification (NVQ) Candidates' Experiences of NVQs.

Science.gov (United States)

Spielhofer, Thomas

2001-01-01

A study of clerical staff in two British banks (n=29) who completed National Vocational Qualifications in customer services shows that the potential for skill development and flexibility was not realized. Workers spent more time writing about their routine tasks to accredit existing skills than they did being trained in new skills. (Contains 49…

An Evaluation of the Role of Simulation Training for Teaching Surgical Skills in Sub-Saharan Africa.

Science.gov (United States)

Campain, Nicholas J; Kailavasan, Mithun; Chalwe, Mumba; Gobeze, Aberra A; Teferi, Getaneh; Lane, Robert; Biyani, Chandra Shekhar

2018-04-01

An estimated 5 billion people worldwide lack access to any surgical care, whilst surgical conditions account for 11-30% of the global burden of disease. Maximizing the effectiveness of surgical training is imperative to improve access to safe and essential surgical care on a global scale. Innovative methods of surgical training have been used in sub-Saharan Africa to attempt to improve the efficiency of training healthcare workers in surgery. Simulation training may have an important role in up-scaling and improving the efficiency of surgical training and has been widely used in SSA. Though not intended to be a systematic review, the role of simulation for teaching surgical skills in Sub-Saharan Africa was reviewed to assess the evidence for use and outcomes. A systematic search strategy was used to retrieve relevant studies from electronic databases PubMed, Ovid, Medline for pertinent articles published until August 2016. Studies that reported the use of simulation-based training for surgery in Africa were included. In all, 19 articles were included. A variety of innovative surgical training methods using simulation techniques were identified. Few studies reported any outcome data. Compared to the volume of surgical training initiatives that are known to take place in SSA, there is very limited good quality published evidence for the use of simulation training in this context. Simulation training presents an excellent modality to enhance and improve both volume and access to high quality surgical skills training, alongside other learning domains. There is a desperate need to meticulously evaluate the appropriateness and effectiveness of simulation training in SSA, where simulation training could have a large potential beneficial impact. Training programs should attempt to assess and report learner outcomes.

Retention of laparoscopic procedural skills acquired on a virtual-reality surgical trainer

DEFF Research Database (Denmark)

Nielsen, Mathilde Maagaard; Sørensen, J L; Oestergaard, Jeanett

2011-01-01

BACKGROUND: Virtual-reality (VR) simulator training has been shown to improve surgical performance in laparoscopic procedures in the operating room. We have, in a randomised controlled trial, demonstrated transferability to real operations. The validity of the LapSim virtual-reality simulator...... as an assessment tool has been demonstrated in several reports. However, an unanswered question regarding simulator training is the durability, or retention, of skills acquired during simulator training. The aim of the present study is to assess the retention of skills acquired using the LapSim VR simulator, 6...... and 18 months after an initial training course. METHODS AND MATERIALS: The investigation was designed as a 6- and 18-month follow-up on a cohort of participants who earlier participated in a skills training programme on the LapSim VR. The follow-up cohort consisted of trainees and senior consultants...

Assessment of minimally invasive surgical skills of pre-medical students: What can we learn from future learners?

Science.gov (United States)

Borahay, Mostafa A; Jackson, Mary; Tapısız, Omer L; Lyons, Elizabeth; Patel, Pooja R; Nassar, Ramsey; Kılıç, Gökhan Sami

2014-01-01

Knowledge of baseline laparoscopic and robotic surgical skills of future learners is essential to develop teaching strategies that best fit them. The objectives of this study are to determine baseline laparoscopic and robotic skills of high school and college students and compare them to those of current obstetrics and gynecology residents. A cross-sectional (Class II-2) pilot study. Laparoscopic and robotic surgical skills of college and high (secondary) school students were evaluated using simulators and compared to those of obstetrics and gynecology residents. In addition, questionnaire data were collected regarding video game playing and computer use. A total of 17 students, both high school (n=9) and college (n=8), in addition to 11 residents, completed the study. Overall, students performed comparably to the residents in simple exercises (p>.05). However, students took significantly longer time to complete complex exercises (p=.001). Finally, students played video games significantly more than residents (pskill set. This difference may be related to improved hand-eye coordination, possibly due to playing video games. The results of this pilot study should spur more research into surgical teaching strategies.

A software-based tool for video motion tracking in the surgical skills assessment landscape

NARCIS (Netherlands)

Ganni, S.; Botden, Sanne M.B.I.; Chmarra, M.K.; Goossens, R.H.M.; Jakimowicz, J.J.

2018-01-01

Background: The use of motion tracking has been proved to provide an objective assessment in surgical skills training. Current systems, however, require the use of additional equipment or specialised laparoscopic instruments and cameras to extract the data. The aim of this study was to determine

Mentor Tutoring: An Efficient Method for Teaching Laparoscopic Colorectal Surgical Skills in a General Hospital.

Science.gov (United States)

Ichikawa, Nobuki; Homma, Shigenori; Yoshida, Tadashi; Ohno, Yosuke; Kawamura, Hideki; Wakizaka, Kazuki; Nakanishi, Kazuaki; Kazui, Keizo; Iijima, Hiroaki; Shomura, Hiroki; Funakoshi, Tohru; Nakano, Shiro; Taketomi, Akinobu

2017-12-01

We retrospectively assessed the efficacy of our mentor tutoring system for teaching laparoscopic colorectal surgical skills in a general hospital. A series of 55 laparoscopic colectomies performed by 1 trainee were evaluated. Next, the learning curves for high anterior resection performed by the trainee (n=20) were compared with those of a self-trained surgeon (n=19). Cumulative sum analysis and multivariate regression analyses showed that 38 completed cases were needed to reduce the operative time. In high anterior resection, the mean operative times were significantly shorter after the seventh average for the tutored surgeon compared with that for the self-trained surgeon. In cumulative sum charting, the curve reached a plateau by the seventh case for the tutored surgeon, but continued to increase for the self-trained surgeon. Mentor tutoring effectively teaches laparoscopic colorectal surgical skills in a general hospital setting.

Employability Skills. At a Glance

Science.gov (United States)

Wibrow, Bridget

2011-01-01

In a competitive workforce it is not just having the right qualification or technical skills that will land an individual a job; it could very well be their interpersonal skills. How someone communicates is often the first impression an employer has of a possible worker. Yet, it is precisely communication skills that employers feel applicants are…

A Novel Clinical-Simulated Suture Education for Basic Surgical Skill: Suture on the Biological Tissue Fixed on Standardized Patient Evaluated with Objective Structured Assessment of Technical Skill (OSATS) Tools.

Science.gov (United States)

Shen, Zhanlong; Yang, Fan; Gao, Pengji; Zeng, Li; Jiang, Guanchao; Wang, Shan; Ye, Yingjiang; Zhu, Fengxue

2017-06-21

Clinical-simulated training has shown benefit in the education of medical students. However, the role of clinical simulation for surgical basic skill training such as suturing techniques remains unclear. Forty-two medical students were asked to perform specific suturing tasks at three stations with the different settings within four minutes (Station 1: Synthetic suture pad fixed on the bench, Station 2: Synthetic suture pad fixed on the standardized patient, Station 3: Pig skin fixed on the standardized patient); the OSATS (Objective Structured Assessment of Technical Skill) tool was used to evaluate the performance of students. A questionnaire was distributed to the students following the examination. Mean performance score of Station 3 was significant lower than that of Station 1 and 2 in the general performance including tissue handling, time, and motion. The suturing techniques of students at Station 2 and 3 were not as accurate as that at Station 1. Inappropriate tension was applied to the knot at Station 2 compared with Station 1 and 3. On the questionnaire, 93% of students considered clinical-simulated training of basic surgical skills was necessary and may increase their confidence in future clinical work as surgeons; 98% of students thought the assessment was more objective when OSATS tool was used for evaluation. Clinical simulation examination assessed with OSATS might throw a novel light on the education of basic surgical skills and may be worthy of wider adoption in the surgical education of medical students.

Radiological Control Technician: Standardized technician Qualification Standard

International Nuclear Information System (INIS)

1992-10-01

The Qualification Standard states and defines the knowledge and skill requirements necessary for successful completion of the Radiological Control Technician Training Program. The standard is divided into three phases: Phase I concerns RCT Academic training. There are 13 lessons associated with the core academics program and 19 lessons associated with the site academics program. The staff member should sign the appropriate blocks upon successful completion of the examination for that lesson or group of lessons. In addition, facility specific lesson plans may be added to meet the knowledge requirements in the Job Performance Measures (JPM) of the practical program. Phase II concerns RCT core/site practical (JPMs) training. There are thirteen generic tasks associated with the core practical program. Both the trainer/evaluator and student should sign the appropriate block upon successful completion of the JPM. In addition, facility specific tasks may be added or generic tasks deleted based on the results of the facility job evaluation. Phase III concerns the oral examination board successful completion of the oral examination board is documented by the signature of the chairperson of the board. Upon completion of all of the standardized technician qualification requirements, final qualification is verified by the student and the manager of the Radiological Control Department and acknowledged by signatures on the qualification standard. The completed Qualification Standard shall be maintained as an official training record

Cognitive skills training in digital era: A paradigm shift in surgical education using the TaTME model.

Science.gov (United States)

Knol, Joep; Keller, Deborah S

2018-04-30

Surgical competence is a complex, multifactorial process, requiring ample time and training. Optimal training is based on acquiring knowledge and psychomotor and cognitive skills. Practicing surgical skills is one of the most crucial tasks for both the novice surgeon learning new procedures and surgeons already in practice learning new techniques. Focus is placed on teaching traditional technical skills, but the importance of cognitive skills cannot be underestimated. Cognitive skills allow recognizing environmental cues to improve technical performance including situational awareness, mental readiness, risk assessment, anticipating problems, decision-making, adaptation, and flexibility, and may also accelerate the trainee's understanding of a procedure, formalize the steps being practiced, and reduce the overall training time to become technically proficient. The introduction and implementation of the transanal total mesorectal excision (TaTME) into practice may be the best demonstration of this new model of teaching and training, including pre-training, course attendance, and post-course guidance on technical and cognitive skills. To date, the TaTME framework has been the ideal model for structured training to ensure safe implementation. Further development of metrics to grade successful learning and assessment of long term outcomes with the new pathway will confirm the success of this training model. Copyright © 2018 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. All rights reserved.

Employability Skills Examined: Ten Key Messages from LSN's Quest to Understand Employability Skills

Science.gov (United States)

Lanning, Jill; Martin, Rob; Villeneuve-Smith, Frank

2008-01-01

As the phrase "Employability Skills" increasingly cropped up in speeches from august platforms, appeared in titles of conferences, peppers publications exhorting more effort for and by UK plc and formed the title of an increasing number of qualifications, Learning and Skills Network (LSN) has been intrigued to find out more about this…

Face and content validation of a novel three-dimensional printed temporal bone for surgical skills development.

Science.gov (United States)

Da Cruz, M J; Francis, H W

2015-07-01

To assess the face and content validity of a novel synthetic, three-dimensional printed temporal bone for surgical skills development and training. A synthetic temporal bone was printed using composite materials and three-dimensional printing technology. Surgical trainees were asked to complete three structured temporal bone dissection exercises. Attitudes and impressions were then assessed using a semi-structured questionnaire. Previous cadaver and real operating experiences were used as a reference. Trainees' experiences of the synthetic temporal bone were analysed in terms of four domains: anatomical realism, usefulness as a training tool, task-based usefulness and overall reactions. Responses across all domains indicated a high degree of acceptance, suggesting that the three-dimensional printed temporal bone was a useful tool in skills development. A sophisticated three-dimensional printed temporal bone that demonstrates face and content validity was developed. The efficiency in cost savings coupled with low associated biohazards make it likely that the printed temporal bone will be incorporated into traditional temporal bone skills development programmes in the near future.

Qualification of contractor/consultant instructors

International Nuclear Information System (INIS)

Hanson, H.D.

1985-01-01

Following a brief discussion of the role of consultant instructors in Public Service Electric and Gas Company's training organization, the qualification process is presented. Consultant instructors are provided with information regarding supervision of the trainees and the instructional process and procedures required. Each individual must have his or her instructional capability, supervisory skills and technical competence verified and documented prior to conducting training independently. Concluding comments describe the overall satisfactory experience with this program

Live transference of surgical subspecialty skills using telerobotic proctoring to remote general surgeons.

Science.gov (United States)

Ereso, Alexander Q; Garcia, Pablo; Tseng, Elaine; Gauger, Grant; Kim, Hubert; Dua, Monica M; Victorino, Gregory P; Guy, T Sloane

2010-09-01

Certain clinical environments, including military field hospitals or rural medical centers, lack readily available surgical subspecialists. We hypothesized that telementoring by a surgical subspecialist using a robotic platform is feasible and can convey subspecialty knowledge and skill to a remotely located general surgeon. Eight general surgery residents evaluated the effect of remote surgical telementoring by performing 3 operative procedures, first unproctored and then again when teleproctored by a surgical subspecialist. The clinical scenarios consisted of a penetrating right ventricular injury requiring suture repair, an open tibial fracture requiring external fixation, and a traumatic subdural hematoma requiring craniectomy. A robotic platform consisting of a pan-and-tilt camera with laser pointer attached to an overhead surgical light with integrated audio allowed surgical subspecialists the ability to remotely teleproctor residents. Performance was evaluated using an Operative Performance Scale. Satisfaction surveys were given after performing the scenario unproctored and again after proctoring. Overall mean performance scores were superior in all scenarios when residents were proctored than when they were not (4.30 +/- 0.25 versus 2.43 +/- 0.20; p knowledge of anatomy, were all superior when residents were proctored (p < 0.001). Satisfaction surveys showed greater satisfaction and comfort among residents when proctored. Proctored residents believed the robotic platform facilitated learning and would be feasible if used clinically. This study supports the use of surgical teleproctoring in guiding remote general surgeons by a surgical subspecialist in the care of a wounded patient in need of an emergency subspecialty operation. Copyright 2010. Published by Elsevier Inc.

Teacher Qualification Guidelines, Ecological Literacy and Outdoor Education

Science.gov (United States)

Martin, Peter

2008-01-01

A key signpost to a profession is clarity of disciplinary knowledge. In this paper I describe the content and outcome of a process to refine the qualification guidelines for outdoor education teachers in Victorian, Australia. The guidelines, developed for the Victorian Institute of Teaching, include both practical skills and disciplinary…

The usefulness of the surgical knowledge and skills acquired via the university curriculum for doctors' medical practice several years after graduation.

Science.gov (United States)

Zyluk, Andrzej; Puchalski, Piotr; Szlosser, Zbigniew

2015-01-01

Teaching surgery during university curriculum comprises transferring theoretical knowledge traditionally and simultaneously acquiring manual skills, i.e., suturing, stitch removal, limb immobilization, catheterization, and assisting operations. Observations of doctors several years after graduation led to the reflection that teachers' ideas about surgical knowledge and skills that are useful in daily practice frequently fail to meet the facts of the case. The objective of this study was to determine which part of the surgical knowledge and skills taught via the university surgical curriculum proved to be useful in the daily practice of young doctors. A custom-made questionnaire was designed and mailed to 200 randomly chosen doctors who had graduated from the medical faculty at the authors' university 5 to 6 years previously. The questionnaire comprised 9 items concerning the knowledge and skills that proved to be the most useful in participants' daily practice, regardless of their specialty. A total of 64 completed questionnaires were returned (32% of 200 sent) and were the subject of analysis. The most useful knowledge in daily practice was that acquired from general surgery, followed by oncological and vascular surgery. The most useful was knowledge about the rational interpretation of clinical symptoms and signs acquired from examination of the patient, followed by arriving at an accurate diagnosis through logical analysis, and next developing "oncological sensitivity" to diagnosing neoplasms. The most effective teaching model was specialized outpatient clinic rounds, followed by training manual skills on a model and classical ward-round teaching. The most frequently learned (acquired) manual skills were removal of stitches, rectal examination, and examination of the abdomen. Of these skills, the most useful in daily practice appeared to be removal of stitches, catheterization of the urinary bladder, and wound suturing. Learning and practicing manual skills

Chapter 9. Personnel qualification and training

International Nuclear Information System (INIS)

2001-01-01

The overall training system and the development of projects for training of all categories of NPP V-1, NPP V-2 Bohunice, SE-VYZ and NPP Mochovce staff were the subject of Nuclear Regulatory Authority of the Slovak Republic (UJD) attention. During 2000, the following inspections were carried out on nuclear personnel training: (a) NPP Bohunice: an inspection focused on compliance with requirements for staff qualifications and compliance with the prescribed training of Bohunice plant staff ; (b) NPP Mochovce: an inspection focused on compliance with the requirements for staff qualifications and compliance with the prescribed training of NPP Mochovce staff; an inspection focused on verifying the simulator aided training; an inspection focused on checking the preparedness of NPP Mochovce operation and technical personnel for NPP Mochovce Unit 2 operation; (c) Technology for treatment and conditioning of radioactive waste Bohunice (BSC): an inspection focused on compliance with the requirements for staff qualifications and compliance with the prescribed training of SE-VYZ staff; VUJE Trnava: verification of technical equipment and professional skills of VUJE Trnava staff and tasks arising out of the 'Authorisation on nuclear installation staff training'. Examinations of selected personnel were scheduled according to the plan of examining committee meetings. For each examined person written tests are generated by the computer from the database of test questions at the Training Centre of VUJE Trnava for individual positions - categories of selected staff of NPP V-1 and NPP V-2 Bohunice and NPP Mochovce so that the examination questions both in written and oral part equally cover individual facilities and regimes of operation of NPP. The database is continuously updated, thereby containing new questions resulting from the recent changes carried out at NPPs. A part of the examination in case of promotion to a higher position is the practical part, which is conducted under

Robotic technology results in faster and more robust surgical skill acquisition than traditional laparoscopy.

Science.gov (United States)

Moore, Lee J; Wilson, Mark R; Waine, Elizabeth; Masters, Rich S W; McGrath, John S; Vine, Samuel J

2015-03-01

Technical surgical skills are said to be acquired quicker on a robotic rather than laparoscopic platform. However, research examining this proposition is scarce. Thus, this study aimed to compare the performance and learning curves of novices acquiring skills using a robotic or laparoscopic system, and to examine if any learning advantages were maintained over time and transferred to more difficult and stressful tasks. Forty novice participants were randomly assigned to either a robotic- or laparoscopic-trained group. Following one baseline trial on a ball pick-and-drop task, participants performed 50 learning trials. Participants then completed an immediate retention trial and a transfer trial on a two-instrument rope-threading task. One month later, participants performed a delayed retention trial and a stressful multi-tasking trial. The results revealed that the robotic-trained group completed the ball pick-and-drop task more quickly and accurately than the laparoscopic-trained group across baseline, immediate retention, and delayed retention trials. Furthermore, the robotic-trained group displayed a shorter learning curve for accuracy. The robotic-trained group also performed the more complex rope-threading and stressful multi-tasking transfer trials better. Finally, in the multi-tasking trial, the robotic-trained group made fewer tone counting errors. The results highlight the benefits of using robotic technology for the acquisition of technical surgical skills.

Systematic Review of Voluntary Participation in Simulation-Based Laparoscopic Skills Training: Motivators and Barriers for Surgical Trainee Attendance.

Science.gov (United States)

Gostlow, Hannah; Marlow, Nicholas; Babidge, Wendy; Maddern, Guy

To examine and report on evidence relating to surgical trainees' voluntary participation in simulation-based laparoscopic skills training. Specifically, the underlying motivators, enablers, and barriers faced by surgical trainees with regard to attending training sessions on a regular basis. A systematic search of the literature (PubMed; CINAHL; EMBASE; Cochrane Collaboration) was conducted between May and July 2015. Studies were included on whether they reported on surgical trainee attendance at voluntary, simulation-based laparoscopic skills training sessions, in addition to qualitative data regarding participant's perceived barriers and motivators influencing their decision to attend such training. Factors affecting a trainee's motivation were categorized as either intrinsic (internal) or extrinsic (external). Two randomised control trials and 7 case series' met our inclusion criteria. Included studies were small and generally poor quality. Overall, voluntary simulation-based laparoscopic skills training was not well attended. Intrinsic motivators included clearly defined personal performance goals and relevance to clinical practice. Extrinsic motivators included clinical responsibilities and available free time, simulator location close to clinical training, and setting obligatory assessments or mandated training sessions. The effect of each of these factors was variable, and largely dependent on the individual trainee. The greatest reported barrier to attending voluntary training was the lack of available free time. Although data quality is limited, it can be seen that providing unrestricted access to simulator equipment is not effective in motivating surgical trainees to voluntarily participate in simulation-based laparoscopic skills training. To successfully encourage participation, consideration needs to be given to the factors influencing motivation to attend training. Further research, including better designed randomised control trials and large

The role of student surgical interest groups and surgical Olympiads in anatomical and surgical undergraduate training in Russia.

Science.gov (United States)

Dydykin, Sergey; Kapitonova, Marina

2015-01-01

Traditional department-based surgical interest groups in Russian medical schools are useful tools for student-based selection of specialty training. They also form a nucleus for initiating research activities among undergraduate students. In Russia, the Departments of Topographical Anatomy and Operative Surgery play an important role in initiating student-led research and providing learners with advanced, practical surgical skills. In tandem with department-led activities, student surgical interest groups prepare learners through surgical competitions, known as "Surgical Olympiads," which have been conducted in many Russian centers on a regular basis since 1988. Surgical Olympiads stimulate student interest in the development of surgical skills before graduation and encourage students to choose surgery as their postgraduate specialty. Many of the participants in these surgical Olympiads have become highly qualified specialists in general surgery, orthopedic surgery, neurosurgery, urology, gynecology, and emergency medicine. The present article emphasizes the role of student interest groups and surgical Olympiads in clinical anatomical and surgical undergraduate training in Russia. © 2015 American Association of Anatomists.

The laparoscopic performance of novice surgical trainees: testing for acquisition, loss, and reacquisition of psychomotor skills.

Science.gov (United States)

Windsor, J A; Zoha, F

2005-08-01

It has been suggested that virtual reality (VR) might be useful for the selection of surgical trainees and the measurement of technical performance during preoperative training and retraining. This study was designed to determine whether it is possible to define and measure the acquisition, loss, and reacquisition of psychomotor skills in novice surgical trainees. Novice surgical trainees (NSTs n = 10, junior surgical registrars with little or no prior experience with laparoscopic surgery) were tested and retested after 1 month using the Minimally Invasive Surgical Trainer-Virtual Reality. Two tasks were used: the simple task [stretch diathermy (SD)] and the more complex task [manipulation diathermy (MD)]. The score was derived from the time taken to complete the task and the number of errors that occurred. Acquisition is the difference between the first and last score of the first training session, loss is the difference in score that occurs between the last score of the first training session and the first score of the second training session, and reacquisition is the difference in the first and last scores of the second training session. A performance criterion level was defined for each task by testing a group of experienced laparoscopic surgeons (n = 10). Groups were compared using the nonparametric Wilcoxon signed rank test, with p psychomotor skills in individual NSTs and to compare them with a predefined performance criterion level. This study defines parameters that will be useful in repeated training sessions of NSTs in the preoperative phase of training and during retraining.

The Returns to Completion or Partial Completion of a Qualification in the Trades. Research Report

Science.gov (United States)

Lu, Tham

2015-01-01

Many students do not complete full qualifications in the vocational education and training (VET) system because their intention is to obtain only the particular skills they require. This can be achieved through the acquisition of skill sets; these enable flexibility in training to quickly respond to changes in the labour market. Skill sets may…

Ready for OR or not? Human reader supplements Eyesi scoring in cataract surgical skills assessment

Directory of Open Access Journals (Sweden)

Selvander M

2013-10-01

Full Text Available Madeleine Selvander,1,2 Peter Åsman11Department of Clinical Sciences, Malmö: Ophthalmology, Lund University, Malmö, Sweden; 2Practicum Clinical Skills Centre, Skåne University Hospital, Malmö, SwedenPurpose: To compare the internal computer-based scoring with human-based video scoring of cataract modules in the Eyesi virtual reality intraocular surgical simulator, a comparative case series was conducted at the Department of Clinical Sciences – Ophthalmology, Lund University, Skåne University Hospital, Malmö, Sweden.Methods: Seven cataract surgeons and 17 medical students performed one video-recorded trial with each of the capsulorhexis, hydromaneuvers, and phacoemulsification divide-and-conquer modules. For each module, the simulator calculated an overall score for the performance ranging from 0 to 100. Two experienced masked cataract surgeons analyzed each video using the Objective Structured Assessment of Cataract Surgical Skill (OSACSS for individual models and modified Objective Structured Assessment of Surgical Skills (OSATS for all three modules together. The average of the two assessors' scores for each tool was used as the video-based performance score. The ability to discriminate surgeons from naive individuals using the simulator score and the video score, respectively, was compared using receiver operating characteristic (ROC curves.Results: The ROC areas for simulator score did not differ from 0.5 (random for hydromaneuvers and phacoemulsification modules, yielding unacceptably poor discrimination. OSACSS video scores all showed good ROC areas significantly different from 0.5. The OSACSS video score was also superior compared to the simulator score for the phacoemulsification procedure: ROC area 0.945 vs 0.664 for simulator score (P = 0.010. Corresponding values for capsulorhexis were 0.887 vs 0.761 (P = 0.056 and for hydromaneuvers 0.817 vs 0.571 (P = 0.052 for the video scores and simulator scores, respectively.The ROC

Technical skill improvement with surgical preparatory courses: What advantages are reflected in residency?

Science.gov (United States)

Green, Courtney A; Huang, Emily; Zhao, Nina W; O'Sullivan, Patricia S; Kim, Edward; Chern, Hueylan

2017-11-01

Sustainability of skill acquisition gained from graduating medical student (GMS) preparatory courses remains uncertain. GMS skills were assessed before (T1) and after a preparatory course (T2) and then again 2 (T3) and 4 (T4) months into residency and compared to surgical interns without such a course. In April, GMS took the preparatory course. In July-August all interns participated in a basic skills curriculum. Learners completed four technical exercises pre/post each course. Three surgeons scored performances. GMS scores were compared across the 4 time points. Control interns were compared at T3 and T4. Thirty-two interns completed all pre/post course assessments (T3 and T4); seven of those were GMSs. GMS scores increased from 74.5%(T1) to 94.2%(T2) (p starting residency compared to control interns (T3, 89.08% vs 65.03%, p start. Without such course, interns require a steep learning curve. Copyright © 2017 Elsevier Inc. All rights reserved.

Communication skills in palliative surgery: skill and effort are key.

Science.gov (United States)

Miner, Thomas J

2011-04-01

Excellence as a surgeon requires not only the technical and intellectual ability to effectively take care of surgical disease but also an ability to respond to the needs and questions of patients. This article provides an overview of the importance of communication skills in optimal surgical palliation and offers suggestions for a multidisciplinary team approach, using the palliative triangle as the ideal model of communication and interpersonal skills. This article also discusses guidelines for advanced surgical decision making and outlines methods to improve communication skills. Copyright © 2011 Elsevier Inc. All rights reserved.

Factors associated with simulator-assessed laparoscopic surgical skills of veterinary students.

Science.gov (United States)

Kilkenny, Jessica J; Singh, Ameet; Kerr, Carolyn L; Khosa, Deep K; Fransson, Boel A

2017-06-01

OBJECTIVE To determine whether simulator-assessed laparoscopic skills of veterinary students were associated with training level and prior experience performing nonlaparoscopic veterinary surgery and other activities requiring hand-eye coordination and manual dexterity. DESIGN Experiment. SAMPLE 145 students without any prior laparoscopic surgical or fundamentals of laparoscopic surgery (FLS) simulator experience in years 1 (n = 39), 2 (34), 3 (39), and 4 (33) at a veterinary college. PROCEDURES A questionnaire was used to collect data from participants regarding experience performing veterinary surgery, playing video games, and participating in other activities. Participants performed a peg transfer, pattern cutting, and ligature loop-placement task on an FLS simulator, and FLS scores were assigned by an observer. Scores were compared among academic years, and correlations between amounts of veterinary surgical experience and FLS scores were assessed. A general linear model was used to identify predictors of FLS scores. RESULTS Participants were predominantly female (75%), right-hand dominant (92%), and between 20 and 29 years of age (98%). No significant differences were identified among academic years in FLS scores for individual tasks or total FLS score. Scores were not significantly associated with prior surgical or video game experience. Participants reporting no handicraft experience had significantly lower total FLS scores and FLS scores for task 2 than did participants reporting a lot of handicraft experience. CONCLUSIONS AND CLINICAL RELEVANCE Prior veterinary surgical and video game experience had no influence on FLS scores in this group of veterinary students, suggesting that proficiency of veterinary students in FLS may require specific training.

Anxiety in veterinary surgical students

DEFF Research Database (Denmark)

Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff

2012-01-01

The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...

Selective automation and skill transfer in medical robotics: a demonstration on surgical knot-tying.

Science.gov (United States)

Knoll, Alois; Mayer, Hermann; Staub, Christoph; Bauernschmitt, Robert

2012-12-01

Transferring non-trivial human manipulation skills to robot systems is a challenging task. There have been a number of attempts to design research systems for skill transfer, but the level of the complexity of the actual skills transferable to the robot was rather limited, and delicate operations requiring a high dexterity and long action sequences with many sub-operations were impossible to transfer. A novel approach to human-machine skill transfer for multi-arm robot systems is presented. The methodology capitalizes on the metaphor of 'scaffolded learning', which has gained widespread acceptance in psychology. The main idea is to formalize the superior knowledge of a teacher in a certain way to generate support for a trainee. In our case, the scaffolding is constituted by abstract patterns, which facilitate the structuring and segmentation of information during 'learning by demonstration'. The actual skill generalization is then based on simulating fluid dynamics. The approach has been successfully evaluated in the medical domain for the delicate task of automated knot-tying for suturing with standard surgical instruments and a realistic minimally invasive robotic surgery system. Copyright © 2012 John Wiley & Sons, Ltd.

Incorporating simulation into gynecologic surgical training.

Science.gov (United States)

Wohlrab, Kyle; Jelovsek, J Eric; Myers, Deborah

2017-11-01

Today's educational environment has made it more difficult to rely on the Halstedian model of "see one, do one, teach one" in gynecologic surgical training. There is decreased surgical volume, but an increased number of surgical modalities. Fortunately, surgical simulation has evolved to fill the educational void. Whether it is through skill generalization or skill transfer, surgical simulation has shifted learning from the operating room back to the classroom. This article explores the principles of surgical education and ways to introduce simulation as an adjunct to residency training. We review high- and low-fidelity surgical simulators, discuss the progression of surgical skills, and provide options for skills competency assessment. Time and money are major hurdles when designing a simulation curriculum, but low-fidelity models, intradepartmental cost sharing, and utilizing local experts for simulation proctoring can aid in developing a simulation program. Copyright © 2017 Elsevier Inc. All rights reserved.

The Development of a Novel Perfused Cadaver Model With Dynamic Vital Sign Regulation and Real-World Scenarios to Teach Surgical Skills and Error Management.

Science.gov (United States)

Minneti, Michael; Baker, Craig J; Sullivan, Maura E

The landscape of graduate medical education has changed dramatically over the past decade and the traditional apprenticeship model has undergone scrutiny and modifications. The mandate of the 80-hour work-week, the introduction of integrated residency programs, increased global awareness about patient safety along with financial constraints have spurred changes in graduate educational practices. In addition, new technologies, more complex procedures, and a host of external constraints have changed where and how we teach technical and procedural skills. Simulation-based training has been embraced by the surgical community and has quickly become an essential component of most residency programs as a method to add efficacy to the traditional learning model. The purpose of this paper is twofold: (1) to describe the development of a perfused cadaver model with dynamic vital sign regulation, and (2) to assess the impact of a curriculum using this model and real world scenarios to teach surgical skills and error management. By providing a realistic training environment our aim is to enhance the acquisition of surgical skills and provide a more thorough assessment of resident performance. Twenty-six learners participated in the scenarios. Qualitative data showed that participants felt that the simulation model was realistic, and that participating in the scenarios helped them gain new knowledge, learn new surgical techniques and increase their confidence performing the skill in a clinical setting. Identifying the importance of both technical and nontechnical skills in surgical education has hastened the need for more realistic simulators and environments in which they are placed. Team members should be able to interact in ways that allow for a global display of their skills thus helping to provide a more comprehensive assessment by faculty and learners. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The role of simulation in developing surgical skills.

Science.gov (United States)

Akhtar, K S N; Chen, Alvin; Standfield, N J; Gupte, C M

2014-06-01

Surgical training has followed the master-apprentice model for centuries but is currently undergoing a paradigm shift. The traditional model is inefficient with no guarantee of case mix, quality, or quantity. There is a growing focus on competency-based medical education in response to restrictions on doctors' working hours and the traditional mantra of "see one, do one, teach one" is being increasingly questioned. The medical profession is subject to more scrutiny than ever before and is facing mounting financial, clinical, and political pressures. Simulation may be a means of addressing these challenges. It provides a way for trainees to practice technical tasks in a protected environment without putting patients at risk and helps to shorten the learning curve. The evidence for simulation-based training in orthopedic surgery using synthetic models, cadavers, and virtual reality simulators is constantly developing, though further work is needed to ensure the transfer of skills to the operating theatre.

Open knot-tying skills: residents skills assessed

NARCIS (Netherlands)

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

2013-01-01

Aim: Open knot-tying and suturing skills are fundamental surgical skills, founding many alternative knot-tying techniques. It is therefore mandatory for residents to possess adequate basic open knot-tying skills. The aim of this study was to compare an objective assessment of open knot-tying skills

Simulation-based cutaneous surgical-skill training on a chicken-skin bench model in a medical undergraduate program.

Science.gov (United States)

Denadai, Rafael; Saad-Hossne, Rogério; Martinhão Souto, Luís Ricardo

2013-05-01

Because of ethical and medico-legal aspects involved in the training of cutaneous surgical skills on living patients, human cadavers and living animals, it is necessary the search for alternative and effective forms of training simulation. To propose and describe an alternative methodology for teaching and learning the principles of cutaneous surgery in a medical undergraduate program by using a chicken-skin bench model. One instructor for every four students, teaching materials on cutaneous surgical skills, chicken trunks, wings, or thighs, a rigid platform support, needled threads, needle holders, surgical blades with scalpel handles, rat-tooth tweezers, scissors, and marking pens were necessary for training simulation. A proposal for simulation-based training on incision, suture, biopsy, and on reconstruction techniques using a chicken-skin bench model distributed in several sessions and with increasing levels of difficultywas structured. Both feedback and objective evaluations always directed to individual students were also outlined. The teaching of a methodology for the principles of cutaneous surgery using a chicken-skin bench model versatile, portable, easy to assemble, and inexpensive is an alternative and complementary option to the armamentarium of methods based on other bench models described.

Approach to team skills training

International Nuclear Information System (INIS)

Koontz, J.L.; Roe, M.L.; Gaddy, C.D.

1987-01-01

The US commercial nuclear power industry has recognized the importance of team skills in control room operation. The desire to combine training of team interaction skills, like communications, with technical knowledge of reactor operations requires a unique approach to training. An NRC-sponsored study identified a five-phase approach to team skills training designed to be consistent with the systems approach to training currently endorsed by the NRC Policy Statement on Training and Qualification. This paper describes an approach to team skills training with emphasis on the nuclear power plant control room crew. An approach to team skills training

Crisis management on surgical wards: a simulation-based approach to enhancing technical, teamwork, and patient interaction skills.

Science.gov (United States)

Arora, Sonal; Hull, Louise; Fitzpatrick, Maureen; Sevdalis, Nick; Birnbach, David J

2015-05-01

To establish the efficacy of simulation-based training for improving residents' management of postoperative complications on a surgical ward. Effective postoperative care is a crucial determinant of patient outcome, yet trainees learn this through the Halstedian approach. Little evidence exists on the efficacy of simulation in this safety-critical environment. A pre-/postintervention design was employed with 185 residents from 5 hospitals. Residents participated in 2 simulated ward-based scenarios consisting of a deteriorating postoperative patient. A debriefing intervention was implemented between scenarios. Resident performance was evaluated by calibrated, blinded assessors using the validated Global Assessment Toolkit for Ward Care. This included an assessment of clinical skills (checklist of 35 tasks), team-working skills (score range 1-6 per skill), and physician-patient interaction skills. Excellent interrater reliability was achieved in all assessments (reliability 0.89-0.99, P pre = 73.7% vs post = 94.8%, P pre = 21.1% vs post = 84.2% P pre = 42.1% vs post = 100%, P pre = 36.8% vs post = 89.8%, P pre = 1.75 vs post = 3.43), leadership (pre = 2.43 vs post = 4.20), and decision-making skills (pre = 2.20 vs post = 3.81, P < 0.001). Finally, residents improved in all elements of interaction with patients: empathy, organization, and verbal and nonverbal expression (Ps < 0.001). The study provides evidence for the efficacy of ward-based team training using simulation. Such exercises should be formally incorporated into training curricula to enhance patient safety in the high-risk surgical ward environment.

Revision of the qualification framework at the Technical University of Denmark

DEFF Research Database (Denmark)

Henneberg, Kaj-Åge

2017-01-01

-instruction. The category, -to interact, includes competencies in communication and teamwork. The category, -to do, includes operative skills and competencies in problem solving. Each of the four main categories contain a number of qualification elements. Suitable taxonomies are suggested for each of the main categories....

Instructor qualification for radiation safety training at a national laboratory

International Nuclear Information System (INIS)

Trinoskey, P.A.

1994-10-01

Prior to 1993, Health Physics Training (HPT) was conducted by the Lawrence Livermore National Laboratory (LLNL) health physics group. The job requirements specified a Masters Degree and experience. In fact, the majority of Health Physicists in the group were certified by the American Board of Health Physics. Under those circumstances, it was assumed that individuals in the group were technically qualified and the HPT instructor qualification stated that. In late 1993, the Health Physics Group at the LLNL was restructured and the training function was assigned to the training group. Additional requirements for training were mandated by the Department of Energy (DOE), which would necessitate increasing the existing training staff. With the need to hire, and the policy of reassignment of employees during downsizing, it was imperative that formal qualification standards be developed for technical knowledge. Qualification standards were in place for instructional capability. In drafting the new training qualifications for instructors, the requirements of a Certified Health Physicists had to be modified due to supply and demand. Additionally, for many of the performance-based training courses, registration by the National Registry of Radiation Protection Technologists is more desirable. Flexibility in qualification requirements has been incorporated to meet the reality of ongoing training and the compensation for desirable skills of individuals who may not meet all the criteria. The qualification requirements for an instructor rely on entry-level requirements and emphasis on goals (preferred) and continuing development of technical and instructional capabilities

Preschool Teacher Candidates' Research Qualifications and Anxiety Level towards Research

Science.gov (United States)

Konokman, Gamze Yavuz; Yelken, Tugba; Yokus, Gürol

2015-01-01

Problem Statement: Acquisition of research qualifications are one of the most demanded learning outcomes of education faculties. There is great emphasis on building a research identity by developing the skills of students in the department of education faculties. However, very few surveys analyze the current situation of university students in the…

A Randomized Controlled Trial of Video Education versus Skill Demonstration: Which Is More Effective in Teaching Sterile Surgical Technique?

Science.gov (United States)

Pilieci, Stephanie N; Salim, Saad Y; Heffernan, Daithi S; Itani, Kamal M F; Khadaroo, Rachel G

2018-04-01

Video education has many advantages over traditional education including efficiency, convenience, and individualized learning. Learning sterile surgical technique (SST) is imperative for medical students, because proper technique helps prevent surgical site infections (SSIs). We hypothesize that video education is at least as effective as traditional skill demonstration in teaching first-year medical students SST. A video series was created to demonstrate SST ( https://www.youtube.com/playlist?list=PLcRU-gvOmxE2mwMWkowouBkxGXkLZ8Uis ). A randomized controlled trial was designed to assess which education method best teaches SST: video education or skill demonstration. First-year medical students (n = 129) were consented and randomly assigned into two groups: those who attended a skill demonstration (control group; n = 70) and those who watched the video series (experimental group; n = 59). The control group attended a pre-existing 90-minute nurse educator-led skill demonstration. Participants then completed a 30-item multiple choice quiz to test their knowledge. Each group then received the alternate education method and completed a 23-item follow-up survey to determine their preferred method. Seven 2- to 6-minute videos (30 minutes total) were created on surgical attire, scrubbing, gowning and gloving, and maintaining sterility. The experimental group (n = 51) scored higher on the quiz compared with the control group (n = 63) (88% ± 1% versus 72% ± 1%; p < 0.0001). Students preferred the videos when it came to convenience, accessibility, efficiency, and review, and preferred the skill demonstration when it came to knowledge retention, preparedness, and ease of completion. Video education is superior to traditional skill demonstration in providing medical students with knowledge of SST. Students identified strengths to each method of teaching. Video education can augment medical students' knowledge prior to their operating room

Features that contribute to the usefulness of low-fidelity models for surgical skills training

DEFF Research Database (Denmark)

Langebæk, Rikke; Berendt, Mette; Pedersen, Lene Tanggaard

2012-01-01

of models were developed to be used in a basic surgical skills course for veterinary students. The models were low fidelity, having limited resemblance to real animals. The aim of the present study was to describe the students' learning experience with the models and to report their perception...... of the usefulness of the models in applying the trained skills to live animal surgery. One hundred and forty-six veterinary fourth-year students evaluated the models on a four-point Likert scale. Of these, 26 additionally participated in individual semistructured interviews. The survey results showed that 75 per...... educational tools in preparation for live animal surgery. However, there are specific features to take into account when developing models in order for students to perceive them as useful....

Estudio observacional de habilidades quirúrgicas en residentes Observational study of surgical skills in residents

Directory of Open Access Journals (Sweden)

Eduardo B. Arribalzaga

2006-03-01

Full Text Available Introducción: existen actualmente "agujeros negros" en la transmisión de conocimientos aplicables que obligan a poner atención en los mecanismos de adquisición de destrezas y habilidades. El objetivo es evaluar características cualitativas de las habilidades en 2 tipos de procedimientos técnicos básicos al alcance de un cirujano general. Material y Métodos: estudio preliminar exploratorio observacional prospectivo en un Hospital Universitario consistente en la observación de los pasos de una toracotomía axilar o una dermolipectomía abdominal anterior con neo ombligo. Se analizó la práctica de las operaciones programadas, no discriminando que médicos residentes las habían efectuado. Los datos se medían en una lista de cotejos con una escala tipo Likert modificada de 3 items. Cada paso de la técnica observada era evaluado sin considerar el tiempo de duración de cada maniobra. Los evaluadores eran ajenos al equipo quirúrgico actuante ubicados donde no se los veía (en miradores para evitar sesgos o maniobras que afectaran la actividad. Se usaron pruebas estadísticas de ANOVA y prueba de t para detectar validez y diferencias en los resultados. Resultados: observada una toracotomía, todos los pasos quirúrgicos fueron evaluados por encima del valor 2 (bueno, sin variaciones en el desarrollo de cada paso ni existir diferencias significativas en la comparación de destrezas. Similares resultados se hallaron en la observación de la otra técnica. Conclusiones: con un sencillo método de observación directa inadvertida por el evaluado con criterios específicos se hizo un diagnóstico de situación demostrando la existencia de habilidades adquiridas en cirujanos en formación durante programas de residencia.Introduction: Some " black holes" in the knowledge transmission process, suggest to pay attention on the correct way to acquire specific surgical skills. The objective is to evaluate qualitative features of main surgical skills

Multimedia educational tools for cognitive surgical skill acquisition in open and laparoscopic colorectal surgery: a randomized controlled trial.

Science.gov (United States)

Shariff, U; Kullar, N; Haray, P N; Dorudi, S; Balasubramanian, S P

2015-05-01

Conventional teaching in surgical training programmes is constrained by time and cost, and has room for improvement. This study aimed to determine the effectiveness of a multimedia educational tool developed for an index colorectal surgical procedure (anterior resection) in teaching and assessment of cognitive skills and to evaluate its acceptability amongst general surgical trainees. Multimedia educational tools in open and laparoscopic anterior resection were developed by filming multiple operations which were edited into procedural steps and substeps and then integrated onto interactive navigational platforms using Adobe® Flash® Professional CS5 10.1. A randomized controlled trial was conducted on general surgical trainees to evaluate the effectiveness of online multimedia in comparison with conventional 'study day' teaching for the acquisition of cognitive skills. All trainees were assessed before and after the study period. Trainees in the multimedia group evaluated the tools by completing a survey. Fifty-nine trainees were randomized but 27% dropped out, leaving 43 trainees randomized to the multimedia group (n = 25) and study day group (n = 18) who were available for analysis. Posttest scores improved significantly in both groups (P multimedia group was not significantly different from the study day group (6.02 ± 5.12 and 5.31 ± 3.42, respectively; P = 0.61). Twenty-five trainees completed the evaluation survey and experienced an improvement in their decision making (67%) and in factual and anatomical knowledge (88%); 96% agreed that the multimedia tool was a useful additional educational resource. Multimedia tools are effective for the acquisition of cognitive skills in colorectal surgery and are well accepted as an educational resource. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

Assessing the surgical skills of trainees in the operating theatre: a prospective observational study of the methodology.

Science.gov (United States)

Beard, J D; Marriott, J; Purdie, H; Crossley, J

2011-01-01

To compare user satisfaction and acceptability, reliability and validity of three different methods of assessing the surgical skills of trainees by direct observation in the operating theatre across a range of different surgical specialties and index procedures. A 2-year prospective, observational study in the operating theatres of three teaching hospitals in Sheffield. The assessment methods were procedure-based assessment (PBA), Objective Structured Assessment of Technical Skills (OSATS) and Non-technical Skills for Surgeons (NOTSS). The specialties were obstetrics and gynaecology (O&G) and upper gastrointestinal, colorectal, cardiac, vascular and orthopaedic surgery. Two to four typical index procedures were selected from each specialty. Surgical trainees were directly observed performing typical index procedures and assessed using a combination of two of the three methods (OSATS or PBA and NOTSS for O&G, PBA and NOTSS for the other specialties) by the consultant clinical supervisor for the case and the anaesthetist and/or scrub nurse, as well as one or more independent assessors from the research team. Information on user satisfaction and acceptability of each assessment method from both assessor and trainee perspectives was obtained from structured questionnaires. The reliability of each method was measured using generalisability theory. Aspects of validity included the internal structure of each tool and correlation between tools, construct validity, predictive validity, interprocedural differences, the effect of assessor designation and the effect of assessment on performance. Of the 558 patients who were consented, a total of 437 (78%) cases were included in the study: 51 consultant clinical supervisors, 56 anaesthetists, 39 nurses, 2 surgical care practitioners and 4 independent assessors provided 1635 assessments on 85 trainees undertaking the 437 cases. A total of 749 PBAs, 695 NOTSS and 191 OSATSs were performed. Non-O&G clinical supervisors and

A software-based tool for video motion tracking in the surgical skills assessment landscape

OpenAIRE

Ganni, S.; Botden, Sanne M.B.I.; Chmarra, M.K.; Goossens, R.H.M.; Jakimowicz, J.J.

2018-01-01

Background: The use of motion tracking has been proved to provide an objective assessment in surgical skills training. Current systems, however, require the use of additional equipment or specialised laparoscopic instruments and cameras to extract the data. The aim of this study was to determine the possibility of using a software-based solution to extract the data. Methods: 6 expert and 23 novice participants performed a basic laparoscopic cholecystectomy procedure in the operating room. The...

Simulation-based cutaneous surgical-skill training on a chicken-skin bench model in a medical undergraduate program

Directory of Open Access Journals (Sweden)

Rafael Denadai

2013-01-01

Full Text Available Background: Because of ethical and medico-legal aspects involved in the training of cutaneous surgical skills on living patients, human cadavers and living animals, it is necessary the search for alternative and effective forms of training simulation. Aims: To propose and describe an alternative methodology for teaching and learning the principles of cutaneous surgery in a medical undergraduate program by using a chicken-skin bench model. Materials and Methods: One instructor for every four students, teaching materials on cutaneous surgical skills, chicken trunks, wings, or thighs, a rigid platform support, needled threads, needle holders, surgical blades with scalpel handles, rat-tooth tweezers, scissors, and marking pens were necessary for training simulation. Results: A proposal for simulation-based training on incision, suture, biopsy, and on reconstruction techniques using a chicken-skin bench model distributed in several sessions and with increasing levels of difficultywas structured. Both feedback and objective evaluations always directed to individual students were also outlined. Conclusion: The teaching of a methodology for the principles of cutaneous surgery using a chicken-skin bench model versatile, portable, easy to assemble, and inexpensive is an alternative and complementary option to the armamentarium of methods based on other bench models described.

[Authorized Qualifications of Staff Conducting Examinations in the Field of Clinical Microbiology].

Science.gov (United States)

Nishiyama, Hiroyuki

2015-04-01

Because of the increase in healthcare-associated infections, appearance of highly resistant bacteria, and that of emerging/re-emerging infectious diseases, it is necessary for the skills of clinical microbiological technologists and the associated technology to be improved. Technologist in Microbiology (4,717 certified) and Specialist in Microbiology (58 certified) are authorized qualifications in the field of examination for clinical microbiology, with a history of 60 years, and Clinical Microbiological Technologist (670 certified) and Infection Control Microbiological Technologist (ICMT) (528 certified) are necessary qualifications to become a member of an infection control team. As problems to be resolved, clarifying the relationships among the authorized qualifications, reconsidering the fairness of evaluating written examinations, and further consideration of the administration method for an increasing number of examinees need to be tackled.

The effect of video review of resident laparoscopic surgical skills measured by self- and external assessment.

Science.gov (United States)

Herrera-Almario, Gabriel E; Kirk, Katherine; Guerrero, Veronica T; Jeong, Kwonho; Kim, Sara; Hamad, Giselle G

2016-02-01

Video review of surgical skills is an educational modality that allows trainees to reflect on self-performance. The purpose of this study was to determine whether resident and attending assessments of a resident's laparoscopic performance differ and whether video review changes assessments. Third-year surgery residents were invited to participate. Elective laparoscopic procedures were video recorded. The Global Operative Assessment of Laparoscopic Skills evaluation was completed immediately after the procedure and again 7 to 10 days later by both resident and attending. Scores were compared using t tests. Nine residents participated and 76 video reviews were completed. Residents scored themselves significantly lower than the faculty scores both before and after video review. Resident scores did not change significantly after video review. Attending and resident self-assessment of laparoscopic skills differs and subsequent video review does not significantly affect Global Operative Assessment of Laparoscopic Skills scores. Further studies should evaluate the impact of video review combined with verbal feedback on skill acquisition and assessment. Copyright © 2016 Elsevier Inc. All rights reserved.

Accomplishments and challenges of surgical simulation.

Science.gov (United States)

Satava, R M

2001-03-01

For nearly a decade, advanced computer technologies have created extraordinary educational tools using three-dimensional (3D) visualization and virtual reality. Pioneering efforts in surgical simulation with these tools have resulted in a first generation of simulators for surgical technical skills. Accomplishments include simulations with 3D models of anatomy for practice of surgical tasks, initial assessment of student performance in technical skills, and awareness by professional societies of potential in surgical education and certification. However, enormous challenges remain, which include improvement of technical fidelity, standardization of accurate metrics for performance evaluation, integration of simulators into a robust educational curriculum, stringent evaluation of simulators for effectiveness and value added to surgical training, determination of simulation application to certification of surgical technical skills, and a business model to implement and disseminate simulation successfully throughout the medical education community. This review looks at the historical progress of surgical simulators, their accomplishments, and the challenges that remain.

The training program self-correcting and developing leadership qualities of sportsmen of high qualification.

Directory of Open Access Journals (Sweden)

Vysochina Nadezhda Leonidovna

2011-09-01

Full Text Available The influence of level of self-esteem on the effectiveness of game of skilled chess players. It is shown the program of correction of self-appraisal of sportsmen of high qualification. Introduced correction technology developed self-esteem in the process of training of sportsmen chess players of high qualification as a set of training exercises aimed at improving the efficiency of sports activity. It is shown that high self-esteem has a positive effect on sports results chess players.

Survey of NDT techniques, services, qualifications and certification of NDT personnel-preliminary results

International Nuclear Information System (INIS)

Aleta, C.R.; Kinilitan, V.E.; Lailo, R.M.

1987-01-01

This paper presented the results of a survey conducted to determine the profile of the NDT industry including its problems. A questionnaire designed in three parts 1) present practices on qualification and certification, 2) NDT equipment and 3) services and problems in NDT. Of the 36 firms contacted only 20 responded. Results indicated the following: a) most firms are engaged in four (4) main techniques, RT, UT, MT and PT. Only 2 indicated capability of ET. b) level III personnel are relatively few in number, c) most firms allow the ASNT recommendation as a basis for their qualifications and certification and are in favor of standardization of the qualification and certification process and supportive of a national center for training of NDT personnel and d) most firms perceived the lack of adequate repair/maintenance skills/facilities, followed by high cost of equipment and the lack of national standard for qualification and certification. (ELC)

Peer video review and feedback improve performance in basic surgical skills.

Science.gov (United States)

Vaughn, Carolyn J; Kim, Edward; O'Sullivan, Patricia; Huang, Emily; Lin, Matthew Y C; Wyles, Susannah; Palmer, Barnard J A; Pierce, Jonathan L; Chern, Hueylan

2016-02-01

Incorporation of home-video assessments allows flexibility in feedback but requires faculty time. Peer feedback (PF) may provide additional benefits while avoiding these constraints. Twenty-four surgical interns completed a 12-week skills curriculum with home-video assignments focused on knot tying and suturing. Interns were randomized into 2 groups: PF or faculty feedback (FF). Peers and faculty provided feedback on home videos with checklists, global rating, and comments. Learners' skills were assessed at baseline, during, and at the conclusion of the curriculum. Performance of the 2 groups as rated by experts was compared. FF and PF were compared. Both groups improved from baseline, and the highest rated scores were seen on their home-video assessments. The PF group performed better at the final assessment than the FF group (effect size, .84). When using a checklist, there was no significant difference between scores given by peers and faculty. The PF group performed better at the final assessment, suggesting reviewing and analyzing another's performance may improve one's own performance. With checklists as guidance, peers can serve as raters comparable to faculty. Copyright © 2016 Elsevier Inc. All rights reserved.

Chapter 9. Personnel qualification and training

International Nuclear Information System (INIS)

2000-01-01

In 1999 the Nuclear Regulatory Authority of the Slovak Republic (UJD) focused on the overall training system and on developing programmes for individual categories for NPP V-1 Bohunice, NPP V-2 Bohunice, NPP Mochovce and SE-VYZ. The fundamental theoretical and periodical training for both Bohunice and Mochovce NPPs personnel, simulator training for NPP Bohunice, and periodical simulator training for Bohunice personnel is carried out by the VUJE Training center in Trnava, whereas the simulator training and periodical training for NPP Mochovce is carried at Mochovce plant. Based on a successful passing of examination before the examining committee, UJD issues, a certificate on special professional skills of selected staff of nuclear installations for specific activity for the given type of nuclear installation and for the following positions: (a)Shift manager for scientific start up with the right of manipulation; (b) Shift supervisor; (c) Unit supervisor; (d) Primary circuit operator; (e) Secondary circuit operator; (f) Reactor physicist; (g) Shift manager for scientific start up without the right of manipulation. Examination of selected personnel is described. Last year the examining committee held twelve session for oral theoretical examination. The number of licenses issued in 1999 and the total number of valid licenses is given.Conclusions from inspections carried out by UJD and inspections and tests carried out by the NPP operators in 1999, as well as results from operation and start up of nuclear units confirm that the standard of professional skills of the staff at nuclear installations a high standard of operational safety is being achieved on a permanent basis. Increasing the qualification of UJD staff was done in a form of training and courses scheduled in the plan of training for the staff for 1999. These training, composed of specialized qualification study, functional study, as well as study aimed at maintaining qualification. Training courses organized

Video gaming enhances psychomotor skills but not visuospatial and perceptual abilities in surgical trainees.

Science.gov (United States)

Kennedy, A M; Boyle, E M; Traynor, O; Walsh, T; Hill, A D K

2011-01-01

There is considerable interest in the identification and assessment of underlying aptitudes or innate abilities that could potentially predict excellence in the technical aspects of operating. However, before the assessment of innate abilities is introduced for high-stakes assessment (such as competitive selection into surgical training programs), it is essential to determine that these abilities are stable and unchanging and are not influenced by other factors, such as the use of video games. The aim of this study was to investigate whether experience playing video games will predict psychomotor performance on a laparoscopic simulator or scores on tests of visuospatial and perceptual abilities, and to examine the correlation, if any, between these innate abilities. Institutional ethical approval was obtained. Thirty-eight undergraduate medical students with no previous surgical experience were recruited. All participants completed a self-reported questionnaire that asked them to detail their video game experience. They then underwent assessment of their psychomotor, visuospatial, and perceptual abilities using previously validated tests. The results were analyzed using independent samples t tests to compare means and linear regression curves for subsequent analysis. Students who played video games for at least 7 hours per week demonstrated significantly better psychomotor skills than students who did not play video games regularly. However, there was no difference on measures of visuospatial and perceptual abilities. There was no correlation between psychomotor tests and visuospatial or perceptual tests. Regular video gaming correlates positively with psychomotor ability, but it does not seem to influence visuospatial or perceptual ability. This study suggests that video game experience might be beneficial to a future career in surgery. It also suggests that relevant surgical skills may be gained usefully outside the operating room in activities that are not

A unified approach to validation, reliability, and education study design for surgical technical skills training.

Science.gov (United States)

Sweet, Robert M; Hananel, David; Lawrenz, Frances

2010-02-01

To present modern educational psychology theory and apply these concepts to validity and reliability of surgical skills training and assessment. In a series of cross-disciplinary meetings, we applied a unified approach of behavioral science principles and theory to medical technical skills education given the recent advances in the theories in the field of behavioral psychology and statistics. While validation of the individual simulation tools is important, it is only one piece of a multimodal curriculum that in and of itself deserves examination and study. We propose concurrent validation throughout the design of simulation-based curriculum rather than once it is complete. We embrace the concept that validity and curriculum development are interdependent, ongoing processes that are never truly complete. Individual predictive, construct, content, and face validity aspects should not be considered separately but as interdependent and complementary toward an end application. Such an approach could help guide our acceptance and appropriate application of these exciting new training and assessment tools for technical skills training in medicine.

Design, development, and validation of a take-home simulator for fundamental laparoscopic skills: using Nintendo Wii for surgical training.

Science.gov (United States)

Bokhari, Ravia; Bollman-McGregor, Jyoti; Kahoi, Kanav; Smith, Marshall; Feinstein, Ara; Ferrara, John

2010-06-01

Assuring quality surgical trainees within the confines of reduced work hours mandates reassessment of educational paradigms. Surgical simulators have been shown to be effective in teaching surgical residents, but their use is limited by cost and time constraints. The Nintendo Wii gaming console is inexpensive and allows natural hand movements similar to those performed in laparoscopy to guide game play. We hypothesize that surgical skills can be improved through take-home simulators adapted from affordable off-the-shelf gaming consoles. A total of 21 surgical residents participated in a prospective, controlled study. An experimental group of 14 surgical residents was assigned to play Marble Mania on the Nintendo Wii using a unique physical controller that interfaces with the WiiMote controller followed by a simulated electrocautery task. Seven residents assigned to the control group performed the electrocautery task without playing the game first. When compared with the control group, the experimental group performed the task with fewer errors and superior movement proficiency (P Nintendo Wii gaming device along with Marble Mania serves as an effective take-home surgical simulator.

Can skills assessment on a virtual reality trainer predict a surgical trainee's talent in laparoscopic surgery?

Science.gov (United States)

Rosenthal, R; Gantert, W A; Scheidegger, D; Oertli, D

2006-08-01

A number of studies have investigated several aspects of feasibility and validity of performance assessments with virtual reality surgical simulators. However, the validity of performance assessments is limited by the reliability of such measurements, and some issues of reliability still need to be addressed. This study aimed to evaluate the hypothesis that test subjects show logarithmic performance curves on repetitive trials for a component task of laparoscopic cholecystectomy on a virtual reality simulator, and that interindividual differences in performance after considerable training are significant. According to kinesiologic theory, logarithmic performance curves are expected and an individual's learning capacity for a specific task can be extrapolated, allowing quantification of a person's innate ability to develop task-specific skills. In this study, 20 medical students at the University of Basel Medical School performed five trials of a standardized task on the LS 500 virtual reality simulator for laparoscopic surgery. Task completion time, number of errors, economy of instrument movements, and maximum speed of instrument movements were measured. The hypothesis was confirmed by the fact that the performance curves for some of the simulator measurements were very close to logarithmic curves, and there were significant interindividual differences in performance at the end of the repetitive trials. Assessment of perceptual motor skills and the innate ability of an individual with no prior experience in laparoscopic surgery to develop such skills using the LS 500 VR surgical simulator is feasible and reliable.

QUALIFICATIONS FRAMEWORK DEVELOPMENT AND QUALIFICATIONS RATING IN THE LAND MANAGEMENT SPHERE

Directory of Open Access Journals (Sweden)

A. A. Myrasheva

2014-01-01

Full Text Available The aim of the research is to observe the existing approaches to qualifications framework development in the sphere of land management, cadastres and real estate management, as well as the qualifications framework adaptation to European system. The relevance of the issue is related to the specific professional and institutional problems facing Russian educational establishments engaged in personnel training in the given sphere. The authors demonstrate the qualifications framework development in the land management sector regarding it as a key mechanism of educational mobility and the router for knowledge acquisition and updates. The qualifications framework is referred to as a systematic and structured description of recognized qualifications. The accepted worldwide methodology of organizing the educational process and quality control system is given. The emphasis is on the need to comply the qualifications framework with the Russian State Educational Standards.

Inspector qualification guidelines

International Nuclear Information System (INIS)

Batty, A.C.; Van Binnebeek, J.J.; Ericsson, P.O.; Fisher, J.C.; Geiger, P.; Grandame, M.; Grimes, B.K.; Joode, A. de; Kaufer, B.; Kinoshita, M.; Klonk, H.; Koizumi, H.; Maeda, N.; Maqua, M.; Perez del Moral, C.; Roselli, F.; Warren, T.; Zimmerman, R.

1994-07-01

The OECD Nuclear Energy Agency Committee on Nuclear Regulatory Activities (CNRA) has a Working Group on Inspection Practices (WGIP). The WGIP provides a forum for the exchange of Information and experience on the safety Inspection practices of regulatory authorities In the CNRA member countries. A consistent qualification process and well defined level of training for all Inspectors who participate In the safety Inspections are needed to provide consistent Inspections and reliable Inspection results. The WGIP organized in 1992 a workshop on the conduct of inspections, inspector qualification and training, and shutdown inspections at the Technical Training Center of the US NRC in Chattanooga, Tennessee. In the connection of workshop the WGIP identified a need to develop guidance for inspector qualification which could be used as a model by those who are developing their qualification practices. The inspector qualification journals of US NRC provided a good basis for the work. The following inspector qualification guideline has been developed for guidance of qualification of a new inspector recruited to the regulatory body. This guideline has been developed for helping the supervisors and training officers to give the initial training and familiarization to the duties of a new inspector in a controlled manner. US NRC inspector qualification journals have been used to define the areas of attention. This guideline provides large flexibility for application in different type organizations. Large organizations can develop separate qualification journals for each inspector positions. Small regulatory bodies can develop individual training programmes by defining the necessary training topics on case by case basis. E.g. the guideline can be used to define the qualifications of contracted inspectors used in some countries. The appropriate part would apply. Annex 1 gives two examples how this guideline could be applied

Inspector qualification guidelines

Energy Technology Data Exchange (ETDEWEB)

Batty, A. C.; Van Binnebeek, J. J.; Ericsson, P. O.; Fisher, J. C.; Geiger, P.; Grandame, M.; Grimes, B. K.; Joode, A. de; Kaufer, B.; Kinoshita, M.; Klonk, H.; Koizumi, H.; Maeda, N.; Maqua, M.; Perez del Moral, C.; Roselli, F.; Warren, T.; Zimmerman, R.

1994-07-15

The OECD Nuclear Energy Agency Committee on Nuclear Regulatory Activities (CNRA) has a Working Group on Inspection Practices (WGIP). The WGIP provides a forum for the exchange of Information and experience on the safety Inspection practices of regulatory authorities In the CNRA member countries. A consistent qualification process and well defined level of training for all Inspectors who participate In the safety Inspections are needed to provide consistent Inspections and reliable Inspection results. The WGIP organized in 1992 a workshop on the conduct of inspections, inspector qualification and training, and shutdown inspections at the Technical Training Center of the US NRC in Chattanooga, Tennessee. In the connection of workshop the WGIP identified a need to develop guidance for inspector qualification which could be used as a model by those who are developing their qualification practices. The inspector qualification journals of US NRC provided a good basis for the work. The following inspector qualification guideline has been developed for guidance of qualification of a new inspector recruited to the regulatory body. This guideline has been developed for helping the supervisors and training officers to give the initial training and familiarization to the duties of a new inspector in a controlled manner. US NRC inspector qualification journals have been used to define the areas of attention. This guideline provides large flexibility for application in different type organizations. Large organizations can develop separate qualification journals for each inspector positions. Small regulatory bodies can develop individual training programmes by defining the necessary training topics on case by case basis. E.g. the guideline can be used to define the qualifications of contracted inspectors used in some countries. The appropriate part would apply. Annex 1 gives two examples how this guideline could be applied.

Micro-surgical endodontics.

Science.gov (United States)

Eliyas, S; Vere, J; Ali, Z; Harris, I

2014-02-01

Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

Simulators and virtual reality in surgical education.

Science.gov (United States)

Chou, Betty; Handa, Victoria L

2006-06-01

This article explores the pros and cons of virtual reality simulators, their abilities to train and assess surgical skills, and their potential future applications. Computer-based virtual reality simulators and more conventional box trainers are compared and contrasted. The virtual reality simulator provides objective assessment of surgical skills and immediate feedback further to enhance training. With this ability to provide standardized, unbiased assessment of surgical skills, the virtual reality trainer has the potential to be a tool for selecting, instructing, certifying, and recertifying gynecologists.

Surgical robotics beyond enhanced dexterity instrumentation: a survey of machine learning techniques and their role in intelligent and autonomous surgical actions.

Science.gov (United States)

Kassahun, Yohannes; Yu, Bingbin; Tibebu, Abraham Temesgen; Stoyanov, Danail; Giannarou, Stamatia; Metzen, Jan Hendrik; Vander Poorten, Emmanuel

2016-04-01

Advances in technology and computing play an increasingly important role in the evolution of modern surgical techniques and paradigms. This article reviews the current role of machine learning (ML) techniques in the context of surgery with a focus on surgical robotics (SR). Also, we provide a perspective on the future possibilities for enhancing the effectiveness of procedures by integrating ML in the operating room. The review is focused on ML techniques directly applied to surgery, surgical robotics, surgical training and assessment. The widespread use of ML methods in diagnosis and medical image computing is beyond the scope of the review. Searches were performed on PubMed and IEEE Explore using combinations of keywords: ML, surgery, robotics, surgical and medical robotics, skill learning, skill analysis and learning to perceive. Studies making use of ML methods in the context of surgery are increasingly being reported. In particular, there is an increasing interest in using ML for developing tools to understand and model surgical skill and competence or to extract surgical workflow. Many researchers begin to integrate this understanding into the control of recent surgical robots and devices. ML is an expanding field. It is popular as it allows efficient processing of vast amounts of data for interpreting and real-time decision making. Already widely used in imaging and diagnosis, it is believed that ML will also play an important role in surgery and interventional treatments. In particular, ML could become a game changer into the conception of cognitive surgical robots. Such robots endowed with cognitive skills would assist the surgical team also on a cognitive level, such as possibly lowering the mental load of the team. For example, ML could help extracting surgical skill, learned through demonstration by human experts, and could transfer this to robotic skills. Such intelligent surgical assistance would significantly surpass the state of the art in surgical

Electrical equipment qualification

International Nuclear Information System (INIS)

Farmer, W.S.

1983-01-01

Electrical equipment qualification research programs being carried out by CEA, JAERI, and Sandia Laboratories are discussed. Objectives of the program are: (1) assessment of accident simulation methods for electrical equipment qualification testing; lower coarse (2) evaluation of equipment aging and accelerated aging methods; (3) determine radiation dose spectrum to electrical equipment and assess simulation methods for qualification; (4) identify inadequacies in electrical equipment qualification procedures and standards and potential failure modes; and (5) provide data for verifying and improving standards, rules and regulatory guides

Knowledge, skills, and abilities for key radiation protection positions at DOE facilities

International Nuclear Information System (INIS)

1997-01-01

This document provides detailed qualification criteria for contractor key radiation protection personnel. Although federal key radiation protection positions are also identified, qualification standards for federal positions are provided in DOE O 360.1 and the DOE Technical Qualifications Program. Appendices B and D provide detailed listings for knowledge, skills, and abilities for contractor and DOE federal key radiation protection positions. This information may be used in developing position descriptions and individual development plans. Information provided in Appendix C may be useful in developing performance measures and assessing an individual's performance in his or her specific position. Additionally, Federal personnel may use this information to augment their Office/facility qualification standards under the Technical Qualifications Program

Qualification and certification of nondestructive testing personnel. Vol. 1

Energy Technology Data Exchange (ETDEWEB)

Aly, E A [Quality Assurance Department, national Center for Nuclear Safety and Radiation Control, Atomic Energy Authority, Cairo, (Egypt)

1996-03-01

Nondestructive testing and inspection are functions in achieving the goals of quality and efficiency at an acceptable cost. All quality assurance systems necessitate that engineers, technicians and craftsmen are able to demonstrate that they have the required level of knowledge and skill. This applies particularly to nondestructive testing (NDT) and inspection. The paper presented highlights most important national and international standards and guidelines addressing training, qualification and certification of NDT personnel.

Qualification and certification of nondestructive testing personnel. Vol. 1

International Nuclear Information System (INIS)

Aly, E.A.

1996-01-01

Nondestructive testing and inspection are functions in achieving the goals of quality and efficiency at an acceptable cost. All quality assurance systems necessitate that engineers, technicians and craftsmen are able to demonstrate that they have the required level of knowledge and skill. This applies particularly to nondestructive testing (NDT) and inspection. The paper presented highlights most important national and international standards and guidelines addressing training, qualification and certification of NDT personnel

Chapter No.8. Personnel qualification and training

International Nuclear Information System (INIS)

2002-01-01

The overall training system and the development projects of training the staff of all categories from NPP V-1, NPP V-2 Bohunice, SE-VYZ and NPP Mochovce were the subject of UJD's attention. During 2001 following inspections were carried out on nuclear personnel training: - PP's Bohunice: an inspection focused on compliance with requirements for staff qualifications and compliance with the prescribed training of Bohunice plant staff; - Mochovce NPP: an inspection focused on compliance with the requirements for staff qualifications and compliance with the prescribed training of NPP Mochovce staff; - SE-VYZ: an inspection focused on compliance with the requirements for staff qualifications and compliance with the prescribed training of SE-VYZ staff. Training the staff of the NPP's Bohunice: - The fundamental and periodical theoretical training as sure as the fundamental and periodical simulator training is carried out by the VUJE Training centre in Trnava. - The fundamental practical training in the workplace and training for the change work- rank is carried at Bohunice plant. Training of the staff of the NPP Mochovce: - The fundamental and periodical theoretical training is carried out by the VUJE Training centre in Trnava. The fundamental practical training in the workplace and training for the change work- rank as well as the fundamental and periodical simulator training is carried at Mochovce plant. Based on a successful passing of examination before the examining committee, UJD issues a certificate on special professional skills of selected staff members of nuclear installations for specific activity for the given type of nuclear installation and for the following positions: 1. Scientific shift manager for start up with the right of manipulation; 2. Shift supervisor; 3. Unit supervisor; 4. Primary circuit operator; 5. Secondary circuit operator; 6. Reactor physicist; 7. Scientific shift manager for start up without the right of manipulation. Examinations of

Kinect technology for hand tracking control of surgical robots: technical and surgical skill comparison to current robotic masters.

Science.gov (United States)

Kim, Yonjae; Leonard, Simon; Shademan, Azad; Krieger, Axel; Kim, Peter C W

2014-06-01

Current surgical robots are controlled by a mechanical master located away from the patient, tracking surgeon's hands by wire and pulleys or mechanical linkage. Contactless hand tracking for surgical robot control is an attractive alternative, because it can be executed with minimal footprint at the patient's bedside without impairing sterility, while eliminating current disassociation between surgeon and patient. We compared technical and technologic feasibility of contactless hand tracking to the current clinical standard master controllers. A hand-tracking system (Kinect™-based 3Gear), a wire-based mechanical master (Mantis Duo), and a clinical mechanical linkage master (da Vinci) were evaluated for technical parameters with strong clinical relevance: system latency, static noise, robot slave tremor, and controller range. Five experienced surgeons performed a skill comparison study, evaluating the three different master controllers for efficiency and accuracy in peg transfer and pointing tasks. da Vinci had the lowest latency of 89 ms, followed by Mantis with 374 ms and 3Gear with 576 ms. Mantis and da Vinci produced zero static error. 3Gear produced average static error of 0.49 mm. The tremor of the robot used by the 3Gear and Mantis system had a radius of 1.7 mm compared with 0.5 mm for da Vinci. The three master controllers all had similar range. The surgeons took 1.98 times longer to complete the peg transfer task with the 3Gear system compared with Mantis, and 2.72 times longer with Mantis compared with da Vinci (p value 2.1e-9). For the pointer task, surgeons were most accurate with da Vinci with average error of 0.72 mm compared with Mantis's 1.61 mm and 3Gear's 2.41 mm (p value 0.00078). Contactless hand-tracking technology as a surgical master can execute simple surgical tasks. Whereas traditional master controllers outperformed, given that contactless hand-tracking is a first-generation technology, clinical potential is promising and could

DOE handbook: Guide to good practices for training and qualification of chemical operators

International Nuclear Information System (INIS)

1996-03-01

The purpose of this Handbook is to provide contractor training organizations with information that can be used as a reference to refine existing chemical operator training programs, or develop new training programs where no program exists. This guide, used in conjunction with facility-specific job analyses, will provide a framework for training and qualification programs for chemical operators at DOE reactor and nonreactor facilities. Recommendations for qualification are made in four areas: education, experience, physical attributes, and training. Contents include: initial qualification; administrative training; industrial safety training; specialized skills training; on-the-job training; trainee evaluation; continuing training; training effectiveness evaluation; and program records. Two appendices describe Fundamentals training and Process operations. This handbook covers chemical operators in transportation of fuels and wastes, spent fuel receiving and storage, fuel disassembly, fuel reprocessing, and both liquid and solid low-level waste processing

Seismic qualification of equipment

International Nuclear Information System (INIS)

Heidebrecht, A.C.; Tso, W.K.

1983-03-01

This report describes the results of an investigation into the seismic qualification of equipment located in CANDU nuclear power plants. It is particularly concerned with the evaluation of current seismic qualification requirements, the development of a suitable methodology for the seismic qualification of safety systems, and the evaluation of seismic qualification analysis and testing procedures

Construct validity for eye-hand coordination skill on a virtual reality laparoscopic surgical simulator.

Science.gov (United States)

Yamaguchi, Shohei; Konishi, Kozo; Yasunaga, Takefumi; Yoshida, Daisuke; Kinjo, Nao; Kobayashi, Kiichiro; Ieiri, Satoshi; Okazaki, Ken; Nakashima, Hideaki; Tanoue, Kazuo; Maehara, Yoshihiko; Hashizume, Makoto

2007-12-01

This study was carried out to investigate whether eye-hand coordination skill on a virtual reality laparoscopic surgical simulator (the LAP Mentor) was able to differentiate among subjects with different laparoscopic experience and thus confirm its construct validity. A total of 31 surgeons, who were all right-handed, were divided into the following two groups according to their experience as an operator in laparoscopic surgery: experienced surgeons (more than 50 laparoscopic procedures) and novice surgeons (fewer than 10 laparoscopic procedures). The subjects were tested using the eye-hand coordination task of the LAP Mentor, and performance was compared between the two groups. Assessment of the laparoscopic skills was based on parameters measured by the simulator. The experienced surgeons completed the task significantly faster than the novice surgeons. The experienced surgeons also achieved a lower number of movements (NOM), better economy of movement (EOM) and faster average speed of the left instrument than the novice surgeons, whereas there were no significant differences between the two groups for the NOM, EOM and average speed of the right instrument. Eye-hand coordination skill of the nondominant hand, but not the dominant hand, measured using the LAP Mentor was able to differentiate between subjects with different laparoscopic experience. This study also provides evidence of construct validity for eye-hand coordination skill on the LAP Mentor.

Systems for tracking minimally invasive surgical instruments

NARCIS (Netherlands)

Chmarra, M. K.; Grimbergen, C. A.; Dankelman, J.

2007-01-01

Minimally invasive surgery (e.g. laparoscopy) requires special surgical skills, which should be objectively assessed. Several studies have shown that motion analysis is a valuable assessment tool of basic surgical skills in laparoscopy. However, to use motion analysis as the assessment tool, it is

Outcomes of a virtual-reality simulator-training programme on basic surgical skills in robot-assisted laparoscopic surgery.

Science.gov (United States)

Phé, Véronique; Cattarino, Susanna; Parra, Jérôme; Bitker, Marc-Olivier; Ambrogi, Vanina; Vaessen, Christophe; Rouprêt, Morgan

2017-06-01

The utility of the virtual-reality robotic simulator in training programmes has not been clearly evaluated. Our aim was to evaluate the impact of a virtual-reality robotic simulator-training programme on basic surgical skills. A simulator-training programme in robotic surgery, using the da Vinci Skills Simulator, was evaluated in a population including junior and seasoned surgeons, and non-physicians. Their performances on robotic dots and suturing-skin pod platforms before and after virtual-simulation training were rated anonymously by surgeons experienced in robotics. 39 participants were enrolled: 14 medical students and residents in surgery, 14 seasoned surgeons, 11 non-physicians. Junior and seasoned surgeons' performances on platforms were not significantly improved after virtual-reality robotic simulation in any of the skill domains, in contrast to non-physicians. The benefits of virtual-reality simulator training on several tasks to basic skills in robotic surgery were not obvious among surgeons in our initial and early experience with the simulator. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Evolving Educational Techniques in Surgical Training.

Science.gov (United States)

Evans, Charity H; Schenarts, Kimberly D

2016-02-01

Training competent and professional surgeons efficiently and effectively requires innovation and modernization of educational methods. Today's medical learner is quite adept at using multiple platforms to gain information, providing surgical educators with numerous innovative avenues to promote learning. With the growth of technology, and the restriction of work hours in surgical education, there has been an increase in use of simulation, including virtual reality, robotics, telemedicine, and gaming. The use of simulation has shifted the learning of basic surgical skills to the laboratory, reserving limited time in the operating room for the acquisition of complex surgical skills". Copyright © 2016 Elsevier Inc. All rights reserved.

Guidelines for training and qualification of radiological protection technicians

International Nuclear Information System (INIS)

1987-08-01

These guidelines, used in combination with plant-specific job analysis, provide the framework for a training and qualification program for radiological protection technicians at nuclear power plants. Radiological protection technicians are defined as those individuals, both plant and contractor, who will be engaged in the evaluation of radiological conditions in the nuclear plant and the implementation of the necessary radiological safety measures as they apply to nuclear plant workers and members of the general public. An important aspect of this work is recognizing and handling unusual situations involving radioactivity, including incidents related to degraded core conditions. These guidelines incorporate the results of an industry-wide job analysis and task analysis (JTA) combined with industry operating experience review. However, the industry-wide analyses did not identify all important academic and fundamental knowledge and skills. Further in-depth analysis by subject matter experts produced additional knowledge and skills that were added to these guidelines. All utilities should use these guidelines in conjunction with plant-specific and industry-wide JTA results to develop or validate their radiological protection technician training program. Plant-specific information should be used to establish appropriate training program content. This plant-specific information should reflect unique job duties, equipment, operating experience, and trainee entry-level qualifications. Revisions to these guidelines should be reviewed for applicability and incorporated into the training program using each utility's training system development (TSD) procedures. Plant-specific job analysis and task analysis data is essential to the development of performance-based training programs. These analyses are particularly useful in selecting tasks for training and in developing on-the-job training (OJT), laboratory training, and mock-up training. Qualification programs based on these

Validation of the da Vinci Surgical Skill Simulator across three surgical disciplines: A pilot study

Science.gov (United States)

Alzahrani, Tarek; Haddad, Richard; Alkhayal, Abdullah; Delisle, Josée; Drudi, Laura; Gotlieb, Walter; Fraser, Shannon; Bergman, Simon; Bladou, Frank; Andonian, Sero; Anidjar, Maurice

2013-01-01

Objective: In this paper, we evaluate face, content and construct validity of the da Vinci Surgical Skills Simulator (dVSSS) across 3 surgical disciplines. Methods: In total, 48 participants from urology, gynecology and general surgery participated in the study as novices (0 robotic cases performed), intermediates (1–74) or experts (≥75). Each participant completed 9 tasks (Peg board level 2, match board level 2, needle targeting, ring and rail level 2, dots and needles level 1, suture sponge level 2, energy dissection level 1, ring walk level 3 and tubes). The Mimic Technologies software scored each task from 0 (worst) to 100 (best) using several predetermined metrics. Face and content validity were evaluated by a questionnaire administered after task completion. Wilcoxon test was used to perform pair wise comparisons. Results: The expert group comprised of 6 attending surgeons. The intermediate group included 4 attending surgeons, 3 fellows and 5 residents. The novices included 1 attending surgeon, 1 fellow, 13 residents, 13 medical students and 2 research assistants. The median number of robotic cases performed by experts and intermediates were 250 and 9, respectively. The median overall realistic score (face validity) was 8/10. Experts rated the usefulness of the simulator as a training tool for residents (content validity) as 8.5/10. For construct validity, experts outperformed novices in all 9 tasks (p < 0.05). Intermediates outperformed novices in 7 of 9 tasks (p < 0.05); there were no significant differences in the energy dissection and ring walk tasks. Finally, experts scored significantly better than intermediates in only 3 of 9 tasks (matchboard, dots and needles and energy dissection) (p < 0.05). Conclusions: This study confirms the face, content and construct validities of the dVSSS across urology, gynecology and general surgery. Larger sample size and more complex tasks are needed to further differentiate intermediates from experts. PMID:23914275

Developments in mechanical ultrasonic inspection and qualification of NDE

International Nuclear Information System (INIS)

Kauppinen, P.; Pitkaenen, J.; Kuusinen, P.

2001-01-01

Reliability of non-destructive testing results has a direct influence on structural integrity assessment and safety of the inspected structures e.g. NPP primary circuit pressure boundaries. Advanced technology together with highly skilled and experienced personnel is required. One of the current trends is automation. Mechanised equipment can replace tedious manual work in positioning and moving of the transducers. Large areas can be scanned, analysed and numerically documented for direct comparison of eventual later repeated inspections. Another major trend is qualification, which aims to ensure that the inspection results are correct and fit the purpose. The suitability and proper operation of equipment, methods and personnel i.e. the whole chain shall be proven. This presentation summarises the advances in automation and qualification of non-destructive inspection during the second project year, Monitoring of material degradation was included in the studied topics and will also be shortly described. (author)

A New Framework for Universiti Kebangsaan Malaysia Soft Skills Course: Implementation and Challenges

Science.gov (United States)

Che-Ani, Adi-Irfan; Ismail, Khaidzir; Ahmad, Azizan; Ariffin, Kadir; Razak, Mohd Zulhanif Abd

2014-01-01

The importance of soft skills to the graduates to compete in the working world is undeniable. Soft skills are complementary to the academic qualifications held by students. Recognizing this, the University Kebangsaan Malaysia (UKM) has established a new framework for Soft Skills courses to improve the existing framework of the course. The…

Ostomy Home Skills Program

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Full Text Available ... Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical Skills Curriculum Cancer Education Cancer Education ... Home Skills Kit supports patients with educational and simulation materials to learn and practice the skills needed ...

Nuclear security personnel for power plants. Content and review procedures for a security training and qualification program

International Nuclear Information System (INIS)

1978-06-01

The applicant and licensee training and qualification plans will outline the process by which guard, watchman, armed response persons and other members of the security organization will be selected, trained, equipped and qualified. This plan should contain: (1) job descriptions for all security positions; (2) duties defined for all positions; (3) critical tasks defined for all duties; (4) skills, knowledge and abilities defined for all critical tasks; (5) performance objectives stated for all critical tasks; and (6) training and qualification plans to train and test to appropriate performance objectives. The document gives guidance on the preparation of this training and qualification plan and contains three parts: (1) an introduction to and brief explanation of job analysis and performance objectives; (2) a statement of the information that should be submitted in response to the requirements and the NRR review procedures; and (3) a sample qualification submittal

Evaluation of clinical skills for first-year surgical residents using orientation programme and objective structured clinical evaluation as a tool of assessment

Directory of Open Access Journals (Sweden)

Pandya J

2010-01-01

Full Text Available Background: Postgraduate specialities require a combination of knowledge and clinical skills. The internship year is less structured. Clinical and practical skills that are picked up during training are not well regulated and the impact is not assessed. In this study, we assessed knowledge and skills using objective structured clinical examination (OSCE. Aim: To evaluate the clinical skills of new first-year surgical residents using orientation programme and OSCE as a tool for assessment. Settings and Design: Observational study. Materials and Methods: Twenty new first-year surgical residents (10 each in 2008 and 2009 participated in a detailed structured orientation programme conducted over a period of 7 days. Clinically important topics and skills expected at this level (e.g., suturing, wound care etc. were covered. The programme was preceded by an OSCE to test pre-programme knowledge (the "pre-test". The questions were validated by senior department staff. A post-programme OSCE (the "post-test" helped to evaluate the change in clinical skill level brought about by the orientation programme. Statistical Analysis: Wilcoxson matched-pairs signed-ranks test. Results: Passing performance was achieved by all participants in both pre- and post-tests. Following the orientation programme, significant improvement was seen in tasks testing the psychomotor and cognitive domains. (P = 0.0001 and P = 0.0401, respectively. Overall reliability of the OSCE was found to be 0.7026 (Cronbach′s coefficient alpha. Conclusions: This study highlighted the lacunae in current internship training, especially for skill-based tasks. There is a need for universal inclusion of structured orientation programmes in the training of first-year residents. OSCE is a reliable, valid and effective method for the assessment of clinical skills.

Ostomy Home Skills Program

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Full Text Available ... Surgical Skills for Exposure in Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills for Trauma Disaster Management and Emergency ...

Distribution of innate psychomotor skills recognized as important for surgical specialization in unconditioned medical undergraduates.

Science.gov (United States)

Moglia, Andrea; Morelli, Luca; Ferrari, Vincenzo; Ferrari, Mauro; Mosca, Franco; Cuschieri, Alfred

2018-03-14

There is an increasing interest for a test assessing objectively the innate aptitude for surgery as a craft specialty to complement the current selection process of surgical residents. The aim of this study was to quantify the size of individuals with high, average, and low level of innate psychomotor skills among medical students. A volunteer sample of 155 medical students, without prior experience with surgical simulator, executed five tasks at a virtual simulator for robot-assisted surgery. They had to reach proficiency twice consecutively in each before moving to the next one. A weighting based on time and number of attempts needed to reach proficiency was assigned to each task. Nine students (5.8%) out of 155 significantly outperformed all the others on median (i.q.r.) weighted time [44.7 (42.2-47.3) min vs. 98.5 (70.8-131.8) min, p specialization in other (non-craft) medical specialties.

Effect of surgical skill on surgically-induced astigmatism in cataract surgery

Directory of Open Access Journals (Sweden)

Numan Eraslan

2015-12-01

Full Text Available AIM:To evaluate the effect of surgical experience on surgically-induced astigmatism(SIAin patients with uncomplicated phacoemulsification surgery.METHODS:Fifty-three eyes of fifty patients, mean age 64.5±10.8y, were randomly divided into two groups(23 eyes and 30 eyes. First group was underwent surgery by cataract specialists and the second was by residents. At baseline all the patients were underwent a complete opthalmological examination including keratometry and autorefractometer measurements. Vector analysis programme including the Alpins' method was used for the calculation of SIA. All the measurements were repeated postoperative first day, first month and second month and changes were recorded. Shapiro Wilk and Mann-Whitney tests were applied for determining the statistical differences between the SIA with two groups.RESULTS:There were no significant differences in demographic data of the groups. Intergroup analysis showed, first group was more effective results in SIA postoperative first day(P=0.002, first month(P=0.004and the second month(P=0.001. For the first group, SIA were 0.79±0.41 diopter(Dat the first postoperative day, 0.54±0.41 D at the first postoperative month and 0.47±0.37 D at the second postoperative month. Second one was 1.27±0.66 D, 0.98±0.56 D and 0.94±0.54 D, respectively.CONCLUSION:According to the results, surgical experience was one of the factors that affects SIA. Residents would perform more phacoemilcification surgery to obtain more surgical experience.

Reaction Qualifications Revisited

DEFF Research Database (Denmark)

Lippert-Rasmussen, Kasper

2009-01-01

  When, in a competitive sphere, people are selected on the basis of qualifications only, their chances of acquiring positions of advantage may seem to depend entirely upon their abilities, not discriminatory bias. However, if reaction qualifications - i.e. characteristics which contribute...... to a person's effectiveness by causing a favourable reaction in customers, co-workers etc. (for short: recipients) - are involved, this assumption is false. Building on work by Wertheimer, Mason, and Miller, this paper proposes an account of the reaction qualifications that count, from the point of view...... of merit. Specifically, it preserves symmetry between negative evaluations of antimeritocratic bases of selection and negative evaluations of qualifications rooted in comparable antimeritocratic reactions. So if employers should not select among applicants on the basis of their (the employers') racial...

The role of non-technical skills in surgery.

Science.gov (United States)

Agha, Riaz A; Fowler, Alexander J; Sevdalis, Nick

2015-12-01

Non-technical skills are of increasing importance in surgery and surgical training. A traditional focus on technical skills acquisition and competence is no longer enough for the delivery of a modern, safe surgical practice. This review discusses the importance of non-technical skills and the values that underpin successful modern surgical practice. This narrative review used a number of sources including written and online, there was no specific search strategy of defined databases. Modern surgical practice requires; technical and non-technical skills, evidence-based practice, an emphasis on lifelong learning, monitoring of outcomes and a supportive institutional and health service framework. Finally these requirements need to be combined with a number of personal and professional values including integrity, professionalism and compassionate, patient-centred care.

The role of non-technical skills in surgery

Science.gov (United States)

Agha, Riaz A.; Fowler, Alexander J.; Sevdalis, Nick

2015-01-01

Non-technical skills are of increasing importance in surgery and surgical training. A traditional focus on technical skills acquisition and competence is no longer enough for the delivery of a modern, safe surgical practice. This review discusses the importance of non-technical skills and the values that underpin successful modern surgical practice. This narrative review used a number of sources including written and online, there was no specific search strategy of defined databases. Modern surgical practice requires; technical and non-technical skills, evidence-based practice, an emphasis on lifelong learning, monitoring of outcomes and a supportive institutional and health service framework. Finally these requirements need to be combined with a number of personal and professional values including integrity, professionalism and compassionate, patient-centred care. PMID:26904193

[Simulation in surgical training].

Science.gov (United States)

Nabavi, A; Schipper, J

2017-01-01

Patient safety during operations hinges on the surgeon's skills and abilities. However, surgical training has come under a variety of restrictions. To acquire dexterity with decreasingly "simple" cases, within the legislative time constraints and increasing expectations for surgical results is the future challenge. Are there alternatives to traditional master-apprentice learning? A literature review and analysis of the development, implementation, and evaluation of surgical simulation are presented. Simulation, using a variety of methods, most important physical and virtual (computer-generated) models, provides a safe environment to practice basic and advanced skills without endangering patients. These environments have specific strengths and weaknesses. Simulations can only serve to decrease the slope of learning curves, but cannot be a substitute for the real situation. Thus, they have to be an integral part of a comprehensive training curriculum. Our surgical societies have to take up that challenge to ensure the training of future generations.

Assessment of the role of aptitude in the acquisition of advanced laparoscopic surgical skill sets: results from a virtual reality-based laparoscopic colectomy training programme.

LENUS (Irish Health Repository)

Nugent, Emmeline

2012-09-01

The surgeons of the future will need to have advanced laparoscopic skills. The current challenge in surgical education is to teach these skills and to identify factors that may have a positive influence on training curriculums. The primary aim of this study was to determine if fundamental aptitude impacts on ability to perform a laparoscopic colectomy.

Surgical experts: born or made?

Science.gov (United States)

Sadideen, Hazim; Alvand, Abtin; Saadeddin, Munir; Kneebone, Roger

2013-01-01

The concept of surgical expertise and the processes involved in its development are topical, and there is a constant drive to identify reliable measures of expert performance in surgery. This review explores the notion of whether surgical experts are "born" or "made", with reference to educational theory and pertinent literature. Peer-reviewed publications, books, and online resources on surgical education, expertise and training were reviewed. Important themes and aspects of expertise acquisition were identified in order to better understand the concept of a surgical expert. The definition of surgical expertise and several important aspects of its development are highlighted. Innate talent plays an important role, but is insufficient on its own to produce a surgical expert. Multiple theories that explore motor skill acquisition and memory are relevant, and Ericsson's theory of the development of competence followed by deliberate self-practice has been especially influential. Psychomotor and non-technical skills are necessary for progression in the current climate in light of our training curricula; surgical experts are adaptive experts who excel in these. The literature suggests that surgical expertise is reached through practice; surgical experts are made, not born. A deeper understanding of the nature of expert performance and its development will ensure that surgical education training programmes are of the highest possible quality. Surgical educators should aim to develop an expertise-based approach, with expert performance as the benchmark. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Environmental/dynamic mechanical equipment qualification and dynamic electrical equipment qualification program (EDQP)

International Nuclear Information System (INIS)

Hunter, J.A.

1984-01-01

Equipment qualification research is being conducted to investigate acceptable criteria, requirements, and methodologies for the dynamic (including seismic) and environmental qualification of mechanical equipment and for the dynamic (including seismic) qualification of electrical equipment. The program is organized into three elements: (1) General Research, (2) Environmental Research, and (3) Dynamic Research. This paper presents the highlights of the results to date in these three elements of the program

Improving Job Prospects for Young, Low-Skilled and Women ...

International Development Research Centre (IDRC) Digital Library (Canada)

Vathana

2015-06-30

Jun 30, 2015 ... 2025(RGC 2015) and help mitigate negative effects, if any, of the ASEAN Economic. Community ... workers have not undergone any formal training to gain skills and qualifications. ..... “Labor Contracts as Partial Gift Exchange.

A management framework for training providers to improve workplace skills development

Directory of Open Access Journals (Sweden)

C. Govender

2007-12-01

Full Text Available Purpose: Deputy President, Ms Phumzile Mlambo-Ngcuka, says a skills revolution is necessary for South Africa’s (SA skills crisis. The SA skills revolution began with the skills legislation of 1998-9 when the Departments of Labour (DOL and Education (DOE intended a seamless, integrated approach to rapid skills development. The National Skills Development Strategy (NSDS, the Sector Education and Training Providers (SETAs, the South African Qualifications Authorities (SAQA and the National Qualifications Framework (NQF were established to drive the human resource and skills development revolutionary strategy. The purpose of this paper is to present the findings of the 2001-3 research investigating an internal management framework for training providers, employers and managers to accelerate workplace skills development. Design/Methodology/Approach: An integrated, multi-method research model was employed to gather empirical evidence on skills practices. A robust quantitative survey was conducted within 600 organisations. Simultaneously, rich, descriptive data was gathered from managers and employees using a structured qualitative interview strategy. The integrated data pool was factor analysed. The research findings, conclusion and recommended framework were reported in a PhD thesis. Findings: The research findings reveal major gaps in the effectiveness of SA training providers to radically accelerate and improve workplace skills development as per national skills legislation, implementation and management criteria. Implications: If the skills revolution in SA is to succeed, training providers especially, must become less complacent, more assertive and fully equipped when participating in the skills development arena. Originality/Value: Via this research, training providers will gain critical, reflective insight into their management framework for meeting skills legislative criteria and for managing training interventions and skills projects.

Union citizens and the recognition of professional qualifications: Where do we go from here?

DEFF Research Database (Denmark)

Adamo, Silvia; Binder, Tom

2018-01-01

and skills across the Union. The system for mutual recognition of professional qualifications is supposed to alleviate the national markets’ shortage of labour, enhancing the intra-mobility of professionals and acting as a guarantee for their skills. However, the agreement on this mutual system has not been...... easy to achieve, and many administrative hurdles persist at a national level. In this chapter, after reviewing the legislation in the area, a selection of Member States’ practices will be used as a showcase for the practical, cultural, and economic barriers Union citizens may encounter when they move...

REGULATION OF NATIONAL QUALIFICATIONS SYSTEMS

Directory of Open Access Journals (Sweden)

Anna A. Muravyeva

2014-01-01

Full Text Available The paper looks into the diverse aspects of qualifications system regulation, designed for balancing the supply and demand in the labor and educational service markets. Both the objects and mechanisms of such regulation are described. Special attention is given to institutions, involved in regulation of qualifications, and their jurisdiction. Another emphasis is on the industry-related regulation of qualifications which proved to be effective both on the national and European level. Such structures were first established on the national levels to regulate the qualifications and ensure their comparability and compatibility, given the economic globalization and growing labor and academic mobility. The author points out the role of the ministries of education and labor in maintaining a steady qualifications system, and outlines the positive experience of Great Britain using the industry councils for continuing development of qualifications system.

In Sickness and In Health: Learning and Assessment Inside and Outside the New Zealand Qualifications Framework.

Science.gov (United States)

Richardson, Laurie

2001-01-01

Examines the implementation of the New Zealand Qualifications Framework, with emphasis on the relationship between educational institutions and industry partner organizations. Argues that government policy must consider the differing skills of industry and education and not create an imbalance in power that inhibits effective implementation of…

Skilled attendance at delivery; how skilled are institutional birth attendants? : An explorative study on birth attendants at Bansang Hospital, The Gambia

OpenAIRE

Kreyberg, Ina; Helsingen, Lise Mørkved

2010-01-01

Abstract Background: As reflected in the United Nations Millennium Development Goals (UN MDG 5), reducing maternal mortality represents an important area of concern. The common causes of maternal deaths may be preventable and treatable by having access to emergency obstetric care (EmOC), including skilled birth attendance (SBA), when needed. Measuring the presence of a birth attendant has been the main focus until now, not their skills and qualifications, and by this we cannot presuppose ...

The Expectation Performance Gap in Accounting Education: A Review of Generic Skills Development in UK Accounting Degrees

Science.gov (United States)

Webb, Jill; Chaffer, Caroline

2016-01-01

Accounting educators are criticised for a focus on the development of technical skills at the expense of generic employability skills. This study considers the perspective of UK graduates training for the CIMA professional accountancy qualification and examines their perceptions of the extent to which opportunities for generic skills development…

Ostomy Home Skills Program

Medline Plus

Full Text Available ... Surgeon Specific Registry Trauma Education Trauma Education Trauma Education Advanced Surgical Skills for Exposure in Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills for Trauma Disaster Management and Emergency ...

Ostomy Home Skills Program

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Full Text Available ... Education Trauma Education Achieving Zero Preventable Deaths Trauma Systems Conference Advanced Surgical Skills for Exposure in Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills for Trauma Disaster Management and ...

Open surgical simulation--a review.

Science.gov (United States)

Davies, Jennifer; Khatib, Manaf; Bello, Fernando

2013-01-01

Surgical simulation has benefited from a surge in interest over the last decade as a result of the increasing need for a change in the traditional apprentice model of teaching surgery. However, despite the recent interest in surgical simulation as an adjunct to surgical training, most of the literature focuses on laparoscopic, endovascular, and endoscopic surgical simulation with very few studies scrutinizing open surgical simulation and its benefit to surgical trainees. The aim of this review is to summarize the current standard of available open surgical simulators and to review the literature on the benefits of open surgical simulation. Open surgical simulators currently used include live animals, cadavers, bench models, virtual reality, and software-based computer simulators. In the current literature, there are 18 different studies (including 6 randomized controlled trials and 12 cohort studies) investigating the efficacy of open surgical simulation using live animal, bench, and cadaveric models in many surgical specialties including general, cardiac, trauma, vascular, urologic, and gynecologic surgery. The current open surgical simulation studies show, in general, a significant benefit of open surgical simulation in developing the surgical skills of surgical trainees. However, these studies have their limitations including a low number of participants, variable assessment standards, and a focus on short-term results often with no follow-up assessment. The skills needed for open surgical procedures are the essential basis that a surgical trainee needs to grasp before attempting more technical procedures such as laparoscopic procedures. In this current climate of medical practice with reduced hours of surgical exposure for trainees and where the patient's safety and outcome is key, open surgical simulation is a promising adjunct to modern surgical training, filling the void between surgeons being trained in a technique and a surgeon achieving fluency in that

Ostomy Home Skills Program

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Full Text Available ... Congress Educational Program Events and Special Activities Resources Housing and Travel Exhibitors Media Information Clinical Congress 2017 ... Surgical Skills for Exposure in Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills ...

Ostomy Home Skills Program

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Full Text Available ... Mentoring for Excellence in Trauma Surgery Advanced Trauma Life Support Verification, Review, and Consultation Program for Hospitals ... Surgical Skills for Exposure in Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills ...

Technical and Technological Skills Assessment in Laparoscopic Surgery

Science.gov (United States)

Chang, Avril; Vincent, Charles

2006-01-01

Objectives: Surgical appraisal and revalidation are key components of good surgical practice and training. Assessing technical skills in a structured manner is still not widely used. Laparoscopic surgery also requires the surgeon to be competent in technological aspects of the operation. Methods: Checklists for generic, specific technical, and technological skills for laparoscopic cholecystectomies were constructed. Two surgeons with >12 years postgraduate surgical experience assessed each operation blindly and independently on DVD. The technological skills were assessed in the operating room. Results: One hundred operations were analyzed. Eight trainees and 10 consultant surgeons were recruited. No adverse events occurred due to technical or technological skills. Mean interrater reliability was kappa=0.88, P=technical and technological skills between trainee and consultant surgeons were significant, Mann-Whitney P=technical and technological skills can be measured to assess performance of laparoscopic surgeons. This technical and technological assessment tool for laparoscopic surgery seems to have face, content, concurrent, and construct validities and could be modified and applied to any laparoscopic operation. The tool has the possibility of being used in surgical training and appraisal. We aim to modify and apply this tool to advanced laparoscopic operations. PMID:17212881

Pathways to Fitness for Practice: National Vocational Qualifications as a Foundation of Competence in Nurse Education.

Science.gov (United States)

Grundy, Lynne

2001-01-01

The movement in British nursing education from nursing schools to higher education has been criticized for deficiencies in skills-based training. Adding a competency-based approach using National Vocational Qualifications is a way to ensure that nurses have practical competence as well as knowledge and understanding. (Contains 24 references.) (SK)

Non-technical skills assessment in surgery.

Science.gov (United States)

Sharma, Bharat; Mishra, Amit; Aggarwal, Rajesh; Grantcharov, Teodor P

2011-09-01

Adverse events in surgery have highlighted the importance of non-technical skills, such as communication, decision-making, teamwork, situational awareness and leadership, to effective organizational performance. These skills carry particular importance to surgical oncology, as members of a multidisciplinary team must work cohesively to formulate effective patient care plans. Several non-technical skills evaluation tools have been developed for use in surgery, without adequate comparison and consensus on which should be standard for training. Eleven articles describing the use of three non-technical evaluation tools related to surgery: NOTSS (Non Technical Skills for Surgeons), NOTECHS (Non Technical Skills) and OTAS (Observational Teamwork Assessment for Surgery) were analyzed with respect to scale formulation, validity, reliability and feasibility. Furthermore, their use in training thus far and the future of non-technical rating scales in surgical curricula was discussed. Future work should focus on incorporating these assessment tools into training and into a real operating room setting to provide formative evaluations for surgical residents. Copyright © 2010 Elsevier Ltd. All rights reserved.

Cognitive Load in Mastoidectomy Skills Training

DEFF Research Database (Denmark)

Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars

2016-01-01

OBJECTIVE: The cognitive load (CL) theoretical framework suggests that working memory is limited, which has implications for learning and skills acquisition. Complex learning situations such as surgical skills training can potentially induce a cognitive overload, inhibiting learning. This study...... aims to compare CL in traditional cadaveric dissection training and virtual reality (VR) simulation training of mastoidectomy. DESIGN: A prospective, crossover study. Participants performed cadaveric dissection before VR simulation of the procedure or vice versa. CL was estimated by secondary...... surgical skills can be a challenge for the novice and mastoidectomy skills training could potentially be optimized by employing VR simulation training first because of the lower CL. Traditional dissection training could then be used to supplement skills training after basic competencies have been acquired...

Radiation protection and safety guide no. GRPB-G-1: qualification and certification of radiation protection personnel

International Nuclear Information System (INIS)

Schandorf, C.; Darko, O.; Yeboah, J.; Osei, E.K.; Asiamah, S.D.

1995-01-01

A number of accidents with radiation sources are invariably due to human factors. The achievement and maintenance of proficiency in protection and safety in working with radiation devices is a necessary prerequisite. This guide specifies the national scheme and minimum requirements for qualification and certification of radiation protection personnel. The objective is to ensure adequate level of skilled personnel by continuous upgrading of knowledge and skill of personnel. The following sectors are covered by this guide: medicine, industry, research and training, nuclear facility operations, miscellaneous activities

Surgical Safety Training of World Health Organization Initiatives.

Science.gov (United States)

Davis, Christopher R; Bates, Anthony S; Toll, Edward C; Cole, Matthew; Smith, Frank C T; Stark, Michael

2014-01-01

Undergraduate training in surgical safety is essential to maximize patient safety. This national review quantified undergraduate surgical safety training. Training of 2 international safety initiatives was quantified: (1) World Health Organization (WHO) "Guidelines for Safe Surgery" and (2) Department of Health (DoH) "Principles of the Productive Operating Theatre." Also, 13 additional safety skills were quantified. Data were analyzed using Mann-Whitney U tests. In all, 23 universities entered the study (71.9% response). Safety skills from WHO and DoH documents were formally taught in 4 UK medical schools (17.4%). Individual components of the documents were taught more frequently (47.6%). Half (50.9%) of the additional safety skills identified were taught. Surgical societies supplemented safety training, although the total amount of training provided was less than that in university curricula (P < .0001). Surgical safety training is inadequate in UK medical schools. To protect patients and maximize safety, a national undergraduate safety curriculum is recommended. © 2013 by the American College of Medical Quality.

The Impact of Automation on Job Requirements and Qualifications for Catalogers and Reference Librarians in Academic Libraries.

Science.gov (United States)

Xu, Hong

1996-01-01

Compares and analyzes job advertisements for catalogers and reference librarians in academic libraries from 1971 to 1990 to trace the impact of automation on job requirements and qualifications. Findings indicate that computer skills are needed, and there are more entry-level jobs being posted for both groups. (Author/JMV)

Evaluating Surgical Residents' Patient-Centered Communication Skills: Practical Alternatives to the "Apprenticeship Model".

Science.gov (United States)

Newcomb, Anna; Trickey, Amber W; Lita, Elena; Dort, Jonathan

2017-10-06

The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to assess communication skills and provide feedback to residents. We aimed to develop a feasible data collection process that generates objective clinical performance information to guide training activities, inform ACGME milestone evaluations, and validate assessment instruments. Residents care for patients in the surgical clinic and in the hospital, and participate in a communication curriculum providing practice with standardized patients (SPs). We measured perception of resident communication using the 14-item Communication Assessment Tool (CAT), collecting data from patients at the surgery clinic and surgical wards in the hospital, and from SP encounters during simulated training scenarios. We developed a handout of CAT example behaviors to guide patients completing the communication assessment. Independent academic medical center. General surgery residents. The primary outcome is the percentage of total items patients rated "excellent;" we collected data on 24 of 25 residents. Outpatient evaluations resulted in significantly higher scores (mean 84.5% vs. 68.6%, p communication assessments in their concurrent patient population (p = 0.017), and (2) receiving CAT example instructions was associated with a lower percentage of excellent ratings by 9.3% (p = 0.047). Our data collection process provides a model for obtaining meaningful information about resident communication proficiency. CAT evaluations of surgical residents by the inpatient population had not previously been described in the literature; our results provide important insight into relationships between the evaluations provided by inpatients, clinic patients, and SPs in simulation. Our example behaviors guide shows promise for addressing a common concern, minimizing ceiling effects when measuring physician-patient communication. Copyright © 2017 Association of Program Directors in Surgery. Published by

Simulation-based surgical education.

Science.gov (United States)

Evgeniou, Evgenios; Loizou, Peter

2013-09-01

The reduction in time for training at the workplace has created a challenge for the traditional apprenticeship model of training. Simulation offers the opportunity for repeated practice in a safe and controlled environment, focusing on trainees and tailored to their needs. Recent technological advances have led to the development of various simulators, which have already been introduced in surgical training. The complexity and fidelity of the available simulators vary, therefore depending on our recourses we should select the appropriate simulator for the task or skill we want to teach. Educational theory informs us about the importance of context in professional learning. Simulation should therefore recreate the clinical environment and its complexity. Contemporary approaches to simulation have introduced novel ideas for teaching teamwork, communication skills and professionalism. In order for simulation-based training to be successful, simulators have to be validated appropriately and integrated in a training curriculum. Within a surgical curriculum, trainees should have protected time for simulation-based training, under appropriate supervision. Simulation-based surgical education should allow the appropriate practice of technical skills without ignoring the clinical context and must strike an adequate balance between the simulation environment and simulators. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Ostomy Home Skills Program

Medline Plus

Full Text Available ... The Ostomy Home Skills Kit supports patients with educational and simulation materials to learn and practice the skills needed for optimal postoperative recovery. The kit supports the entire surgical team with quality, comprehensive education. The standardized interactive program has been ...

Retention of Mastoidectomy Skills After Virtual Reality Simulation Training

DEFF Research Database (Denmark)

Andersen, Steven Arild Wuyts; Konge, Lars; Cayé-Thomasen, Per

2016-01-01

IMPORTANCE: The ultimate goal of surgical training is consolidated skills with a consistently high performance. However, surgical skills are heterogeneously retained and depend on a variety of factors, including the task, cognitive demands, and organization of practice. Virtual reality (VR......) simulation is increasingly being used in surgical skills training, including temporal bone surgery, but there is a gap in knowledge on the retention of mastoidectomy skills after VR simulation training. OBJECTIVES: To determine the retention of mastoidectomy skills after VR simulation training...... with distributed and massed practice and to investigate participants' cognitive load during retention procedures. DESIGN, SETTING, AND PARTICIPANTS: A prospective 3-month follow-up study of a VR simulation trial was conducted from February 6 to September 19, 2014, at an academic teaching hospital among 36 medical...

determinant of psychophysiological state of sportsmen of high qualification with different emotional characteristics

OpenAIRE

Korobeynikova L.G.

2011-01-01

The purpose of the work - to study the determinants of psycho-physiological state of sportsmen of high qualification with different emotional characteristics. In experiment took part 19 highly skilled athletes involved in the Greco-Roman wrestling. The survey was carried out using a hardware-software complex psychodiagnostic "Multipsihometr-05. Determined by the emotional background of athletes according to the method A. Rukavishnikova features of visual perception and perceptual speed.

5 CFR 302.403 - Qualifications for promotion.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Qualifications for promotion. 302.403... EMPLOYMENT IN THE EXCEPTED SERVICE Selection and Appointment; Reappointment; and Qualifications for Promotion § 302.403 Qualifications for promotion. In determining qualifications for promotion with respect to an...

Understanding interdisciplinary health care teams: using simulation design processes from the Air Carrier Advanced Qualification Program to identify and train critical teamwork skills.

Science.gov (United States)

Hamman, William R; Beaudin-Seiler, Beth M; Beaubien, Jeffrey M

2010-09-01

In the report "Five Years After 'To Err is Human' ", it was noted that "the combination of complexity, professional fragmentation, and a tradition of individualism, enhanced by a well-entrenched hierarchical authority structure and diffuse accountability, forms a daunting barrier to creating the habits and beliefs of common purpose, teamwork, and individual accountability for successful interdependence that a safe culture requires". Training physicians, nurses, and other professionals to work in teams is a concept that has been promoted by many patient safety experts. However the model of teamwork in healthcare is diffusely defined, no clear performance metrics have been established, and the use of simulation to train teams has been suboptimal. This paper reports on the first three years of work performed in the Michigan Economic Development Corporation (MEDC) Tri-Corridor life science grant to apply concepts and processes of simulation design that were developed in the air carrier industry to understand and train healthcare teams. This work has been monitored by the American Academy for the Advancement of Science (AAA) and is based on concepts designed in the Advanced Qualification Program (AQP) from the air carrier industry, which trains and assesses teamwork skills in the same manner as technical skills. This grant has formed the foundation for the Center of Excellence for Simulation Education and Research (CESR).

The french safety approach regarding equipment qualification

International Nuclear Information System (INIS)

Jalouneix, J.; Deletre, G.; Henry, J.Y.; Rousseau, L.

1989-10-01

The qualification of the equipment, used in France on nuclear reactors and reactor components, is discussed. The approach on safety involves the qualification of mechanical and electrical components, under operating and under seismic conditions. The principles of the qualification program and the list of the equipment concerned, are given. The conditions in which qualification tests are performed and the methods applied, are summarized. The actions for preserving the qualification procedures, are considered

Empowering Engineering Students through Employability Skills

Directory of Open Access Journals (Sweden)

Urvashi Kaushal

2016-12-01

Full Text Available A professional course like engineering strives to get maximum number of its students placed through campus interviews. While communication skills have been added in all the engineering courses with the aim to improve their performance in placement, the syllabus mostly concentrates on the development of four language skills. The students are not made aware of the employability skills and their significance. the increasing competition makes it imperative that apart from a regular degree certain skills are required by engineers. Industries while advertising for various posts even mention essential skills required along with the essential qualification. However skills and the significance of skills while applying for jobs or while facing interviews is a topic which is rarely given consideration while preparing for job interviews or while entering the job market. This paper intends to enlist the importance of skills and why students need to be aware of the skills they possess and how they can work on packaging their candidature around a few skills.  Different profession requires different skills and if students identify their skills or acquire certain skills they can unquestionably have an added advantage in the interview and placement. Hence, this paper intends to enlist the skills, the importance of skills, ways to create awareness of individual skills specifically in engineering students who will step into the industry in near future.

Environmental qualification program for new designs

International Nuclear Information System (INIS)

Doerffer, K.

2007-01-01

Qualification of nuclear power plant equipment and components important to safety (ITS) is an integral part of the design process. The qualification methodology differs based on the severity of service conditions (operational and ambient), to which the ITS equipment is exposed. In Canada, the licensing requirements for environmental qualification for new designs are governed by the Canadian Standard Association (CSA) standard, N290.13-2005 titled 'Environmental Qualification of Equipment for CANDU Nuclear Power Plants' and the pre-consultation draft, 'Requirements for Design of Nuclear Power Plants'(DRD), issued for trial use by the Canadian Nuclear Safety Commission (CNSC) in March 2005. This paper will describe AECL's current Environmental Qualification program developed to comply with the above licensing requirements as applied to new designs. The focus will be given to qualification of ITS systems structures and components (SSC) to harsh conditions occurring due to the Design Basis Accidents (DBA). (author)

Optimizing microsurgical skills with EEG neurofeedback

Directory of Open Access Journals (Sweden)

Benjamin Larry

2009-07-01

Full Text Available Abstract Background By enabling individuals to self-regulate their brainwave activity in the field of optimal performance in healthy individuals, neurofeedback has been found to improve cognitive and artistic performance. Here we assessed whether two distinct EEG neurofeedback protocols could develop surgical skill, given the important role this skill plays in medicine. Results National Health Service trainee ophthalmic microsurgeons (N = 20 were randomly assigned to either Sensory Motor Rhythm-Theta (SMR or Alpha-Theta (AT groups, a randomized subset of which were also part of a wait-list 'no-treatment' control group (N = 8. Neurofeedback groups received eight 30-minute sessions of EEG training. Pre-post assessment included a skills lab surgical procedure with timed measures and expert ratings from video-recordings by consultant surgeons, together with state/trait anxiety self-reports. SMR training demonstrated advantages absent in the control group, with improvements in surgical skill according to 1 the expert ratings: overall technique (d = 0.6, p Conclusion SMR-Theta neurofeedback training provided significant improvement in surgical technique whilst considerably reducing time on task by 26%. There was also evidence that AT training marginally reduced total surgery time, despite suboptimal training efficacies. Overall, the data set provides encouraging evidence of optimised learning of a complex medical specialty via neurofeedback training.

5 CFR 319.302 - Individual qualifications.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Individual qualifications. 319.302... Individual qualifications. Agency heads are delegated authority to approve the qualifications of individuals appointed to SL and ST positions. The agency head must determine that the individual meets the...

Developments in undergraduate teaching of small-animal soft-tissue surgical skills at the University of Sydney.

Science.gov (United States)

Gopinath, Deepa; McGreevy, Paul D; Zuber, Richard M; Klupiec, Corinna; Baguley, John; Barrs, Vanessa R

2012-01-01

This article discusses recent developments in soft-tissue surgery teaching at the University of Sydney, Faculty of Veterinary Science. An integrated teaching program was developed for Bachelor of Veterinary Science (BVSc) students with the aim of providing them with optimal learning opportunities to meet "Day One" small-animal soft-tissue surgical competencies. Didactic lectures and tutorials were introduced earlier into the curriculum to prepare students for live-animal surgery practical. In addition to existing clinics, additional spay/neuter clinics were established in collaboration with animal welfare organizations to increase student exposure to live-animal surgery. A silicon-based, life-like canine ovariohysterectomy model was developed with the assistance of a model-making and special effects company. The model features elastic ovarian pedicles and suspensory ligaments, which can be stretched and broken like those of an actual dog. To monitor the volume and type of student surgical experience, an E-portfolio resource was established. This resource allows for the tracking of numbers of live, student-performed desexing surgeries and incorporates competency-based assessments and reflective tasks to be completed by students. Student feedback on the integrated surgical soft-tissue teaching program was assessed. Respondents were assessed in the fourth year of the degree and will have further opportunities to develop Day One small-animal soft-tissue surgical competencies in the fifth year. Ninety-four percent of respondents agreed or strongly agreed that they were motivated to participate in all aspects of the program, while 78% agreed or strongly agreed that they received an adequate opportunity to develop their skills and confidence in ovariohysterectomy or castration procedures through the fourth-year curriculum.

Computers and virtual reality for surgical education in the 21st century.

Science.gov (United States)

Haluck, R S; Krummel, T M

2000-07-01

Surgeons must learn to perform operations. The current system of surgical resident education is facing many challenges in terms of time efficiency, costs, and patient safety. In addition, as new types of operations are developed rapidly, practicing surgeons may find a need for more efficient methods of surgical skill education. An in-depth examination of the current learning environment and the literature of motor skills learning provides insights into ways in which surgical skills education can be improved. Computers will certainly be a part of this process. Computer-based training in technical skills has the potential to solve many of the educational, economic, ethical, and patient safety issues related to learning to perform operations. Although full virtual-reality systems are still in development, there has been early progress that should encourage surgeons to incorporate computer simulation into the surgical curriculum.

VHDL basics applied design by SIPAC qualification system

International Nuclear Information System (INIS)

Park, In Ha; Mun, Da Cheol; Lee, Gwang Yeob

2005-12-01

This book has six chapters, which are about Flowrian of SIPAC qualification system including internet CAD system and remote server service, logic circuit on design and qualification of device such as gate circuit, multiplex and decoder, order logic circuit with D type flip-flop design and qualification and Rom and RAM's design and qualification, finite state machine such as odd checker, sequence detector, test clock generator and traffic light controller, design and qualification about data path, design of application circuit. It has two appendixes on install and the way to use SIPAC qualification system and remote service for SIPAC qualification system.

Assessment of surgeon fatigue by surgical simulators

Directory of Open Access Journals (Sweden)

Tuwairqi K

2015-04-01

Full Text Available Khaled Tuwairqi,1 Jessica H Selter,2 Shameema Sikder3 1College of Medicine, University of Utah, Salt Lake City, UT, 2Johns Hopkins School of Medicine, 3Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA Background: The impact of fatigue on surgical performance and its implications for patient care is a growing concern. While investigators have employed a number of different tools to measure the effect of fatigue on surgical performance, the use of the surgical simulator has been increasingly implemented for this purpose. The goal of this paper is to review the published literature to achieve a better understanding of evaluation of fatigue on performance as studied with surgical simulators. Methods: A PubMed and Cochrane search was conducted using the search terms “simulator”, “surgery”, and “fatigue”. In total, 50 papers were evaluated, and 20 studies were selected after application of exclusion criteria. Articles were excluded if they did not use the simulator to assess the impact of fatigue on surgeon performance. Systematic reviews and case reports were also excluded. Results: Surgeon fatigue led to a consistent decline in cognitive function in six studies. Technical skills were evaluated in 18 studies, and a detrimental impact was reported in nine studies, while the remaining nine studies showed either no change or positive results with regard to surgical skills after experience of fatigue. Two pharmacological intervention studies reversed the detrimental impact of fatigue on cognitive function, but no change or a worsening effect was recognized for technical skills. Conclusion: Simulators are increasingly being used to evaluate the impact of fatigue on the surgeon's performance. With regard to the impact of fatigue in this regard, studies have demonstrated a consistent decline in cognitive function and mixed outcomes for technical skills. Larger studies that relate the simulator's results to real surgical

Public sector pay gap in Serbia during large-scale privatisation, by educational qualification

OpenAIRE

Laušev Jelena

2012-01-01

The paper explores the effect of large-scale privatization of public sector activities on public-private sector pay differential, for groups of workers according to educational qualification on average and across the pay distribution in Serbia, from 2004 until 2008. The paper finds that both unskilled and skilled men and women in the public sector saw significant improvements in their financial position relative to their private sector counterparts with the progress of the economic tran...

determinant of psychophysiological state of sportsmen of high qualification with different emotional characteristics

Directory of Open Access Journals (Sweden)

Korobeynikova L.G.

2011-04-01

Full Text Available The purpose of the work - to study the determinants of psycho-physiological state of sportsmen of high qualification with different emotional characteristics. In experiment took part 19 highly skilled athletes involved in the Greco-Roman wrestling. The survey was carried out using a hardware-software complex psychodiagnostic "Multipsihometr-05. Determined by the emotional background of athletes according to the method A. Rukavishnikova features of visual perception and perceptual speed.

Procedural Skills Education – Colonoscopy as a Model

Directory of Open Access Journals (Sweden)

Maitreyi Raman

2008-01-01

Full Text Available Traditionally, surgical and procedural apprenticeship has been an assumed activity of students, without a formal educational context. With increasing barriers to patient and operating room access such as shorter work week hours for residents, and operating room and endoscopy time at a premium, alternate strategies to maximizing procedural skill development are being considered. Recently, the traditional surgical apprenticeship model has been challenged, with greater emphasis on the need for surgical and procedural skills training to be more transparent and for alternatives to patient-based training to be considered. Colonoscopy performance is a complex psychomotor skill requiring practioners to integrate multiple sensory inputs, and involves higher cortical centres for optimal performance. Colonoscopy skills involve mastery in the cognitive, technical and process domains. In the present review, we propose a model for teaching colonoscopy to the novice trainee based on educational theory.

Surgical treatment of parastomal hernia

International Nuclear Information System (INIS)

Basti, Z.; Mayer, A.

2013-01-01

Stoma construction is among standard surgical skills and is performed for many indications. Every stoma means huge impact on quality of life for patients even with great improvement in surgical technique and ostomy devices. All patients are very sensitive to complication of stoma and the most frequent complication is parastomal hernia. Incidence reported in literature is very high and unacceptable, it is 30-70%. Surgical approach is very demanding on technical equipment and experiences of surgeon. Authors focus on each surgical approach for treating this complication weather it´s using mesh or laparoscopic or open approach. (author)

Adolescent Cognitive Skills, Attitudinal/Behavioral Traits and Career Wages

Science.gov (United States)

Hall, Matthew; Farkas, George

2011-01-01

We use panel data from the National Longitudinal Survey of Youth (NLSY79) to estimate the effects of cognitive skills (measured by the Armed Forces Qualification Test) and attitudinal/behavioral traits (a latent factor based on self-reported self-esteem, locus of control, educational aspirations and educational expectations) on career wage…

Surgical competence.

Science.gov (United States)

Patil, Nivritti G; Cheng, Stephen W K; Wong, John

2003-08-01

Recent high-profile cases have heightened the need for a formal structure to monitor achievement and maintenance of surgical competence. Logbooks, morbidity and mortality meetings, videos and direct observation of operations using a checklist, motion analysis devices, and virtual reality simulators are effective tools for teaching and evaluating surgical skills. As the operating theater is also a place for training, there must be protocols and guidelines, including mandatory standards for supervision, to ensure that patient care is not compromised. Patients appreciate frank communication and honesty from surgeons regarding their expertise and level of competence. To ensure that surgical competence is maintained and keeps pace with technologic advances, professional registration bodies have been promoting programs for recertification. They evaluate performance in practice, professional standing, and commitment to ongoing education.

A cross sectional study of surgical training among United Kingdom general practitioners with specialist interests in surgery.

Science.gov (United States)

Ferguson, H J M; Fitzgerald, J E F; Reilly, J; Beamish, A J; Gokani, V J

2015-04-08

Increasing numbers of minor surgical procedures are being performed in the community. In the UK, general practitioners (family medicine physicians) with a specialist interest (GPwSI) in surgery frequently undertake them. This shift has caused decreases in available cases for junior surgeons to gain and consolidate operative skills. This study evaluated GPwSI's case-load, procedural training and perceptions of offering formalised operative training experience to surgical trainees. Prospective, questionnaire-based cross-sectional study. A novel, 13-item, self-administered questionnaire was distributed to members of the Association of Surgeons in Primary Care (ASPC). A total 113 of 120 ASPC members completed the questionnaire, representing a 94% response rate. Respondents were general practitioners practising or intending to practice surgery in the community. Respondents performed a mean of 38 (range 5-150) surgical procedures per month in primary care. 37% (42/113) of respondents had previously been awarded Membership or Fellowship of a Surgical Royal College; 22% (25/113) had completed a surgical certificate or diploma or undertaken a course of less than 1 year duration. 41% (46/113) had no formal British surgical qualifications. All respondents believed that surgical training in primary care could be valuable for surgical trainees, and the majority (71/113, 63%) felt that both general practice and surgical trainees could benefit equally from such training. There is a significant volume of surgical procedures being undertaken in the community by general practitioners, with the capacity and appetite for training of prospective surgeons in this setting, providing appropriate standards are achieved and maintained, commensurate with current standards in secondary care. Surgical experience and training of GPwSI's in surgery is highly varied, and does not yet benefit from the quality assurance secondary care surgical training in the UK undergoes. The Royal Colleges of

Objective assessment of technical surgical skills

NARCIS (Netherlands)

van Hove, P. D.; Tuijthof, G. J. M.; Verdaasdonk, E. G. G.; Stassen, L. P. S.; Dankelman, J.

2010-01-01

Surgeons are increasingly being scrutinized for their performance and there is growing interest in objective assessment of technical skills. The purpose of this study was to review all evidence for these methods, in order to provide a guideline for use in clinical practice. A systematic search was

Use of cardio-diagnostics of D&K-TEST for individualizations of training process of skilled short track speed skaters high qualification

Directory of Open Access Journals (Sweden)

Kygayevskiy S.A.

2009-10-01

Full Text Available In the article possibilities of individualization of training process of short track speed skaters high qualification are resulted on the basis of influence of application of loadings of different orientation on the indexes of cardio-diagnostics of D&K-TEST. The influences of loadings of different physiological and metabolic orientation given about efficiency are resulted on the level of functional preparedness of short track speed skaters of high qualification.

Establishment of nuclear equipment qualification system

International Nuclear Information System (INIS)

Joo, Po Kook; Lim, Nam Jin; Lee, Young Gun

2003-04-01

This study is carried out by KEARI(Korea Atomic Energy Research Institute) as the lead organization in cooperation with KIMM(Korea Institute of Machinery and Materials), KTL(Korea Testing Laboratory) and KRISS(Korea Research Institute of Standards and Science) to construct a basis of efficient management of nuclear equipment qualification business by expanding test equipment of each of participating organization, and developing qualification technologies. As for KIMM, control system of large scale shaker was replaced with advanced system, and LOCA(Loss of Coolant Accident) test facility was installed. KTL is now capable of conducting seismic tests of nuclear I and C as a result of installation of seismic test equipment during the first two project years. KRISS participated in the Project with a view to have large scale EMI test equipment and related technologies. In parallel with expansion of test equipment, a industrial-educational-research cooperation committee, as an intermediate step toward integrated equipment qualification system to maximize the usage of test equipment, was established and cooperation methods were investigated. As a result, Korea Nuclear Equipment Qualification Association, an corporate juridical person, was established. Research on development of thermal and radiation aging test technology of nuclear materials was carried out by Hanyang University and SECO(Saehan Engineering and Qualification Co., Ltd.). Integrated Equipment Qualification Database was developed which contains material test data, equipment qualification data and other EQ related informations. Standard qualification procedures were developed in order for test laboratories and manufacturers to establish design requirements and to efficiently perform tests

The Nature of the Current and Anticipated Shortage of Professional Skills and Qualities of Workers in the Russian Labor Market

Science.gov (United States)

Bondarenko, Natal'ia

2015-01-01

This article analyzes the characteristics of the existing and expected deficit of professional skills and qualities of workers employed by Russian companies. Analyzed factors include generic skills, soft or behavioral skills, the influence of the qualification, and shortage on the effectiveness of the companies as a whole. The data is based on a…

Qualification of ISI for Bulgarian NPP: UK support

International Nuclear Information System (INIS)

Booler, R.

2000-01-01

UK Regulator (NII) Phare project provides an assistance to the Bulgarian Regulator in setting up the technical infrastructure for inspection qualification consistent with IAEA Guidelines and western European practice. The Strategy Document defines the methodology for inspection qualification and general roles and responsibilities of the involved organizations. The Qualification Inputs Document describes the information required for the Technical Specifications (component details, inspection aims and limitations). It applies the idea of qualification level - level 1(lowest) to level 3 (highest). The Qualification Procedure Document provides a guidance to the utility ('Kozloduy' NPP) on the preparation of Qualification Procedures (QP). The appendix provides a specific guidance on the performance of the all aspects of qualification at different levels and recommendations for technical justification. QB Method Working Document provides guidance for the Qualification Body. Facilities and Resources Document defines the facilities and resources required for the Qualification Body to perform the tasks described in the Method Working Document. High level QA Document defines the principles of quality control. Other issues and progress report are also presented

Facilitating Experiential Learning of Study Skills in Sports Students

Science.gov (United States)

Groves, Mark; Bowd, Belinda; Smith, Julian

2010-01-01

In recent years the student population in the UK has grown considerably, and students are entering higher education with a more diverse range of qualifications and skills. This is particularly the case in post-1992 universities with a widening participation agenda, as these institutions have a larger share of students from non-traditional…

Using virtual reality technology and hand tracking technology to create software for training surgical skills in 3D game

Science.gov (United States)

Zakirova, A. A.; Ganiev, B. A.; Mullin, R. I.

2015-11-01

The lack of visible and approachable ways of training surgical skills is one of the main problems in medical education. Existing simulation training devices are not designed to teach students, and are not available due to the high cost of the equipment. Using modern technologies such as virtual reality and hands movements fixation technology we want to create innovative method of learning the technics of conducting operations in 3D game format, which can make education process interesting and effective. Creating of 3D format virtual simulator will allow to solve several conceptual problems at once: opportunity of practical skills improvement unlimited by the time without the risk for patient, high realism of environment in operational and anatomic body structures, using of game mechanics for information perception relief and memorization of methods acceleration, accessibility of this program.

Slow Path to the Superintendency: Women's Social Networks and Negotiation Skills

Science.gov (United States)

Montz, Carol B.; Wanat, Carolyn L.

2008-01-01

Women superintendents in one Midwestern state participated in this study of their personal demographics, professional qualifications and career paths, and demographics of districts and boards of education that hired them. Participants identified characteristics, skills, and barriers to women seeking superintendencies. Thirty-one of 36 women…

An analysis of the relationship between staff qualification and export readiness of pharmaceutical companies: the case of iran.

Science.gov (United States)

Mohammadzadeh, Mehdi

2012-01-01

Export and the readiness to export constitute the first step of international marketing, which are affected by both internal and external factors of firms. One of the most important internal factors is the presence of skilled personnel. The purpose of this study was to define the relationship between staff qualification and encouragment with the readiness level of Iranian pharmacuetical firms for engagement in export marketing. The research was based on a single case study on a basket of seven leading domestic firms. For the bias reduction, questionnaires as well as interviews with managers were used. The performance of the studied factor was lower than the desired level for export readiness and there was much scope for improvement in staff qualifications to achieve such readiness. The results of this research enable small and medium-sized pharmaceutical companies to evaluate their staff qualification levels needed for export readiness and to detect their shortcomings in order to improve them.

The Relationship between Student Teachers' Citizenship Skills and Critical

Directory of Open Access Journals (Sweden)

İsmail Acun

2010-05-01

Full Text Available The aim of the research is to investigate the relationship between student teachers’ citizenship skills and their critical thinking skills. The New Turkish Primary Curriculum aims at educating pupils with pre-requisite skills and knowledge that are necessary for operating efficiently in a knowledge based society. There is a strong emphasis on improving generic skills of students. The skills of critical thinking, reflective thinking, inquiry and working in groups are thought to be necessary skills for effective teaching and learning. When it comes to citizenship education those skills, especially critical thinking skills, become even more important.There has been a shift in policy with the curriculum both in terms of its structure and its philosophy from ‘creating good citizens’ to ‘empowerment’. The teachers will be the agents for the proposed shift to occur in schools and in pupils’ hearts and minds. That is why it is important that teachers themselves should be equipped with the necessary skills and knowledge. In order to predict whether those aims will be realized or not, it is important to know whether teachers have those knowledge and skills. Thus, the question of whether there is relationship with citizenship qualifications and critical thinking skills will be investigated through student teachers.This study employs a survey research method. In order to collect data two different research tools are used. The data on student teachers’ citizenship skills were gathered through a ‘Citizenship Qualifications Scale’ developed by Yucel, Acun, Demirhan and Goz. The scale has to parts. First part contains questions on demographic information about teachers and teachers’ professional practice. Second part of the scale includes question/statements to determine teachers’ level of knowledge on citizenship themes, level of their behaviors and level of their importance attribution on the same themes. Those themes are categorized as

Pilot study approach and qualification dossier components

International Nuclear Information System (INIS)

Ammirato, F.; Ashwin, P.

2000-01-01

The aim of the Pilot Project is to evaluate the IAEA Guidelines and methodology for the benefit of IAEA Member States trough a simulation of qualification activities. The Project is based on a real component and available data - NPP Kozloduy unit 5, weld 3. The initial phase is limited to the Qualification dossier. The Project relies on the input from the team members and Member States. Team organization and responsibilities are presented. The components of the Qualification Dossier (technical specification, inspection procedure and preliminary review, qualification procedure) and their current status are also presented. A comparison is done with their qualification programs. The characteristics of performance demonstrations are discussed. The results show that the teamwork has been successful and the IAEA methodology covers all situations. It is expected that the End Project will become 'Benchmark's' for future qualification activities

Reflections in a time of transition: orthopaedic faculty and resident understanding of accreditation schemes and opinions on surgical skills feedback

Directory of Open Access Journals (Sweden)

Kenneth R. Gundle

2016-04-01

Full Text Available Introduction: Orthopaedic surgery is one of the first seven specialties that began collecting Milestone data as part of the Accreditation Council for Graduate Medical Education's Next Accreditation System (NAS rollout. This transition from process-based advancement to outcome-based education is an opportunity to assess resident and faculty understanding of changing paradigms, and opinions about technical skill evaluation. Methods: In a large academic orthopaedic surgery residency program, residents and faculty were anonymously surveyed. A total of 31/32 (97% residents and 29/53 (55% faculty responded to Likert scale assessments and provided open-ended responses. An internal end-of-rotation audit was conducted to assess timeliness of evaluations. A mixed-method analysis was utilized, with nonparametric statistical testing and a constant-comparative qualitative method. Results: There was greater familiarity with the six core competencies than with Milestones or the NAS (p<0.05. A majority of faculty and residents felt that end-of-rotation evaluations were not adequate for surgical skills feedback. Fifty-eight per cent of residents reported that end-of-rotation evaluations were rarely or never filled out in a timely fashion. An internal audit demonstrated that more than 30% of evaluations were completed over a month after rotation end. Qualitative analysis included themes of resident desire for more face-to-face feedback on technical skills after operative cases, and several barriers to more frequent feedback. Discussion: The NAS and outcome-based education have arrived. Residents and faculty need to be educated on this changing paradigm. This transition period is also a window of opportunity to address methods of evaluation and feedback. In our orthopaedic residency, trainees were significantly less satisfied than faculty with the amount of technical and surgical skills feedback being provided to trainees. The quantitative and qualitative analyses

Virtual Reality Simulator Systems in Robotic Surgical Training.

Science.gov (United States)

Mangano, Alberto; Gheza, Federico; Giulianotti, Pier Cristoforo

2018-06-01

The number of robotic surgical procedures has been increasing worldwide. It is important to maximize the cost-effectiveness of robotic surgical training and safely reduce the time needed for trainees to reach proficiency. The use of preliminary lab training in robotic skills is a good strategy for the rapid acquisition of further, standardized robotic skills. Such training can be done either by using a simulator or by exercises in a dry or wet lab. While the use of an actual robotic surgical system for training may be problematic (high cost, lack of availability), virtual reality (VR) simulators can overcome many of these obstacles. However, there is still a lack of standardization. Although VR training systems have improved, they cannot yet replace experience in a wet lab. In particular, simulated scenarios are not yet close enough to a real operative experience. Indeed, there is a difference between technical skills (i.e., mechanical ability to perform a simulated task) and surgical competence (i.e., ability to perform a real surgical operation). Thus, while a VR simulator can replace a dry lab, it cannot yet replace training in a wet lab or operative training in actual patients. However, in the near future, it is expected that VR surgical simulators will be able to provide total reality simulation and replace training in a wet lab. More research is needed to produce more wide-ranging, trans-specialty robotic curricula.

Virtual Reality Surgical Simulation: Implications for Resection of Intracranial Gliomas.

Science.gov (United States)

Dakson, Ayoub; Hong, Murray; Clarke, David B

2018-01-01

Surgical simulation has the potential to play important roles in surgical training and preoperative planning. The advent of virtual reality (VR) with tactile haptic feedback has revolutionized surgical simulation, creating a novel environment for residents to learn manual skills without compromising patient safety. This concept is particularly relevant in neurosurgical training where the acquired skill set demands performance of technically challenging tasks under pressure and where the consequences of error are significant. The evolution of VR simulation is discussed here within the context of neurosurgical training and its implications for resection of intracranial gliomas. VR holds the promise of providing a useful educational tool for neurosurgical residents to hone their surgical skills and for neurosurgeons to rehearse specific segments of the surgery prior to the actual operation. Also discussed are several important issues related to simulation and simulation-based training that will need to be addressed before widespread adoption of VR simulation as a useful technology. © 2018 S. Karger AG, Basel.

Multidisciplinary crisis simulations: the way forward for training surgical teams.

Science.gov (United States)

Undre, Shabnam; Koutantji, Maria; Sevdalis, Nick; Gautama, Sanjay; Selvapatt, Nowlan; Williams, Samantha; Sains, Parvinderpal; McCulloch, Peter; Darzi, Ara; Vincent, Charles

2007-09-01

High-reliability organizations have stressed the importance of non-technical skills for safety and of regularly providing such training to their teams. Recently safety skills training has been applied in the practice of medicine. In this study, we developed and piloted a module using multidisciplinary crisis scenarios in a simulated operating theatre to train entire surgical teams. Twenty teams participated (n = 80); each consisted of a trainee surgeon, anesthetist, operating department practitioner (ODP), and scrub nurse. Crisis scenarios such as difficult intubation, hemorrhage, or cardiac arrest were simulated. Technical and non-technical skills (leadership, communication, team skills, decision making, and vigilance), were assessed by clinical experts and by two psychologists using relevant technical and human factors rating scales. Participants received technical and non-technical feedback, and the whole team received feedback on teamwork. Trainees assessed the training favorably. For technical skills there were no differences between surgical trainees' assessment scores and the assessment scores of the trainers. However, nurses overrated their technical skill. Regarding non-technical skills, leadership and decision making were scored lower than the other three non-technical skills (communication, team skills, and vigilance). Surgeons scored lower than nurses on communication and teamwork skills. Surgeons and anesthetists scored lower than nurses on leadership. Multidisciplinary simulation-based team training is feasible and well received by surgical teams. Non-technical skills can be assessed alongside technical skills, and differences in performance indicate where there is a need for further training. Future work should focus on developing team performance measures for training and on the development and evaluation of systematic training for technical and non-technical skills to enhance team performance and safety in surgery.

Benefits of Digital Equipment Generic Qualification Activities

International Nuclear Information System (INIS)

Thomas, James E.; Steiman, Samuel C.

2002-01-01

As a result of nuclear power plant instrumentation and control obsolescence issues, there have been numerous activities during recent years relating to the qualification of digital equipment. Some of these activities have been 'generic' in nature in that the qualification was not limited to plant specific applications, but was intended to cover a broad base of potential applications of the digital equipment. These generic qualifications have been funded by equipment manufacturers and by utility groups and organizations. The generic activities sponsored by the Electric Power Research Institute (EPRI) have been pilot projects for an overall generic qualification approach. The primary benefit resulting from the generic qualification work to date is that a number of digital platforms and digital devices are now available for use in various nuclear safety-related applications. Many of the tests and evaluations necessary to support plant specific applications have been completed. The amount of data and documentation that each utility must develop on a case by case basis has been significantly reduced. There are also a number of additional benefits resulting from these industry efforts. The challenges and difficulties in qualifying digital equipment for safety-related applications are now more clearly understood. EPRI has published a lessons learned document (EPRI Report 1001452, Generic Qualification of Commercial Grade Digital Devices: Lessons Learned from Initial Pilots, which covers several different qualification areas, including device selection, project planning, vendor surveys and design reviews, and electromagnetic compatibility (EMC) qualification. Application of the experience and lessons learned from the EPRI pilot activities should help reduce the effort and cost required for future qualification work. Most generic qualification activities for commercial equipment have been conducted using the approach of EPRI TR-106439, Guideline on Evaluation and Acceptance

49 CFR 180.507 - Qualification of tank cars.

Science.gov (United States)

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Qualification of tank cars. 180.507 Section 180... QUALIFICATION AND MAINTENANCE OF PACKAGINGS Qualification and Maintenance of Tank Cars § 180.507 Qualification of tank cars. (a) Each tank car marked as meeting a “DOT” specification or any other tank car used...

A serious game skills competition increases voluntary usage and proficiency of a virtual reality laparoscopic simulator during first-year surgical residents' simulation curriculum.

Science.gov (United States)

El-Beheiry, Mostafa; McCreery, Greig; Schlachta, Christopher M

2017-04-01

The objective of this study was to assess the effect of a serious game skills competition on voluntary usage of a laparoscopic simulator among first-year surgical residents' standard simulation curriculum. With research ethics board approval, informed consent was obtained from first-year surgical residents enrolled in an introductory surgical simulation curriculum. The class of 2013 served as a control cohort following the standard curriculum which mandates completion of six laparoscopic simulator skill tasks. For the 2014 competition cohort, the only change introduced was the biweekly and monthly posting of a leader board of the top three and ten fastest peg transfer times. Entry surveys were administered assessing attitudes towards simulation-based training and competition. Cohorts were observed for 5 months. There were 24 and 25 residents in the control and competition cohorts, respectively. The competition cohort overwhelmingly (76 %) stated that they were not motivated to deliberate practice by competition. Median total simulator usage time was 132 min (IQR = 214) in the competition cohort compared to 89 (IQR = 170) in the control cohort. The competition cohort completed their course requirements significantly earlier than the control cohort (χ 2  = 6.5, p = 0.01). There was a significantly greater proportion of residents continuing to use the simulator voluntarily after completing their course requirements in the competition cohort (44 vs. 4 %; p = 0.002). Residents in the competition cohort were significantly faster at peg transfer (194 ± 66 vs. 233 ± 53 s, 95 % CI of difference = 4-74 s; p = 0.03) and significantly decreased their completion time by 33 ± 54 s (95 % CI 10-56 s; paired t test, p = 0.007). A simple serious games skills competition increased voluntary usage and performance on a laparoscopic simulator, despite a majority of participants reporting they were not motivated by competition. Future directions should

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ENIQ: European Network for Inspection Qualification

International Nuclear Information System (INIS)

Champigny, F.; Crutzen, S.; Lemaitre, P.

1995-01-01

Many countries are currently considering their own approach to inspection qualification and are carefully assessing experience to date. ENIQ, which stands for European Network for Inspection Qualification, groups the major part of the utilities in Western Europe. The general objective of ENIQ is to coordinate and manage at European level expertise and resources for the assessment and qualification of NDE inspection techniques and procedures, primarily for nuclear components. Also non-nuclear heavy duty components will be considered. Within ENIQ there is a growing consensus of opinion on the general principles of a European approach towards inspection qualification. In this paper the main activities, organization and actual status of ENIQ will be discussed

Impact of the draft DOE Training and Qualification Standard on an established training and qualification program

International Nuclear Information System (INIS)

Taylor, R.G.; Worley, C.A.

1999-01-01

One of the provisions of Defense Nuclear Facilities Safety Board (DNFSB) Recommendation 97-2 was that the US Department of Energy (DOE) hor e llipsis Develop and institute ahor e llipsiscourse in criticality and criticality safety hor e llipsis to serve as the foundation for a program of formal qualification of criticality engineers. In response, a draft DOE standard establishing requirements for a formal qualification program for nuclear criticality safety (NCS) engineers has been prepared and is currently in review. The Oak Ridge Y-12 plant implemented a formal training and qualification program for NCS engineers in 1995. The program complies with existing DOE requirements. The program was developed using a performance-based systematic approach to training and is accomplished through structured mentoring where experienced personnel interact with candidates through various learning exercises. Self-study, exercises, and work under instruction are all utilized. The candidate's performance is evaluated by mentors and oral boards. Competency gained through experience at other sites can also be credited. Technical portions of the program are primarily contained in an initial Engineer-in-Training segment and in subsequent task-specific qualifications. The Engineer-in-Training segment exposes the candidate to fundamental NCS concepts through example problems; ensures the initial compliance training requirements are met; and includes readings from applicable procedures, technical documents, and standards. Upon completion of this initial training, candidates proceed to task qualifications. Tasks are defined NCS activities such as operational reviews, criticality safety evaluations, criticality safety computations, criticality accident alarm system (CAAS) evaluations, support for emergency management, etc. Qualification on a task basis serves to break up training into manageable pieces and expedites qualification of candidates to perform specific production activities. The

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Equipment qualification testing methodology research at Sandia Laboratories

International Nuclear Information System (INIS)

Jeppesen, D.

1983-01-01

The Equipment Qualification Research Testing (EQRT) program is an evolutionary outgrowth of the Qualification Testing Evaluation (QTE) program at Sandia. The primary emphasis of the program has been qualification methodology research. The EQRT program offers to the industry a research-oriented perspective on qualification-related component performance, as well as refinements to component testing standards which are based upon actual component testing research

Instructional skills evaluation in nuclear industry training

International Nuclear Information System (INIS)

Mazour, T.J.; Ball, F.M.

1985-11-01

This report provides information to nuclear power plant training managers and their staffs concerning the job performance requirements of instructional personnel to implement prformance-based training programs (also referred to as the Systems Approach Training). The information presented in this report is a compilation of information and lessons learned in the nuclear power industry and in other industries using performance-based training programs. The job performance requirements in this report are presented as instructional skills objectives. The process used to develop the instructional skills objectives is described. Each objective includes an Instructional Skills Statement describing the behavior that is expected and an Instructional Skills Standard describing the skills/knowledge that the individual should possess in order to have achieved mastery. The instructional skills objectives are organized according to the essential elements of the Systems Approach to Training and are cross-referenced to three categories of instructional personnel: developers of instruction, instructors, and instructional managers/supervisors. Use of the instructional skills objectives is demonstrated for reviewing instructional staff training and qualification programs, developing criterion-tests, and reviewing the performance and work products of individual staff members. 22 refs

14 CFR 121.453 - Flight engineer qualifications.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Flight engineer qualifications. 121.453... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Crewmember Qualifications § 121.453 Flight engineer qualifications. (a) No certificate holder may use any person nor may any person serve as a flight engineer on an...

Beliefs and Values about Intra-Operative Teaching and Learning: A Case Study of Surgical Teachers and Trainees

Science.gov (United States)

Ong, Caroline C.; Dodds, Agnes; Nestel, Debra

2016-01-01

Surgeons require advanced psychomotor skills, critical decision-making and teamwork skills. Much of surgical skills training involve progressive trainee participation in supervised operations where case variability, operating team interaction and environment affect learning, while surgical teachers face the key challenge of ensuring patient…

Development of a Laparoscopic Box Trainer Based on Open Source Hardware and Artificial Intelligence for Objective Assessment of Surgical Psychomotor Skills.

Science.gov (United States)

Alonso-Silverio, Gustavo A; Pérez-Escamirosa, Fernando; Bruno-Sanchez, Raúl; Ortiz-Simon, José L; Muñoz-Guerrero, Roberto; Minor-Martinez, Arturo; Alarcón-Paredes, Antonio

2018-05-01

A trainer for online laparoscopic surgical skills assessment based on the performance of experts and nonexperts is presented. The system uses computer vision, augmented reality, and artificial intelligence algorithms, implemented into a Raspberry Pi board with Python programming language. Two training tasks were evaluated by the laparoscopic system: transferring and pattern cutting. Computer vision libraries were used to obtain the number of transferred points and simulated pattern cutting trace by means of tracking of the laparoscopic instrument. An artificial neural network (ANN) was trained to learn from experts and nonexperts' behavior for pattern cutting task, whereas the assessment of transferring task was performed using a preestablished threshold. Four expert surgeons in laparoscopic surgery, from hospital "Raymundo Abarca Alarcón," constituted the experienced class for the ANN. Sixteen trainees (10 medical students and 6 residents) without laparoscopic surgical skills and limited experience in minimal invasive techniques from School of Medicine at Universidad Autónoma de Guerrero constituted the nonexperienced class. Data from participants performing 5 daily repetitions for each task during 5 days were used to build the ANN. The participants tend to improve their learning curve and dexterity with this laparoscopic training system. The classifier shows mean accuracy and receiver operating characteristic curve of 90.98% and 0.93, respectively. Moreover, the ANN was able to evaluate the psychomotor skills of users into 2 classes: experienced or nonexperienced. We constructed and evaluated an affordable laparoscopic trainer system using computer vision, augmented reality, and an artificial intelligence algorithm. The proposed trainer has the potential to increase the self-confidence of trainees and to be applied to programs with limited resources.

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Skills upgrading for newly qualified surgeon: Is the district hospital in ...

African Journals Online (AJOL)

Background: Surgical training in many settings involves acquisition of both knowledge and skill in an environment of adequate caseloads and dedicated supervision. With adequate surgical activity in these settings, the trainee's confidence is boosted to the point of independence. This skill acquisition is a continuous process ...

Materials qualification for nuclear power plants

International Nuclear Information System (INIS)

Braconi, F.

1987-01-01

The supply of materials to be used in the fabrication of components submitted to pressure destined to Atucha II nuclear power plant must fulfill the quality assurance requirements in accordance with the international standards. With the aim of promoting the national participation in CNA II, ENACE had the need to adapt these requirements to the national industry conditions and to the availability of official entities' qualification and inspection. As a uniform and normalized assessment for the qualification of materials did not exist in the country, ENACE had to develop a materials suppliers qualification system. This paper presents a suppliers qualification procedure, its application limits and the alternative procedures for the acceptance of individual stock and for the stock materials purchase. (Author)

Teamwork and error in the operating room: analysis of skills and roles.

Science.gov (United States)

Catchpole, K; Mishra, A; Handa, A; McCulloch, P

2008-04-01

To analyze the effects of surgical, anesthetic, and nursing teamwork skills on technical outcomes. The value of team skills in reducing adverse events in the operating room is presently receiving considerable attention. Current work has not yet identified in detail how the teamwork and communication skills of surgeons, anesthetists, and nurses affect the course of an operation. Twenty-six laparoscopic cholecystectomies and 22 carotid endarterectomies were studied using direct observation methods. For each operation, teams' skills were scored for the whole team, and for nursing, surgical, and anesthetic subteams on 4 dimensions (leadership and management [LM]; teamwork and cooperation; problem solving and decision making; and situation awareness). Operating time, errors in surgical technique, and other procedural problems and errors were measured as outcome parameters for each operation. The relationships between teamwork scores and these outcome parameters within each operation were examined using analysis of variance and linear regression. Surgical (F(2,42) = 3.32, P = 0.046) and anesthetic (F(2,42) = 3.26, P = 0.048) LM had significant but opposite relationships with operating time in each operation: operating time increased significantly with higher anesthetic but decreased with higher surgical LM scores. Errors in surgical technique had a strong association with surgical situation awareness (F(2,42) = 7.93, P skills of the nurses (F(5,1) = 3.96, P = 0.027). Detailed analysis of team interactions and dimensions is feasible and valuable, yielding important insights into relationships between nontechnical skills, technical performance, and operative duration. These results support the concept that interventions designed to improve teamwork and communication may have beneficial effects on technical performance and patient outcome.

Assessment of psychomotor skills acquisition during laparoscopic cholecystectomy courses.

Science.gov (United States)

Hance, Julian; Aggarwal, Rajesh; Moorthy, Krishna; Munz, Yaron; Undre, Shabnam; Darzi, Ara

2005-09-01

Standardized short courses in laparoscopic cholecystectomy aim to teach laparoscopic skills to surgical trainees, although end-of-course assessments of performance remain subjective. The current study aims to objectively assess psychomotor skills acquisition of trainees attending laparoscopic cholecystectomy courses. Thirty-seven junior surgical trainees had their laparoscopic skills assessed before and after attending 1 of 3 separate 2-day courses (A, B, and C), all with identical format. Assessments were comprised of a standardized simulated laparoscopic task, with performance measured using a valid electromagnetic hand-motion tracking device. Overall, trainees made significant improvements in path length (P=.006), number of movements (Ppsychomotor skills on courses. In addition to providing participants with an insight into their skills, these data can be used to demonstrate course efficacy.

Unintended Consequences: How Qualification Constrains Innovation

Science.gov (United States)

Brice, Craig A.

2011-01-01

The development and implementation of new materials and manufacturing processes for aerospace application is often hindered by the high cost and long time span associated with current qualification procedures. The data requirements necessary for material and process qualification are extensive and often require millions of dollars and multiple years to complete. Furthermore, these qualification data can become obsolete for even minor changes to the processing route. This burden is a serious impediment to the pursuit of revolutionary new materials and more affordable processing methods for air vehicle structures. The application of integrated computational materials engineering methods to this problem can help to reduce the barriers to rapid insertion of new materials and processes. By establishing predictive capability for the development of microstructural features in relation to processing and relating this to critical property characteristics, a streamlined approach to qualification is possible. This paper critically examines the advantages and challenges to a modeling-assisted qualification approach for aerospace structural materials. An example of how this approach might apply towards the emerging field of additive manufacturing is discussed in detail.

Establishment of an unrelated umbilical cord blood bank qualification program: ensuring quality while meeting Food and Drug Administration vendor qualification requirements.

Science.gov (United States)

Rabe, Fran; Kadidlo, Diane; Van Orsow, Lisa; McKenna, David

2013-10-01

Qualification of a cord blood bank (CBB) is a complex process that includes evaluation of multiple aspects of donor screening and testing, processing, accreditation and approval by professional cell therapy groups, and results of received cord blood units. The University of Minnesota Medical Center Cell Therapy Laboratory has established a CBB vendor qualification process to ensure the CBB meets established regulatory and quality requirements. The deployed qualification of CBBs is based on retrospective and prospective review of the CBB. Forty-one CBBs were evaluated retrospectively: seven CBBs were disqualified based on failed quality control (QC) results. Eight CBBs did not meet the criteria for retrospective qualification because fewer than 3 cord blood units were received and the CBB was not accredited. As of March 2012, three US and one non-US CBBs have been qualified prospectively. One CBB withdrew from the qualification process after successful completion of the comprehensive survey and subsequent failure of the provided QC unit to pass the minimum criteria. One CBB failed the prospective qualification process based on processing methods that were revealed during the paper portion of the evaluation. A CBB qualification process is necessary for a transplant center to manage the qualification of the large number of CBBs needed to support a umbilical cord blood transplantation program. A transplant center that has utilized cord blood for a number of years before implementation of a qualification process should use a retrospective qualification process along with a prospective process. © 2013 American Association of Blood Banks.

Instrumentation qualification. Seismic qualification of C-E instrumentation equipment. Part One

International Nuclear Information System (INIS)

1977-05-01

A summary of the C-E seismic qualification program utilized to demonstrate the seismic design adequacy of the instrumentation and control equipment used in C-E supplied Nuclear Steam Supply Systems (NSSS) is presented. The report is divided into two parts. Part One includes the equipment seismic requirements and a description of the qualification methods. Part Two lists the specific equipment by nuclear station in which it is used and the equipment test results are summarized in a standard data sheet format to facilitate review. The seismic requirements are based on individual contract commitments with C-E customers and the NRC Standard Review Plan, Section 3.10 ''Seismic Qualification of Category I Instrumentation and Electrical Equipment.'' Equipment is qualified for use in a seismic environment where damage potential to the equipment is less than or equal to that simulated seismic environment to which it has been qualified. The anticipated Safe Shutdown Earthquake (SSE) environment at the inservice location of equipment should be confirmed by each applicant as not exceeding that to which it is qualified

Intensive skills week for military medical students increases technical proficiency, confidence, and skills to minimize negative stress.

Science.gov (United States)

Mueller, Genevieve; Hunt, Bonnie; Wall, Van; Rush, Robert; Molof, Alan; Schoeff, Jonathan; Wedmore, Ian; Schmid, James; Laporta, Anthony

2012-01-01

The effects of stress induced cortisol on learning and memory is well documented in the literature.1-3 Memory and learning are enhanced at low levels while high levels are detrimental. Repetitive training in stressful situations enables management of the stress response4 as demonstrated by the high intensity training military members undergo to prepare for tactical situations. Appropriate management of one?s stress response is critical in the medical field, as the negative effects of stress can potentially hinder life-saving procedures and treatments. This also applies to physicians-in-training as they learn and practice triage, emergency medicine, and surgical skills prior to graduation. Rocky Vista University?s Military Medicine Honor?s Track (MMHT) held a week long high-intensity emergency medicine and surgical Intensive Skills Week (ISW), facilitated by military and university physicians, to advance students? skills and maximize training using the Human Worn Partial Surgical Task Simulator (Cut Suit). The short-term goal of the ISW was to overcome negative stress responses to increase confidence, technical and non-technical knowledge, and skill in surgery and emergency medicine in an effort to improve performance as third-year medical students. The long-term goal was to enhance performance and proficiency in residency and future medical practice. The metrics for the short-term goals were the focus of this pilot study. Results show an increase in confidence and decrease in perceived stress as well as statistically significant improvements in technical and non-technical skills and surgical instrumentation knowledge throughout the week. There is a correlative benefit to physician and non-physician military personnel, especially Special Operations Forces (SOF) medical personnel, from developing and implementing similar training programs when live tissue or cadaver models are unavailable or unfeasible. 2012.

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Nuclear energy electricity technical regulation on the qualification

International Nuclear Information System (INIS)

1995-01-01

It tells the range of application purpose and of the qualification. It describes how to qualify of the class 1 E equipment, which are type test, operating experience, analysis and combined method. Next it deals with qualification procedure, which are specification requirement, requirement of qualification program, type testing, operating experience, analysis and combined qualification, acceptance criteria modification and extension with qualified life, simulated test profiles and document about type test data, operating experience data and extrapolation.

Simulation for ward processes of surgical care.

Science.gov (United States)

Pucher, Philip H; Darzi, Ara; Aggarwal, Rajesh

2013-07-01

The role of simulation in surgical education, initially confined to technical skills and procedural tasks, increasingly includes training nontechnical skills including communication, crisis management, and teamwork. Research suggests that many preventable adverse events can be attributed to nontechnical error occurring within a ward context. Ward rounds represent the primary point of interaction between patient and physician but take place without formalized training or assessment. The simulated ward should provide an environment in which processes of perioperative care can be performed safely and realistically, allowing multidisciplinary assessment and training of full ward rounds. We review existing literature and describe our experience in setting up our ward simulator. We examine the facilities, equipment, cost, and personnel required for establishing a surgical ward simulator and consider the scenario development, assessment, and feedback tools necessary to integrate it into a surgical curriculum. Copyright © 2013 Elsevier Inc. All rights reserved.

Reliability and Validity of 3 Methods of Assessing Orthopedic Resident Skill in Shoulder Surgery.

Science.gov (United States)

Bernard, Johnathan A; Dattilo, Jonathan R; Srikumaran, Uma; Zikria, Bashir A; Jain, Amit; LaPorte, Dawn M

Traditional measures for evaluating resident surgical technical skills (e.g., case logs) assess operative volume but not level of surgical proficiency. Our goal was to compare the reliability and validity of 3 tools for measuring surgical skill among orthopedic residents when performing 3 open surgical approaches to the shoulder. A total of 23 residents at different stages of their surgical training were tested for technical skill pertaining to 3 shoulder surgical approaches using the following measures: Objective Structured Assessment of Technical Skills (OSATS) checklists, the Global Rating Scale (GRS), and a final pass/fail assessment determined by 3 upper extremity surgeons. Adverse events were recorded. The Cronbach α coefficient was used to assess reliability of the OSATS checklists and GRS scores. Interrater reliability was calculated with intraclass correlation coefficients. Correlations among OSATS checklist scores, GRS scores, and pass/fail assessment were calculated with Spearman ρ. Validity of OSATS checklists was determined using analysis of variance with postgraduate year (PGY) as a between-subjects factor. Significance was set at p shoulder approaches. Checklist scores showed superior interrater reliability compared with GRS and subjective pass/fail measurements. GRS scores were positively correlated across training years. The incidence of adverse events was significantly higher among PGY-1 and PGY-2 residents compared with more experienced residents. OSATS checklists are a valid and reliable assessment of technical skills across 3 surgical shoulder approaches. However, checklist scores do not measure quality of technique. Documenting adverse events is necessary to assess quality of technique and ultimate pass/fail status. Multiple methods of assessing surgical skill should be considered when evaluating orthopedic resident surgical performance. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights

Changing existing qualifications into outcomes-based qualifications ...

African Journals Online (AJOL)

Various workshops were facilitated to determine the outcomes of each level of our qualification, B Tech: Policing. This led to the formulation of a purpose statement, exit level outcomes and specific outcomes as well as assessment criteria and the critical outcomes embedded in each level identified. Using the specific ...

Adaptive Virtual Reality Training to Optimize Military Medical Skills Acquisition and Retention.

Science.gov (United States)

Siu, Ka-Chun; Best, Bradley J; Kim, Jong Wook; Oleynikov, Dmitry; Ritter, Frank E

2016-05-01

The Department of Defense has pursued the integration of virtual reality simulation into medical training and applications to fulfill the need to train 100,000 military health care personnel annually. Medical personnel transitions, both when entering an operational area and returning to the civilian theater, are characterized by the need to rapidly reacquire skills that are essential but have decayed through disuse or infrequent use. Improved efficiency in reacquiring such skills is critical to avoid the likelihood of mistakes that may result in mortality and morbidity. We focus here on a study testing a theory of how the skills required for minimally invasive surgery for military surgeons are learned and retained. Our adaptive virtual reality surgical training system will incorporate an intelligent mechanism for tracking performance that will recognize skill deficiencies and generate an optimal adaptive training schedule. Our design is modeling skill acquisition based on a skill retention theory. The complexity of appropriate training tasks is adjusted according to the level of retention and/or surgical experience. Based on preliminary work, our system will improve the capability to interactively assess the level of skills learning and decay, optimizes skill relearning across levels of surgical experience, and positively impact skill maintenance. Our system could eventually reduce mortality and morbidity by providing trainees with the reexperience they need to help make a transition between operating theaters. This article reports some data that will support adaptive tutoring of minimally invasive surgery and similar surgical skills. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

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48 CFR 1553.209 - Contractor qualifications.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Contractor qualifications. 1553.209 Section 1553.209 Federal Acquisition Regulations System ENVIRONMENTAL PROTECTION AGENCY CLAUSES AND FORMS FORMS Prescription of Forms 1553.209 Contractor qualifications. ...

On relaxing the Mangasarian-Fromovitz constraint qualification

Czech Academy of Sciences Publication Activity Database

Kruger, A.Y.; Minchenko, L.; Outrata, Jiří

2014-01-01

Roč. 18, č. 1 (2014), s. 171-189 ISSN 1385-1292 R&D Projects: GA ČR GAP402/12/1309 Institutional support: RVO:67985556 Keywords : Nonlinear programming * Regularity conditions * Constraint qualifications * Lagrange multipliers * Mangasarian–Fromovitz constraint qualification * Constant rank constraint qualification Subject RIV: BA - General Mathematics Impact factor: 0.679, year: 2014 http://library.utia.cas.cz/separaty/2014/MTR/outrata-0426110.pdf

5 CFR 317.502 - Qualifications Review Board certification.

Science.gov (United States)

2010-01-01

... REGULATIONS EMPLOYMENT IN THE SENIOR EXECUTIVE SERVICE Career Appointments § 317.502 Qualifications Review Board certification. (a) A Qualification Review Board (QRB) convened by OPM must certify the executive... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Qualifications Review Board certification...

Nuclear Criticality Safety Department Qualification Program

International Nuclear Information System (INIS)

Carroll, K.J.; Taylor, R.G.; Worley, C.A.

1996-01-01

The Nuclear Criticality Safety Department (NCSD) is committed to developing and maintaining a staff of highly qualified personnel to meet the current and anticipated needs in Nuclear Criticality Safety (NCS) at the Oak Ridge Y-12 Plant. This document defines the Qualification Program to address the NCSD technical and managerial qualification as required by the Y-1 2 Training Implementation Matrix (TIM). This Qualification Program is in compliance with DOE Order 5480.20A and applicable Lockheed Martin Energy Systems, Inc. (LMES) and Y-1 2 Plant procedures. It is implemented through a combination of WES plant-wide training courses and professional nuclear criticality safety training provided within the department. This document supersedes Y/DD-694, Revision 2, 2/27/96, Qualification Program, Nuclear Criticality Safety Department There are no backfit requirements associated with revisions to this document

Appraisal of psychomotor skills of dental students at University Complutense of Madrid.

Science.gov (United States)

de Andrés, Alfonso García; Sánchez, Esperanza; Hidalgo, Juan J; Díaz, María J

2004-02-01

The aim of this study was to evaluate the psychomotor skills of the dental students at University Complutense of Madrid (UCM), using a battery of psychometric tests. The sample comprised 306 students of the 1st, 2nd, 3rd and 4th years of Odontology, who, during the last month of the academic term, took the test on rotation of solid shapes, the Embedded Figures test in its group form (GEFT), the O'Connor Tweezer test, the MacQuarrie test for mechanical ability and the indirect vision test. Before these tests began, some personal data of all students were collected. The results showed some statistically significant correlation between several personal variables (sex, manual dominance and previous skills) and performance in the psychometric tests, although no significant relation was found between these variables and the students' academic qualifications. When comparisons were made between the psychomotor tests and the academic results of the students, significant differences appeared in the tracing and dotting subtests of the MacQuarrie test, whereby those students with higher practical qualifications reached the best punctuation. In the O'Connor Tweezer test, the students who obtained the worst results were those with lower qualifications. These data could serve to detect at an early stage those students who need greater educational support. No relation was found between the GEFT and the indirect vision test.

Surgical virtual reality - highlights in developing a high performance surgical haptic device.

Science.gov (United States)

Custură-Crăciun, D; Cochior, D; Constantinoiu, S; Neagu, C

2013-01-01

Just like simulators are a standard in aviation and aerospace sciences, we expect for surgical simulators to soon become a standard in medical applications. These will correctly instruct future doctors in surgical techniques without there being a need for hands on patient instruction. Using virtual reality by digitally transposing surgical procedures changes surgery in are volutionary manner by offering possibilities for implementing new, much more efficient, learning methods, by allowing the practice of new surgical techniques and by improving surgeon abilities and skills. Perfecting haptic devices has opened the door to a series of opportunities in the fields of research,industry, nuclear science and medicine. Concepts purely theoretical at first, such as telerobotics, telepresence or telerepresentation,have become a practical reality as calculus techniques, telecommunications and haptic devices evolved,virtual reality taking a new leap. In the field of surgery barrier sand controversies still remain, regarding implementation and generalization of surgical virtual simulators. These obstacles remain connected to the high costs of this yet fully sufficiently developed technology, especially in the domain of haptic devices. Celsius.

Using an Individual Procedure Score Before and After the Advanced Surgical Skills Exposure for Trauma Course Training to Benchmark a Hemorrhage-Control Performance Metric.

Science.gov (United States)

Mackenzie, Colin F; Garofalo, Evan; Shackelford, Stacy; Shalin, Valerie; Pugh, Kristy; Chen, Hegang; Puche, Adam; Pasley, Jason; Sarani, Babak; Henry, Sharon; Bowyer, Mark

2015-01-01

Test with an individual procedure score (IPS) to assess whether an unpreserved cadaver trauma training course, including upper and lower limb vascular exposure, improves correct identification of surgical landmarks, underlying anatomy, and shortens time to vascular control. Prospective study of performance of 3 vascular exposure and control procedures (axillary, brachial, and femoral arteries) using IPS metrics by 2 colocated and trained evaluators before and after training with the Advanced Surgical Skills Exposure for Trauma (ASSET) course. IPS, including identification of anatomical landmarks, incisions, underlying structures, and time to completion of each procedure was compared before and after training using repeated measurement models. Audio-video instrumented cadaver laboratory at University of Maryland School of Medicine. A total of 41 second to sixth year surgical residents from surgical programs throughout Mid-Atlantic States who had not previously taken the ASSET course were enrolled, 40 completed the pre- and post-ASSET performance evaluations. After ASSET training, all components of IPS increased and time shortened for each of the 3 artery exposures. Procedure steps performed correctly increased 57%, anatomical knowledge increased 43% and skin incision to passage of a vessel loop twice around the correct vessel decreased by a mean of 2.5 minutes. An overall vascular trauma readiness index, a comprehensive IPS score for 3 procedures increased 28% with ASSET Training. Improved knowledge of surface landmarks and underlying anatomy is associated with increased IPS, faster procedures, more accurate incision placement, and successful vascular control. Structural recognition during specific procedural steps and anatomical knowledge were key points learned during the ASSET course. Such training may accelerate acquisition of specific trauma surgery skills to compensate for shortened training hours, infrequent exposure to major vascular injuries, or when just

Informatics Approach to Improving Surgical Skills Training

Science.gov (United States)

Islam, Gazi

2013-01-01

Surgery as a profession requires significant training to improve both clinical decision making and psychomotor proficiency. In the medical knowledge domain, tools have been developed, validated, and accepted for evaluation of surgeons' competencies. However, assessment of the psychomotor skills still relies on the Halstedian model of…

The correction of skilled athletes' constitution, specializing in bodybuilding in the preparatory period of the annual cycle.

Directory of Open Access Journals (Sweden)

Usychenko Vitalij Viktorovich

2011-09-01

Full Text Available The program of correction of build of highly skilled bodybuilders is developed. In researches took part 17 bodybuilders of high qualification. In examination the judges of international and national category were involved in bodybuilding. The biomechanics monitoring of build of sportsmen is conducted. Practical recommendations are developed in relation to the directed correction of build of highly skilled bodybuilders.

48 CFR 53.209 - Contractor qualifications.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Contractor qualifications. 53.209 Section 53.209 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS FORMS Prescription of Forms 53.209 Contractor qualifications. ...

Equality of employment opportunities for nurses at the point of qualification: an exploratory study.

Science.gov (United States)

Harris, Ruth; Ooms, Ann; Grant, Robert; Marshall-Lucette, Sylvie; Chu, Christine Sek Fun; Sayer, Jane; Burke, Linda

2013-03-01

Securing employment after qualification is of utmost importance to newly qualified nurses to consolidate knowledge and skills. The factors that influence success in gaining this first post are not known. The study aimed to describe the first post gained after qualification in terms of setting, nature of employment contract and geographical distribution and explore the relationship between a range of factors (including ethnicity) and employment at the point of qualification. An exploratory study using structured questionnaires and secondary analysis of data routinely collected by the universities about students and their progress during their course. The study was conducted in eight universities within a large, multicultural city in the UK as part of the 'Readiness for Work' research programme. Eight hundred and four newly qualified nurses who had successfully completed a diploma or degree from one of the universities; a response rate of 77% representing 49% of all graduating students in the study population. Data were collected by self-completed semi-structured questionnaires administered to students at the time of qualification and at three months post-qualification. Routinely collected data from the universities were also collected. Fifty two percent of participants had been offered a job at the point of qualification (85% of those who had applied and been interviewed). Of these, 99% had been offered a nursing post, 88% in the city studied, 67% in the healthcare setting where they had completed a course placement. 44% felt "confident" and 32% "very confident" about their employment prospects. Predictors of employment success included ethnicity, specialty of nursing and university attended. Predictors of confidence and preparedness for job seeking included ethnicity, nursing specialty, gender and grade of degree. Newly qualified nurses from non-White/British ethnic groups were less likely to get a job and feel confident about and prepared for job seeking. This

Ostomy Home Skills Program

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Does previous open surgical experience have any influence on robotic surgery simulation exercises?

Science.gov (United States)

Cumpanas, Alin Adrian; Bardan, Razvan; Ferician, Ovidiu Catalin; Latcu, Silviu Constantin; Duta, Ciprian; Lazar, Fulger Octavian

2017-12-01

Within the last years, there has been a trend in many hospitals to switch their surgical activity from open/laparoscopic procedures to robotic surgery. Some open surgeons have been shifting their activity to robotic surgery. It is still unclear whether there is a transfer of open surgical skills to robotic ones. To evaluate whether such transfer of skills occurs and to identify which specific skills are more significantly transferred from the operative table to the console. Twenty-five volunteers were included in the study, divided into 2 groups: group A (15 participants) - medical students (without any surgical experience in open, laparoscopic or robotic surgery); and group B (10 participants) - surgeons with exclusively open surgical experience, without any previous laparoscopic or robotic experience. Participants were asked to complete 3 robotic simulator console exercises structured from the easiest one (Peg Board) to the toughest one (Sponge Suture). Overall scores for each exercise as well as specific metrics were compared between the two groups. There were no significant differences between overall scores of the two groups for the easiest task. Overall scores were better for group B as the exercises got more complex. For the intermediate and high-difficulty level exercises, most of the specific metrics were better for group B, with the exception of the working master space item. Our results suggest that the open surgical skills transfer to robotic skills, at least for the very beginning of the training process.

Application of operating experience in environmental qualification program

International Nuclear Information System (INIS)

Lee, S.Y.; Wise, R.

2000-01-01

Environmental qualification (EQ) of equipment related to nuclear safety has been carried out in the nuclear community since the 70's. It started with electrical equipment and then expanded to include mechanical equipment. During this evolutionary process, the methods used for EQ have gone through a long period of refinement and clarification. Prior to 1971, qualification for equipment in licensed nuclear power plants was based on the use of electrical components of commonly accepted high industrial quality without the benefit of specific environmental qualification standards. Between 1971 and 1974, most plants used the criteria of IEEE Standard 323-1971 as the basis for demonstrating qualification. Also during this period related 'daughter' standards, mainly by IEEE, became available which addressed qualification for specific equipment items. After July 1974, plants were required to meet the more comprehensive guidelines specified in IEEE Standard 323-1974 and the related 'daughter' standards. IEEE Standard 323-1974 later evolved into IEEE Standard 323-1983. For nuclear power plants built in Ontario during the 70's, i.e. Pickering B and Bruce B, has included the environmental qualification requirements in their respective nuclear safety design guides. It is now recognized that they are not up to the current EQ standards. Darlington, constructed during the 80's, implemented the environmental qualification program in its project. An Environmental Qualification (EQ) Program is now under way in Ontario Power Generation (OPG) to formally implement the Environmental Qualification for Bruce B, Pickering B, and Pickering A and to preserve the Qualification for Darlington G.S. This paper makes a thorough a review of the standard methods used in the past by utilities for environmental qualification. These methods include type testing, analysis, and operating experience. Both type testing and analysis have been clearly defined in standards listed in References [2] to [6] and

Qualification tests for a dosimetry system

International Nuclear Information System (INIS)

Anon.

2005-01-01

The report of qualification tests for personnel dosemeters is detailed. Qualification test for the energy response and the incidence angle is given. The procedure of test is resumed. Different coefficients of conversion used in these tests are given in tables. (N.C.)

48 CFR 253.209 - Contractor qualifications.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Contractor qualifications. 253.209 Section 253.209 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CLAUSES AND FORMS FORMS Prescription of Forms 253.209 Contractor qualifications. ...

Inspection qualification and implementation of ENIQ in Sweden

International Nuclear Information System (INIS)

Zettervall, Tommy

2013-01-01

Many countries are currently considering their approaches to inspection qualification and risk-informed in-service inspection (RI-ISI) and are carefully assessing experience data. In Europe most of the utilities operating nuclear power plants have joined together to form the European Network for Inspection Qualification ENIQ. In practice, qualification can be performed with varying degrees of complexity and cost, varying from capability statement based on existing evidence, through to an extensive qualification consisting of a detailed Technical Justification (TJ) together with open and blind trials on full-scale test blocks. An Inspection Qualification is an investigation and demonstration, which confirm that an inspection system has the ability to solve its specific tasks. The qualification is a Quality Assurance of an inspection system based on documents and practical trials. A reliable inspection system, based on a reliable qualification and correct prerequisites, will reduce total costs for Licensees and increase the credibility of the inspection result. To get such inspection system, which could be valid for many years, it's of necessity to fulfil all included parts in the process. It begins with the Technical Specification from Licensee, where input data and requirements about the actual component are specified. To get an inspection system that could live over time, the Technical Justification is of importance. Finally the test blocks and used simulation techniques play an important part of the final result, and these test blocks together with TJ form the basis for qualification body's decision. (author)

Transferability of laparoscopic skills using the virtual reality simulator.

Science.gov (United States)

Yang, Cui; Kalinitschenko, Uljana; Helmert, Jens R; Weitz, Juergen; Reissfelder, Christoph; Mees, Soeren Torge

2018-03-30

Skill transfer represents an important issue in surgical education, and is not well understood. The aim of this randomized study is to assess the transferability of surgical skills between two laparoscopic abdominal procedures using the virtual reality simulator in surgical novices. From September 2016 to July 2017, 44 surgical novices were randomized into two groups and underwent a proficiency-based basic training consisting of five selected simulated laparoscopic tasks. In group 1, participants performed an appendectomy training on the virtual reality simulator until they reached a defined proficiency. They moved on to the tutorial procedural tasks of laparoscopic cholecystectomy. Participants in group 2 started with the tutorial procedural tasks of laparoscopic cholecystectomy directly. Finishing the training, participants of both groups were required to perform a complete cholecystectomy on the simulator. Time, safety and economy parameters were analysed. Significant differences in the demographic characteristics and previous computer games experience between the two groups were not noted. Both groups took similar time to complete the proficiency-based basic training. Participants in group 1 needed significantly less movements (388.6 ± 98.6 vs. 446.4 ± 81.6; P virtual reality simulator; however, the transfer of cognitive skills is limited. Separate training curricula seem to be necessary for each procedure for trainees to practise task-specific cognitive skills effectively. Mentoring could help trainees to get a deeper understanding of the procedures, thereby increasing the chance for the transfer of acquired skills.

Similarity principles for equipment qualification by experience

International Nuclear Information System (INIS)

Kana, D.D.; Pomerening, D.J.

1988-07-01

A methodology is developed for seismic qualification of nuclear plant equipment by applying similarity principles to existing experience data. Experience data are available from previous qualifications by analysis or testing, or from actual earthquake events. Similarity principles are defined in terms of excitation, equipment physical characteristics, and equipment response. Physical similarity is further defined in terms of a critical transfer function for response at a location on a primary structure, whose response can be assumed directly related to ultimate fragility of the item under elevated levels of excitation. Procedures are developed for combining experience data into composite specifications for qualification of equipment that can be shown to be physically similar to the reference equipment. Other procedures are developed for extending qualifications beyond the original specifications under certain conditions. Some examples for application of the procedures and verification of them are given for certain cases that can be approximated by a two degree of freedom simple primary/secondary system. Other examples are based on use of actual test data available from previous qualifications. Relationships of the developments with other previously-published methods are discussed. The developments are intended to elaborate on the rather broad revised guidelines developed by the IEEE 344 Standards Committee for equipment qualification in new nuclear plants. However, the results also contribute to filling a gap that exists between the IEEE 344 methodology and that previously developed by the Seismic Qualification Utilities Group. The relationship of the results to safety margin methodology is also discussed. (author)

Systematic Reviews in Surgical Decision Making: Unpacking the Data

African Journals Online (AJOL)

The practice of surgery has always involved a process of trying to understand the pathophysiology of surgical conditions and introducing interventions to alter their course. With time, numerous interventions have become available and contemporary surgical practice warrants that surgeons possess skills in utilizing the best ...

Equipment qualification testing - a practical approach

International Nuclear Information System (INIS)

Davies, G.A.; McDougall, R.I.; Poirier, M.P.

1996-01-01

When nuclear safety equipment is credited with a Required Safety Function it must properly perform that function to facilitate safe control and/or shutdown of the plant during a design basis accident. When such equipment is required to be environmentally (EQ) and/or seismically qualified (SQ) for safety related use in CANDU nuclear power plants, the preferred method of qualification is by type testing. The qualification testing process requires that the test specimen equipment be subjected to the aging stressors associated with the normal service conditions that it would experience during it's required qualified (or service) life. Following the aging process, the test specimen is in a condition representative of that in which it would be at the end of its service life in the plant. The test specimen is then subjected to a simulated accident during which it must satisfy performance requirements thereby demonstrating that it can perform its required safety function. The performance requirements specified for the qualification testing must be designed to ensure that satisfactory performance of the safety function is demonstrated during the qualification program. This paper provides descriptions of practical methods used in the deriving and satisfying of relevant performance requirements during the qualification testing of safety related equipment. (author)

Total qualification of class 1E electric equipment

International Nuclear Information System (INIS)

Chauvin, G.

1982-09-01

For nuclear power plant projects in France, Framatome and its partners Electricite de France (EDF) and the Commissariat a l'Energie Atomique (CEA) have responded to the present qualification context by implementing a wide-ranging qualification program to acquire significant organizational and practical experience. The following sections detail Framatome's approach to the activities of an organization mandated to provide a complete spectrum of qualification services. Thorough implementation of a Class 1E electric equipment qualification program by the competent organization or qualifier entails completion of three consecutive steps: 1) program preparation, 2) program implementation, and 3) analysis of test results and conclusion. The qualifier assumes extensive responsibility for each of these steps. The following sections present test facilities used in France to conduct a total qualification program for Class 1E electric equipment

Qualification criteria for persons responsible for radiation protection

International Nuclear Information System (INIS)

Wehner, G

1980-01-01

A survey of the qualification criteria included in the German atomic law (Atomic Energy Act, Radiological Protection Ordinance and X-ray Protection Ordinance) for persons responsible for radiation protection is given. Especially the various activities for which a health physics officer is required, the range of qualification in each case and the way the qualification has to be proved, are pointed out. Also the different guides that are issued to complete the legal requirements are mentioned. The definitions of the term qualification for health physics given in the different guides are cited and it is shown, that the qualification of a healt physics officer has to be based on the three criteria (I) vocational training. (II) professional experience and (III) the necessary knowledge in radiation protection. (orig./HP) [de

Assessment Of Common Surgical Conditions ~ncountered Py cal ...

African Journals Online (AJOL)

on-the-job training by visiting specialists and training at a referral facility as the best method to improve their surgical skills so as to competently deal with major surgical problems in their area. The majority (85%) of the respondents preferred that training should take 6-12 months. Medical officers, supported by periodic visits ...

Ostomy Home Skills Program

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Mastery versus the standard proficiency target for basic laparoscopic skill training: effect on skill transfer and retention.

Science.gov (United States)

Kolozsvari, Nicoleta O; Kaneva, Pepa; Brace, Chantalle; Chartrand, Genevieve; Vaillancourt, Marilou; Cao, Jiguo; Banaszek, Daniel; Demyttenaere, Sebastian; Vassiliou, Melina C; Fried, Gerald M; Feldman, Liane S

2011-07-01

Little evidence exists to guide educators in the best way to implement simulation within surgical skills curricula. This study investigated whether practicing a basic Fundamentals of Laparoscopic Surgery (FLS) simulator task [peg transfer (PT)] facilitates learning a more complex skill [intracorporeal suturing (ICS)] and compared the effect of PT training to mastery with training to the passing level on PT retention and on learning ICS. For this study, 98 surgically naïve subjects were randomized to one of three PT training groups: control, standard training, and overtraining. All the participants then trained in ICS. The learning curves for ICS were analyzed by estimating the learning plateau and rate using nonlinear regression. Skill retention was assessed by retesting participants 1 month after training. The groups were compared using analysis of variance (ANOVA). Effectiveness of skill transfer was calculated using the transfer effectiveness ratio (TER). Data are presented as mean±standard deviation (pstandard, and 23 overtrained subjects). The ICS learning plateau rose with increasing PT training (452±10 vs. 459±10 vs. 467±10; p0.5). The PT training took 20±10 min for standard training and 39±20 min for overtraining (pstandard training group, suggesting that PT overtraining took longer than the time saved on ICS training. For surgically naïve subjects, part-task training with PT alone was associated with slight improvements in the learning curve for ICS. However, overtraining with PT did not improve skill retention, and peg training alone was not an efficient strategy for learning ICS.

Non-technical skills for scrub practitioners.

Science.gov (United States)

McClelland, Guy

2012-12-01

The non-technical skills of situational awareness and the formation of effective interpersonal relationships are essential to enhance surgical outcomes. However, most scrub practitioners demonstrate only tacit awareness of these skills and develop such qualities on an informal basis. Application of non-technical skills may be assessed formally, using a structured framework, to transform normative behaviour and to strengthen barriers against the latent threats that may result from fallible humans working in inadequate organisational systems.

Ostomy Home Skills Program

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Full Text Available ... to Choosing a Surgical Residency Education Modules Practice Management Workshops Patients and Family Patient Education Patient Education ... Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills for Trauma Disaster Management and ...

Ostomy Home Skills Program

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Full Text Available ... Systems Consultation Program Trauma Education Achieving Zero Preventable Deaths Conference Publications and Posters National Trauma System Injury ... Education Trauma Education Trauma Education Achieving Zero Preventable Deaths Trauma Systems Conference Advanced Surgical Skills for Exposure ...

Ostomy Home Skills Program

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Full Text Available ... Safety Resources About the Patient Education Program The Recovery Room Choosing Wisely Educational Programs Educational Programs Educational ... and practice the skills needed for optimal postoperative recovery. The kit supports the entire surgical team with ...

Ostomy Home Skills Program

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Full Text Available JACS Jobs Events Find a Surgeon Patients and Family Contact My Profile Shop ( 0 ) Cart Donate Become ... a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education Patients Medical Professionals Skills ...

Ostomy Home Skills Program

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Full Text Available ... Online Guide to Choosing a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education ... Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills for Trauma Disaster Management and ...

Cognitive training: How can it be adapted for surgical education?

Science.gov (United States)

Wallace, Lauren; Raison, Nicholas; Ghumman, Faisal; Moran, Aidan; Dasgupta, Prokar; Ahmed, Kamran

2017-08-01

There is a need for new approaches to surgical training in order to cope with the increasing time pressures, ethical constraints, and legal limitations being placed on trainees. One of the most interesting of these new approaches is "cognitive training" or the use of psychological processes to enhance performance of skilled behaviour. Its ability to effectively improve motor skills in sport has raised the question as to whether it could also be used to improve surgical performance. The aim of this review is to provide an overview of the current evidence on the use of cognitive training within surgery, and evaluate the potential role it can play in surgical education. Scientific database searches were conducted to identify studies that investigated the use of cognitive training in surgery. The key studies were selected and grouped according to the type of cognitive training they examined. Available research demonstrated that cognitive training interventions resulted in greater performance benefits when compared to control training. In particular, cognitive training was found to improve surgical motor skills, as well as a number of non-technical outcomes. Unfortunately, key limitations restricting the generalizability of these findings include small sample size and conceptual issues arising from differing definitions of the term 'cognitive training'. When used appropriately, cognitive training can be a highly effective supplementary training tool in the development of technical skills in surgery. Although further studies are needed to refine our understanding, cognitive training should certainly play an important role in future surgical education. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Reliable and valid assessment of Lichtenstein hernia repair skills

DEFF Research Database (Denmark)

Carlsen, C G; Lindorff Larsen, Karen; Funch-Jensen, P

2014-01-01

PURPOSE: Lichtenstein hernia repair is a common surgical procedure and one of the first procedures performed by a surgical trainee. However, formal assessment tools developed for this procedure are few and sparsely validated. The aim of this study was to determine the reliability and validity...... of an assessment tool designed to measure surgical skills in Lichtenstein hernia repair. METHODS: Key issues were identified through a focus group interview. On this basis, an assessment tool with eight items was designed. Ten surgeons and surgical trainees were video recorded while performing Lichtenstein hernia...... a significant difference between the three groups which indicates construct validity, p skills can be assessed blindly by a single rater in a reliable and valid fashion with the new procedure-specific assessment tool. We recommend this tool for future assessment...

Emotions in veterinary surgical students

DEFF Research Database (Denmark)

Langebæk, Rikke; Eika, Berit; Pedersen, Lene Tanggaard

2012-01-01

A surgical educational environment is potentially stressful and can negatively affect students' learning. The aim of the present study was to investigate the emotions experienced by veterinary students in relation to their first encounter with live-animal surgery and to identify possible sources...... of positive and negative emotions, respectively. During a Basic Surgical Skills course, 155 veterinary fourth-year students completed a survey. Of these, 26 students additionally participated in individual semi-structured interviews. The results of the study show that students often experienced a combination...

14 CFR 121.434 - Operating experience, operating cycles, and consolidation of knowledge and skills.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Operating experience, operating cycles, and... Qualifications § 121.434 Operating experience, operating cycles, and consolidation of knowledge and skills. (a... position, the operating experience, operating cycles, and the line operating flight time for consolidation...

Perception of Surgical Faculty on the Utility of Modified Thiel Embalmed Cadavers

Directory of Open Access Journals (Sweden)

Ashwini C Appaji

2017-10-01

Full Text Available Introduction: Surgical skills training on low and high fidelity simulators have been in practice for over a decade, but due to the high cost of virtual reality simulators it is beyond the reach of institutions and trainees. Among the simulators, high fidelity simulators such as a suitably prepared human anatomical specimen would give a real feel as if doing the procedure in the living. Hence, having soft, supple cadaver with organoleptic properties is an ideal situation for training by simulation and research. To facilitate the surgical skill training and research, chemical embalming was adopted with modifications of the Thiel method, for cadaver preservation. Aim: The aim of this study was to study the perception of the surgical faculty’s experience on the utility of modified Thiel embalmed cadavers for surgical procedures. Materials and Methods: In this cross-sectional study, a feedback was taken from practicing surgeons of broad and sub specialties such as general surgery, orthopedic surgery, neurosurgery, plastic surgery, pediatric surgery, ophthalmology, ENT, OBG, Transplant surgery (n=54. A 5 point Likert scale questionnaire was used with criteria of measurements like skin color, consistency, odour, differentiation of the layers, approach to the area, joint mobility and suitability for the procedure. Results: The scores ranged from 3.9 to 4.46/5. The participants expressed satisfaction on the cadaver quality on their utility for performance of surgical procedures. They expressed that, such embalmed cadavers would be excellent for learning purpose, surgical skills training in orthopedic procedures like arthroscopy. They felt the joint mobility was good, the consistency was soft and differentiation of layers was good. Some felt the tissues were fragile and would easily give away losing their strength. Conclusion: Thiel embalmed cadavers retain their organoleptic properties and hence facilitate surgical skills training. The thiel embalmed

Safety design guides for environmental qualification for CANDU 9

International Nuclear Information System (INIS)

Lee, Duk Su; Chang, Woo Hyun; Lee, Nam Young; A. C. D. Wright

1996-03-01

This safety design guide describes the safety philosophy and requirements for the environmental qualification of safety related systems and components for CANDU 9. The environmental qualification program identifies the equipments to be qualified and conditions to be used for qualification and provides comprehensive set of documentation to ensure that the qualification is complete and can be maintained for the life of the plant. A summary of the system, components and structures requiring environmental qualification is provided in the table for the guidance of the system design, and this table will be subject to change or confirmation by the environmental qualification program. Also, plant ares subject to harsh environment is provided in the figure. The change status of the regulatory requirements, code and standards should be traced and this safety design guide shall be updated accordingly. 1 tab., 5 figs. (Author) .new

Surgical dummy: a surrogate to live animal in teaching Veterinary ...

African Journals Online (AJOL)

The ethos of the course veterinary surgery is to install core surgical skills at the very start of a ... 2d to 4d nail gauges with large nail head. Cadaver ... Teaching model. Virtual surgery. Dummy. Cadaver. Live animal. Motor skill. -. ++. ++. ++.

Ostomy Home Skills Program

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Full Text Available ... ASE Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical Skills Curriculum Cancer Education Cancer Education Cancer Education Cancer Programs Conference: Learn. Interact. Transform. CoC Events Quality Education Quality Education Quality Education ...

Equipment Qualification Data Base user manual

International Nuclear Information System (INIS)

Decker, Q.R.; Fackrell, L.J.; Fitch, L.R.; Meeky, O.B.

1985-09-01

This manual details the Equipment Qualification Data Base (EQDB), its usage, and contents. The EQDB consists of two files; the Plant Qualification File (PQF) and the Equipment Qualification File (EQF). The PQF contains plant specific environmental data and the EQF contains summaries of various test results. Two data management systems are used to manipulate the data and are discussed in this manual. SAS Institute System 2000 (S2K) is the management system for the PQF and Query Update (QU) is the operating system for the EQF. Each management system contains report writers. These writers and how to use them are discussed in detail in this manual

Solar array qualification through qualified analysis

Science.gov (United States)

Zijdemans, J.; Cruijssen, H. J.; Wijker, J. J.

1991-04-01

To achieve qualification is in general a very expensive exercise. For solar arrays this is done by a dedicated test program through which final qualification is achieved. Due to severe competition on the solar array market, cheaper means are looked for to achieve a qualified product for the customers. One of the methods is to drastically limit the environmental test program and to qualify the solar-array structure against its environmental loads by analysis. Qualification by analysis is possible. The benefits are that a significant amount of development effort can be saved in case such a powerful tool is available. Extensive testing can be avoided thus saving time and money.

The impact of secondary-task type on the sensitivity of reaction-time based measurement of cognitive load for novices learning surgical skills using simulation.

Science.gov (United States)

Rojas, David; Haji, Faizal; Shewaga, Rob; Kapralos, Bill; Dubrowski, Adam

2014-01-01

Interest in the measurement of cognitive load (CL) in simulation-based education has grown in recent years. In this paper we present two pilot experiments comparing the sensitivity of two reaction time based secondary task measures of CL. The results suggest that simple reaction time measures are sensitive enough to detect changes in CL experienced by novice learners in the initial stages of simulation-based surgical skills training.

Acquiring surgical skills: the history of surgical teaching at the University of Sydney 1883-2014.

Science.gov (United States)

Brown, Kilian G M; Storey, Catherine E

2016-06-01

There have been at least 10 major revisions of the medical curriculum since the inauguration of the Faculty of Medicine at the University of Sydney in 1883. This study traced the evolution of the teaching of surgery at our institution by examination of the set curriculum of each period; the expectations of student knowledge in the final examination as well as examining some of the insights provided by past students of their surgical experience through their writings. In the early years, medical graduates were qualified to perform operative surgery without any further training, whereas the modern postgraduate medical curriculum provides students with the basis for further surgical training. © 2016 Royal Australasian College of Surgeons.

A study on factors of dissatisfaction and stress of the blacksmiths resulting from the organizational culture in the surgical instrument industry of India.

Science.gov (United States)

Ghosh, Tirthankar; Das, Banibrata; Gangopadhyay, Somnath

2011-07-01

It is important to understand what motivates workers and the extent to which the organization and other contextual variables satisfy them. The aim of the study was to determine factors of dissatisfaction resulting from the organizational culture among the blacksmiths involved in the surgical instrument industry. Fifty male surgical blacksmiths each of the skilled and unskilled groups of the forging section were selected. Organizational Role Stress Scale was used to measure the individuals' role stress and several forms of conflict within an organization. Also, the organizational culture and personal involvement in an organization was measured among the surgical blacksmiths. The mean score for total role stress for Skilled was 71.7 and for unskilled was 77.2. The most frequent type of organizational culture was reported to be hierarchy, both by skilled and unskilled surgical blacksmiths, followed by market and clan culture. This study shows that the skilled surgical blacksmiths have lower level of stress and conflicts in comparison with unskilled surgical blacksmiths. Both skilled and unskilled surgical blacksmiths estimated their level of personal involvement as low and indicated insufficient involvement in work teams. The satisfaction of the employees with their status and role in the organizational culture was also poor for both skilled and unskilled surgical blacksmiths.

Implementation plans for the Korean certified tumor registrar qualification system.

Science.gov (United States)

Boo, Yoo-Kyung; Lim, Hyun-Sook; Won, Young-Joo

2014-01-01

Cancer registration data is used to understand the nation's cancer burden, and to provide significant baseline data for cancer control efforts, as well as, research on cancer incidence, mortality, survival, and prevalence. A system that approves, assesses, and manages the qualification of specialists, responsible for performing cancer registration, has not been developed in Korea. This study presents ways to implement a certification system designed for the qualification of tumor registrars in Korea. Requirements for implementing a certified tumor registrar qualification system were determined by reviewing the system for establishing qualifications in Korea and the American qualification system via the National Cancer Registrars Association (NCRA). Moreover, a survey was conducted on Korean medical records administrators, who had taken the U.S. Certified Tumor Registrar (CTR) examination, in order to review their opinions regarding these requirements. This study verified the feasibility of a qualification examination based on the opinions of CTR specialists by determining the following: items, and the associated ratings, of the qualifications necessary to register individuals as certified tumor registrars in a private qualification system; status of human resources required for the examination or training processes; plans regarding the organization needed for management, and operation of qualifications, examination standards, subject areas, examination methods, examination qualifications, or education and training programs. The implementation of a certified tumor registrar qualification system will lead to enhanced job competency for specialists and a qualitative improvement of cancer registration data. It will also reliably foster human resources that will lay the groundwork needed to establish scientific and reasonable national cancer management policies.

Malaysian qualification and certification scheme for NDT personnel: achievements and steps toward harmonization in accordance with ISO 9712

International Nuclear Information System (INIS)

Abd Nassir Ibrahim

2001-01-01

Development of skilled manpower in the field of NDT is one the most important component that must be given priority in order to ensure the sustainability of the technology in any country. In this respect ISO 9712 provides a guideline on the implementation of HRD program in the field of NDT that involved training, qualification and certification processes. ISO 9712 was developed with the hope that it provided a guideline for the establishment of qualification and certification scheme acceptable to the whole NDT community throughout the world. With this guideline, the process of qualification and certification of NDT personnel of different countries throughout the world will be harmonized. In Malaysia, such a scheme was established in 1985 with the National Vocational Training Council was appointed as the Certification Body. Although the scheme was developed based on ISO 97121 some local requirement were included which made the scheme somewhat deviated from the ISO practices. Twenty years after it was first implemented, the scheme was revised and amended to ensure that requirements of ISO 9712 are complied. The new scheme was revised and approved in April 2000 and was implemented for the first time in November radiography level 1 examination. (Author)

A primer on standards setting as it applies to surgical education and credentialing.

Science.gov (United States)

Cendan, Juan; Wier, Daryl; Behrns, Kevin

2013-07-01

Surgical technological advances in the past three decades have led to dramatic reductions in the morbidity associated with abdominal procedures and permanently altered the surgical practice landscape. Significant changes continue apace including surgical robotics, natural orifice-based surgery, and single-incision approaches. These disruptive technologies have on occasion been injurious to patients, and high-stakes assessment before adoption of new technologies would be reasonable. We reviewed the drivers for well-established psychometric techniques available for the standards-setting process. We present a series of examples that are relevant in the surgical domain including standards setting for knowledge and skills assessments. Defensible standards for knowledge and procedural skills will likely become part of surgical clinical practice. Understanding the methodology for determining standards should position the surgical community to assist in the process and lead within their clinical settings as standards are considered that may affect patient safety and physician credentialing.

Approach to customer qualification of the BNFL Sellafield Mox Plant

International Nuclear Information System (INIS)

Sullivan, P.

2003-01-01

BNFL started plutonium commissioning of its Sellafield MOX Plant (SMP) in December 2001, with the first MOX pellets being produced in May 2002. SMP was designed to manufacture a range of both PWR and BWR fuel types for a number of different customers. During commissioning and early MOX fuel manufacturing BNFL has been demonstrating its ability to both automatically manufacture and inspect MOX fuel to meet the requirements of different customers' specifications and fuel types. The qualification project consisted of common and project specific qualification. Common qualification was carried out to demonstrate BNFL could meet several customers' requirements during the same qualification test. Project specific qualification was carried out for one customer only as the fabrication or inspection equipment was specific to their fuel type. An example is the fuel assembly process. The reasons for BNFL carrying out common qualification were: - Develop a common qualified process to meet different customer specifications. - Minimise future qualifications prior to starting future fuel campaigns. - Ensure BNFL understands and effectively manages different customer requirements in SMP. BNFL has approached qualification of SMP systematically. Firstly the inspection system was qualified, and once completed the inspection system was then used in the qualification of the manufacturing process. (orig.)

49 CFR 214.351 - Training and qualification of flagmen.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Training and qualification of flagmen. 214.351... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD WORKPLACE SAFETY Roadway Worker Protection § 214.351 Training and qualification of flagmen. (a) The training and qualification for roadway workers assigned the...

Ostomy Home Skills Program

Medline Plus

Full Text Available ... in Residence Clinical Trials Methods Course Health Services Research Methods Course Surgeon Specific Registry Trauma Education Trauma Education Trauma Education Advanced Surgical Skills for Exposure in Trauma Advanced Trauma Life Support ... Quality Program Initiatives Communications to the Profession ...

Surgical simulators in cataract surgery training.

Science.gov (United States)

Sikder, Shameema; Tuwairqi, Khaled; Al-Kahtani, Eman; Myers, William G; Banerjee, Pat

2014-02-01

Virtual simulators have been widely implemented in medical and surgical training, including ophthalmology. The increasing number of published articles in this field mandates a review of the available results to assess current technology and explore future opportunities. A PubMed search was conducted and a total of 10 articles were reviewed. Virtual simulators have shown construct validity in many modules, successfully differentiating user experience levels during simulated phacoemulsification surgery. Simulators have also shown improvements in wet-lab performance. The implementation of simulators in the residency training has been associated with a decrease in cataract surgery complication rates. Virtual reality simulators are an effective tool in measuring performance and differentiating trainee skill level. Additionally, they may be useful in improving surgical skill and patient outcomes in cataract surgery. Future opportunities rely on taking advantage of technical improvements in simulators for education and research.

On safety 1E qualification of electrical equipment for nuclear power stations

International Nuclear Information System (INIS)

Segarceanu, D.; Geambasu, C.; Avramescu, M.

1995-01-01

Electrical equipment and systems for the emergency shutdown of a nuclear reactor are qualified according to safety class 1E. Methods of qualification meeting the requirements should be used, either individually or in combination include, type-test qualification, qualification by operating experience, qualification by analysis, combined qualification. These methods qualification principles, procedures and documents are discussed. (N.T.). 1 fig

Social Media: Changing the Paradigm for Surgical Education.

Science.gov (United States)

Petrucci, Andrea M; Chand, Manish; Wexner, Steven D

2017-09-01

The role of social media (SoMe) in surgical education is emerging as a tool that augments and complements traditional learning. As SoMe usage has steadily increased in our personal and professional lives, it is no surprise that it has permeated into surgical education. Different SoMe sites offer distinct platforms from which knowledge can be transmitted, while catering to various learning styles. The purpose of this review is to outline the various SoMe platforms and their use in surgical education. Moreover, it will discuss their effectiveness in teaching and learning surgical knowledge and skills as well as other potential roles SoMe has to offer to improve surgical education.

Surgical Education's 100 Most Cited Articles: A Bibliometric Analysis.

Science.gov (United States)

Matthews, Alexander H; Abdelrahman, Tarig; Powell, Arfon G M T; Lewis, Wyn G

2016-01-01

Bibliometric analysis highlights the key topics and publications, which have shaped surgical education. Here, the 100 most cited articles in the arena of surgical education were analyzed. Thomson Reuters Web of Science was interrogated using the keyword search terms "surgery" and ("learning" or "skills" or "competence" or "assessment" or "training" or "procedure-based assessments" or "performance" or "technical skills" or "curriculum" or "education" or "mentoring"] to identify all English language full articles, and the 100 most cited articles were analyzed by topic, journal, author, year, institution, and country of origin. A total of 403,733 eligible articles were returned and the median citation number was 164 (range: 107-1018). The most cited article (by Seymour, Yale University School of Medicine, Annals of Surgery, 1018 citations) focused on the use of virtual reality surgical simulation training. Annals of Surgery published the highest number of articles and received the most citations (n = 16, 3715 citations). The countries with the greatest number of publications were the USA (n = 45), Canada (n = 19), and the UK (n = 18). The commonest topics included simulation (n = 45) and assessment of clinical competence (n = 40). Surgical skill acquisition and assessment was the area of focus of 85% of the most cited contemporary articles, and this study provides the most cited references, serving as a guide as to what makes a citable published work in the field of surgical education. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Prior video game exposure does not enhance robotic surgical performance.

Science.gov (United States)

Harper, Jonathan D; Kaiser, Stefan; Ebrahimi, Kamyar; Lamberton, Gregory R; Hadley, H Roger; Ruckle, Herbert C; Baldwin, D Duane

2007-10-01

Prior research has demonstrated that counterintuitive laparoscopic surgical skills are enhanced by experience with video games. A similar relation with robotic surgical skills has not been tested. The purpose of this study was to determine whether prior video-game experience enhances the acquisition of robotic surgical skills. A series of 242 preclinical medical students completed a self-reported video-game questionnaire detailing the frequency, duration, and peak playing time. The 10 students with the highest and lowest video-game exposure completed a follow-up questionnaire further quantifying video game, sports, musical instrument, and craft and hobby exposure. Each subject viewed a training video demonstrating the use of the da Vinci surgical robot in tying knots, followed by 3 minutes of proctored practice time. Subjects then tied knots for 5 minutes while an independent blinded observer recorded the number of knots tied, missed knots, frayed sutures, broken sutures, and mechanical errors. The mean playing time for the 10 game players was 15,136 total hours (range 5,840-30,000 hours). Video-game players tied fewer knots than nonplayers (5.8 v 9.0; P = 0.04). Subjects who had played sports for at least 4 years had fewer mechanical errors (P = 0.04), broke fewer sutures (P = 0.01), and committed fewer total errors (P = 0.01). Similarly, those playing musical instruments longer than 5 years missed fewer knots (P = 0.05). In the extremes of video-game experience tested in this study, game playing was inversely correlated with the ability to learn robotic suturing. This study suggests that advanced surgical skills such as robotic suturing may be learned more quickly by athletes and musicians. Prior extensive video-game exposure had a negative impact on robotic performance.

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.

The effects of fatigue on robotic surgical skill training in Urology residents.

Science.gov (United States)

Mark, James R; Kelly, Douglas C; Trabulsi, Edouard J; Shenot, Patrick J; Lallas, Costas D

2014-09-01

This study reports on the effect of fatigue on Urology residents using the daVinci surgical skills simulator (dVSS). Seven Urology residents performed a series of selected exercises on the dVSS while pre-call and post-call. Prior to dVSS performance a survey of subjective fatigue was taken and residents were tested with the Epworth Sleepiness Scale (ESS). Using the metrics available in the dVSS software, the performance of each resident was evaluated. The Urology residents slept an average of 4.07 h (range 2.5-6 h) while on call compared to an average of 5.43 h while not on call (range 3-7 h, p = 0.08). Post-call residents were significantly more likely to be identified as fatigued by the Epworth Sleepiness Score than pre-call residents (p = 0.01). Significant differences were observed in fatigued residents performing the exercises, Tubes and Match Board 2 (p = 0.05, 0.02). Additionally, there were significant differences in the total number of critical errors during the training session (9.29 vs. 3.14, p = 0.04). Fatigue in post-call Urology residents leads to poorer performance on the dVSS simulator. The dVSS may become a useful instrument in the education of fatigued residents and a tool to identify fatigue in trainees.

Ostomy Home Skills Program

Medline Plus

Full Text Available ... Workforce Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative ... supports the entire surgical team with quality, comprehensive education. The ... A booklet with information on the operation, home skills such as emptying ...

Surgeons' and trainees' perceived self-efficacy in operating theatre non-technical skills.

Science.gov (United States)

Pena, G; Altree, M; Field, J; Thomas, M J W; Hewett, P; Babidge, W; Maddern, G J

2015-05-01

An important factor that may influence an individual's performance is self-efficacy, a personal judgement of capability to perform a particular task successfully. This prospective study explored newly qualified surgeons' and surgical trainees' self-efficacy in non-technical skills compared with their non-technical skills performance in simulated scenarios. Participants undertook surgical scenarios challenging non-technical skills in two simulation sessions 6 weeks apart. Some participants attended a non-technical skills workshop between sessions. Participants completed pretraining and post-training surveys about their perceived self-efficacy in non-technical skills, which were analysed and compared with their performance in surgical scenarios in two simulation sessions. Change in performance between sessions was compared with any change in participants' perceived self-efficacy. There were 40 participants in all, 17 of whom attended the non-technical skills workshop. There was no significant difference in participants' self-efficacy regarding non-technical skills from the pretraining to the post-training survey. However, there was a tendency for participants with the highest reported self-efficacy to adjust their score downwards after training and for participants with the lowest self-efficacy to adjust their score upwards. Although there was significant improvement in non-technical skills performance from the first to second simulation sessions, a correlation between participants' self-efficacy and performance in scenarios in any of the comparisons was not found. The results suggest that new surgeons and surgical trainees have poor insight into their non-technical skills. Although it was not possible to correlate participants' self-belief in their abilities directly with their performance in a simulation, in general they became more critical in appraisal of their abilities as a result of the intervention. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

Guidelines for seismic qualification by experience in ALWRs

International Nuclear Information System (INIS)

Bandyopadhyay, K.K.

1994-01-01

The methodologies and acceptance criteria for seismic qualification of equipment are provided in IEEE Std. 344 endorsed by the Nuclear Regulatory Commission (NRC) in the Standard Review Plan. The IEEE Standard allows seismic qualification by use of the similarity analysis method. Data available from past earthquake events or vibration tests can be used in this regard. The nuclear industry has collected a vast amount of earthquake experience and test data in the last decade, and is planning to use it for seismic qualification of equipment in advanced light water reactor (ALWR) plants. This paper discusses the existing data bases including their limitations and describes the ways these data bases can be used for equipment qualification in ALWR plants

Guidelines for seismic qualification by experience in ALWRs

International Nuclear Information System (INIS)

Bandyopadhyay, K.K.

1993-01-01

The methodologies and acceptance criteria for seismic qualification of equipment are provided in IEEE Std. 344 endorsed by the Nuclear Regulatory Commission (NRC) in the Standard Review Plan. The IEEE Standard allows seismic qualification by use of the similarity analysis method. Data available from past earthquake events or vibration tests can be used in this regard. The nuclear industry has collected a vast amount of earthquake experience and test data in the last decade, and is planning to use it for seismic qualification of equipment in advanced light water reactor (ALWR) plants. This paper discusses the existing data bases including their limitations and describes the ways these data bases can be used for equipment qualification in ALWR plants

A study on factors of dissatisfaction and stress of the blacksmiths resulting from the organizational culture in the surgical instrument industry of India

Directory of Open Access Journals (Sweden)

Tirthankar Ghosh

2011-01-01

Full Text Available Background: It is important to understand what motivates workers and the extent to which the organization and other contextual variables satisfy them. The aim of the study was to determine factors of dissatisfaction resulting from the organizational culture among the blacksmiths involved in the surgical instrument industry. Materials and Methods: Fifty male surgical blacksmiths each of the skilled and unskilled groups of the forging section were selected. Organizational Role Stress Scale was used to measure the individuals′ role stress and several forms of conflict within an organization. Also, the organizational culture and personal involvement in an organization was measured among the surgical blacksmiths. Results: The mean score for total role stress for Skilled was 71.7 and for unskilled was 77.2. The most frequent type of organizational culture was reported to be hierarchy, both by skilled and unskilled surgical blacksmiths, followed by market and clan culture. Conclusion: This study shows that the skilled surgical blacksmiths have lower level of stress and conflicts in comparison with unskilled surgical blacksmiths. Both skilled and unskilled surgical blacksmiths estimated their level of personal involvement as low and indicated insufficient involvement in work teams. The satisfaction of the employees with their status and role in the organizational culture was also poor for both skilled and unskilled surgical blacksmiths.

Safety review for seismic qualification on nuclear power plant equipment

International Nuclear Information System (INIS)

Fang Qingxian

1995-01-01

The standards and requirements for seismic qualification of nuclear power plant's component have been fully addressed, including the scope of seismic qualification, the approach and the method of common seismic qualification, the procedure of the seismic tests, and the criteria for the seismic qualification review. The problems discovered in the safety review and the solution for these problems and some other issues are also discussed

Evaluation of multi-professional obstetric skills training for postpartum hemorrhage

DEFF Research Database (Denmark)

Markova, Veronika; Sørensen, Jette Led; Holm, Charlotte

2012-01-01

To evaluate the effect of multi-professional obstetric skills training on the incidence of postpartum hemorrhage (PPH) indicated by red blood cell (RBC) transfusion and time delay in surgical interventions before, during, and after implementation of the training.......To evaluate the effect of multi-professional obstetric skills training on the incidence of postpartum hemorrhage (PPH) indicated by red blood cell (RBC) transfusion and time delay in surgical interventions before, during, and after implementation of the training....

Does simulation-based training facilitate the integration of human anatomy with surgery? A report of a novel Surgical Anatomy Course.

Science.gov (United States)

Torres, K; Denisow-Pietrzyk, M; Pietrzyk, Ł; Maciejewski, R; Torres, A

2018-01-01

Knowledge of gross anatomy, as a basic core subject, is fundamental for medical students and essential to medical practitioners, particularly for those intending a surgical career. However, both medical students and clinical teachers have found a significant gap in teaching basic sciences and the transition into clinical skills. The authors present a Surgical Anatomy Course developed to teach the anatomical basis of surgical procedures with particular emphasis on laparo-scopic skills while incorporating medical simulation. An evaluation of the students' satisfaction of the Surgical Anatomy Course was completed using a mix of multiple choice and open-ended questions, and a six-point Likert Scale. Questions were asked about the students' perceived improvement in surgical and laparoscopic skills. Manual skills were assessed using a laparoscopic simulator. Both evaluation of the course structure and the general impression of the course were positive. Most students believed the course should be an integral part of a modern curriculum. The course supported the traditional surgical classes and improved anatomical knowledge and strengthened students' confidentiality and facilitated understanding and taking surgical rotations. A medical course combining the practical learning of anatomy and surgical-based approaches will bring out the best from the students. Medical students positively evaluated the Surgical Anatomy Course as useful and benefi-cial regarding understanding anatomical structure and relationship necessary for further surgical education. (Folia Morphol 2018; 77, 2: 279-285).

Systematic Review of Patient-Specific Surgical Simulation: Toward Advancing Medical Education.

Science.gov (United States)

Ryu, Won Hyung A; Dharampal, Navjit; Mostafa, Ahmed E; Sharlin, Ehud; Kopp, Gail; Jacobs, William Bradley; Hurlbert, Robin John; Chan, Sonny; Sutherland, Garnette R

Simulation-based education has been shown to be an effective tool to teach foundational technical skills in various surgical specialties. However, most of the current simulations are limited to generic scenarios and do not allow continuation of the learning curve beyond basic technical skills to prepare for more advanced expertise, such as patient-specific surgical planning. The objective of this study was to evaluate the current medical literature with respect to the utilization and educational value of patient-specific simulations for surgical training. We performed a systematic review of the literature using Pubmed, Embase, and Scopus focusing on themes of simulation, patient-specific, surgical procedure, and education. The study included randomized controlled trials, cohort studies, and case-control studies published between 2005 and 2016. Two independent reviewers (W.H.R. and N.D) conducted the study appraisal, data abstraction, and quality assessment of the studies. The search identified 13 studies that met the inclusion criteria; 7 studies employed computer simulations and 6 studies used 3-dimensional (3D) synthetic models. A number of surgical specialties evaluated patient-specific simulation, including neurosurgery, vascular surgery, orthopedic surgery, and interventional radiology. However, most studies were small in size and primarily aimed at feasibility assessments and early validation. Early evidence has shown feasibility and utility of patient-specific simulation for surgical education. With further development of this technology, simulation-based education may be able to support training of higher-level competencies outside the clinical settingto aid learners in their development of surgical skills. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A novel virtual reality simulation for hemostasis in a brain surgical cavity: perceived utility for visuomotor skills in current and aspiring neurosurgery residents.

Science.gov (United States)

Gasco, Jaime; Patel, Achal; Luciano, Cristian; Holbrook, Thomas; Ortega-Barnett, Juan; Kuo, Yong-Fang; Rizzi, Silvio; Kania, Patrick; Banerjee, Pat; Roitberg, Ben Z

2013-12-01

To understand the perceived utility of a novel simulator to improve operative skill, eye-hand coordination, and depth perception. We used the ImmersiveTouch simulation platform (ImmersiveTouch, Inc., Chicago, Illinois, USA) in two U.S. Accreditation Council for Graduate Medical Education-accredited neurosurgical training programs: the University of Chicago and the University of Texas Medical Branch. A total of 54 trainees participated in the study, which consisted of 14 residents (group A), 20 senior medical students who were neurosurgery candidates (group B), and 20 junior medical students (group C). The participants performed a simulation task that established bipolar hemostasis in a virtual brain cavity and provided qualitative feedback regarding perceived benefits in eye-hand coordination, depth perception, and potential to assist in improving operating skills. The perceived ability of the simulator to positively influence skills judged by the three groups: group A, residents; group B, senior medical students; and group C, junior medical students was, respectively, 86%, 100%, and 100% for eye-hand coordination; 86%, 100%, and 95% for depth perception; and 79%, 100%, and 100% for surgical skills in the operating room. From all groups, 96.2% found the simulation somewhat or very useful to improve eye-hand coordination, and 94% considered it beneficial to improve depth perception and operating room skills. This simulation module may be suitable for resident training, as well as for the development of career interest and skill acquisition; however, validation for this type of simulation needs to be further developed. Copyright © 2013 Elsevier Inc. All rights reserved.

Training situational awareness to reduce surgical errors in the operating room

NARCIS (Netherlands)

Graafland, M.; Schraagen, J.M.C.; Boermeester, M.A.; Bemelman, W.A.; Schijven, M.P.

2015-01-01

Background: Surgical errors result from faulty decision-making, misperceptions and the application of suboptimal problem-solving strategies, just as often as they result from technical failure. To date, surgical training curricula have focused mainly on the acquisition of technical skills. The aim

Reaction Qualifications Revisited

DEFF Research Database (Denmark)

Lippert-Rasmussen, Kasper

2009-01-01

to a person's effectiveness by causing a favourable reaction in customers, co-workers etc. (for short: recipients) - are involved, this assumption is false. Building on work by Wertheimer, Mason, and Miller, this paper proposes an account of the reaction qualifications that count, from the point of view...... preferences, recipients should not respond to the applicant actually hired on the basis of their (the recipients') racial preferences. My account decomposes the meritocratic ideal into four separate norms, one of which applies to recipients rather than to selectors. Finally, it defends the view that reaction...... qualifications based on antimeritocratic reactions, while not unproblematic, are not entirely irrelevant from the point of view of merit. Notably, selectors need not discount them when no one - including the targets of the objectionable preferences - is unfairly disadvantaged. Because not all problematic...

QUALIFICATIONS FRAMEWORKS FOR LIFELONG LEARNING CONQUERING THE WORLD?

Directory of Open Access Journals (Sweden)

Arjen Deij

2014-01-01

Full Text Available The paper reveals the international prospects of developing and spreading the qualifications frameworks across the globe. It introduces the key terms and concepts related to the given issue, and examines both the benefits and challenges of qualifications frameworks implementation. The author looks into the origins and causes of the worldwide interest in qualifications framework application, and gives the overview of related recent publications and their conclusions to reinforce the provided argumentation.

Qualification of safety-related valve actuators

International Nuclear Information System (INIS)

Anon.

1981-01-01

This Standard describes the qualification of all types of power-driven valve actuators, including damper actuators, for safety-related functions in nuclear power generating stations. It may also be used to separately qualify actuator components. This Standard establishes the minimum requirements for, and guidance regarding, the methods and procedures for qualification of all safety-related functions of power-driven valve actuators

LTP fibre injector qualification and status

International Nuclear Information System (INIS)

Bogenstahl, J; Cunningham, L; Fitzsimons, E D; Hough, J; Killow, C J; Perreur-Lloyd, M; Robertson, D; Rowan, S; Ward, H

2009-01-01

This paper presents the current state of the LISA Technology Package (LTP) fibre injector qualification project in terms of vibration and shock tests. The fibre injector is a custom built part and therefore must undergo a full space qualification process. The mounting structure and method for sinusoidal vibration and random vibration tests as well as shock tests will be presented. Furthermore a proposal will be presented to use the fibre injector pair qualification model to build an optical prototype bench. The optical prototype bench is a full-scale model of the flight model. It will be used for development and rehearsal of all the assembly stages of the flight model and will provide an on-ground simulator for investigation as an updated engineering model.

Get SET: aligning anatomy demonstrator programmes with Surgical Education and Training selection criteria.

Science.gov (United States)

Rhodes, Danielle; Fogg, Quentin A; Lazarus, Michelle D

2018-05-01

Prevocational doctors aspiring to surgical careers are commonly recruited as anatomy demonstrators for undergraduate and graduate medical programmes. Entry into Surgical Education and Training (SET) is highly competitive and a unique opportunity exists to align anatomy demonstrator programmes with the selection criteria and core competencies of SET programmes. This study used a qualitative approach to (i) determine what criteria applicants for SET are assessed on and (ii) identify criteria that could be aligned with and enhanced by an anatomy demonstrator programme. The selection guidelines of all nine surgical specialties for the 2017 intake of SET trainees were analysed using qualitative content analysis methodology. The Royal Australasian College of Surgeons adopted a holistic approach to trainee selection that assessed both discipline-specific and discipline-independent skills. Qualitative content analysis identified eight categories of key selection criteria: medical expertise, scholarly activity, professional identity, interpersonal skills, integrity, self-management, insight and self-awareness and community involvement. The structured curriculum vitae was heavily weighted towards discipline-specific skills, such as medical expertise and scholarly activity. Insufficient information was available to determine the weighting of selection criteria assessed by the structured referee reports or interviews. Anatomy demonstrator programmes provide prevocational doctors with unique opportunities to develop surgical skills and competencies in a non-clinical setting. Constructively aligned anatomy demonstrator programmes may be particularly beneficial for prevocational doctors seeking to improve their anatomical knowledge, teaching skills or scholarly activity. © 2017 Royal Australasian College of Surgeons.

Qualification of software and hardware

International Nuclear Information System (INIS)

Gossner, S.; Schueller, H.; Gloee, G.

1987-01-01

The qualification of on-line process control equipment is subdivided into three areas: 1) materials and structural elements; 2) on-line process-control components and devices; 3) electrical systems (reactor protection and confinement system). Microprocessor-aided process-control equipment are difficult to verify for failure-free function owing to the complexity of the functional structures of the hardware and to the variety of the software feasible for microprocessors. Hence, qualification will make great demands on the inspecting expert. (DG) [de

Background information for NDT qualification of Finnish disposal canisters of spent fuel

International Nuclear Information System (INIS)

Sarkimo, M.; Pitkaenen, J.

2013-12-01

This report presents a review to basic concepts, which are applied in the qualification of non-destructive testing (NDT) techniques. The qualification systems developed and used in some countries are briefly described in the beginning of the report. Anyway the report mainly discusses the qualification practices applied in the Finnish nuclear industry. The Finnish Radiation and Nuclear Safety Authority (STUK) in the YVL Guide 3.8 define the Finnish qualification approach applied for the in-service inspections. The principles presented in this document follow the views of the international organisations: Nuclear Regulator Working Group (NRWG) and European Network for Inspection and Qualification (ENIQ). For the practical qualification work a national guideline is established using so called SP-documents that include specific rules and instructions for execution of qualifications in accordance with YVL Guide 3.8 principles. Altogether the Finnish qualification system can be seen very well to follow the European (ENIQ) methodology. The report discusses several qualification terms and documents. Thus the normally necessary tasks and parts of a qualification are described. The qualification can be seen as a project that includes several tasks, which will be performed by different parties. Enough resources and time should be reserved for the planning and control of a qualification project to ensure its fluent progress. Some tasks are discussed in the report taking into account the situation in the qualification cases that are seen to be linked to the inspections of disposal canisters of spent fuel. (orig.)

Background information for NDT qualification of Finnish disposal canisters of spent fuel

Energy Technology Data Exchange (ETDEWEB)

Sarkimo, M. [VTT Technical Research Centre of Finland, Espoo (Finland); Pitkaenen, J.

2013-12-15

This report presents a review to basic concepts, which are applied in the qualification of non-destructive testing (NDT) techniques. The qualification systems developed and used in some countries are briefly described in the beginning of the report. Anyway the report mainly discusses the qualification practices applied in the Finnish nuclear industry. The Finnish Radiation and Nuclear Safety Authority (STUK) in the YVL Guide 3.8 define the Finnish qualification approach applied for the in-service inspections. The principles presented in this document follow the views of the international organisations: Nuclear Regulator Working Group (NRWG) and European Network for Inspection and Qualification (ENIQ). For the practical qualification work a national guideline is established using so called SP-documents that include specific rules and instructions for execution of qualifications in accordance with YVL Guide 3.8 principles. Altogether the Finnish qualification system can be seen very well to follow the European (ENIQ) methodology. The report discusses several qualification terms and documents. Thus the normally necessary tasks and parts of a qualification are described. The qualification can be seen as a project that includes several tasks, which will be performed by different parties. Enough resources and time should be reserved for the planning and control of a qualification project to ensure its fluent progress. Some tasks are discussed in the report taking into account the situation in the qualification cases that are seen to be linked to the inspections of disposal canisters of spent fuel. (orig.)

48 CFR 1437.7001 - Contractor qualification requirements.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Contractor qualification requirements. 1437.7001 Section 1437.7001 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR... Contractor qualification requirements. (a) Prior to award of a contract for real property appraisal services...

Can the learning of laparoscopic skills be quantified by the measurements of skill parameters performed in a virtual reality simulator?

Directory of Open Access Journals (Sweden)

Natascha Silva Sandy

2013-06-01

Full Text Available Purpose To ensure patient safety and surgical efficiency, much emphasis has been placed on the training of laparoscopic skills using virtual reality simulators. The purpose of this study was to determine whether laparoscopic skills can be objectively quantified by measuring specific skill parameters during training in a virtual reality surgical simulator (VRSS. Materials and Methods Ten medical students (with no laparoscopic experience and ten urology residents (PGY3-5 with limited laparoscopic experience were recruited to participate in a ten-week training course in basic laparoscopic skills (camera, cutting, peg transfer and clipping skills on a VRSS. Data were collected from the training sessions. The time that individuals took to complete each task and the errors that they made were analyzed independently. Results The mean time that individuals took to complete tasks was significantly different between the groups (p < 0.05, with the residents being faster than the medical students. The residents' group also completed the tasks with fewer errors. The majority of the subjects in both groups exhibited a significant improvement in their task completion time and error rate. Conclusion The findings in this study demonstrate that laparoscopic skills can be objectively measured in a VRSS based on quantified skill parameters, including the time spent to complete skill tasks and the associated error rate. We conclude that a VRSS is a feasible tool for training and assessing basic laparoscopic skills.

Evidence Regarding Teaching and Assessment of Record-Keeping Skills in Training of Dental Students.

Science.gov (United States)

Amos, Kate J; Bearman, Margaret; Palermo, Claire

2015-10-01

The aim of this study was to assess the literature on teaching and assessing dental students' record-keeping skills prior to qualification to practice independently as a dentist. A systematic literature review was performed using Ovid MEDLINE and SCOPUS. Keywords used in the search included dental, record, audit, education, and assessment. Electronic search results were screened for publications that targeted undergraduate dental training, related to a record-keeping education intervention, and were published in English and available in full text. Six studies met the inclusion and exclusion criteria. Data extraction and quality assessment were performed, and research findings were compared across the included studies. These six articles addressed the techniques used to teach and assess record-keeping skills in a pre-qualification context. The techniques included supervisor audits, peer audits, lectures, tutorials, research assignments, case reports, record-keeping templates, and checklists of required record components. The use of record audit as part of teaching and evaluation dominated these articles; it was used as the assessment method in five of the six studies. All methods of record-keeping training in studies published to date were found effective in improving student record-keeping skills. However, there was insufficient evidence to determine whether certain methods were more effective than others.

Surgical Residency Training in Developing Countries: West African College of Surgeons as a Case Study.

Science.gov (United States)

Ajao, Oluwole Gbolagunte; Alao, Adekola

2016-01-01

In 1904, William Halsted introduced the present model of surgical residency program which has been adopted worldwide. In some developing countries, where surgical residency training programs are new, some colleges have introduced innovations to the Halsted's original concept of surgical residency training. These include 1) primary examination, 2) rural surgical posting, and 3) submission of dissertation for final certification. Our information was gathered from the publications on West African College of Surgeons' (WACS) curriculum of the medical schools, faculty papers of medical schools, and findings from committees of medical schools. Verbal information was also gathered via interviews from members of the WACS. Additionally, our personal experience as members and examiners of the college are included herein. We then noted the differences between surgical residency training programs in the developed countries and that of developing countries. The innovations introduced into the residency training programs in the developing countries are mainly due to the emphasis placed on paper qualifications and degrees instead of performance. We conclude that the innovations introduced into surgical residency training programs in developing countries are the result of the misconception of what surgical residency training programs entail. Published by Elsevier Inc.

Europeans come together on qualification

International Nuclear Information System (INIS)

Whittle, J.

1996-01-01

Utilities operating nuclear power plants in Europe have formed the European Network for Inspection Qualification (ENIQ) to produce a common approach to demonstrating that non-destructive testing is capable providing the information to ensure the absence of significant defects in nuclear plants. Major developments over recent months have included the issue by ENIQ of a formal document defining the methodology for the conduct of qualification which sets out the principles that detailed systems, within an individual country context, should embody. A pilot study on pipe welds typical of those in BWR recirculation loops is being conducted to explore the issues involved in the practical application of the methodology. In parallel with ENIQ, the European Nuclear Regulators Working Group has set up a Task Force in an attempt to define a common regulatory position on non-destructive testing qualifications and has produced its own document which is wider in scope than that of ENIQ. (UK)

[Orthognathic surgery: surgical failures and complications].

Science.gov (United States)

Guyot, Laurent

2016-03-01

Orthognathic surgery procedures mark the endpoint of lengthy orthodontic-surgical preparations and herald the completion of treatment for patients and their families. The main types of procedure are full maxillary Le Fort I osteotomies, mandibular osteotomies and chin surgery. To ensure a successful outcome, all require a favorable environment and extreme technical skill. But, like all surgical operations, they are also subject to peri- and post-operative complications resulting from treatment hazards or errors. Whatever the cause, surgical complications can entail failures in the management of the malformation. By seeking to understand and analyzing these complications, we can already help to prevent and reduce the contingent risks of failure. © EDP Sciences, SFODF, 2016.

The cutting-edge training modalities and educational platforms for accredited surgical training: A systematic review.

Science.gov (United States)

Forgione, Antonello; Guraya, Salman Y

2017-01-01

Historically, operating room (OR) has always been considered as a stand-alone trusted platform for surgical education and training. However, concerns about financial constraints, quality control, and patient safety have urged the surgical educators to develop more cost-effective, surgical educational platforms that can be employed outside the OR. Furthermore, trained surgeons need to regularly update their surgical skills to keep abreast with the emerging surgical technologies. This research aimed to explore the value of currently available modern surgical tools that can be used outside the OR and also elaborates the existing laparoscopic surgical training programs in world-class centers across the globe with a view to formulate a blended and unified structured surgical training program. Several data sources were searched using MeSH terms "Laparoscopic surgery" and "Surgical training" and "Surgical curriculum" and "fundamentals of endoscopic surgery" and "fundamentals of laparoscopic surgery" and "Telementoring" and "Box trainer." The eligibility criteria used in data extraction searched for original and review articles and by excluding the editorial articles, short communications, conference proceedings, personal view, and commentaries. Data synthesis and data analysis were done by reviewing the initially retrieved 211 articles. Irrelevant and duplicate and redundant articles were excluded from the study. Finally, 12 articles were selected for this systematic review. Data results showed that a myriad of cutting-edge technical innovations have provided modern surgical training tools such as the simulation-based mechanical and virtual reality simulators, animal and cadaveric labs, telementoring, telerobotic-assisted surgery, and video games. Surgical simulators allow the trainees to acquire surgical skills in a tension-free environment without supervision or time constraints. The existing world-renowned surgical training centers employ various clusters of training

Video content analysis of surgical procedures.

Science.gov (United States)

Loukas, Constantinos

2018-02-01

In addition to its therapeutic benefits, minimally invasive surgery offers the potential for video recording of the operation. The videos may be archived and used later for reasons such as cognitive training, skills assessment, and workflow analysis. Methods from the major field of video content analysis and representation are increasingly applied in the surgical domain. In this paper, we review recent developments and analyze future directions in the field of content-based video analysis of surgical operations. The review was obtained from PubMed and Google Scholar search on combinations of the following keywords: 'surgery', 'video', 'phase', 'task', 'skills', 'event', 'shot', 'analysis', 'retrieval', 'detection', 'classification', and 'recognition'. The collected articles were categorized and reviewed based on the technical goal sought, type of surgery performed, and structure of the operation. A total of 81 articles were included. The publication activity is constantly increasing; more than 50% of these articles were published in the last 3 years. Significant research has been performed for video task detection and retrieval in eye surgery. In endoscopic surgery, the research activity is more diverse: gesture/task classification, skills assessment, tool type recognition, shot/event detection and retrieval. Recent works employ deep neural networks for phase and tool recognition as well as shot detection. Content-based video analysis of surgical operations is a rapidly expanding field. Several future prospects for research exist including, inter alia, shot boundary detection, keyframe extraction, video summarization, pattern discovery, and video annotation. The development of publicly available benchmark datasets to evaluate and compare task-specific algorithms is essential.

Strategy for Qualification of the Plutonium Immobilized Form

International Nuclear Information System (INIS)

Marra, J.C.; Marra, S.L.; Bibler, N.E.; Strachan, D.M.; Shaw, H.F.

1998-01-01

In order to dispose of a radioactive waste form in a federal high- level waste repository, a waste form qualification strategy and program must be developed. The waste form qualification program must include the acceptance specifications for the product, show how compliance with these specifications will be met, and then demonstrate compliance. An important element of this program is developing a measure to demonstrate product consistency. For the can- in-canister option, waste form qualification is needed not only for the Pu immobilized form but also for the high-level waste glass canister containing the Pu waste form. The latter will require close interaction and coordination with the U.S. Department of Energy - Office of Environmental Management (DOE-EM) who, through their contractor at the Savannah River Site (SRS), is the producer of the high-level waste form at the Defense Waste Processing Facility (DWPF). In this paper a waste form qualification strategy for the plutonium ceramic form is described that utilizes, as much as possible, the qualification strategy successfully used for vitrified high-level waste

Does playing video games improve laparoscopic skills?

Science.gov (United States)

Ou, Yanwen; McGlone, Emma Rose; Camm, Christian Fielder; Khan, Omar A

2013-01-01

A best evidence topic in surgery was written according to a structured protocol. The question addressed was whether playing video games improves surgical performance in laparoscopic procedures. Altogether 142 papers were found using the reported search, of which seven represented the best evidence to answer the clinical question. The details of the papers were tabulated including relevant outcomes and study weaknesses. We conclude that medical students and experienced laparoscopic surgeons with ongoing video game experience have superior laparoscopic skills for simulated tasks in terms of time to completion, improved efficiency and fewer errors when compared to non-gaming counterparts. There is some evidence that this may be due to better psycho-motor skills in gamers, however further research would be useful to demonstrate whether there is a direct transfer of skills from laparoscopic simulators to the operating table. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Liability exposure for surgical robotics instructors.

Science.gov (United States)

Lee, Yu L; Kilic, Gokhan; Phelps, John Y

2012-01-01

Surgical robotics instructors provide an essential service in improving the competency of novice gynecologic surgeons learning robotic surgery and advancing surgical skills on behalf of patients. However, despite best intentions, robotics instructors and the gynecologists who use their services expose themselves to liability. The fear of litigation in the event of a surgical complication may reduce the availability and utility of robotics instructors. A better understanding of the principles of duty of care and the physician-patient relationship, and their potential applicability in a court of law likely will help to dismantle some concerns and uncertainties about liability. This commentary is not meant to discourage current and future surgical instructors but to raise awareness of liability issues among robotics instructors and their students and to recommend certain preventive measures to curb potential liability risks. Published by Elsevier Inc.

49 CFR 214.349 - Training and qualification of watchmen/lookouts.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Training and qualification of watchmen/lookouts...) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD WORKPLACE SAFETY Roadway Worker Protection § 214.349 Training and qualification of watchmen/lookouts. (a) The training and qualification for...

SRS H1616 Hydride Transport Vessel Qualification Report

International Nuclear Information System (INIS)

Smith, A.C.

1999-01-01

This report serves as the design qualification basis for both transport and facility use. Headings identify report sections as containing qualification information for transport use, facility use, or both transport and facility use

SRS H1616 Hydride Transport Vessel Qualification Report

International Nuclear Information System (INIS)

Van Alstine, M.N.

1998-01-01

This report serves as the design qualification basis for both transport and facility use. Headings identify report sections as containing qualification information for transport use, facility use, or both transport and facility use

Technical skills assessment toolbox: a review using the unitary framework of validity.

Science.gov (United States)

Ghaderi, Iman; Manji, Farouq; Park, Yoon Soo; Juul, Dorthea; Ott, Michael; Harris, Ilene; Farrell, Timothy M

2015-02-01

The purpose of this study was to create a technical skills assessment toolbox for 35 basic and advanced skills/procedures that comprise the American College of Surgeons (ACS)/Association of Program Directors in Surgery (APDS) surgical skills curriculum and to provide a critical appraisal of the included tools, using contemporary framework of validity. Competency-based training has become the predominant model in surgical education and assessment of performance is an essential component. Assessment methods must produce valid results to accurately determine the level of competency. A search was performed, using PubMed and Google Scholar, to identify tools that have been developed for assessment of the targeted technical skills. A total of 23 assessment tools for the 35 ACS/APDS skills modules were identified. Some tools, such as Operative Performance Rating System (OSATS) and Objective Structured Assessment of Technical Skill (OPRS), have been tested for more than 1 procedure. Therefore, 30 modules had at least 1 assessment tool, with some common surgical procedures being addressed by several tools. Five modules had none. Only 3 studies used Messick's framework to design their validity studies. The remaining studies used an outdated framework on the basis of "types of validity." When analyzed using the contemporary framework, few of these studies demonstrated validity for content, internal structure, and relationship to other variables. This study provides an assessment toolbox for common surgical skills/procedures. Our review shows that few authors have used the contemporary unitary concept of validity for development of their assessment tools. As we progress toward competency-based training, future studies should provide evidence for various sources of validity using the contemporary framework.

Integrated Information System for Higher Education Qualifications

Directory of Open Access Journals (Sweden)

Catalin Ionut SILVESTRU

2012-10-01

Full Text Available In the present article we aim to study thoroughly and detail aspects related to architectures specific for e-learning and management of human resources training interconnected to management of qualifications. In addition, we take into consideration combining e-learning architectures with software in an e-learning system interconnected with the National Registry of Qualifications of Higher Education, in view of developing and information system that correlates educational supply from higher education from Romania with labor market demands through qualifications. The scientific endeavor consists of original architectural solutions to integrate data, systems, processes, services from various sources and to use them in the proposed system. The practical result of the scientific endeavor is represented by design of architectures required for developing an e-learning system interconnected with the National Registry of Qualifications from Romania, which involve in first stage the qualifications provided by higher education. The proposed innovative solution consists in the fact that the proposed information system combines the advantages of content management system (CMS with learning content management system (LCMS and with reusable learning objects (RLO. Thus, the architecture proposed in the research ensures the integration of a content management system with a portal for information, guidance and support in making a professional project. The integration enables correlation of competences with content areas and specific items from various teaching subjects, thus evaluating the usefulness for this registry from learning/educational perspective. Using the proposed information system in enables correlation among qualifications, content of educational program and continuous self-evaluation opportunities, which facilitate monitoring of progress and adjustment of learning content.

The skill-divide in job quality: a cross-national analysis of 28 countries.

Science.gov (United States)

Stier, Haya

2015-01-01

This study focuses on the skill divide in job quality and the role of social institutions in structuring the relation of workers' qualifications to the attributes of their jobs. Four measures of job quality are examined: job security, job achievement, job content and work schedule flexibility. The study is based on the 2005 ISSP module on work orientations and encompasses 28 countries. Obtained through multilevel modeling, the findings show that low-skilled workers are disadvantaged in all aspects of job quality. However, skill inequality in the quality of employment depends on countries' characteristics, with declining inequality in countries at higher levels of technological development and to some extent also in times of technological growth. At times of high unemployment, skill disparities in job security widen while on other measures of job quality they decline. Under high market regulation, the low skilled enjoy better job security but on other measures, skill inequalities increase. Copyright © 2014 Elsevier Inc. All rights reserved.

Developing competence based qualification system in the nuclear energy sector

International Nuclear Information System (INIS)

Ceclan, Mihail

2016-01-01

The Institute for Energy and Transport of the Joint Research Centre, European Commission, developed a strategy and road map for ECVET implementation. The JRC road map for European Credit System for Vocational Education and Training (ECVET) implementation has reached the stage of Competence-Based Qualification System development. The Competence-Based Qualification System can help bridge the gap between Human Resources demand and supply in the nuclear market by structuring qualifications in small independent parts. This very specific ECVET feature of a qualification, facilitates the process of competences accumulation and the lifelong learning, mobility and flexible learning pathways. New developments are presented about the Competence-Based Qualification System development for the nuclear energy sector.

Developing competence based qualification system in the nuclear energy sector

Energy Technology Data Exchange (ETDEWEB)

Ceclan, Mihail [European Commission, Petten (Netherlands). Inst. for Energy and Transport

2016-04-15

The Institute for Energy and Transport of the Joint Research Centre, European Commission, developed a strategy and road map for ECVET implementation. The JRC road map for European Credit System for Vocational Education and Training (ECVET) implementation has reached the stage of Competence-Based Qualification System development. The Competence-Based Qualification System can help bridge the gap between Human Resources demand and supply in the nuclear market by structuring qualifications in small independent parts. This very specific ECVET feature of a qualification, facilitates the process of competences accumulation and the lifelong learning, mobility and flexible learning pathways. New developments are presented about the Competence-Based Qualification System development for the nuclear energy sector.

The effects of the European Working Time Directive on surgical training: the basic surgical trainee's perspective.

LENUS (Irish Health Repository)

Kelly, B D

2012-01-31

BACKGROUND: On the 1 August 2009, the implementation of European Working Time Directive became European law and was implemented in Galway University Hospital (GUH). AIMS: The aim of the study is to ascertain the opinion of the 25 surgical SHOs in GUH on the effect of the implementation of an EWTD compliant roster had on the quality of their training. METHODS: A questionnaire was circulated to all 25 surgical SHOs. RESULTS: Twenty-two (88%) SHOs report a reduction in the quality of their training. 18 (72%) report a reduction in the development of their operative skills. The SHOs believed the EWTD Rotas would encourage Irish graduates to train abroad. CONCLUSIONS: Surgical training faces a challenge with the implementation of EWTD Rotas. Major changes need to be made to the surgical training structure to train surgeons to the highest standard and to retain Irish-trained surgeons in the Irish healthcare system.

Value Added: the Case for Point-of-View Camera use in Orthopedic Surgical Education.

Science.gov (United States)

Karam, Matthew D; Thomas, Geb W; Taylor, Leah; Liu, Xiaoxing; Anthony, Chris A; Anderson, Donald D

2016-01-01

Orthopedic surgical education is evolving as educators search for new ways to enhance surgical skills training. Orthopedic educators should seek new methods and technologies to augment and add value to real-time orthopedic surgical experience. This paper describes a protocol whereby we have started to capture and evaluate specific orthopedic milestone procedures with a GoPro® point-of-view video camera and a dedicated video reviewing website as a way of supplementing the current paradigm in surgical skills training. We report our experience regarding the details and feasibility of this protocol. Upon identification of a patient undergoing surgical fixation of a hip or ankle fracture, an orthopedic resident places a GoPro® point-of-view camera on his or her forehead. All fluoroscopic images acquired during the case are saved and later incorporated into a video on the reviewing website. Surgical videos are uploaded to a secure server and are accessible for later review and assessment via a custom-built website. An electronic survey of resident participants was performed utilizing Qualtrics software. Results are reported using descriptive statistics. A total of 51 surgical videos involving 23 different residents have been captured to date. This includes 20 intertrochanteric hip fracture cases and 31 ankle fracture cases. The average duration of each surgical video was 1 hour and 16 minutes (range 40 minutes to 2 hours and 19 minutes). Of 24 orthopedic resident surgeons surveyed, 88% thought capturing a video portfolio of orthopedic milestones would benefit their education. There is a growing demand in orthopedic surgical education to extract more value from each surgical experience. While further work in development and refinement of such assessments is necessary, we feel that intraoperative video, particularly when captured and presented in a non-threatening, user friendly manner, can add significant value to the present and future paradigm of orthopedic surgical

Interprofessional non-technical skills for surgeons in disaster response: a literature review.

Science.gov (United States)

Willems, Anneliese; Waxman, Bruce; Bacon, Andrew K; Smith, Julian; Kitto, Simon

2013-09-01

Natural disasters impose a significant burden on society. Current disaster training programmes do not place an emphasis on equipping surgeons with non-technical skills for disaster response. This literature review sought to identify non-technical skills required of surgeons in disaster response through an examination of four categories of literature: "disaster"; "surgical"; "organisational management"; and "interprofessional". Literature search criteria included electronic database searches, internet searches, hand searching, ancestry searching and networking strategies. Various potential non-technical skills for surgeons in disaster response were identified including: interpersonal skills such as communication, teamwork and leadership; cognitive strategies such flexibility, adaptability, innovation, improvisation and creativity; physical and psychological self-care; conflict management, collaboration, professionalism, health advocacy and teaching. Such skills and the role of interprofessionalism should be considered for inclusion in surgical disaster response training course curricula.

Effects of Transcranial Direct-Current Stimulation on Neurosurgical Skill Acquisition: A Randomized Controlled Trial.

Science.gov (United States)

Ciechanski, Patrick; Cheng, Adam; Lopushinsky, Steven; Hecker, Kent; Gan, Liu Shi; Lang, Stefan; Zareinia, Kourosh; Kirton, Adam

2017-12-01

Recent changes in surgical training environments may have limited opportunities for trainees to gain proficiency in skill. Complex skills such as neurosurgery require extended periods of training. Methods to enhance surgical training are required to overcome duty-hour restrictions, to ensure the acquisition of skill proficiency. Transcranial direct-current stimulation (tDCS) can enhance motor skill learning, but is untested in surgical procedural training. We aimed to determine the effects of tDCS on simulation-based neurosurgical skill acquisition. Medical students were trained to acquire tumor resection skills using a virtual reality neurosurgical simulator. The primary outcome of change in tumor resection was scored at baseline, over 8 repetitions, post-training, and again at 6 weeks. Participants received anodal tDCS or sham over the primary motor cortex. Secondary outcomes included changes in brain resected, resection effectiveness, duration of excessive forces (EF) applied, and resection efficiency. Additional outcomes included tDCS tolerability. Twenty-two students consented to participate, with no dropouts over the course of the trial. Participants receiving tDCS intervention increased the amount of tumor resected, increased the effectiveness of resection, reduced the duration of EF applied, and improved resection efficiency. Little or no decay was observed at 6 weeks in both groups. No adverse events were documented, and sensation severity did not differ between stimulation groups. The addition of tDCS to neurosurgical training may enhance skill acquisition in a simulation-based environment. Trials of additional skills in high-skill residents, and translation to nonsimulated performance are needed to determine the potential utility of tDCS in surgical training. Copyright © 2017 Elsevier Inc. All rights reserved.

A system for personnel qualification of non-destructive testing procedures from testing and and qualification system in Sweden

International Nuclear Information System (INIS)

Kuna, M.; Kubis, S.; Plasek, J.

1999-01-01

The method for qualification of non-destructive testing personnel carrying out inspections by means of ultrasonic and eddy-current tests to inspect cladding in BWR reactor pressure vessel and core shroud lid. Development of procedures tests with real artificial cracks, blind tests. Evaluation of results by the Swedish Qualification Commission. Performance of the tests at Oskarshamn-1

Chest drainage teaching and training for medical students. Use of a surgical ex vivo pig model.

Science.gov (United States)

Tube, Milton Ignacio Carvalho; Netto, Fernando Antonio Campelo Spencer; Costa, Elaine; Lafayette, Daniell de Siqueira Araújo; Lima, George Augusto da Fonseca Carvalho Antunes; Menezes, Jamile Isabela Santos de; Aires, Vinicius Gueiros Buenos; Ferraz, Álvaro Antônio Bandeira; Campos, Josemberg Marins; Moraes, Fernando Ribeiro de

2016-05-01

Implement a constructivist approach in thoracic drainage training in surgical ex vivo pig models, to compare the acquisition of homogeneous surgical skills between medical students. Experimental study, prospective, transversal, analytical, controlled, three steps. Selection, training, evaluation. a) students without training in thoracic drainage; b) without exposure to constructivist methodology. 2) EXCLUSION CRITERIA: a) students developed surgical skills; b) a history of allergy. (N = 312). Two groups participated in the study: A and B. Lecture equal for both groups. Differentiated teaching: group A, descriptive and informative method; group B, learning method based on problems. A surgical ex vivo pig model for training the chest drain was created. Were applied pre and post-test, test goal-discursive and OSATS scale. Theoretical averages: Group A = 9.5 ± 0.5; Group B = 8.8 ± 1.1 (p = 0.006). Medium Practices: Group A = 22.8 ± 1.8; Group B = 23.0 ± 2.8 (p <0.001). Through the constructivist methodology implemented in the thoracic drainage training in surgical ex vivo pig models, has proven the acquisition of surgical skills homogeneous compared among medical students.

Systems for tracking minimally invasive surgical instruments.

Science.gov (United States)

Chmarra, M K; Grimbergen, C A; Dankelman, J

2007-01-01

Minimally invasive surgery (e.g. laparoscopy) requires special surgical skills, which should be objectively assessed. Several studies have shown that motion analysis is a valuable assessment tool of basic surgical skills in laparoscopy. However, to use motion analysis as the assessment tool, it is necessary to track and record the motions of laparoscopic instruments. This article describes the state of the art in research on tracking systems for laparoscopy. It gives an overview on existing systems, on how these systems work, their advantages, and their shortcomings. Although various approaches have been used, none of the tracking systems to date comes out as clearly superior. A great number of systems can be used in training environment only, most systems do not allow the use of real laparoscopic instruments, and only a small number of systems provide force feedback.

A review of the available urology skills training curricula and their validation.

Science.gov (United States)

Shepherd, William; Arora, Karan Singh; Abboudi, Hamid; Shamim Khan, Mohammed; Dasgupta, Prokar; Ahmed, Kamran

2014-01-01

The transforming field of urological surgery continues to demand development of novel training devices and curricula for its trainees. Contemporary trainees have to balance workplace demands while overcoming the cognitive barriers of acquiring skills in rapidly multiplying and advancing surgical techniques. This article provides a brief review of the process involved in developing a surgical curriculum and the current status of real and simulation-based curricula in the 4 subgroups of urological surgical practice: open, laparoscopic, endoscopic, and robotic. An informal literature review was conducted to provide a snapshot into the variety of simulation training tools available for technical and nontechnical urological surgical skills within all subgroups of urological surgery using the following keywords: "urology, surgery, training, curriculum, validation, non-technical skills, technical skills, LESS, robotic, laparoscopy, animal models." Validated training tools explored in research were tabulated and summarized. A total of 20 studies exploring validated training tools were identified. Huge variation was noticed in the types of validity sought by researchers and suboptimal incorporation of these tools into curricula was noted across the subgroups of urological surgery. The following key recommendations emerge from the review: adoption of simulation-based curricula in training; better integration of dedicated training time in simulated environments within a trainee's working hours; better incentivization for educators and assessors to improvise, research, and deliver teaching using the technologies available; and continued emphasis on developing nontechnical skills in tandem with technical operative skills. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

10 CFR 50.76 - Licensee's change of status; financial qualifications.

Science.gov (United States)

2010-01-01

... the financial qualifications information that would be required for obtaining an initial operating license as specified in § 50.33(f)(2). The financial qualifications information must address the first... 10 Energy 1 2010-01-01 2010-01-01 false Licensee's change of status; financial qualifications. 50...

Test report: Electron-proton spectrometer qualification test unit, qualification test

Science.gov (United States)

Vincent, D. L.

1972-01-01

Qualification tests of the electron-proton spectrometer test unit are presented. The tests conducted were: (1) functional, (2) thermal/vacuum, (3) electromagnetic interference, (4) acoustic, (5) shock, (6) vibration, and (7) humidity. Results of each type of test are presented in the form of data sheets.

Effects of a novel mental skills curriculum on surgical novices' attention.

Science.gov (United States)

Anton, Nicholas E; Mulji, Neelam; Howley, Lisa D; Yurco, Ashley M; Tobben, Daniel; Bean, Eric; Stefanidis, Dimitrios

2017-11-01

Surgery is very cognitively demanding, particularly for novices. Novices are required to direct full attention on the procedure at hand, and additional demands can lead to cognitive overload. Through extensive practice, experts develop spare attentional capacity (SAC) for simultaneous tasks. However, little effort has been made to enhance novices' SAC. Mental skills may enhance attention management and increase SAC. The purpose of this study was to determine the efficacy of a novel mental skills curriculum (MSC) to enhance novices' attention management. Sixty novice volunteers were randomly stratified to a control or MSC group based on baseline laparoscopic skill and mental skill use (assessed with the Test of Performance Strategies version 2 [TOPS-2]). All participants received laparoscopic training, whereas the MSC group received additional mental skills training. At all sessions, participants completed a secondary task during laparoscopy, which assessed SAC. Participants also completed the D2 Test of Attention and the TOPS-2 attention control subscale, which are valid attention measures. Fifty-five novices completed the study. Both groups displayed significantly improved laparoscopic suturing ability (P attention control scores. However, only the MSC group displayed significantly improved hit rate on the secondary task (P attentional capacity is currently underway. Copyright © 2017 Elsevier Inc. All rights reserved.

Program plan for environmental qualification of mechanical and dynamic (including seismic) qualification of mechanical and electrical equipment program (EDQP)

International Nuclear Information System (INIS)

Weidenhamer, G.H.

1986-06-01

The equipment qualification program described in this plan is intended to provide the technical basis for resolving uncertainties in existing equipment qualification standards. In addition, research results are contributing to the resolution of safety issues GI-23, GI-87, USI-A44, titled, ''Reactor Coolant Pump Seal Failure,'' ''Failure of HPCI Steam Line Without Isolation,'' and ''Station Blackout,'' respectively. Also, research effort is being directed at providing information on the behavior of containment isolation valves under severe accident environments. Although the results of the latter research will not contribute to resolving uncertainties in qualification standards, it has proven cost effective to obtain this information under this program

Crowdsourcing: a valid alternative to expert evaluation of robotic surgery skills.

Science.gov (United States)

Polin, Michael R; Siddiqui, Nazema Y; Comstock, Bryan A; Hesham, Helai; Brown, Casey; Lendvay, Thomas S; Martino, Martin A

2016-11-01

Robotic-assisted gynecologic surgery is common, but requires unique training. A validated assessment tool for evaluating trainees' robotic surgery skills is Robotic-Objective Structured Assessments of Technical Skills. We sought to assess whether crowdsourcing can be used as an alternative to expert surgical evaluators in scoring Robotic-Objective Structured Assessments of Technical Skills. The Robotic Training Network produced the Robotic-Objective Structured Assessments of Technical Skills, which evaluate trainees across 5 dry lab robotic surgical drills. Robotic-Objective Structured Assessments of Technical Skills were previously validated in a study of 105 participants, where dry lab surgical drills were recorded, de-identified, and scored by 3 expert surgeons using the Robotic-Objective Structured Assessments of Technical Skills checklist. Our methods-comparison study uses these previously obtained recordings and expert surgeon scores. Mean scores per participant from each drill were separated into quartiles. Crowdworkers were trained and calibrated on Robotic-Objective Structured Assessments of Technical Skills scoring using a representative recording of a skilled and novice surgeon. Following this, 3 recordings from each scoring quartile for each drill were randomly selected. Crowdworkers evaluated the randomly selected recordings using Robotic-Objective Structured Assessments of Technical Skills. Linear mixed effects models were used to derive mean crowdsourced ratings for each drill. Pearson correlation coefficients were calculated to assess the correlation between crowdsourced and expert surgeons' ratings. In all, 448 crowdworkers reviewed videos from 60 dry lab drills, and completed a total of 2517 Robotic-Objective Structured Assessments of Technical Skills assessments within 16 hours. Crowdsourced Robotic-Objective Structured Assessments of Technical Skills ratings were highly correlated with expert surgeon ratings across each of the 5 dry lab drills

Virtual reality based surgical assistance and training system for long duration space missions.

Science.gov (United States)

Montgomery, K; Thonier, G; Stephanides, M; Schendel, S

2001-01-01

Access to medical care during long duration space missions is extremely important. Numerous unanticipated medical problems will need to be addressed promptly and efficiently. Although telemedicine provides a convenient tool for remote diagnosis and treatment, it is impractical due to the long delay between data transmission and reception to Earth. While a well-trained surgeon-internist-astronaut would be an essential addition to the crew, the vast number of potential medical problems necessitate instant access to computerized, skill-enhancing and diagnostic tools. A functional prototype of a virtual reality based surgical training and assistance tool was created at our center, using low-power, small, lightweight components that would be easy to transport on a space mission. The system consists of a tracked, head-mounted display, a computer system, and a number of tracked surgical instruments. The software provides a real-time surgical simulation system with integrated monitoring and information retrieval and a voice input/output subsystem. Initial medical content for the system has been created, comprising craniofacial, hand, inner ear, and general anatomy, as well as information on a number of surgical procedures and techniques. One surgical specialty in particular, microsurgery, was provided as a full simulation due to its long training requirements, significant impact on result due to experience, and likelihood for need. However, the system is easily adapted to realistically simulate a large number of other surgical procedures. By providing a general system for surgical simulation and assistance, the astronaut-surgeon can maintain their skills, acquire new specialty skills, and use tools for computer-based surgical planning and assistance to minimize overall crew and mission risk.

Progress in virtual reality simulators for surgical training and certification.

Science.gov (United States)

de Visser, Hans; Watson, Marcus O; Salvado, Olivier; Passenger, Joshua D

2011-02-21

There is increasing evidence that educating trainee surgeons by simulation is preferable to traditional operating-room training methods with actual patients. Apart from reducing costs and risks to patients, training by simulation can provide some unique benefits, such as greater control over the training procedure and more easily defined metrics for assessing proficiency. Virtual reality (VR) simulators are now playing an increasing role in surgical training. However, currently available VR simulators lack the fidelity to teach trainees past the novice-to-intermediate skills level. Recent technological developments in other industries using simulation, such as the games and entertainment and aviation industries, suggest that the next generation of VR simulators should be suitable for training, maintenance and certification of advanced surgical skills. To be effective as an advanced surgical training and assessment tool, VR simulation needs to provide adequate and relevant levels of physical realism, case complexity and performance assessment. Proper validation of VR simulators and an increased appreciation of their value by the medical profession are crucial for them to be accepted into surgical training curricula.

AGR-1 Data Qualification Interim Report

International Nuclear Information System (INIS)

Abbott, Machael

2009-01-01

Projects for the very-high-temperature reactor (VHTR) program provide data in support of Nuclear Regulatory Commission licensing of the VHTR. Fuel and materials to be used in the reactor are tested and characterized to quantify performance in high temperature and high fluence environments. The VHTR Program has established the NGNP Data Management and Analysis System (NDMAS) to ensure that VHTR data are (1) qualified for use, (2) stored in a readily accessible electronic form, and (3) analyzed to extract useful results. This document focuses on the first NDMAS objective. It describes the data streams associated with the first Advanced Gas Reactor (AGR-1) experiment, the processing of these data within NDMAS, and reports the interim FY09 qualification status of the AGR-1 data to date. Data qualification activities within NDMAS for specific types of data are determined by the data qualification category, which is assigned by the data generator, and include: (1) capture testing, to confirm that the data stored within NDMAS are identical to the raw data supplied, (2) accuracy testing, to confirm that the data are an accurate representation of the system or object being measured, and (3) documentation that the data were collected under an NQA-1 or equivalent QA program. The interim qualification status of the following four data streams is reported in this document: (1) fuel fabrication data, (2) fuel irradiation data, (3) fission product monitoring system (FPMS) data, and (4) Advanced Test Reactor (ATR) operating conditions data. A final report giving the NDMAS qualification status of all AGR-1 data (including cycle 145A) is planned for February 2010